SMJ // December 1978, Volume 71 - Issue 12
Article
T4 Toxicosis
Article
Cold Water Syncope
Article
“Dome and Dart” P Waves
Clinical Brief
VIGNETTES ON MEDICAL WRITING
Clinical Brief
GENERAL ANNOUNCEMENTS
Current Concept
Staging Laparotomy in Hodgkins Disease: A Critical Appraisal of Its Value
ABSTRACT: Although staging laparotomy changes the stage of one third of patients with Hodgkins disease, this change in stage does not establish that routine staging laparotomy is of clinical value. The value of laparotomy depends on the results of clinical decisions which are based on the information provided by laparotomy….
Editorial
THANKS
Our Medical Heritage
Attitudes Toward Nutrition and Health in the Ancient North
Primary Article
Erroneous Diagnosis of Meningitis Due to False-Positive Gram Stains
ABSTRACT: During a two-month period, 6% of Gram stains of predominantly CSF specimens revealed gram-negative bacilli with no growth. The source of the false-positive Gram stain results was an alcohol storage bath from which slides were taken and flamed to remove residual alcohol. All 11 patients in the outbreak had…
Primary Article
Ferritin as an Index of Bone Marrow Iron Stores
ABSTRACT: We examined the relationship of serum ferritin to bone marrow iron stores in 73 anemic male medical inpatients with liver disease, alcoholism, chronic inflammatory disease, and malignancies. A correlation of r=0.75 (P<.00005) was found between serum ferritin and bone marrow iron stores (BMIS) for the entire group. Liver disease…
Primary Article
Huntingtons Disease: Comprehension of the Facts by Patients and Their Families
ABSTRACT: The accuracy of the knowledge of genetic patterns of Huntingtons disease was studied by interview in 14 patients who had been in regular contact with physicians. Only one patient had completely accurate knowledge of the genetic risk entailed by autosomal dominance. Inaccurate knowledge often prevented optimal judgment concerning major…
Primary Article
Primary Hypothyroidism and Pituitary Insufficiency
ABSTRACT: A 40-year-old man with primary hypothyroidism and sellar enlargement is described. There was deficiency of all pituitary tropic hormones except TSH which was elevated. TRH stimulation revealed responsiveness of pituitary thyrotropic cells, and thyroxine administration suppressed the elevated TSH. These findings are compatible with either a TSH-producing chromophobe adenoma…
Primary Article
Role of the Psyche in Recovery From Myocardial Infarction
ABSTRACT: The need for psychosocial counseling in survivors of myocardial infarction is often overlooked. A few casual remarks at the bedside will not suffice. These patients progress through three definable stages: (1) stress, (2) disorganization, and (3) reconstruction. The assistance of the physician in helping the patient through these phases…
Primary Article
Normal Vaginal Axis
ABSTRACT: Vaginograms were done on 20 normal women to determine the exact axis, length, and direction of the normal vagina. The vagina was found to be a curved organ with a distinct upper portion that has an axis between the third and fourth sacral vertebrae. The importance of restoring this…
Primary Article
Diagnosis of Lymphangitic Carcinomatosis by Transbronchial Lung Biopsy
ABSTRACT: The records of patients who had transbronchial lung biopsy at Walter Reed Army Medical Center between January 1974 and September 1977 were retrospectively reviewed. Nine patients were found whose clinical and radiographic presentations were compatible with lymphangitic carcinomatosis. In five patients the lymphangitic spread of carcinoma was diagnosed from…
Primary Article
Optimal Enzyme Test Combination for Diagnosis of Acute Myocardial Infarction
ABSTRACT: One hundred consecutive patients admitted to our cardiology service with the suspected diagnosis of acute myocardial infarction were evaluated with serial enzyme and isoenzyme determinations in an attempt to develop the medically and financially optimal combination of enzyme tests. In patients with onset of chest pain less than 24…
Primary Article
ECT in the Treatment of Recurrent Psychotic Depression
ABSTRACT: Two cases of recurrent psychotic depression are reported in which ECT (electroconvulsive therapy) was administered with good results for previous episodes of depression, but treatment of the current episode with combined drug therapy (antidepressant and antipsychotic drugs) in one case and antidepressant chemotherapy in the other resulted in failure…
Primary Article
Sternoclavicular Joint Involvement in Ankylosing Spondylitis
ABSTRACT: Two patients with sternoclavicular joint involvement in ankylosing spondylitis are described, both of whom presented with referred pain syndromes which delayed diagnosis. The anatomy of the sternoclavicular joint and the salient features of this entity are reviewed.
Primary Article
Photochemotherapy: Dermatologic Uses
ABSTRACT: Photochemotherapy is a new concept in treating selected skin disease. Psoralens taken orally two hours before high-intensity UVA radiation results in clinical clearing of psoriasis, mycosis fungoides, vitiligo, and atopic eczema. The results of two large cooperative studies in the treatment of psoriasis presented similar results.
Primary Article
The Doctors Touch: Tactile Communication in the Doctor-Patient Relationship
ABSTRACT: This paper reviews the historical meanings of tactile communication to the doctor (the diagnostic touch) and to the patient (the healing touch) and discusses the importance of touching in the context of changing medical technology. The quality of health care depends not only on how well physicians and other…
Primary Article
New Method for Obtaining Uncontaminated Urine From Women
ABSTRACT: Midstream sampling and colony counts have greatly improved precision in diagnosing urinary tract infections. In women, however, contamination by vaginal flora and cells still poses a diagnostic problem. We have devised an instrument for helping collect uncontaminated urine from women and have tested it in three sets of observations….
Primary Article
Serum IgE Levels and Recurrent Abdominal Pain in Children
ABSTRACT: Serum IgE levels were measured in 25 consecutive children with recurrent abdominal pain (RAP) of undetermined cause and 25 consecutive controls of similar age and sex without evidence of RAP, allergy, or parasitic infection. No significant difference in serum IgE levels was demonstrated in children with and without RAP.
Primary Article
Hemodialysis in Chronic Schizophrenic Patients
ABSTRACT: Ten schizophrenic patients were dialyzed once a week for 16 weeks. They showed marked abnormalities in thinking, affect, and behavior. When out of the hospital, they lived vegetative, nonproductive lives. Seven patients at the end of the 16-week period showed no or minimal symptoms involving thinking, affect, and behavior….
Primary Article
Two-Plane Fixation of Acute Supracondylar and Intracondylar Fractures of the Femur
ABSTRACT: In 37 cases of supracondylar and intracondylar fractures of the femur treated by open reduction and internal fixation, a two-plane compression device, affording firm fixation in either the sagittal or frontal plane, was used with excellent results. Certain anatomic factors and associated injuries to the musculoskeletal system deserve classification,…
Primary Article
Tubal Patency: Hysterosalpingography Compared With Laparoscopy
ABSTRACT: Laparoscopy was done about three months after hysterosalpingography (HSG) in 121 patients complaining of infertility. Normal patency was found with both technics in 71 patients (58.6%). In 23 of the 97 patients with a normal HSG, however, peritubal or tubal disease was observed at the time of laparoscopy (false-negative…
Primary Article
Teaching Psychiatry in a New Medical School A Multimedia Approach
ABSTRACT: As a developing department in a new medical school, we were able to improve our curriculum by using a multimedia approach to teaching psychiatry. We relied heavily on a programmed self-instructional text with videotaped clinical examples (PLS), learning objectives, formal classroom presentations, small group discussions, self-assessment exercises, an affective…
Primary Article
Blood Chemistry Abnormalities in Bacterial Endocarditis of Narcotic Addicts
ABSTRACT: We recently treated two narcotic addicts with bacterial endocarditis who developed the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This prompted a retrospective review of blood chemistry studies in all narcotic addicts admitted to our hospital over a 30-month period because of a clinical suspicion of bacterial endocarditis. Patients…
Primary Article
Facial Reanimation in Möbius Syndrome
ABSTRACT: The psychosocial deformity associated with total lack of facial animation (as seen in Möbius syndrome) is an extremely crippling situation. This inability to show happiness, sadness, or anger by facial expression frequently results in severe introversion and a reclusive personality. Restoration of even a minimal degree of controlled facial…
Primary Article
Pancreatic Pseudocyst as a Cause of Jaundice
ABSTRACT: Three cases of jaundice caused by a pseudocyst in the head of the pancreas which compressed the distal common bile duct are presented. These were seen at the VA Hospital, Clarksburg, West Virginia, in a four-year period. The need for bypass drainage of the biliary tree in such cases…
Primary Article
Treatment of Otitis Media Caused by Hemophilus influenzae: Evaluation of Three Antimicrobial Regimens
ABSTRACT: Ninety young children with otitis media, proven by tympanocentesis culture to be due to Hemophilus influenzae, were treated in a prospective double-blind study with one of three antimicrobial regimens: ampicillin, erythromycin ethylsuccinate, or erythromycin ethylsuccinate with concomitant trisulfapyrimidines. Results of efficacy evaluation indicated that the combination was as effective…
Primary Article
Botryomycosis: First Report of Human Brain Involvement
ABSTRACT: A 57-year-old man, previously well except for dental caries and a history of Wolff-Parkinson-White syndrome, presented with marching right-sided motor seizures of sudden onset. Cerebral arteriography and scan demonstrated an avascular left frontal lobe mass. At operation, it was identified as an abscess and was totally excised. Histologically, granules…
