Abstract:
OBJECTIVE:Intraventricular hemorrhage (IVH) represents a clinicopathologic entity with a dismal prognosis. The associated mortality rate has been reported as high as 80%; the morbidity is also quite high. The use of various fibrinolytic agents (streptokinase, urokinase, and recombinant tissue-type plasminogen activator [rt-PA]) has been reported in a small number of clinical series with a very limited number of participants, yielding significant variability regarding inclusion criteria, treatment protocol, and outcome analysis. METHODS:In our prospective study, we report our experience using rt-PA in 21 patients with IVH. Patients with IVH of aneurysmal or arteriovenous malformation origin were excluded. Intraventricular administration of rt-PA was initiated within 24 hours after the ictal event (dose, 3 mg every 24 hours) through a ventricular catheter. The patients' intracranial and cerebral perfusion pressures, cerebrospinal fluid (CSF) cell count, and head CT scans with emphasis to frontal horn dimension and inner cranium diameter at the same level ratio were collected and analyzed. RESULTS:Good outcome was observed in 47.5% of our patients, whereas 28.5% died and 24.0% survived with severe disability. The development of rt-PA-associated complications was as follows: new hemorrhage in 19%, infection in 14.3%, and CSF pleocytosis in 100% of patients. Permanent CSF shunt was required in 40%. The intermediate (3-month) follow up of our survivors showed no significant outcome changes compared with the immediate (1-month) follow up. CONCLUSIONS:Intraventricular administration of rt-PA appears to be beneficial in cases of IVH even though it is occasionally associated with serious complications. Further multi-institutional studies are required for validating this treatment modality and standardizing its parameters.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Fountas KN,Kapsalaki EZ,Parish DC,Smith B,Smisson HF,Johnston KW,Robinson JSdoi
10.1097/01.smj.0000170732.24324.easubject
Has Abstractpub_date
2005-08-01 00:00:00pages
767-73issue
8eissn
0038-4348issn
1541-8243journal_volume
98pub_type
临床试验,杂志文章abstract:BACKGROUND:Cluster headache (CH), though not fully characterized until this century, is a relatively common primary headache disorder. METHODS:We reviewed pertinent literature on CH and related cephalalgias. RESULTS:We found that CH typically occurs in middle-aged men and has a characteristic cyclic temporal pattern....
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199807000-00002
更新日期:1998-07-01 00:00:00
abstract::The patient we have described had lower extremity numbness, paresthesias, constipation, urinary retention, and sexual dysfunction. Laboratory evaluation confirmed a diagnosis of acute intermittent porphyria (AIP). Vitamin B6 and glucose therapy initiated resolution of symptoms. The sensory neuropathy described here is...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract::Urinary incontinence in the elderly is a significant health problem fraught with isolation, depression, and an increased risk of institutionalization and medical complications. Stress urinary incontinence (SUI), the complaint of involuntary loss of urine during effort or exertion or during sneezing or coughing, is the...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000146587.06656.98
更新日期:2005-01-01 00:00:00
abstract::Although exceedingly rare, fulminant hepatic failure (FHF) in immunocompetent patients can develop with primary or recurrent infection due to herpes simplex virus (HSV). The diagnosis is frequently obscured by the absence of mucocutaneous involvement. Elevated transaminase values with leukopenia and a relatively low b...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2000-12-01 00:00:00
abstract::We have described a patient with fatal Corynebacterium hemolyticum endocarditis on a native bicuspid aortic valve. This is the first report of endocarditis and the first fatal infection of any kind caused by Corynebacterium hemolyticum. This organism and other nondiphtheria corynebacteria must be considered as potenti...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198510000-00030
更新日期:1985-10-01 00:00:00
abstract::We compared personal and sexual behavior of a group of 32 young adult women who had a culture proven urinary tract infection (UTI) and a group of 28 women who had no urinary symptoms. All women were sexually active, and the two groups were similar for age, race, marital status, history of previous pregnancy, and use o...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198106000-00018
更新日期:1981-06-01 00:00:00
abstract:OBJECTIVES:Cystic fibrosis (CF) is associated with vitamin D deficiency, which can lead to adverse effects including recurrent pulmonary infections and osteoporosis. We longitudinally investigated calcifediol or 25-hydroxyvitamin D (25(OH)D) levels for our pediatric patients with CF based on the time of year as well as...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000254
更新日期:2015-03-01 00:00:00
abstract::Sickle cell trait is present in about 8% of black Americans, and clinically significant sickling disorders are common in this population. These disorders can be accurately defined by combinations of quantitative hemoglobin electrophoresis at alkaline pH, citrate agar electrophoresis, solubility tests for sickle hemogl...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197804000-00021
更新日期:1978-04-01 00:00:00
abstract::Myxoma is the most common primary tumor of the heart. The typical presentations include a triad of embolic phenomena, intracardiac flow obstruction, and constitutional symptoms. We report a case of cardiac myxoma presenting as prolonged fever. Leukocytosis with a left shift, anemia, and elevated C-reactive protein wer...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3182142bbd
更新日期:2011-05-01 00:00:00
abstract::The development of hyperthyroidism after primary hypothyroidism is unusual. We report such a case in a 37-year old man and review the clinical and immunologic aspects of the previously published cases of 50 female and 19 male patients with a similar condition. ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2000-07-01 00:00:00
abstract::Although successful transposition of the ovaries at the time of staging laparotomy for Hodgkin's disease is well documented, little comment has been made on potential complications. This case report of a primary ovarian neoplasm (benign) developing in a transposed ovary serves to alert physicians as to possible ovaria...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198307000-00039
更新日期:1983-07-01 00:00:00
abstract::An increased risk of skin and lymphoreticular malignancies is well documented in renal transplant patients receiving long-term immunosuppressive therapy, but squamous cell carcinoma of the esophagus is rare. We have reported the first case in the English literature in which there is a strong association between long-t...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198712000-00025
更新日期:1987-12-01 00:00:00
abstract::We discuss the cases of four immigrant workers in whom lead intoxication developed via inhalation while they were cutting steel beams removed from a dismantled bridge. They all had toxic lead levels with symptoms and received chelation therapy; the therapy was followed by a decrease in blood lead levels. Rebound incre...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199407000-00003
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the prevalence of peripheral diseases in diabetics of different age groups, the role of color Doppler in peripheral arterial disease in diabetics, and to compare the prevalence of peripheral arterial disease (PAD) in diabetics taking different therapy modalities. METHO...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000221624.68378.5d
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVES:Studies have shown that the overutilization of laboratory tests ("labs") for hospitalized patients is common and can cause adverse health outcomes. Our objective was to compare the ordering tendencies for routine complete blood counts (CBC) and chemistry panels by internal medicine residents and hospitalists...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000592
更新日期:2017-01-01 00:00:00
abstract::From 1976 to 1982, 12 children with myelodysplasia had surgery at our institution for knee flexion contractures (21 affected knees). Follow-up was a minimum of 18 months and averaged 47 months. Soft tissue lengthening of the hamstring tendons and release of the posterior capsule with or without femoral osteotomy yield...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198607000-00009
更新日期:1986-07-01 00:00:00
abstract::Patients with recurrent thrombosis may have one of the thrombophilias described in recent literature. These clotting disorders may involve abnormalities in platelets, fibrinogen, plasminogen, protein C, protein S, or antithrombin III. There is usually a family history of clotting disorders, since most of these are inh...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1988-10-01 00:00:00
abstract::This descriptive study prospectively examined the performance and supervision of interpretive and procedural skills during an internal medicine clerkship. Students (N = 150) documented having done 7 required and 12 elective skills. Preceptors of required skills were interns (44%), residents (29%), attending physicians...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199606000-00009
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Tobacco use causes significant morbidity and mortality. Resident physicians at the George Washington University Medical Center are trained to counsel patients to stop smoking. METHODS:I retrospectively reviewed charts of 300 patients treated by resident physicians in the Department of Medicine (200) and the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199910000-00007
更新日期:1999-10-01 00:00:00
abstract::The urushiol dermatitis caused by plants of the Anacardiaceae family is the most common cause of acute allergic contact dermatitis. We have reported a case of cashew nut urushiol dermatitis due to ingestion of homemade cashew nut butter contaminated by cashew nut shell oil. With the precautions taken today to avoid co...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199404000-00026
更新日期:1994-04-01 00:00:00
abstract::Although it is common in the adult population, sigmoid volvulus is unusual in childhood. We report the cases of four children treated for sigmoid volvulus, and we review an additional 44 cases. The mean age of occurrence was 8 years. Predisposing factors were present in 33%. Abdominal pain (66%), vomiting (31%), and o...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199007000-00015
更新日期:1990-07-01 00:00:00
abstract::The application of 70% helium-30% oxygen mixtures by tight-fitting face mask in the emergency management of large airway obstruction is well known. We present the case of an infant with severe large airway obstruction and respiratory failure that was unresponsive to the more traditional approaches of airway management...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract::A total of 37 physicians and other health care professionals have been accepted into a monitoring and advocacy program for an average of 24 months. Thirty-five are working in their profession, one is in treatment, and one has repeatedly relapsed and is no longer practicing medicine (an overall improvement rate of 97%)...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199409000-00003
更新日期:1994-09-01 00:00:00
abstract::Highly trained medical specialists now possess a vast array of sophisticated technical apparatus with which to fight diseases. These tools, coupled with a growing emphasis on cost accounting and a medical paradigm emphasizing facts and depicting the human body as a machine, depersonalize health care by militating agai...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199307000-00017
更新日期:1993-07-01 00:00:00
abstract::We have reported a case of aplastic crisis occurring in an 11-year-old black boy with occult hereditary spherocytosis. An etiologic diagnosis of human parvovirus (HPV) B19 infection was confirmed serologically. The Coulter Model S + IV proved useful for both diagnosis and treatment monitoring through serial histograms...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198902000-00023
更新日期:1989-02-01 00:00:00
abstract:OBJECTIVE:No standard therapeutic option exists for men with prostate cancer who have failed local therapy, have no gross metastatic disease, and whose only manifestation of disease is a rising prostate-specific antigen (PSA) level. Soy products are able to affect PSA kinetics in some men with prostate cancer, and this...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3182335151
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:The objective of this population-based study was to examine the relationship between race, socioeconomic characteristics (socioeconomic status, SES), physician density, and colon cancer incidence in Alabama. METHODS:Data for 5,788 colon cancer cases from 1996 to 1999 provided by the Alabama Statewide Cancer...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000184844.01148.10
更新日期:2005-11-01 00:00:00
abstract::A variant of hereditary hemorrhagic telangiectasia may be gastrointestinal bleeding with no other classical symptoms. This case demonstrates the effectiveness of surgical resection as treatment of duodenal bleeding from telangiectatic lesions. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198703000-00024
更新日期:1987-03-01 00:00:00
abstract::Most exercise programs designed for healthy persons older than 65 emphasize fitness development, but the maintenance of functional capacity and quality of life are equally important. The basic guidelines for frequency, intensity, and duration of training and the mode of activity recommended by the American College of ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVES:To determine the prevalence of overweight in a cardiac stress testing population, and the percentage of subjects who indicate a history of overweight. METHODS:A total of 251 consecutive subjects presenting for cardiac stress testing in a 450-bed community hospital from June to September 2010 were asked to c...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31821e9359
更新日期:2011-07-01 00:00:00