Chronic pelvic pain--noncyclic pain that persists for more than six months and alters lifestyle and behavior--is a significant cause of discomfort, anxiety, physician office visits and surgery. In the United States, chronic pelvic pain annually accounts
The seven categories of alternative medicine, as established by the National Institutes of Health Office of Alternative Medicine, are mind-body interventions, bioelectromagnetic therapies, alternative systems of medical practice, manual healing methods,
Chronic pelvic pain in women may involve more than the gynecologic organ systems. Urologic, gastrointestinal, musculoskeletal and psychiatric disease processes may be contributing factors, the majority of which can be treated medically. A thorough histo
A basic approach to the patient presenting with acute monoarthritis includes a careful history, a physical examination and a selected battery of laboratory tests and radiographs. Because of the possibility of septic joint, rapid assessment and treatment
Uncommon headache syndromes can be classified into two broad categories: (1) urgent conditions, including subarachnoid hemorrhage, giant cell arteritis and bacterial meningitis, and (2) special syndromes, such as cluster headache, migraine with aura and
The etiology of primary nocturnal enuresis remains somewhat controversial but may include genetic factors, decreased functional bladder capacity, increased diuresis at night, and constipation. Deep sleep and emotional illness usually play only a minimal
In evaluating recurrent childhood infections, the physician must keep in mind the rarity of true immunodeficiency and the frequency of atopy, day care, exposure to cigarette smoke and anatomic variations as predisposing factors in recurrent childhood il
Recent reviews of the effect of estrogen on the cardiovascular system suggest that long-term estrogen replacement therapy after menopause may prevent cardiovascular disease in women who are at risk. Short-term effects of estrogen on coronary vascular re
Chlamydia trachomatis and Trichomonas vaginalis are common sexually transmitted infections associated with adverse pregnancy outcome. Since patients are frequently asymptomatic, diagnosis on the basis of symptoms or physical findings is unreliable. If m
Acute cholecystitis is a common abdominal condition resulting from chemical or bacterial inflammation of the gallbladder. It is generally related to gallstones and subsequent unresolved obstruction. Early surgery is the treatment of choice because of th
Date: August, 1991
Up to one-third of patients undergoing surgical treatment of pancreatic injuries or the performance of pancreaticointestinal anastomoses develop fistulas caused by the release of proteolytic enzymes. Pancreatic fistula formation is a serious complication causing significant morbidity and mortality. Several methods, such as suture techniques and omental patches, have been used with limited success to prevent fistula formation. Kram and colleagues evaluated the safety and efficacy of fibrin glue made from highly concentrated human fibrinogen and clotting factors in preventing fistula formation in patients undergoing pancreatic surgery.
Fifteen patients were included in the study. Ten of these patients required surgery for pancreatic trauma. Surgery was indicated in the other patients because of pancreatic cancer, chronic pancreatitis or pseudocysts.
Fibrin glue was used directly on penetrating injuries and on suture and staple lines. No complications attributable to the glue were observed, and no pancreatic fistulas developed in the patients. Previously, the incidence of pancreatic fistulas after pancreatic surgery for trauma has been reported to be as high as 30 percent.
The authors believe that fibrin glue may become an important adjunct in the prevention of fistula formation after pancreatic surgery. Further studies are needed to confirm these findings. (American Journal of Surgery, April 1991, vol. 161, p. 479.) 1
COPYRIGHT 1991 American Academy of Family PhysiciansCOPYRIGHT 2004 Gale Group