Case Report

Seminal Vesicle Abscess Due to Tuberculosis Role of Tissue Culture in Making the Diagnosis

ABSTRACTAbscess formation involving the seminal vesicle occurs rarely. We report a case of seminal vesicle abscess due to tuberculosis. Urine and fluid cultures and histologic examination of the prostate were negative for mycobacteria. The cause of the abscess was confirmed only after tissue cultures were done.

Primary Article

“One‐Stop” Surgery Implications for Anesthesiologists of an Expedited Pediatric Surgical Process

ABSTRACTBackground“One-stop surgery” (OSS) allows pediatric patients to undergo initial surgical evaluation, anesthesia, surgery, and discharge home, on the same day.MethodsPatients referred for umbilical hernia repair, circumcision, or central venous catheter removal completed a screening questionnaire, after which they were scheduled for initial surgical and anesthesia evaluation if eligible and had…

Primary Article

Comparison of Internal Medicine, Pediatric, and Medicine/Pediatrics Applicants and Factors Influencing Career Choices

ABSTRACTBackgroundA reemergence of medical students choosing primary care is occurring, with medicine/pediatrics as an increasingly popular option. We compared applicants to pediatrics, medicine, and medicine/pediatrics and the factors that influence career choice.MethodsWe designed a survey to gather objective data and information shown to influence career choices. Applicants interviewing in our…

Primary Article

Study of Condom Integrity After Brief Exposure to Over‐the-Counter Vaginal Preparations

ABSTRACTBackgroundLatex condoms are used as contraceptives and as preventives against sexually transmitted diseases. Latex rapidly and significantly deteriorates when exposed to pure mineral oil and vegetable oil. We wanted to determine if short exposures to readily available over-the-counter (OTC) intravaginal preparations could affect latex condom integrity.MethodsWe compared the mean burst…

Primary Article

Prostate Cancer Screening in Primary Care

ABSTRACTBackgroundLittle is known about the actual frequency with which men have prostate screening in primary care settings, nor are the determinants of screening understood.MethodsWe examined the records of 50 consecutive primary care office visits by men aged 50 or older. Men were asked to complete a brief questionnaire outlining their…

Primary Article

Postoperative Pulmonary Edema

ABSTRACTBackgroundNoncardiogenic pulmonary edema may be caused by upper airway obstruction due to laryngospasm after general anesthesia. This syndrome of “negative pressure pulmonary edema” is apparently well known among anesthesiologists but not by other medical specialists.MethodsWe reviewed the cases of seven patients who had acute pulmonary edema postoperatively.ResultsThere was no evidence…

Primary Article

Purulent Pericarditis Misdiagnosed as Septic Shock

ABSTRACTBackgroundSeptic shock is common, with approximately 200,000 cases recognized annually. This syndrome is so well characterized that when a patient is febrile and in shock, septic shock may be diagnosed without regard to alternative possibilities. Purulent pericarditis is a relatively rare disorder in which fever and hypotension are common. Classic…

Current Concepts

Aging and Sensory Senescence

ABSTRACTBackgroundThe aging process typically is associated with decline in function for the various senses. A decline in sensory ability may simulate an intellectual decline that is not present. Sensory decline can lead to depression, social isolation, and even to hallucinations.MethodsI reviewed the medical literature via computer, focusing on recent findings.ResultsSensory…

Current Concepts

Human Pulmonary Dirofilariasis Review of the Literature

ABSTRACTBackgroundThe dog heartworm Dirofilaria immitis is known to cause solitary pulmonary nodules in humans. Human pulmonary dirofilariasis (HPD) is more prevalent along the coastal regions of the United States, especially along the Mississippi River Valley. Diagnosis is generally made by surgical resection, since HPD is often preoperatively presumed to be…

Primary Article

Clinical Presentation, Radiographic Findings, and Diagnostic Methods of Pulmonary Blastomycosis A Review of 100 Consecutive Cases

ABSTRACTBackgroundWe sought to determine the relationship among radiographic findings, clinical presentation, and diagnostic testing of pulmonary blastomycosis.MethodsWe reviewed the medical records of 100 consecutive patients with pulmonary blastomycosis.ResultsAir-space infiltrates were the usual radiographic finding of pulmonary blastomycosis. Mass-like infiltrates were associated more with chronic than acute presentations. Air-space and mass-like…

Case Report

Basal Cell Carcinoma With Lung Metastasis Diagnosed by Fine‐Needle Aspiration Biopsy

ABSTRACTBasal cell carcinoma of the skin is one of the most common types of cancer. Its natural history is one of local recurrence rather than metastatic spread. Certain histologic features and primary tumor size seem to be risk factors for metastases. The diagnosis of metastatic disease imparts a poor prognosis…

Case Report

Midline Posterior Cervical Cystic Hygroma

ABSTRACTCystic hygromas are among the most common congenital neck masses. They have a predilection for the left posterior triangle and manifest early in life. Although various locations of cystic hygromas are found in the literature, we believe our case of a 9-month-old girl represents the first reported occurrence of a…

Case Report

Near Fatal Acute Respiratory Distress Syndrome in a Patient With Human Ehrlichiosis

ABSTRACTHuman ehrlichiosis is not a common cause of acute respiratory distress syndrome (ARDS). Physicians should be aware of this life-threatening but treatable entity. Progression to ARDS may be related to delay in diagnosis and treatment. Fever, leukopenia, thrombocytopenia, and a history of tick exposure in an endemic area during the…

Case Report

Ehrlichiosis With Severe Pulmonary Manifestations Despite Early Treatment

ABSTRACTIt is generally thought that if patients with ehrlichiosis are treated promptly, life-threatening illness can be avoided. We report a patient who sought medical attention 1 day after the onset of symptoms, was immediately given doxycycline, and still had serious illness with generalized edema, pulmonary infiltrates, acute respiratory distress syndrome,…

Case Report

Anesthetic Management of a Patient With Tetra‐amelia

ABSTRACTThe case presented is that of a parturient with tetra-amelia, the congenital absence or near absence of all limbs. The difficulties encountered with monitoring and venous access due to absence of extremities illustrate the necessity for a detailed management plan with emphasis on early intervention. The reasons for the high…

Current Concepts

Demographic Changes in Tuberculosis High Risk Groups

ABSTRACTWe conducted a statistical analysis of all verifiable tuberculosis (TB) cases in Tennessee from 1990 through 1996 to determine the demographic changes in TB. We studied variables, including age, sex, race, site of the disease, and possible impact of known risk factors such as human immunodeficiency virus (HIV) infection, homelessness,…

Case Report

Heterotopic Pregnancy Discovery of Ectopic Pregnancy After Elective Abortion

ABSTRACTWe report a case of combined intrauterine and tubal pregnancy in a 23-year-old woman. The patient came to the emergency department complaining of lower abdominal pain after having had an elective abortion 2 weeks earlier. Her physician had done pelvic ultrasonography, noting an intrauterine pregnancy before the abortion. Our working…

Case Report

Traumatic L5‐S1 Spondylolisthesis

ABSTRACTWe report a case of traumatic spondylolisthesis in a 31-year-old man struck by a steel I-beam. Although most reported traumatic spondylolisthesis cases are from low-energy trauma, this was a high-energy trauma case. The initial examination revealed no signs of cauda equina syndrome, and the patient's spinal injury was primarily capsuloligamentous….

Abstract

ACUTE MYOCARDIAL INFARCTION ASSOCIATED WITH VIAGRA IN THE ABSENCE OF SEXUAL ACTIVITY

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ALCOHOL INTAKE REDUCES WOMEN'S FERTILITY

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ANTIDEPRESSANTS AND RISK OF FALLING AMONG NURSING HOME RESIDENTS

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CATARACTS AND EXPOSURE TO SUNLIGHT

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CHANGES IN PHYSICAL FITNESS AND MORTALITY

Expired CME Article

CME Article of the Month Southern Medical Association CME CREDIT

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DEPRESSION IN PATIENTS WITH DEMENTIA

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ENDOGENOUS HORMONES AND RISK OF FRACTURES IN WOMEN

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MORTALITY FROM CORONARY HEART DISEASE 1987–1994

Article

News Potpourri

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ORAL FAMCICLOVIR FOR RECURRENT GENITAL HERPES

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PAROXETINE FOR SOCIAL ANXIETY DISORDERS

Our Medical Heritage

Public Hospital • Williamsburg, Virginia

Abstract

SECOND‐EYE CATARACT SURGERY IS BENEFICIAL

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