Psychological and existential issues and quality of life in people living with HIV infection.

This paper focuses on psychological and existential issues and their impact on psychological functioning and quality of life in adults living with HIV. Further, it suggests that many of the issues that people with HIV face today are similar to those that were on the pre-HAART agenda.

Long-standing resolution of anemia in symptomatic low-grade non-Hodgkin's lymphoma patients treated with recombinant human erythropoietin as sole therapy.

Anemia is a predominant clinical problem in the management of patients with non-Hodgkin's lymphoma and often an indication to initiate chemotherapy. However, many elderly patients, especially those with concomitant disorders, do not tolerate such therapy very well. This report describes three patients with low-grade non-Hodgkin's lymphoma who were treated solely with recombinant human erythropoietin (rhEPO) for lymphoma-associated anemia.

Plate osteosynthesis of the humerus shaft fracture an its association with radial nerve injury--a retrospective study in Melaka General Hospital.

Over a seven-year period, 170 cases of humerus fractures were plated in Hospital Melaka. Of these, 131 cases were successfully traced for this study. Besides looking at fracture epidemiology, its relationship with radial nerve injury was examined.

[A clinical and experimental study on autologous nail transplantation ophthalmoplasty].

Objective: To seek for better materials for ophthalmoplasty.

Methods: The nails were used as autografts in an experimental and a clinical study. The paws were subcutaneously grafted in the backs of 15 rabbits.

Aggregated dilated pores.

We report a 74-year-old Japanese man who had a 10-year history of approximately 20 open comedones crowded onto his lateral neck. An excisional biopsy revealed that each comedo was histologically a dilated pore. Dilated pores are usually solitary.

Long-term cardiac morbidity and mortality in a randomized trial of pre- and postoperative radiation therapy versus surgery alone in primary breast cancer.

Background And Purpose: Some types of radiation therapy have been associated with an increased risk of cardiac mortality and morbidity in patients with early-stage breast cancer. A relationship has been observed between cardiac radiation dose-volume and the level of excess risk of cardiac mortality. However, relatively few data are available on the morbidity from myocardial infarction associated with adjuvant radiotherapy.

Evaluation of irradiated heart volumes in stage I breast cancer patients treated with postoperative adjuvant radiotherapy.

Purpose: To quantify the proportion of heart volumes that received at least 25 Gy with tangential photon fields in patients with left-sided stage I (T1 NOMO) breast cancer treated with breast-conserving surgery.

Methods And Materials: The dose planning of 100 consecutive patients was reviewed. All were irradiated with tangential photon fields that covered the left breast only.

Detection of radiation-induced myocardial damage by technetium-99m sestamibi scintigraphy.

A prospective study was initiated to assess the side-effects of postoperative adjuvant radiotherapy in patients with left-sided early breast cancer. Twelve patients with early breast cancer were examined before and a year after radiotherapy. Echocardiography, ECG and bicycle ergometry stress test with technetium-99m sestamibi myocardial perfusion scintigraphic were carried out to assess changes in regional myocardial blood flow.

Myocardial damage in breast cancer patients treated with adjuvant radiotherapy: a prospective study.

Purpose: To look for early and late signs of cardiac side effects of postoperative radiotherapy in patients with left-sided breast cancer.

Methods And Materials: Seventeen left-sided primary (Stage I-III) breast cancer patients considered eligible were recruited. Their computer tomography-based dose planning showed a part of the heart's left ventricle irradiated with at least 85-95% of the total dose.

Transurethral microwave thermotherapy for benign prostatic hyperplasia. Subjective response and urodynamic changes.

Results of transurethral microwave thermotherapy for benign prostatic hyperplasia were good after 1 year in 68% of 66 cases. Despite good correlation between subjective assessment of results and improvement in urodynamic parameters, no predictive factors for probably successful outcome could be identified. Diminution in frequency of micturition (diurnal from 8.

Knee arthrodesis with interlocking nail after excision of giant cell tumour of the distal femur.

Giant cell tumour of bone occurring around the knee is fairly common and can be difficult to manage. We report a case of such tumour involving the distal femur which was successfully treated with complete excision followed by arthrodesis of the knee with a long interlocking intramedullary nail.

Management of symptomatic hyponatraemia: dependence on the duration of development.

Serious neurological symptoms are common in patients with a serum sodium concentration below 115 mmol l-1. The treatment is controversial and the most adequate rate of sodium correction to avoid both morbidity due to residual hypo-osmolality and therapy-induced neurological sequelae is debated. The management of symptomatic hyponatraemia is discussed here against the background of two cases and a literature review.

High-performance liquid chromatographic method for the enantioselective analysis of mefloquine in plasma and urine.

An HPLC method for analysis of the enantiomers of the antimalarial drug mefloquine is presented. A complete resolution of (-)-(11S,2'R) and (+)-(11R,2'S) erythro-mefloquine from plasma and urine was obtained on a commercial AGP column. Mefloquine enantiomers were detected by UV at 222 nm.

Morbidity of ischemic heart disease in early breast cancer 15-20 years after adjuvant radiotherapy.

Purpose: To assess the cardiac side effects, primarily the occurrence of ischemic heart disease in symptom-free patients with early breast cancer treated with radiotherapy.

Methods And Materials: Thirty-seven survivors of a former randomized study of early breast cancer were examined. Twenty patients irradiated pre- or postoperatively for left sided disease (study group patients) were compared with 17 controls who were either treated for right sided disease, or were nonirradiated patients.

Clinical features in 28 consecutive cases of laboratory confirmed massive poisoning with carbamazepine alone.

A retrospective study of consecutive cases of massive carbamazepine poisoning treated in an intensive care unit during the period 1981-1991 was performed, mainly to determine whether serum carbamazepine levels were predictive of toxicity. Out of a total of 51 admissions with a diagnosis of carbamazepine self-poisoning, 28 (25 patients) were included. The reasons for exclusion were coingestion of other drugs (11 cases), incorrect diagnosis or inadequate information (6 cases), a peak observed serum concentration of carbamazepine below 76 mumol/L [18 mg/L] (4 cases), and lack of any documented serum carbamazepine assay (2 cases).

Diagnosis of acute symptomatic aortic aneurysm--ultrasonography an important tool.

Symptomatic aortic aneurysm is an extremely acute condition with manifest or threatening aortic rupture. The mortality is high and urgent surgery is essential and often life-saving. A correct diagnosis needs to be made without delay, a fact which places great demands on the doctor--often not a surgeon--who is first consulted by the patient.

A placebo-controlled trial of flumazenil given by continuous infusion in severe benzodiazepine overdosage.

A controlled trial was performed to study the effect and any adverse reactions of continuously infused flumazenil in severe benzodiazepine overdosage. The study comprised 51 adults admitted to an intensive care unit with poisoning. Enrollment criteria were unconsciousness on admission and a clear response within 5 min after an i.

[Correction of complete blepharoptosis with suspension by Frontalis aponeurosis flap].

The surgical corrective result of complete blepharoptosis is often uncertain. With suspension by Frontalis aponeurosis flap under the brow, the author treated 73 cases satisfactorily, the results conforming to Fox's criteria of a normal eyelid. The incision is made in the skin and Orbicularis oculi at the double-fold of the eyelid, and a muscle flap 2 cm wide is separated from under the Orbicularis oculi at the brow in the conjunction of Orbicularis oculi and Frontalis.

State III squamous cell carcinoma of the vulva. Results of a Swedish study.

One hundred fifty-three cases of stage III vulvar squamous cell carcinoma were studied. The survival rate was significantly higher in the 99 patients given standard treatment than in the 54 given other treatments. The principal prognostic factor was the presence of groin metastases.

Functional restitution after lower leg fractures. A long-term follow-up.

Twenty-five patients with fractures of the lower leg treated by closed reduction and plaster fixation were examined an average of 7 years and 8 months after trauma. The end result was assessed according to the following: (1) The patient's own opinion; (2) clinical examination including comparing range of motion in knee and ankle in the fractured and non-fractured leg, leg length discrepancy, malrotation of the injured extremity and muscle force analysis; (3) radiological examination. All fractures had healed after a mean of 13.

Diagnostic utility of flumazenil in coma with suspected poisoning: a double blind, randomised controlled study.

Objective: To assess the diagnostic value and safety of the benzodiazepine antagonist flumazenil in patients with coma of unclear origin with suspected poisoning.

Design: Double blind, placebo controlled, randomised study.

Setting: Intensive care unit at a major teaching hospital.

Metabolic control and complications over 3 years in patients with insulin dependent diabetes (IDDM): the Stockholm Diabetes Intervention Study (SDIS).

In a planned 5-year study, 97 patients with insulin dependent diabetes mellitus (IDDM), non-proliferative retinopathy and unsatisfactory blood glucose control were monitored for 3 years. The patients were randomized to an intensified conventional treatment (ICT, n = 44) or a regular treatment (RT, n = 53) group. HbA1c (normal range 3.

Benzodiazepine poisoning: experience of 702 admissions to an intensive care unit during a 14-year period.

A retrospective study covering a 14-year period was carried out to estimate the incidence and assess the clinical features of benzodiazepine (BZD) poisoning. The annual contribution of BZDs to the total number of drug overdose cases admitted to an intensive care unit displayed an increasing trend over the period, and during the last years BZDs were involved in nearly one-third of all cases. Among the 702 cases of BZD overdosage, 144 had ingested BZD alone, 200 had poisoned themselves with BZD combined with alcohol and 358 had taken BZD with other miscellaneous drugs.

Nephropathy is delayed by intensified insulin treatment in patients with insulin-dependent diabetes mellitus and retinopathy.

Patients with insulin-dependent diabetes mellitus (IDDM) and non-proliferative retinopathy were randomized to intensified conventional insulin treatment (ICT, n = 44) or regular treatment (RT, n = 51). During a 3-year period the glycosylated haemoglobin (HbA1c) levels were reduced to a greater extent (P = 0.00001) in the ICT group (from 9.

Carpal tunnel syndrome (CTS) and exposure to vibration, repetitive wrist movements, and heavy manual work: a case-referent study.

Possible connections between carpal tunnel syndrome (CTS) and exposure to vibrating handheld tools, repetitive wrist movements, and heavy manual work were examined in a case-referent study. The cases were 38 men operated on for CTS between 1974 and 1980. For each case, two referents were drawn from among other surgical cases (hospital referents) and two further referents from the population register and telephone directory, respectively (population referents).