SMJ // October 1976, Volume 69 - Issue 10
Editorial
ABBREVIATED WRITING
Commentary
High School Football Injuries
Commentary
High School Football Injuries Prevention of Injury to the Central Nervous System
Injuries to the head, neck, and spinal cord of high school athletes account for over 90% of the fatalities directly related to football. Preseasonal and seasonal guidelines that have proven to be helpful in the prevention of these injuries are presented.
Commentary
Hypoglycemia The “Undisease”
Patients with a wide variety of medical problems have been labeled as having “hypoglycemia” during the past several years. Hypoglycemia, however, indicates only a diminished content of blood or plasma glucose. In individual cases the existence of hypoglycemia needs to be ascertained by objective laboratory measurements. Once confirmed, it is…
Commentary
Chronic Mesenteric Arterial Insufficiency Results of Revascularization in 33 Cases
The symptoms of mesenteric arterial insufficiency and the advantages of surgical revascularization have become widely recognized in recent years. Follow-up data are accumulating on patients who have had surgery for revascularization. In this study we report on 33 patients who had mesenteric revascularization for intestinal angina. Twenty-nine patients presented with…
Commentary
Harrington Instrumentation in Fractures and Dislocations of the Thoracic and Lumbar Spine
Harrington instrumentation was used to treat 23 injuries of the thoracic and lumbar spine accompanied by neural damage encountered during an 8-year period. The indication for the use of Harrington instrumentation is instability of the thoracic or lumbar spine due to trauma, laminectomy, or both. Of the 13 patients with…
Commentary
Usefulness of Serial Carcinoembryonic Antigen (CEA) Determinations in Monitoring Chemotherapy
Serial carcinoembryonic antigen (CEA) levels were measured during chemotherapy for metastatic cancer in 94 patients. Criteria for chemotherapy responses were those used by the Central Oncology Group. Patients were classified according to changes in CEA levels and response to chemotherapy. Four categories represented a positive correlation: (1) increasing abnormal CEA…
Commentary
Skin Changes in Graft‐vs-Host Disease
In this review of the clinical and histopathologic manifestations of the graft-vs-host reaction, the characteristic changes in the skin are given particular emphasis, since they are among the earliest and most obvious signs of this syndrome. The acute and chronic forms of graft-vs-host disease are distinguished, with notation of their…
Commentary
Current Management of Pelvic Fractures A Combined Surgical‐Angiographic Approach to Hemorrhage
Pelvic retroperiloneal hemorrhage after pelvic fracture accounts for the high mortality and morbidity associated with this injury, a concept confirmed by analysis of 357 patients with pelvic fractures at the University of Kentucky Medical Center. The overall mortality of 9.8% was almost exclusively limited to patients with unstable fractures or…
Commentary
Practical Uses of a Quantitative Renal Scintillation Camera Study
A quantitative renal scintillation camera study has been described for the evaluation of total renal function and the split function of the two kidneys by a noninvasive technic. It requires no patient preparation, is not affected by bowel gas, and no allergic reactions have been reported. Six cases are reported…
Commentary
Anesthesia for EMI Scanning in Infants and Small Children
Computerized transverse axial scanning is a new, noninvasive method of diagnosing intracranial and orbital lesions. It is mandatory that the patient's head be motionless throughout the scanning procedure. This requirement creates problems in managing infants and small children for the scanning process. Ketamine hydrochloride was given intramuscularly to produce the…
Commentary
The Ocusert Pilocarpine System Advantages and Disadvantages
Thirty-four patients with glaucoma were treated with the Ocusert pilocarpine system, a unique method of providing round-the-clock delivery of pilocarpine in the eye for seven-day periods. Advantages of the device include therapeutic effectiveness and continuous release rate, less effect on accommodation, less miosis, convenience for the patient, and reliability in…
Commentary
Gallbladder Disease in Patients 20 Years of Age and Under
Cholecystitis is uncommon in individuals under 21 years of age and, when present, usually is associated with pregnancy, sepsis, metabolic defects, hemolytic anemia, or hereditary disorders. Over the past 4 years, 92 patients 20 years of age and younger have been admitted to our institution with gallbladder disease. Of these…
Commentary
Subacute Necrotizing Encephalopathy (Leigh's Disease) Two Unusual Cases
Two unusual cases of subacute necrotizing encephalopathy are described. In one, a marked hirsutism led to a suspicion of adrenal tumor or other endocrinopathy. In the other case, there was an agenesis of the corpus callosum, the second instance in which a malformation of the corpus callosum was associated with…
Commentary
Lens Surgery With the Vitreous Infusion Suction Cutter
The vitreous infusion suction cutter was used in the removal of congenital and adult cataracts or lens remnants. The instrument may be used through a standard corneoscleral incision or through the pars plana. When a hard nucleus cannot be dispersed, ultrasonic phacofragmentation may be of help. Several brief case illustrations…
Commentary
Modification of Blood Flow to the Extremities by Electrical Stimulation of the Nervous System
Sixteen patients who had electrical stimulation applied to various portions of the nervous system were examined for increase in blood flow to the extremities. Clinical observations and a one-channel plethysmograph were used to measure arterial dilatation. Seven patients had transcutaneous stimulation applied over the cervical or thoracic spinal cord, peripheral…
Commentary
An Antacid Tasting The Relative Payability of 19 Liquid Antacids
The taste of liquid antacids is proposed as a major factor in patient compliance in taking such medication when prescribed. A study was made of the relative palatability of 19 antacids: The antacids can be divided into three groups of varying palatability (p < 0.05).
Commentary
Atypical Radiographic Appearance and Clinical Presentation of Pulmonary Tuberculosis
Fourteen patients with unusual presentations of pulmonary tuberculosis are described. Often, exposure to the tubercle bacillus was not apparent. In other cases, there was tuberculous infection or reactivation of a previous focus in individuals with altered immunity. The radiographic presentation often differed from the classic cavitating upper lobe disease. Persistent…
Commentary
Fantasy and Self‐Esteem of Renal Dialysis Patients and Their Spouses
The fantasy life and self-esteem of 22 male and 13 female renal dialysis patients and their spouses were examined using a Self-Esteem Evaluation Scale, Empathic Fantasy Scale, and eight portions of the Imaginal Process Inventory reflecting eight types of fantasy use. For the patient group as a whole, a high…
Commentary
Duodenal Crypts
During the course of 2,340 barium examinations of the upper gastrointestinal tract, four male patients were found to have multiple small outpouchihgs on the surface of the duodenal bulb. These findings, designated duodenal crypts, are considered to be asymptomatic and are not to be confused with inflammatory changes. The endoscopic…
Commentary
The Cost of Auditing Outpatient Records
When patient records are to be audited in a program designed to assess the quality of medical care rendered, careful consideration must be given to the cost of the system implemented. Structured data collection and a defined treatment plan are advantageous in facilitating the use of nonphysicians for the majority…
Commentary
Treatment of Cystic Hygroma
To determine ideal treatment, 58 patients with cystic hygroma of the neck were studied. Approximately equal distribution of the lesion among sexes and sides of the neck was noted, but frequency was less than expected among blacks. Complete excision, the treatment of choice, gave an 81% cure rate. Partial excision…
Commentary
Association of Tuberculosis With Alcoholism
To define the extent of the association between tuberculosis and alcoholism, all cases of tuberculosis reported in 1972 to the Fulton County Health Department (Georgia) were reviewed. Alcoholics accounted for 49% of all adult cases. Because of this high association, alcoholics should be screened regularly for possible tuberculosis.
Commentary
Obscure Distal Femoral Epiphyseal Injury
Undisplaced type I epiphyseal fracture of the distal femur in the adolescent athlete may mimic injury to a ligament. Roentgenographic examination with the knee under stress will reveal the diagnosis, thereby avoiding unnecessary arthrotomy and dictating appropriate treatment and follow-up.
Commentary
Shigellosis Transmitted by Nurses
Twelve cases of Shigella sonnei infection, with two deaths, occurred at a custodial institution in Donelson, Tennessee, in April and May 1973. Nine of the cases and both deaths were in patients hospitalized at the institution's infirmary. The patients with nosocomial shigellosis were significantly younger and had been hospitalized significantly…
Commentary
Vaginal Candidiasis its Diagnosis and Relation to Urinary Infection
candidal vaginal cultures performed on 100 women who gave a history of a specific symptom complex, 85% were positive. In contrast, only 3% were positive in 100 women who did not have this history. The data indicate a definite relationship between the symptom complex and vaginal candidiasis. An additional 110…
Commentary
A Review of Tibial Lengthening Procedures
Eight patients had tibial lengthening procedures according to Anderson's method. The necessity of early determination of callus formation and bone grafting, if necessary, is emphasized. The potential morbidity in this procedure is great and the parents must be made fully aware of them. As Anderson states, it is a procedure…
Commentary
Human Sexuality An Interdisciplinary Program for Health Care Professionals and the Physically Disabled
The central feature of a program In human sexuality for health care professionals and persons with physical disabilities developed at the Texas Institute for Rehabilitation and Research (TIRR) is a 2-day Sexual Attitude Reassessment (SAR) Workshop. Although the content of this Workshop has many features in common with ones used…
Commentary
Agranulocytosis Secondary to Methimazole Therapy Report of Two Cases
Seventy-three cases of thyrotoxicosis were treated at Lloyd Noland Hospital with methimazole, propylthiouracil or both. Two cases of agranulocytosis occurred (2.7%) secondary to methimazole. Both responded to hospitalization, reverse isolation, and antibiotic coverage with complete recovery of the peripheral blood picture. The toxicity of methimazole is noted. The need for…
Review Article
Placental Transport of Nutrients
Current Concepts
Malignancies in Blood‐Forming Organs Following Diagnostic and Therapeutic Procedures A Review
Ionizing radiation used for diagnosis or therapy has been associated with an increased incidence of malignancies of blood-forming organs. The increased incidence of hematopoietic malignancies following exposure to ionizing radiation obtained in the course of occupation, diagnosis and therapy of disease, or as a weapon of war is documented. The…
Current Concepts
A Comparison of Modern Methods of Reduction Mammaplasty
There are many technics available today for reducing the oversize female breast. The most commonly used operations may be divided into two categories, depending on treatment of the nipple-areolar complex: (1) free graft or (2) transposition on underlying tissue. According to this division, various methods are outlined and discussed.
