Antiarrhythmic therapy as an adjuvant to promote post pulmonary vein isolation success-a meta-analysis.

Background: Three months of empirical antiarrhythmic drug (AAD) therapy after atrial fibrillation ablation (AFA) is a common practice to prevent early arrhythmia recurrence; the data of influence of this practice on longer term ablation outcomes is limited.

Purpose: The aim of this study was to perform a meta-analysis of published controlled trials comparing temporary AAD therapy after AFA with no AAD therapy in patients after AFA. The primary outcome was recurrence of arrhythmia.

Necrotizing fasciitis and gangrene associated with topical herbs in an infant.

A 4-mo-old Chinese infant developed necrotizing fasciitis and gangrene from a small skin infection on his buttock that was treated with topical herbs. Sequential cultures revealed a number of organisms: Enterococcus species, sensitive to ampicillin, were isolated throughout the course, and coagulasenegative staphylococci replaced gram-negative rods during the later phase of the illness. The infant required prolonged intravenous antibiotic treatment and underwent multiple surgical procedures for debridement and reconstruction.

Conservative management of acute pseudo-obstruction in a major burn.

We present a case of recurrent acute colonic pseudo-obstruction (ACPO) in a burn patient that responded to a postural change which has not been previously reported.

Prognostic significance of allelic losses in primary melanoma.

Loss of genetic material, including loss of loci on chromosome arms 6q, 9p, and 10q, occurs frequently in cutaneous melanoma but infrequently in benign melanocytic nevi or other melanocytic lesions, suggesting that these genetic alterations are important in the development and progression of melanoma. To examine whether allelic loss is of prognostic importance in melanoma, disease-free survival was related to loss of heterozygosity on 6q, 9p and 10q in 83 individuals with sporadic primary cutaneous melanoma. Loss of chromosome arms 6q and 10q were each significantly associated with a poorer clinical outcome (P=0.

Operation and output pulse characteristics of an extremely compact capillary-discharge tabletop soft-x-ray laser.

We report on the operating parameters and laser output pulse characteristics of an extremely compact discharge-pumped 46.9-nm laser of a size comparable with that of many widely utilized visible and ultraviolet gas lasers. This capillary-discharge laser generated subnanosecond laser pulses with energies of as much as 25microJ by single-pass amplification in an 18.

Magnetic resonance imaging of an ovarian mucinous cystadenoma immediately before and after rupture.

The MRI findings are described in a case of rupture of an ovarian mucinous cystadenoma which occurred during the course of an MR scan. While the rupture was presumed to be spontaneous, possible precipitating factors are discussed.

Severe burns resulting from an exploding teat on a bottle of infant formula milk heated in a microwave oven.

Accidental injury to infants can result from the use of home microwave ovens. The spectrum of injury includes scald burns of the trachea, palate oropharynx and oesophagus due to aspiration and ingestion of foods that have been overheated. There is one previous case report of a child with second-degree burns of 6 per cent of his body area due to explosion of the plastic liner and nipple on a feeding bottle top.

Problems and priorities of plastic surgical waiting list initiative schemes: an audit.

According to figures published by the College of Health, 34,837 patients were waiting for in-patient plastic surgery treatment nationwide in 1986. By 1989 this number had increased to 40,085--an increase of 15%. Out of this waiting list, nearly 2000 patients were waiting in Manchester in 1990.

Cutaneous malignant melanoma in the young.

Between the years 1967 and 1993, 3246 patients were diagnosed with malignant melanoma at Frenchay Hospital, Bristol. This paper reports 47 patients, 21 years of age or under, including 10 preadolescent cases under 14 years of age. It represents a further follow-up of a cohort originally published from this centre in 1986 in addition to 18 new cases.

Burns of the female genitalia and perineum.

Burns of the female genitalia and perineum mostly occur in connection with more extensive thermal injuries to the trunk and lower extremities. Isolated burns to the vulva are very unusual because this area is anatomically well-protected. A few reports in the literature describe injuries due to bizarre accidents and now obsolete techniques.

An algorithmic approach to the treatment of hydrofluoric acid burns.

Hydrofluoric acid (HF) injuries have a potential for both systemic toxicity as well as severe tissue destruction. We present an algorithm for the management of HF burns. This algorithm addresses these issues emphasizing the differences between major and minor cutaneous burns, and includes the approach to inhalation, ingestion and eye injuries.

Hydrofluoric acid burns: a review.

Hydrofluoric acid (HF) is a highly dangerous substance with a wide range of industrial as well as domestic applications. It is unique in both the severity of the cutaneous burns it may produce, and its potential for systemic and occasionally lethal toxicity. The literature on the treatment of HF injuries is extensive, though occasionally confusing and often contradictory, with no coherent management policy emerging.

The costs of eating: a behavioral economic analysis of food refusal.

Behavioral economic concepts were applied to the analysis and treatment of pediatric feeding disorders in a clinical setting. In Experiment 1, children who chronically refused food were presented with varying amounts of food on a spoon (empty, dipped, quarter, half, and level). Each child exhibited a different but orderly demand function of response (acceptance, expulsion, and mouth clean) by cost (increasing spoon volume) for a constant pay-off of toys and social interaction.

Corneal burns with eyelid sparing and their treatment.

In a flash injury the eyes are protected by the blink reflex. With our patients the eyes were open looking for a means of escape, exposing the globe to injury by hot smoke and protecting the eyelids. It is essential to examine the eyes in any facial burn, especially if there is any history of being injured in an enclosed space.

Early cardiorespiratory patterns in patients with major burns and pulmonary insufficiency.

We examined the case records of 50 consecutive patients with major cutaneous burns who required early mechanical ventilation. In 22 patients full haemodynamic and respiratory data were available within 24 h of their injury. Unexpectedly the haemodynamic and oxygen transport patterns of survivors and non-survivors were essentially similar although pulmonary artery occlusion pressure measurements and estimations of net fluid input suggest that non-survivors were relatively underresuscitated compared with survivors.

An algorithmic approach to the management of cutaneous burns.

An algorithm of fluid resuscitation for cutaneous burns is presented. The management of these cases entails an initial process of evaluation followed, when appropriate, by the administration of intravenous fluids. The fluid requirements are prospectively calculated and subsequently modified by using closed loop feedback with monitoring of urine output, plasma deficit, osmolality and vital signs.

The effect of tissue expansion on dermal fibroblast contraction.

Tissue expansion alters the function of skin cells. We studied the effects of expansion on the contractile function of dermal fibroblasts using an in vitro model, the fibroblast-populated collagen lattice (FPCL). Spherical expanders were placed dorsally in 30 Sprague-Dawley rats; one-half were serially inflated.

Basal cell carcinoma in a BCG scar in a young woman. Case report.

A 31 year old woman presented with a crusting lesion on the scar of her BCG vaccination. Histological examination showed it to be a basal cell carcinoma, which only rarely arises in vaccination scars, and is particularly unusual in BCG vaccination scars.

Hyaluronan and wound healing: a new perspective.

Hyaluronan has long been associated with the remodelling extracellular matrix. Such remodelling occurs in development, growth and wound healing. This role has been thought to be related to the physical structure and chemical composition of the pure glycosaminoglycan chain.