SMJ // August 1973, Volume 66 - Issue 8
Commentary
Medical Ethics and Medical Education
Primary Article
Neurologic Findings in Retroperitonal Mass Lesions
The case records of 42 patients with biopsy-proven retroperitoneal lesions were reviewed. Eleven patients had neurologic findings. In these the signs and symptoms pointed to involvement of the lumbosacral plexus in a variety of ways, and no consistent neurologic syndrome emerged as being characteristic of lesions in this location. If…
Primary Article
Recovery Scoring Revisited
The authors offer a system of scoring in the recovery room to evaluate the patient in the postanesthetic period. They hope this system can circumvent the numerous systems developed which, however, do not permit of easy comparisons.
Case Report
Viral Hepatitis in Home Hemodialysis
Primary Article
Autonomic Hyperreflexia in Spinal Cord Injury
Bladder distention in the quadriplegic patient with a spinal cord injury above the fourth thoracic segment causes an exaggerated automatic response via the spinothalamic tracts and an autonomic outflow of the vasomotor center, resulting in hypertension and bradycardia. Although the usual clinical manifestations are mild, severe complications and even death…
Primary Article
Differential Diagnosis of Tall T Waves in the Resting Electrocardiogram
Tall T waves are characteristic of a limited number of conditions. Tall T waves are associated with increased QRS voltage or conduction abnormalities in left ventricular hypertrophy and left bundle branch block. High voltage of the T wave unaccompanied by high QRS voltage may be present in acute myocardial infarction,…
Primary Article
Postpartum Pituitary Insufficiency: Report of Five Unusual Cases with Long-Term Follow-up
Five cases of postpartum pituitary insufficiency are reported. The manifestations of the disease vary with the degree of absence of particular trophic hormones. Pituitary damage is not necessarily proportional to the degree of blood loss. Irregular and scanty menstrual periods resulted in one of the patients although otherwise symptomatic. Adrenal…
Primary Article
Gliomatosis Cerebri: A Case Report and Review of the Literature
A clinicopathologic study of a case of gliomotosis cerebri is described in 41-year-old man who had progressive memory loss, confusion, and mental deterioration. He developed bilateral signs in the last month of hospitalization and died 13 months after the onset of the symptoms. Postmortem examination showed the brain to be…
Primary Article
Serratia Arthritis: Report of Three Cases
Serratia marcescens arthritis is rare. Three patients with debilitating illness and Serratia arthritis are reported. Infectious arthritis was diagnosed after joint destruction had occurred. Early diagnosis is essential if destruction is to be kept at a minimum.
Primary Article
Psychotropic Drug Treatment of Mixed Anxiety and Depression in Nonpsychiatric Office Patients Expected and Unexpected Findings—Comparing Doxepin, Chlordiazepoxide and Placebo
The present study was designed to compare the efficacy of doxepin (a tricyclic antidepressant with antianxiety properties), chlordiazepoxide (a benzodiazepine antianxiety compound), and placebo in nonpsychiatric, moderately anxious-depressed patients commonly seen by a family practitioner. Patients treated with doxepin improved significantly by a reduction in the severity of symptoms of…
Primary Article
Stroke: Malignant and Benign Syndromes
Treatment of cerebrovascular disease is faciliated by determining the clinical presentation (transient ischemic attacks, progressing stroke, and completed stroke), the anatomic area involved (disease of the large vs small vessels, disease of the carotid vs basilar vertebrae), and the etiology: occlusive (thrombotic or embolic) or hemorrhagic (subarrachnois or intracerebral) vascular…
Primary Article
Pseudotumor in a Patient with Factor IX Deficiency
The occurrence of hemophilic pseudotumor, or bone cyst, is rare and its excision has not often been attempted. The successful removal of such a devastating lesion from a patient with factor IX deficiency has not been described previously. This report describes the use of a commercially available concentrate of human…
Primary Article
Regional Enteritis and Growth Retardation Without Intestinal Symptoms
Severe growth failure associated with regional enteritis can occur even in the absence of intestinal symptoms. This association is more likely when the disease is present in the jejunum or proximal ileum. Accordingly, roengenographic barium study of the small bowel is essential in the diagnosis of this occult condition. In…
Primary Article
Chronic Tricuspid Insufficiency
The authors report the fourteenth instance of chronic traumatic tricuspid regurgitation. Pericardial rupture and cardiac torsion are the usual concomitants of severe injury to the chest which lead to the valvular incompetency. The authors report upon the hemodynamics of the lesion and comment on management.
Primary Article
Comparison of Carbenicillin and Penicillin in the Treatment of Uncomplicated Gonorrhea
This paper presents the results of a Phase II controlled study evaluating the effectiveness of a new drug, carbenicillin, in the treatment of uncomplicated gonorrhea in men and women. Aqueous procaine penicillin G was used as the control drug. Intramuscular injections of carbenicillin and penicillin were found to be of…
Primary Article
Use of Temporary Prostheses to Repair Difficult Hernias
Temporary prostheses made of Silastic-encased Dacron sheets have been demonstrated both experimentally and clinically to have considerable potential for repair of abdominal wall defects which are not amenable to conventional surgical management. The fact that they are used only temporarily while they generate a host-tissue reaction which serves to correct…
Primary Article
Is Coronary Care Really Feasible in Small Rural Hospitals?
In 1968, 13 coronary care beds were established in eight small community hospitals in rural western North Carolina. Physician and nurse education programs in coronary care were conducted. The cumulative mortality rate in hospitalized patients with myocardial infarction prior to opening of these beds was 33% (40 of 120); the…
Primary Article
Elimination of Surgical Wound Infections by Delayed Primary Closure
Invasive infection of major surgical wounds continues as a serious problem. In spite of good surgical technics, proper wound draping, irrigation, local and systemic antibiotics, etc, the incidence of wound infections remains unacceptably high. In an attempt to solve this problem, a technic was developed wherein primary closure of the…
Current Concepts
Current Concepts in Therapy: General Concepts in the Use of Antibiotics in Adults
Appropriate antibiotic use require an accurate knowledge of the anti-microbial susceptibility of the drug to be given, sound clinical reasoning as to why the drug is being given, and whether it will reach the site of the pathogen in adequate concentrations without producing serious side effects. Physicians also should be…
Review Article
Unusual Lesions Involving the Sella Turcica
Ten cases of unusual lesions involving the sella turcica are presented to demonstrate their variance with neurologic, endocrinologic, and neuro-radiologic principles. These lesions, as well as other lesions described inthe literature, would indicate the hazard of making a specific diagnosis without biopsy. The application of the transsphenoidal microscopic approach to…
