June 2003, Volume 96 - Issue 6

Ambulatory Blood Pressure Monitoring

Michael E. Ernst PharMD, BCPS, George R. Bergus MD

Abstract: Noninvasive, 24-hour ambulatory blood pressure monitoring (ABPM) has evolved over the past 25 years from a novel research tool of limited clinical use into an important and useful modality for stratifying cardiovascular risk and guiding therapeutic decisions. Early clinical...

(pp 563-568)

Generalized Anxiety Disorder

Ray Pary MD, Paul R. Matuschka PHARMD, Susan Lewis ARNP, CS, PHD, William Caso MD, Steven Lippmann MD

Abstract: Anxiety is a part of daily life. While mild levels of anxiety can be positive, moderate to severe levels can cause intense distress. When anxiety interferes with a person's ability to function, it warrants treatment. Generalized anxiety disorder (GAD) is a chronic...

(pp 581-586)

CME Credit—June 2003 Featured CME Topic: Generalized Anxiety Disorder


Abstract: To receive a CME certificate for 1 hour in category 1 credit toward the AMA Physician's Recognition Award, complete all sections of this form and mail it with a check (payable to SMA) for $15 ($30 for nonmembers) to: Publications Department, SMA, PO Box...

(pp 587)

Bee Envenomation: A Rare Cause of Thrombotic Thrombocytopenic Purpura

Jennifer R. Ashley MD, Henry Otero MD, David M. Aboulafia MD

Abstract: Thrombotic thrombocytopenic purpura (TTP) is characterized by the pentad of microangiopathic hemolytic anemia, thrombocytopenia, neurologic symptoms, renal insufficiency, and fever. Although many underlying diseases and conditions are associated with TTP, there has been...

(pp 588-591)

Pulmonary Aspergillosis and Central Nervous System Hemorrhage as Complications of Autoimmune Hemolytic Anemia Treated with Corticosteroids

Dennis J. Cleri, MD, FACP, FAAM, FIDSA, Robert L. Moser, MD, FACP, Francisco J. Villota, MD, Yue Wang, MD, Syed A. Husain, MD, Shahzinah Nadeem, MD, Tarek Anjari, MD, Mohammad Sajed, MD

Abstract: Warm, active antibody adult autoimmune hemolytic anemia is the most common form of hemolytic anemia not related to drug therapy. Mortality in adult autoimmune hemolytic anemia is related to the inability to successfully treat patients’ underlying disease, or the...

(pp 592-595)

Mycobacterium xenopi Pneumonia in the Southeastern United States

Jihane A. Faress, MD, Lisa A. McKinney, DO, Maroun T. Semaan, MD, Ryland P. Byrd, Jr., MD, Jay B. Mehta, MD, Thomas M. Roy, MD

Abstract: Mycobacterium xenopi (M. xenopi) is a slow-growing, nontuberculous mycobacterium (NTM). This organism is found in fresh water and has been isolated in water samples collected from water systems in homes and hospitals. Before the acquired immunodeficiency syndrome epidemic,...

(pp 596-599)

Painful Diabetic Peripheral Neuropathy Relieved with Use of Oral Topiramate

Kristina M. Kline, MD, Dana G. Carroll, PHARMD, Karen F. Malnar, RN, CTR, CCRC

Abstract: Diabetic peripheral neuropathy affects 5 to 50% of people with diabetes in the United States. It is a progressive disorder that results in a gradual decrease in peripheral sensation and eventually complete loss of sensation. Patients with diabetic peripheral neuropathy are...

(pp 602-605)

Reversible Cortical Blindness after Lung Transplantation

Mark T. Knower, MD, Scott D. Pethke, MD, Vincent G. Valentine, MD

Abstract: Cyclosporine (CYA) is a calcineurin inhibitor widely used in immunosuppressive regimens after organ transplantation. Several neurologic side effects are frequently associated with CYA use; however, reversible cortical blindness is a rare manifestation of CYA toxicity...

(pp 606-612)

Epidermodysplasia Verruciformis

Joshua E. Lane, MD, Paul H. Bowman, MD, David J. Cohen, MD

Abstract: Epidermodysplasia verruciformis is an uncommon cutaneous entity characterized by persistent human papillomavirus infection. A defect in cell-mediated immunity is the suggested causative factor. Numerous specific human papillomavirus types have been detected in this disease....

(pp 613-615)

A Sewing Needle in the Liver

Bernardino Roca, MD, PhD

Abstract: An 85-year-old woman with Alzheimer's dementia was hospitalized because of prolonged fever, breathlessness, and generalized pain. Blood analysis showed an elevated erythrocyte sedimentation rate, and temporal artery biopsy showed giant cell arteritis. Prednisone therapy was...

(pp 616-617)

Pemphigus Vulgaris: An Acquired Blistering Disease

Kirby J. Scott, LCDR, MC, USN, Brian J. McKinnon, LCDR, MC, USNR

Abstract: Pemphigus vulgaris is one of a group of autoimmune disorders that are caused by autoantibodies against the desmoglein adhesion molecules of squamous epithelial cells. It is a rare form of immune dysfunction that can prove vexing to the patient and physician, but it has...

(pp 618-620)

Pulmonic Valve Endocarditis

Muhammad Tariq, MBBS, MRCP, Raymond A. Smego, Jr., MD, MPh, Adil Soofi, MBBS, Najmul Islam, MBBS, MRCP

Abstract: Pulmonic valve endocarditis is an extremely rare infection that shares epidemiologic, clinical, radiologic, microbiologic, and prognostic features with tricuspid valve endocarditis. We report a case of pulmonic valve infection on a structurally normal heart and review the...

(pp 621-623)

Improvement in Hypertrophic Cardiomyopathy after Significant Weight Loss: Case Report

Gabriel I. Uwaifo, MD, Erica M. Fallon, BS, Karim A. Calis, PharMD, MPh, Bart Drinkard, PT, MSPT, CCS, Jennifer R. McDuffie, PhD, Jack A. Yanovski, MD, PhD

Abstract: A 17-year-old obese boy found to have familial apical hypertrophic cardiomyopathy on routine screening was enrolled in a weight loss program on the basis of the hypothesis that significant weight loss would improve his cardiac status. He was followed with serial dual-energy...

(pp 626-631)

Physical Activity Levels Among Overweight and Obese Adults in South Carolina

Swann A. Adams, MS, Cheryl A. Der Ananian, MS, Katrina D. DuBose, MS, Karen A. Kirtland, PHD, Barbara E. Ainsworth, PHD, MPH

Abstract: Background: Obesity in the United States has reached epidemic proportions and is a major cause of morbidity and...

(pp 539-543)

Aromatase Inhibition for the Treatment of Idiopathic Hypogonadotropic Hypogonadism in Men with Premature Ejaculation

John M. Holbrook, PHD, Paul G. Cohen, MD

Abstract: Background: Idiopathic hypogonadotropic hypogonadism (IHH) has been observed to occur in men with premature ejaculation (PE). Common IHH therapies include testosterone replacement, which increases testosterone levels but suppresses gonadotropin release; and...

(pp 544-547)

Effect of Stress on Pregnancy Outcome among Women Undergoing Assisted Reproduction Procedures

Laurie P. Lovely, MD, William R. Meyer, MD, R. David Ekstrom, MD, Robert N. Golden, MD

Abstract: Background: This study was performed to examine the effect of stress on pregnancy outcome in women who underwent assisted reproductive technology (ART)...

(pp 548-551)

Effect of Obesity on Health-Related Quality of Life among Appalachian Elderly

R. Turner Goins, PHD, S. Melinda Spencer, BS, Debra A. Krummel, PHD, RD

Abstract: Background: There is a paucity of research on health behaviors, health status, and overall health-related quality of life among Appalachian elderly. Identifying factors among older adults that place them at risk for low health-related quality of life is important for...

(pp 552-557)

Prevalence of Overweight, Obesity, and Associated Diseases among Outpatients in a Public Hospital

Jian Huang, MD, Estela Marin MA, Herbert Yu, MD, PHD, Donna Carden, MD, Connie Arnold, PH,D, Terry Davis, PHD, Daniel Banks, MD

Abstract: Background: The prevalence of obesity is increasing and may be particularly high among indigent public hospital patients. The purpose of this study was to determine the prevalence of obesity and its associated chronic medical conditions among outpatients at Louisiana State...

(pp 558-562)

West Nile Virus Infection Presenting as Cerebellar Ataxia and Fever: Case Report

Karthikeyan Kanagarajan, MD, Sivajini Ganesh, MD, Mazen Alakhras, MD, Eddie S. Go, MD, Rose A. Recco MD, Muhammad M. Zaman, MD

Abstract: Evidence of West Nile encephalitis virus infection has been documented in most states of the continental United States within a short period of its first introduction in 1999. Health care providers are mostly aware of the usual presentations of this disease, eg, aseptic...

(pp 600-601)

Gastrointestinal Metastases from Breast Cancer: A Case Report

Moustapha Tohfe, MD, Paul Shami, MD, Georges Aftimos, MD, Michel Saade, MD

Abstract: Breast cancer is the most frequently encountered cancer in women and the second leading cause of cancer death. Distant metastases are present in about 60% of the patients at the time of diagnosis. 1 The lymph nodes, lung, bone, liver, peritoneal cavity, and brain are the...

(pp 624-625)

Obesity and the Heart: An Ever-growing Problem

Carl J. Lavie, MD, Richard V. Milani, MD, Franz H. Messerli, MD

Abstract: Recent evidence indicates that the prevalence of overweight and obesity in the United States has been increasing at epidemic proportions over the past two decades, and that the impact of obesity and cardiovascular diseases is being appropriately and increasingly recognized....

(pp 535-536)

Obesity: An Epidemic

Ronald C. Hamdy, MD, FRCP, FACP

Abstract: More than half of the adults in the United States today are either overweight or obese, compared with about 25% in the 1960s. 1,2 The prevalence of obesity increased by 5.6% between 2000 and 2001 alone. Obesity is associated with increased mortality risk, and statistics...

(pp 531-532)

Management and Treatment of Obesity

Claire A. Zizza, PHD

Abstract: Although there is no longer any doubt that obesity poses a health risk for individuals and is a tremendous public health problem in the United States, little research has been conducted to study the effect of obesity on the use of health services. In this issue of Southern...

(pp 537-538)

Stress and Infertility

Randall S. Hines, MD

Abstract: I'm under a great deal of stress at work. Will this affect my upcoming IVF cycle?” Patients commonly ask this question in my practice, and Lovely et al 1 address the subject in this issue of Southern Medical Journal. In their study, Lovely et al measured cortisol and...

(pp 533-534)

Extraintestinal Hodgkin's Disease in a Patient with Crohn's Disease

Joseacute Manuel Calvo-Villas, MD, Mariacute a Jose Ramirez Sanchez, MD, Jorge Cuesta Tovar, MD, Carlos Garciacutea, MD

Abstract: To the Editor: The relationship between Crohn's colitis and non-Hodgkin's lymphoma is well established. 1,2 Only a few publications that associate Crohn's disease (CD) with Hodgkin's disease (HD) have been reported, however. We report an unusual case of a patient who...

(pp 632)

A Different Therapeutic Approach in Patients with Severe Ulcerative Colitis: Hyperbaric Oxygen Treatment

Ahmet Kemal Guumlrbuumlz, MD, Emin Elbuumlken, MD, Yusuf Yazgan, MD, Senol Yinodotldinodotz, MD

Abstract: ...

(pp 632-633)

Arsenic and Heavy Metal Poisons

Phillip Rouss, Jr.

Abstract: To the Editor: In April 1997, shortly after opening an antique automobile restoration business, I gradually began to experience several debilitating illnesses. My symptoms included severe burning sensations in my hands and feet, which ultimately resulted in what is known as...

(pp 632-633)

Can Angiotensin-converting Enzyme Inhibitors Reverse Atherosclerosis?

John P. Higgins, MD, MPhil

Abstract: Angiotensin II, a potent vasoconstrictor, is mainly present in the vascular endothelium. Multiple studies have confirmed that angiotensin-converting enzyme (ACE) inhibitors, which block the formation of angiotensin II, lower blood pressure and also improve heart failure....

(pp 569-579)