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Showing papers by "Lincoln Hospital published in 1990"


Journal Article
TL;DR: It is concluded that a conservative approach to penetrating pancreatic injuries yields optimal results and that associated colon injury is an important predeterminant for abscess formation.
Abstract: The present study analyzes 103 consecutive patients with these wounds treated in a 14-year period. Twenty-seven patients died within 48 hours from extensive associated trauma (Abdominal Trauma Index [ATI] 46.7). The majority of the remaining 76 patients were treated by debridement and drainage. Nineteen patients with grade III injuries had distal pancreatectomy. Six patients whit extensive combined pancreatoduodenal injuries had pancreatoduodenectomy

45 citations


Journal ArticleDOI
TL;DR: Cases of three adults with a history of intravenous drug abuse who developed endocarditis caused by Corynebacterium xerosis, NeISSeria subflava, and Neisseria flavescens are reported, and it is speculated that infection with human immunodeficiency virus may play a role in the pathogenesis of endocardritis caused by these unusual organisms.
Abstract: We report the cases of three adults with a history of intravenous drug abuse who developed endocarditis caused by Corynebacterium xerosis, Neisseria subflava, and Neisseria flavescens, respectively. No cases of endocarditis caused by C. xerosis or N. flavescens and only one case caused by N. subflava have previously been reported in association with narcotic addiction. The prominent clinical features in all patients included poor response to antibiotic therapy, persistent fever, and major embolic events. Stigmata of infection with human immunodeficiency virus, as manifested by oral candidiasis, cervical lymphadenopathy, and serologic evidence, were present in two of the three patients. At our institution, where Staphylococcus aureus remains the most frequent etiologic agent of narcotic-associated endocarditis, the occurrence of these three cases in a 9-month period is striking. We speculate that infection with human immunodeficiency virus may play a role in the pathogenesis of endocarditis caused by these unusual organisms.

26 citations


Journal ArticleDOI
TL;DR: The authors question when the RTS, ISS, the ISS and age, or the probability of survival calculated using the TRISS method should be used to control for severity of injuries in trauma research.
Abstract: The injury severity score (ISS) and age have been used retrospectively to control for trauma severity. Other control variables such as the revised trauma score (RTS) and the TRISS method (which estimales the probability of survival for each patient) additionally require that values of blood pressure, Glasgow coma scale, and respiratory rale, be recorded in the emergency department. The authors question when the RTS, ISS, the ISS and age, or the probability of survival calculated using the TRISS method should be used to control for severity of injuries in trauma research. Relations between predictor variables and (1) survival to hospital discharge, (2) hospital length of stay for survivors, and (3) length of ICU stay were compared by cause of injury: penetrating, motor vehicle accident, low fall, or other blunt. Data were collected over 12 months for 2,914 consecutive adult patients who died or stayed in five nontrauma and three trauma centers for 48 hours or more. For survival, the false-negative rates of probability of survival calculated using the TRISS method were approximately half that of the ISS and age; no variable adequately explained survival among those with low falls. Combinations of ISS, RTS, and age explained the most variation in lengths of hospital stay among survivors, while ISS explained the most variation in lengths of intensive care unit (ICU) stay. Researchers should consider the ISS with RTS and age to control for severity when lengths of hospital or ICU stay are studied. The TRISS method should be used in studies of survival. In both cases, the RTS which requires data collection in the emergency department must be calculated.

18 citations


Journal ArticleDOI
TL;DR: A case of malignant hemangiopericytoma arising in the left maxillary gingiva in a 2-year-old boy is presented, representing an extremely rare intraoral lesion that is impossible to diagnose clinically.

12 citations