General Supportive Treatment Research Articles

Toxic amoebic colitis and amoebic colon perforation in children: An improved prognosis.

Fourteen children were treated for complications of severe colonic amebiasis. Seven had colon perforation; seven had toxic amoebic colitis. Those with perforation underwent colon resection limited to the perforation and adjacent abnormal colon. Those having toxic amoebic colitis without perforation were managed by temporary ileostomy. Vigorous general supportive treatment for endotoxic shopck and amebiasis was given pre and postoperatively. Careful barium enema examinations proved safe and effective in diagnosis and follow-up. Ten patients survived (72%), five from each group.

Indomethacin treatment of pericarditis in chronic hemodialysis patients

Symptomatic pericarditis occurs in the course of maintenance hemodialysis and often requires pericardiectomy in addition to other conventional measures. Three of 11 such patients were treated with frequent dialysis and general supportive treatment. Two of these required pericardiocentesis. The other eight received indomethacin; this was followed by prompt defervescence and abatement of pain within 6 to 24 hours. Only one patient required pericardiocentesis. On every occasion when treatment was discontinued during the first week, symptoms recurred. After three weeks to four months, the drug dosage could be tapered and discontinued. The pericardial aspirate was hemorrhagic in all three patients who required pericardiocentesis. Indomethacin appears to be effective in the treatment of the pericarditis associated with dialysis and precludes the need for invasive procedures.

Indomethacin Treatment of Pericarditis in Chronic Hemodialysis Patients

Symptomatic pericarditis occurs in the course of maintenance hemodialysis and often requires pericardiectomy in addition to other conventional measures. Three of 11 such patients were treated with frequent dialysis and general supportive treatment. Two of these required pericardiocentesis. The other eight received indomethacin; this was followed by prompt defervescence and abatement of pain within 6 to 24 hours. Only one patient required pericardiocentesis. On every occasion when treatment was discontinued during the first week, symptoms recurred. After three weeks to four months, the drug dosage could be tapered and discontinued. The pericardial aspirate was hemorrhagic in all three patients who required pericardiocentesis. Indomethacin appears to be effective in the treatment of the pericarditis associated with dialysis and precludes the need for invasive procedures.

Muco-Cutaneous Ocular Syndrome. A Case Report

The patient developed acute chorioiditis of the eye, as seen in previously reported cases, but recovered from it without losing the sight. The patient received general supportive treatment and Predonisolone, starting with 30 mg. a day. The dosage was gradually decreased by 5 mg. every 2 to 3 days.The disease was thought to be fall into a category of collagen disease, but allergic nature of the disease was also suggested.

EVALUATION OF CORTISONE IN THE TREATMENT OF CEREBRAL INFARCTION

• Thirty-six patients brought to a hospital with symptoms of cerebral infarction were classified as to the severity of the condition and divided into two groups comparable as to severity, age, blood pressure, and other essential criteria. Both groups received the usual supportive care. The test group of 17 patients received, in addition, 300 mg. of cortisone and 3 gm. of potassium chloride daily with a low-salt diet. The cortisone was given in divided doses, and the dosage was reduced after the second day. The contra-test group of 19 patients received a placebo. There were 13 deaths in the cortisone and 10 in the placebo group. The difference, though small enough to have arisen by chance, discouraged further use of cortisone in this situation. The classification according to severity was found to have prognostic value, and an impressive number of patients were seen who could not be admitted to either group because their symptoms cleared up spontaneously within a few hours. Cortisone must not be used indiscriminately. Its unfavorable effects in this series of patients occurred despite observance of known contraindications. Emphasis in cases of cerebral infarction should be on general supportive treatment.

OSTEOMYELITIS OF THE SUPERIOR MAXILLA: TREATMENT WITH PENICILLIN

It is well known that osteomyelitis of any bone of the skull is fraught with great danger to life, secondary to extension of the lesion throughout the cranium. In a previous article on osteomyelitis, 1 under the heading Conclusions, the following statements were made: One may expect any osteomyelitic lesion in the skull to cover pachymeningitis or to be complicated by an abscess of the brain. The first surgical step in the treatment of these two frequent complications of osteomyelitis is removal of the foci of infection.... The importance of general supportive treatment and measures to increase resistance cannot be overestimated. Today otolaryngologists must add chemotherapy to their armamentarium. I still maintain that it is always desirable, when possible, to limit the infection of bone to its orignal site. Extensions are often difficult to determine in early stages, and consequently in the past surgeons have been compelled to advocate radical surgical

A clinical and therapeutic evaluation of portal cirrhosis

(1) A study of 246 cases of portal cirrhosis was made. (2) The recognition of the latent and early phase of the disease was stressed. (3) The early symptoms of cirrhosis are vague and may be exclusively referred to the G. I. tract, hemopoietic system, biliary tract, and to the nervous system. (4) A comparative evaluation of the effects of a highly nutritious diet with vitamin concentrates in a group of 112 patients was made with the results in 134 treated by diuretics, paracentesis and general supportive treatment. (5) The best results were obtained in the non-ascitic group and in patients with the early phase of the disease where multiple liver function tests have shown minimal impairment.