THE USE OF HYSTEROSALPINGOGRAPHY IN THE DIAGNOSIS OF INFERTILITY AND OTHER GYNECOLOGICAL CONDITIONS.
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Hysterosalpingography was performed on 175 patients who had gynecological symptoms but negative pelvic findings, in order to test a new method of introducing the contrast medium into the uterus and tubes and to record the incidence of pathology revealed. In 132 patients, an attempt was made to secure a No. 14 Foley catheter in the uterus for introducing the contrast medium. This method was successful in 124 patients and can be recommended as being simple, less painful and more efficient than older methods. Of 156 patients with the complaints of infertility (68), dysmenorrhea (31), pelvic pain (29) or menstrual disorder (28), hysterosalpingography revealed significant abnormality in 58; most of these (47) had chronic salpingitis. One flare-up of pelvic inflammation occurred but no other complications were observed. It was concluded that hysterosalpingography is now sufficiently safe and reliable to merit wider utilization in gynecological diagnosis. (+info)
URINARY EXCRETION OF METABOLITES OF CATECHOLAMINES IN NORMAL INDIVIDUALS AND HYPERTENSIVE PATIENTS.
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The 24-hour urinary output of 3-methoxy-4-hydroxy mandelic acid (V.M.A.) has been determined in 20 normal adults, 150 hypertensive patients, and four cases of phaeochromocytoma. In this last group estimations of urinary catecholamines and total urinary methylated amines were also performed and the overall results have been compared with the urinary excretory pattern of catecholamines and their metabolites following the injection of radioactive adrenaline and noradrenaline. (+info)
A NEW DIAGNOSTIC SIGN IN NECK INJURIES.
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The aggravation of neck pain and headache as a result of the use of diathermy or other forms of energy in the treatment of neck sprain may represent a diagnostic sign by which to distinguish severe injury of the neck from simple sprain. In the case of simple neck sprain, the patient's complaints may be inadvertently continued more or less indefinitely by the use of high frequency energy or even locally applied heat. That recovery sometimes follows settlement of litigation in such cases may be due not to the award of money but to discontinuance of an aggravating medical treatment. (+info)
ACUTE PURULENT MENINGITIS IN CHILDREN: EXPERIENCE AT THE HOSPITAL FOR SICK CHILDREN, TORONTO.
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Sixty-eight children with acute purulent meningitis were treated at The Hospital for Sick Children, Toronto, in 1962; nine deaths occurred. Hemophilus influenzae type B and meningitis in which no organism was cultured accounted for 35 and 17 cases, respectively. A number of other etiological agents caused six or fewer cases each.The principal presenting complaints were fever and vomiting, the more familiar symptoms of meningeal irritation occurring in 20% or less. A short duration of onset suggested a more severe illness and graver prognosis. Seven of the nine fatal cases had a presenting history of less than 24 hours' duration. Persisting high fever, convulsions, cyanosis and abdominal distension were also associated more specifically with the fatal cases.The laboratory examination of the initial spinal fluid sample, while of value in the identification of the causative organism, was not of prognostic value.The value of general treatment measures, as well as specific therapy, was evident in all cases. (+info)
PERINATAL DEATH. A CLINICOPATHOLOGICAL ANALYSIS OF 99 CASES.
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The findings at autopsy in 99 cases of perinatal deaths in a ten-year period and on pathologic examination of the accompanying placentas in 39 cases were analyzed clinicopathologically. Also reviewed were the pathologic diagnoses of 225 placentas that were examined for causes other than neonatal death. Cardiovascular and pulmonary problems, particularly hyaline membrane disease, atelectasis and cardiac anomalies were most common. Asphyxia, heart failure and premature placental separation were the most frequent causes of death. In slightly more than half of the cases a reasonable final diagnosis was established by autopsy, and if the placenta was examined, nearly two-thirds could be properly classified. In the remaining 37 per cent, as previously reported in larger series, neither the autopsy nor placental examinations disclosed a satisfactory explanation of the perinatal death. (+info)
COMMUNICATION IN ILLNESS: THE RELATIONSHIP OF NATIONAL ORIGIN TO SYMPTOMS AND DIAGNOSIS.
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This study compares the subjective symptoms recorded by questionnaire, and the diagnoses applied, in 289 adult medical outpatients of six national origins, namely, Canada (Ontario), England, Germany, Hungary, Italy, and Scotland. No significant differences were observed in the number or type of symptoms presented among the national groups. In each group, women and patients with psychological diagnoses reported more symptoms. There were considerable differences in the incidence of somatic (organic) and psychological diagnoses between the groups, which did not reflect equivalent variations in the incidence of definite clinical entities. It is suggested that the symptom habits of the groups studied appeared similar, with the method of investigation used, but that difficulties in patient-physician communication may lead to significantly different diagnostic habits for the national groups involved. (+info)
TELEPHONIC ELECTROCARDIOGRAPHY.
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Telephonic electrocardiography is a new and useful adjunct to the diagnosis and treatment of cardiovascular disease. It has already demonstrated its great value both in clinical practice and in hospital teaching. It has, however, many other possible roles, for example, in more efficient monitoring after operations on the heart, or in the office monitoring of seriously ill patients with infarction or Adams-Stokes attacks. The availability of increased data in cardiac cases leads automatically to a better understanding of cardiac disease. (+info)
REGIONAL ENTERITIS: DISEASE PATTERENS AND MEDICAL MANAGEMENT.
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The clinical picture of regional enteritis was reviewed in 98 cases collected from five hospitals in the City of Edmonton. There was no apparent racial prevalence, although only one case was reported among Indians and Eskimos. More than one-half had their onset between the ages of 11 and 30 years. Men were more commonly affected than women. The onset in 44 patients was acute and closely mimicked acute appendicitis. Twenty-eight patients had had abdominal surgery prior to the onset of symptoms. Major symptoms were abdominal pain, diarrhea and weight loss. Abdominal tenderness, fever and abdominal mass were the most consistent physical signs. The most valuable diagnostic procedure was radiological examination of the bowel. Complications were largely confined to the gastrointestinal tract. In the majority of cases, surgery was the ultimate form of therapy. (+info)