JAMA : the journal of the American Medical Association
-
Tuberculous mycotic aneurysm has been reported with surprising frequency, especially in the aorta. Because the diagnosis can often be made on clinical and roentgenologic grounds, and because of the very poor prognosis if untreated and surgical curability if recognized, experience with three cases is reported. ⋯ Contiguous tuberculosis in the form of lymphadenitis or Pott abscess is generally responsible for the aortic involvement that results in the aneurysm. Miliary tuberculosis, which is often present, is probably a result rather than the cause.
-
Seventy-one children with the diagnosis of systemic lupus erythematosus (SLE) (39 cases), dermatomyositis (25 cases), or scleroderma (7 cases) were studied retrospectively. The children with SLE were much sicker than those with the other two diseases and were found to have a poorer prognosis than adults with SLE. In general, the earlier the age of onset, the poorer the prognosis. ⋯ Corticosteroids were the main therapeutic agents. The patients with scleroderma also received varying doses of vitamin E, penicillamine, chloroquine hydrochloride, and salicylates. The antimetabolites were used to treat SLE starting in the late 1960s.
-
The first reported case of hereditary spherocytosis (HS) and glucose-6-phosphate dehydrogenase deficiency in a black is presented. The recent literature is reviewed, with emphasis on the frequency of multiple inherited RBC defects in this ethnic group. Despite a coexisting hemoglobinopathy or enzyme deficiency, HS can be diagnosed in most cases by the peripheral blood smear, osmotic fragility curve, and family history. The implications of the double RBC abnormality are discussed, stressing the importance of splenectomy in relieving the hemolytic component due to spherocytosis.
-
As determined by the Center for Disease Control's epidemiologic surveillance of abortion mortality, the death-to-case rate for legal abortion in the United States for the three years 1972 to 1974 was 3.9/100,000 procedures. This mortality compares favorably with that from other commonly performed surgical procedures. ⋯ Duration of pregnancy proved to be the most important determinant of risk. Compared to mortality from pregnancy and childbirth, legal abortion in the first trimester was almost nine times safer.