SMJ // June 1983, Volume 76 - Issue 6
Editorial
EKG COMPUTERS A PUBLIC HEALTH HAZARD
Retrospective
Lest We Forget
Article
Inappropriate Use of Cimetidine in Hospitalized Patients
ABSTRACTWe reviewed the records of 100 medical and surgical patients who received cimetidine while hospitalized. Cimetidine use was categorized by FDA criteria as justified (23%), acceptable (40%), or unjustified (37%); prescribing patterns were similar in medical and surgical patients. Furthermore, intravenous cimetidine was often given when patients were receiving oral…
Article
Surgical Treatment of Mitral Valve Disease Pathologic Findings and Atrial Dysrhythmia
ABSTRACTOne hundred fifty patients underwent surgery for mitral valve disease between January 1974 and May 1981. There were 98 female and 52 male patients with a mean age of 57 years (≤ 18.6). One hundred forty-six patients were in New York Heart Association functional class III or IV. Pathologic diagnoses…
Article
Four-way, Multicenter, Crossover Trial of Ibuprofen, Fenoprofen Calcium, Naproxen, and Tolmetin Sodium in Osteoarthritis Comparative Clinical Profiles
ABSTRACTOne hundred forty-one subjects with osteoarthritis completed this double-blind, multicenter, crossover trial comparing four nonsteroidal anti-inflammatory (NSAI) agents after single-blind aspirin stabilization. Preferences of both patients and physicians showed the following rank order from most to least preferable; tolmetin sodium, naproxen, ibuprofen, fenoprofen calcium. By all but three of more…
Article
Association of Mitral Valve Prolapse and Intracranial Aneurysms
ABSTRACTThis paper describes five patients with mitral valve prolapse (MVP) and intracranial aneurysms. Patients with MVP frequently have evidence of a more generalized disorder of connective tissue. An association of intracranial aneurysms and MVP could be related to mesodermal disturbances involving collagen and elastic tissue in the vasculature. Further study…
Article
Effect of Erythromycin Stearate on Serum Theophylline Concentration in Patients With Chronic Obstructive Lung Disease
ABSTRACTThe effect of erythromycin sterate (ES) on serum theophylline concentration (STC) was studied in 15 male adult subjects taking maintenance oral theophylline for clinically stable chronic obstructive lung disease. Steady-state trough STCs were measured before and after two-and seven-day courses of ES, 500 mg every six hours. For the group…
Article
Congenital Subglottic Stenosis Diagnosis and Management
ABSTRACTIn contrast to the generally accepted concept, I have classified congenital subglottic stenosis in a different way. During the first months of life, the abnormality may be recognized by its frequent association with acute respiratory infections, providing the opportunity to recognize it once the infection has been controlled. I emphasize…
Article
Ultrasonography of Small Organs Experience in a Community Hospital
ABSTRACTUnmodified, commercially available, gray-scale ultrasound equipment has been used in a small community hospital to image various small organs. Seven examples are presented to emphasize the versatility of such equipment for obtaining clinically useful information.
Acknowledgement
BOOKS RECEIVED
Article
High-Energy Irradiation in the Management of Chondrosarcoma
ABSTRACTWe present a retrospective analysis of seven patients with chondrosarcoma of the bone treated by high-energy irradiation between 1961 and 1976. Its major role in this series was prevention of local recurrence in cases with inadequate resection. In three of the five cases in which radiation therapy was adjuvant rather…
Article
Ocular Manifestations of Pituitary Adenomas
ABSTRACTFifty patients with pituitary adenomas were evaluated preoperatively by an ophthalmologist; of these, 68% had visual field defects, the msot common (25%) a superior bitemporal depression and 16%, bitemporal hemianopsia. Almost 60% of patients with field defects had visual complaints; 38% had visual acuity in one eye of 20/60 or…
Article
Hip Dislocations in Myelodysplasia A Functional Assessment
ABSTRACTWe reviewed the records of 281 patients with myelodysplasia to ascertain the effect of hip dislocation on their ability to walk. There was no difference in the prevalence of myelodysplasia by gender. When adjusted for neurologic level and patient age, no statistical differences were found in the methods of locomotion…
Article
Lyme Disease in North Carolina
ABSTRACTWe report two cases of Lyme disease in North Carolina, further expanding the distribution of known sporadic cases of this predominantly northeastern problem in southern states. Physicians in areas where Lyme disease has traditionally not been recognized should be alerted to its characteristic rash (erythema chronicum migrans), tick vector (Ixodes…
Article
Rh Immunoglobulin Use With Placenta Previa and Abruptio Placentae
ABSTRACTPatients with obstetric hemorrhage from placenta previa or abruptio placentae may be at increased risk of Rh sensitization because they fail to receive Rh immunoglobulin (RhIG) or are given an inadequate dose. To evaluate the use of RhIG in this clinical situation, we studied 498 patients with hemorrhage from placenta…
Article
Severe Systemic Sepsis Resulting From Neglected Perineal Infections
ABSTRACTEleven patients with severe necrotizing fasciitis involving the soft tissues and muscles of the perineum, abdominal wall, buttocks, and thighs were treated on the Tulane Surgical Service in New Orleans between 1979 and 1981. The etiologic factor in ten of these patients was a neglected or inadequately drained perirectal abscess….
Article
Adolescent Sexuality A Gynecologists Viewpoint
ABSTRACTAdolescent sexuality is affecting a younger age group each year. Diseases and conditions traditionally seen by the gynecologist are now found in both sexes in an age group seen in most cases only by the pediatrician. An awareness of these problems, a willingness to search out sexual involvement, and a…
Review Article
Interaction of Cimetidine With Other Drugs
ABSTRACTAfter five years extensive use of cimetidine, drug interactions have emerged as one of its major adverse effects. Clinically important interactions with warfarin, phenytoin, diazepam, chlormethiazole, propranolol, lidocaine, and a number of other drugs have been reported. An appreciation of the variety of underlying mechanisms, inhibition of drug metabolism, decreased…
Current Concepts
Clinical Investigation of Abnormalities of Ventilatory Regulation
ABSTRACTThe clinical assessment of disorders of ventilatory regulation is based on an understanding of the physiology of the control of ventilation in man. Apart from clinical examination and standard pulmonary function tests, recent research studies have provided newer tests that can be applied in clinical practice. These consist mainly of…
Medical Education
Evaluating Continuity of Care in Primary Care Internal Medicine Programs
ABSTRACTOne goal of primary care training programs is to provide “continuity experiences” for residents. Although programs funded by the Health Resources Administration are mandated to provide and evaluate such experiences, a wide variety may exist in both the concept and the evaluation of continuity in these training programs. To investigate…
Case Report
Metastasis of Bronchogenic Adenocarcinoma to Renal Adenocarcinoma
METASTASIS OF A PRIMARY CANCER to a benign host tumor has been reported in 67 cases,1–7 and of a malignant tumor to another cancer in 36 instances.8–23 I report a bronchogenic adenocarcinoma metastatic to a renal adenocarcinoma.
Article
Trichoderma viride Peritonitis
Article
Pericarditis A Complication of Minoxidil Therapy
MINOXIDIL is a potent vasodilator, indicated in the treatment of severe refractory hypertension.1 Observed adverse side effects include salt and water retention due to augmented reabsorption in the proximal tubule; reflex increase in sympathetic activity caused by baroreceptor stimuli, resulting in tachycardia and increased cardiac output occasionally causing angina pectoris…
Article
Intracranial Placement of Nasogastric Tube An Unusual Complication
NASOGASTRIC INTUBATION is almost always necessary in severely injured patients. Nasotracheal and nasopharyngeal malposition is common. Intracranial placement, an unusual complication and malposition, has been recorded.1–8 The purpose of this paper is to report a severely injured patient in whom intracranial nasogastric tube placement occurred.
Letter to the Editor
Serum Haptoglobin as Tumor Marker
(Letters to the Editor are welcomed. They may report new clinical or laboratory observations and new developments in medical care or may contain comments on recent contents of theJournal. They will be published, if found suitable, as space permits. Like other material submitted for publication, Letters must be typewritten in…
