62例有机磷农药中毒救治临床体会

目的:急性有机磷中毒是农村基层医院常见急症之一,它发病急、进展快,如不及时抢救或救治不当,患者可迅速死亡.本研究目的为总结我院近年来有机磷中毒患者救治体会,为基层医院救治农药中毒患者提供更多救治参考.方法:回顾性分析我院2008年6月-2010年3月收治的62例口服有机磷农药中毒患者,分析病例的发病情况和救治方法,并评价不同中毒剂量和不同救治时间患者的预后.结果:62例患者中,中、重度中毒45例,其中救治成功56例,4例因中毒时间较长,毒量大抢救无效死亡.结论:仔细观察患者症状,详细询问中毒途径及量,合理应用解毒药,维持呼吸功能,防止反跳,重视救治后的护理.     

Mephenesin as a relaxing agent in the treatment of tetanus; clinical experience in 12 cases

Maintenance of a patent airway in cases of tetanus is best accomplished by means of tracheotomy performed early in the course of the disease. This eliminates the possibility of upper respiratory obstruction and facilitates the elimination of irritating and obstructing secretions from the lower respiratory passages. In many cases the amount of sedation required is decidedly reduced following tracheotomy. The combination of phenobarbital and Tolserol(R) is very satisfactory in controlling the muscular rigidity and spasm in cases of moderately severe tetanus. In severe cases, response is not always satisfactory. Severe respiratory depression was observed in only one case in which phenobarbital and Tolserol(R) were used.     

Bromocriptine treatment in tall adolescents: two years of clinical experience

34 adolescents referred for excessive height prediction (HP) (11 boys with HP greater than 196 cm, 23 girls with HP greater than 180 cm) were treated for 9-15 months with bromocriptine (5-7.5 mg/day). Minor and transient side effects were observed in 20% of the subjects at the beginning of the treatment. Treatment had to be stopped in 1 boy complaining of asthenia and headache. Puberty developed normally, 19 girls experienced menarche during treatment and 1 continued regular menses. Bromocriptine treatment induced: (1) a significant decrease (p less than 0.001) in growth velocity from (mean +/- SEM) 8.6 +/- 0.4 to 5.3 +/- 1.5 cm/year in boys and from 7.1 +/- 0.2 to 4.6 +/- 0.6 cm/year in girls; (2) a twofold mean increase in skeletal maturation rate. Adult HP was reduced significantly from 202 +/- 1.4 to 195.4 +/- 1.2 cm in boys, and from 184 +/- 0.7 to 179.8 +/- 0.7 in girls. These results confirm our previous report suggesting that bromocriptine is a valuable alternative to sex steroid treatment in order to limit the final height in excessively tall adolescents.     

Objective assessment of speech after surgical treatment for oral cancer: experience from 196 selected cases

In 1992, a personal computer-based workstation for speech-digitized analysis was developed in conjunction with Canniesburn Hospital and Edinburgh University to measure all dispersion in speech after surgery for oral cancer. The voices of 196 patients with tumor of the oral cavity were recorded preoperatively and postoperatively. Surgical resection was carefully mapped out on standard diagrams of the oral cavity. Patients' recordings were assessed for conversational understandability by two referees. Patients also self-scored their speech using the Functional Intraoral Glasgow Scale self-questionnaire. Many patients had similar if not identical resections; therefore, 12 homogeneous groups were identified. Functional outcome for speech was correlated with the site and size of resected tissue and with the reconstruction modalities. The original association of an objective, computer-based tool and two subjective assessment tools proved to be the most suitable investigation method for speech. The general pattern was for consistently better speech quality with smaller excisions. The reconstruction modalities did not seem to influence the overall speech quality, as it was related mainly to the extent of surgical demolition. The authors present a detailed correlation between site and size of excision and functional outcome using color multiple-view diagrams for immediate appreciation. Positive and negative prognostic factors were identified in surgery for oral cancer.     

Razor-assisted treatment of axillary osmidrosis

Shaving off the sweat glands and hair follicles with a single-use safety razor is described.     

Ultrasound-assisted lipectomy using the solid probe: a retrospective review of 100 consecutive cases

Ultrasound-assisted lipectomy using the solid probe is a predictable and safe method that can yield excellent results. This method is particularly useful and is indicated when the subdermis must be approached to smooth out surface irregularities and/or to stimulate skin retraction. The authors present their method using the solid probe and a retrospective study of their first 100 consecutive cases. The indications for using the solid probe, its advantages and disadvantages, associated complications, and representative cases are presented.     

Saphenous vein bypass grafting for coronary atherosclerosis: clinical experience

Saphenous vein bypass grafting is a recent and important procedure in the management of atherosclerotic coronary artery disease. A review of the first 150 patients operated on to July 1971 at the Toronto General Hospital is presented. Many had multiple bypass grafts and some had additional procedures including internal mammary artery implantation, valve replacement and scar tissue resection. There were five operative deaths (3%) and an additional five hospital deaths; the majority were related to myocardial infarction.A clinical review of the results six months to three years after operation indicates marked improvement in over 80% of the survivors. Postoperative hemodynamic studies were performed in many. It is suggested that patients with poor myocardial function presenting in failure may not benefit from the operation.