The darkness shall be the light.

This case study is the author's attempt to share a cardiac patient's experience in a personal and respectful manner. Case studies ordinarily share all of the medical and physiologic aspects of what is happening to patients and leave out the essence of the person. This is an effort to go beyond the ordinary and see the human being who has had a severe myocardial infarction and now lies in an intensive care unit.

Prostate-specific antigen nadir: the optimum level after irradiation for prostate cancer.

Purpose: The prostate-specific antigen (PSA) nadir that reflects potential cure of prostate cancer by irradiation has not been established. This report attempts to demonstrate the PSA nadir goal for radiotherapy.

Materials And Methods: From January 1984 through April 1994, 536 stage T1T2NO prostate cancer patients were treated with radioactive iodine 125 (125I) prostate implants followed by external-beam radiation.

Occupational hazards of operating: opportunities for improvement.

The emergence of hepatitis C virus compels us to refocus on protecting ourselves, our coworkers, and our families from potential illness, disability, or death. As blood-borne pathogens continue to evolve and mutate, the best option available is to prevent exposure. Surgeons have the opportunity to prevent the majority of exposures by utilizing currently available technology and knowledge.

Laparoscopic cholangiography: a new technique for difficult cannulation.

Laparoscopic surgery has become accepted in the United States as the surgical procedure of choice for treatment of symptomatic cholelithiasis. The general surgeon is now presented with a vast array of instrumentation and new techniques that have rapidly developed since the introduction of laparoendoscopic surgery. Much of this new technology is designed for easier and less expensive laparoscopic cholangiography.

Surgical treatment options for colorectal cancer.

The aging of our national population is recognized as a major achievement of modern society. The National Institutes of Health have recently redefined "old" as beginning at age 70. This segment of our population lead active and productive lives.

Interdisciplinary team approach in the rehabilitation of hip and knee arthroplasties.

Use of an interdisciplinary case management team approach in the treatment of patients with hip or knee arthroplasty has resulted in a decrease in length of stay and achievement of functional outcomes at the authors' center. Case management was used to standardize patient care and to measure each patient's progress toward independence against established criteria of treatment outcomes. Outcomes established for physical therapy were ambulation distance, performance of a home exercise program, stair climbing, amount of active knee flexion (for knee arthroplasties), and incorporation of hip precautions.

Kangaroo care.

Kangaroo Care--skin-to-skin contact between parent and baby--is becoming a popular adjunct to the routine, technology-driven care provided to premature babies in neonatal intensive care units (NICUs) across the country. Research suggests that Kangaroo Care is safe and that it is therapeutic for the infant and parent alike. The purpose of this article is to review the Kangaroo Care Program at Brigham and Women's Hospital and to illustrate how it meets the needs of parents of premature infants.

Analgesic rebound headache: experience in a community hospital.

In the past, chronic daily headaches have been attributed to many possible causes, including "tension," excessive contraction of pericranial muscles, and depression. A careful history reveals that many patients start out with fairly typical intermittent migraine attacks that evolve over the years into a pattern of daily or almost daily head pain. Overuse of analgesics is usually a part of this clinical picture, which has been termed "analgesic rebound headache.

Linda.

We tend to define pastoral care and medical intervention in very limiting terms. Too often we are more concerned with the delivery of the product than we are with the manner in which it is received. This paper looks at the experiences of a young woman with cancer and how she sought a certain personal component to the pastoral care she received and the medical treatments she was willing to accept.

A technique for extracorporeal suturing.

Advances in laparoscopic surgical procedures will be facilitated by the ability to perform suturing efficiently and effectively. A simple technique of extracorporeal suturing is described, which permits rapid and reliable knot placement for a wide variety of laparoscopic procedures.

Techniques for laparoscopic cholangiography and removal of common duct stones.

As laparoscopic cholecystectomy becomes more prevalent, the unexpected finding of common duct stones by operative cholangiography presents a therapeutic dilemma for the surgeon. We present our current techniques for laparoscopic cholangiography and management of choledocholithiasis, including the use of angioplasty balloons for ampullary dilation.

Intra-arterial calcium infusion for hydrofluoric acid burns.

Between March 3, 1987 and Sept. 8, 1989, intra-arterial calcium infusions were used to treat 28 patients (38 extremities) suffering hydrofluoric acid (HF) exposures that failed to respond to topical treatments. Although 18 of the injuries occurred at work, only 1 patient was using HF in a concentration greater than 12%.

Teicoplanin nephrotoxicity: first case report.

A 71-year-old man with type I diabetes mellitus was admitted to the hospital for the treatment of osteomyelitis of the left great toe secondary to methicillin-resistant Staphylococcus aureus. The patient was enrolled in an investigational protocol and was treated with teicoplanin 1200 mg/day. Following 40 days of treatment, the patient developed both markedly elevated serum creatinine and blood urea nitrogen.

Haemophilus influenzae resistance in a community hospital.

We prospectively tabulated all isolates of Haemophilus influenzae at DeKalb Medical Center from 1987 through 1989 to assess the occurrence of antibiotic resistance in patients of different ages. Of 325 total strains isolated, 24% produced beta-lactamase, rendering them resistant to ampicillin and amoxicillin. Antibiotic resistance was as common in patients older than age 60 (24%) as in younger patients (23%).

Alternative therapies, 1990. An overview.

The availability of alternative therapies for many health problems is a well-documented historical fact. Alternative therapies are generally understood to be those therapies outside of the usually accepted medical therapies for disease processes, such as cancer, arthritis, diabetes, psoriasis, lupus, and AIDS. Some other descriptive terms utilized include questionable, unproven, dubious, unorthodox, and unconventional.

Soft tissue rheumatism of the upper extremities: diagnosis and management.

Upper extremity tendinitis and bursitis are usually the result of repetitive microtrauma, probably resulting in disruption of fibers. A focus of inflammation often occurs, producing pain, spasm, and disability. With a careful history and physical exam, the diagnosis can be made, distinguishing soft tissue rheumatism from arthritis.

Death, sin, and God's judgment.

Grief is difficult for everyone, including the professional. And yet resolving grief is necessary for life to be comfortable and productive. This paper looks at the story of a young man and how unresolved grief, inappropriate guilt, and uncontrollable despair colored every phase of his life.

Hi-tech education: teleconferencing in a hospital setting.

The video teleconference is the educational tool of the future, but it is not as simple as setting a student in a dark room and turning on a machine. Staff development educators will want to use the ideas in this article to initiate, market, and adapt the teleconference to fit the student's real educational needs.