Harefuah
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Tetanus is preventable by proper immunization, which has almost eradicated the disease in countries with a high standard of living. However, the disease is still prevalent even in the most advanced countries and it often appears in the elderly. ⋯ Because of their age, they often do not remember when they last had tetanus immunization, nor are records always adequate. We point out the necessity and feasibility of incorporating a special immunization review program for the elderly, including a cost-benefit analysis.
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Malignant retroperitoneal tumors are relatively rare. The most likely diagnosis by a surgeon encountering a retroperitoneal mass is metastatic disease, but primary retroperitoneal malignant disease or benign tumor should also be considered. ⋯ Primary extragonadal germ cell tumors constitute 1-2% of all germ cell tumors, most of which are found in the mediastinum and retroperitoneum. We report the successful treatment of a 20-year-old man whose primary retroperitoneal extragonadal germ cell tumor was treated by chemotherapy and surgery.
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Comparative Study
[Survival and mortality in amputees with dysvascular lower limbs].
Survival and mortality in 248 cases of lower limb amputation for vascular disease, after prosthetic rehabilitation, were assessed. Mean survival time was 3.5 years, with survival in women less than in men. Survival was shorter in those with peripheral vascular disease as compared to diabetics, and also shorter in above-knee than below-knee amputations.
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3 patients with Arnold-Chiari malformation with vertigo as the sole clinical presentation are described. 2 of them had been undiagnosed for many years despite repeated examinations, including CT scans. The third patient was diagnosed 2 weeks following the initial vertiginous attack. ⋯ The cases presented emphasize the important contribution of electronystagmography in the evaluation of vertigo due to intracranial lesions. However, computerized imaging examination remains the main diagnostic tool for intracranial pathologic processes.