1/7. Medical treatment of the adolescent drug abuser. An opportunity for rehabilitative intervention.Illnesses related to both the pharmacologic properties of abused substances and their methods of administration often bring the teenager to medical attention and may provide sufficient motivation for the adolescent to seek help beyond the acute problem. Successful treatment of an overdose reaction, an abstinence syndrome, or any other medical complication of drug abuse may give the physician a unique opportunity to begine further evalution for future care.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. cytomegalovirus mononucleosis in a healthy adult: association with hepatitis, secondary Epstein-Barr Virus antibody response and immunosuppression.A 35 year old previously healthy physician had clinical manifestations of a mononucleosis illness complicated by arthralgia, vesicular pharyngitis and hepatitis. Initially, the patient had cytomegalovirus (CMV) viremia (predominantly in polymorphonuclear leukocytes) followed by the presence of CMV in the urine, throat and semen. He also had an antibody response to the Epstein-Barr virus which appeared to be a secondary type. During the acute phase of illness, only 7 per cent of the patient's lymphocytes formed spontaneous T cell rosettes as compared to a normal value of 65 to 70 per cent. Concurrently, evidence of abnormal delayed hypersensitivity was manifested by the loss of reactivity to mumps skin test antigen. All clinical and laboratory abnormalities except for the persistence of CMV in the pharynx, urine and semen returned to normal after resolution of the clinical illness.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. hepatitis a. Analysis of a community outbreak.The 1987 outbreak of hepatitis a in the Southwest missouri town of nevada illustrates a number of public health measures that can quickly and effectively halt an epidemic. Cooperation among state health officials, individual physicians and the news media is just one aspect of the control of such an outbreak.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. Hospital outbreak of hepatitis a: risk factors for spread.A 34-month-old girl with Down's syndrome from the Marshall islands was hospitalized in September, 1981, at Tripler Army Medical Center for evaluation of a heart murmur and definitive repair of an imperforate anus for which she had had a colostomy since birth. She became jaundiced and had serologic evidence of hepatitis a infection. Over the next month eight hospital personnel (four nurses, three nursing assistants and one physician) who had had direct contact with the patient became ill with hepatitis a. Our patient, like the index cases in five previous reports of nosocomial hepatitis a outbreaks, was incontinent of feces. In addition she was hospitalized during the incubation period before clinical illness when virus fecal excretion is likely to be maximal. patients in the prodromal stage of hepatitis a infection who are hospitalized pose a significant risk to exposed hospital staff. This risk is enhanced if there are additional factors present which promote spread of disease by the fecal-oral route such as infancy, mental retardation, diarrhea and fecal incontinence.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. Nosocomial transmission of hepatitis a from a hospital-acquired case.An outbreak of hepatitis a occurred in a pediatric hospital in texas. The index case had been admitted during the incubation period for cardiac surgery and developed symptoms while hospitalized. A child in a nearby bed acquired hepatitis a, as did three staff members. The second child was still hospitalized when she developed symptoms and infected 12 nurses, 3 physicians, 2 medical students, 2 patients and 1 respiratory therapist. Children with diarrhea can effectively disseminate this virus even when normal hospital routines and rules of hygiene are observed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. Simultaneous amebic liver abscess and hepatitis a.A child with amebic colitis, liver abscess and hepatitis a is reported. Speculation as to why these two infectious agents have rarely been associated is presented. diagnosis of hepatitis was not suspected in this case until physicians caring for the patient developed clinical hepatitis. The importance of suspecting hepatitis a in all patients with unexplained liver enzyme elevations is stressed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. Hospital-acquired hepatitis a: report of an outbreak.A nosocomial outbreak of hepatitis a occurred after hospitalization of a 21-month-old girl with amebic liver abscess and unsuspected, anicteric hepatitis A. The index patient, who had an acute diarrheal illness prior to enzyme elevations, seroconverted from IgM hepatitis a antibody to IgG hepatitis a antibody. Of the 103 hospital personnel with known or potential exposure, three physicians (2.9%) contracted clinical hepatitis a, 27 to 29 days after their initial contact with the source patient. A fourth physician developed subclinical infection. Two of the three clinical cases occurred in two of the three primary care physicians of the source patient. hepatitis a should be considered in any patient with acute, unexplained liver enzyme abnormalities. diarrhea occurring in a fecally incontinent child incubating hepatitis a may increase the risk of transmission.- - - - - - - - - - ranking = 3keywords = physician (Clic here for more details about this article) |