SMJ // February 1977, Volume 70 - Issue 2
Editorial
PREVENTION OF PREMATURITY
Editorial
GENERAL ANNOUNCEMENTS
Article
Clinical Correlates of Bone Marrow Plasmacytosis
ABSTRACT:In light of the variable clinical expression and bone marrow plasmacytosis of multiple myeloma, we studied prospectively the prevalence and clinical correlates of bone marrow plasmacytosis in 133 anemic medical inpatients. Seventeen patients (13%) had 5% or more, and four patients (3%) had 10% or more marrow plasma cells. Only…
Article
Urinary Estriol for Assessment of Fetoplacental Function
ABSTRACT:A total of 1,607 urinary estriol determinations were performed in 447 patients with normal and complicated pregnancies. In general, the test provided reliable information concerning fetal status, particularly in pregnancies complicated by toxemia, diabetes, and postmaturity. When measured consecutively, a drop of 50% or more in estriol level usually should…
Article
Foreign Bodies in the Hand in Children
ABSTRACT:Foreign bodies in the hand in children are best managed when the surgeon has a well-organized approach to the total problem. The procedure of restraining a child, infiltrating the wound with local anesthetic, and probing the wound deep in the hand on the day of injury to remove the foreign…
Article
Leptospirosis A Neglected Cause of Nonbacterial Meningoencephalitis
ABSTRACT:Two cases of leptospirosis with different clinical presentations are presented. The importance of recognizing mild, nonicteric and meningoencephalitic forms in order to identify vectors and contaminated areas and prevent further infections is emphasized. Cerebrospinal fluid (CSF) findings in reported cases of leptospirosis are reviewed and possible prognostic implications of CSF…
Article
Psychologic Response to Coronary Artery Bypass
ABSTRACT:This study reports the psychologic findings in 30 patients undergoing this operation. Approximately one third developed postcardiotomy delirium, an occurrence consistent with that after other forms of open-heart surgery. Acceptance of the operation as opposed to preoperative anxiety, depression or denial, adequate comprehension of the proposed procedure, and a stable…
Article
Close Monitoring Is Essential During Isoniazid Prophylaxis
ABSTRACT:A three-year prospective study during the entire course of preventive therapy with isoniazid (INH) for recently infected hospital employees was undertaken to evaluate the risk of developing INH-related hepatic injury. Results of clinical and laboratory tests at 1, 2, 6, and 12 months were correlated to ascertain the significance and…
Article
Hypertension, Blood Pressure Variability, and Juvenile Delinquency
ABSTRACT:Although the possible role of hypertension and/or blood pressure variability in the causation of juvenile delinquency has not been directly investigated hitherto, there is evidence to suggest (a) that an excess prevalence of blood pressure, variability rather than hypertension is the aspect of cardiovascular functioning which characterizes adolescents, and some…
Article
Pancreatic Encephalopathy
ABSTRACT:Cerebral, fat embolism was established as the cause of death in a 34-year-old man with acute pancreatitis. Encephalopathy complicating pancreatitis may be due to hypoxia secondary to pulmonary fat embolism, cerebral fat embolism, or the complicating syndromes of disseminated intravascular coagulation or hyperosmolality.
Article
Adoption in Evolution Recent Influences on Adoption in Virginia
ABSTRACT:Adoption is a relatively new and evolving institution. The characteristics of children available for adoption are changing. Some hard-to-place children will be helped by subsidized adoption. The concept of children as property of biologic parents continues to shadow efforts to terminate parental rights. Virginia law allows adoption against parental consent…
Article
Dislocation of the Elbow A Retrospective Study of 115 Patients
ABSTRACT:Of the 115 elbow dislocations treated at two New Orleans hospitals between 1959 and 1969, 78% were posterior. Sixty-one percent of the patients were 21 years of age or younger, and the male-female ratio was 1.7:1.0. The most common associated injuries were fractures of the medial condyle or epicondyle. All…
Book Review
Bedside Diagnosis
Book Review
Vitamins in Your Life
Book Review
Lifespan—and Factors Affecting It
Article
Acetabular Labrum Tears A Cause of Hip Pain and Degenerative Arthritis
ABSTRACT:A torn acetabular labrum causing disabling hip pain has been noted in two patients. One patient had obvious erosion of the articular surfaces of the femoral head and acetabulum corresponding to the location of the displaced torn labrum. Excision of the torn labrum fragments afforded relief of the symptoms. In…
Article
Ascariasis—Its Complications, Unusual Presentations and Surgical Approaches
ABSTRACT:Serious complications of ascariasis are varied and occur at all stages of worm development. The acute condition within the abdomen heralds the presence of intestinal, pancreatic, or biliary tract obstruction secondary to the physical presence of the adult parasites. Larvae may be responsible for acute respiratory disease, either as a…
Article
Intraoperative Ureteral Catheterization in Pelvic and Abdominal Operations
ABSTRACT:Ureteral catheters are often inserted as a preliminary procedure before pelvic operations. We recommend insertion of ureteral catheters only if they are needed and during the operative procedure through a cystotomy or ureterotomy. Assessment of the need for catheterization is best made intraoperatively rather than preoperatively.
Article
Synovectomies in Moderately to Severely Involved Rheumatoid Knees An Alternative to Implant Arthroplasty
ABSTRACT:A retrospective study of 19 synovectomies revealed significant relief of pain for two to ten years in selected patients with moderate to severe rheumatoid arthritis of the knee diagnosed roentgenographically. The usual indications for this procedure may be extended to include well-motivated patients when synovectomy is combined with good medical…
Article
Advocacy and Compliance Factors in a Voluntary Selective Screening Program
ABSTRACT:To evaluate factors responsible for compliance with a voluntary selective screening program, we surveyed 495 participants and 212 nonparticipants in a screening program for Tay-Sachs disease. Knowledge about the program and motivation are the most important factors in compliance. The primary incentive for participation was to avoid having abnormal children…
Article
Cholecystostomy—An Old Dog With New Tricks
ABSTRACT:A large minority of patients having cholecystostomy show cystic duct or common duct stones on postoperative tube cholangiograms. The use of mechanical (Dormia stone basket) and chemical (heparin and sodium cholate) means to remove gallstones via the cholecystostomy fistula reduces the need for additional surgery (ie, cholecystectomy), which is particularly…
Article
A Comparative Review of Cylindrical Inlay Facet Fusions for Scoliosis
ABSTRACT:Results in three series of spinal fusions with Harrington instrumentation for scoliosis were compared. Patient ages ranged from 9 to 22 years, and follow-up from 12 to 105 months. Cylindrical inlay facet grafting was done in all cases. Supplemental heterologous bone was used in the first series of 51 cases,…
Article
Medical Education Retrospective and Prospective Observations
ABSTRACT:Significant advances in medicine have occurred in the past 50 years. Medical education, too, has undergone many changes, and is due for an in-depth study and appraisal similar to that of the 1910 Flexner report. Some of the changes in medical education discussed include excessive emphasis on incurable diseases and…
Article
Cardiovascular Malformations Associated With Choanal Atresia
ABSTRACT:In this study, cardiovascular malformations were present in 11 of 63 (17.5%) patients with choanal atresia. The most frequently encountered cardiac lesions were ventricular septal defect and patent ductus arteriosus, while cyanotic heart disease was uncommon.
Article
Evaluation of Autosutures in Gastrointestinal Surgery
ABSTRACT:Autosuture surgical instruments were used in over 300 gastrointestinal operations including 60 gastric resections. The technic and its advantages and disadvantages are reviewed, specifically for gastric surgery. Operating time required has been decreased, and results have been good. The instruments have wide application, and their safety has been proved.
Article
Gastrocolic Fistula Secondary to Benign Gastric Ulcer Not Operated Upon Case Report and Review of Literature
ABSTRACT:A case report and review of the literature of benign gastric ulcer complicated by gastrocolic fistula are presented. Twenty-seven percent of patients were found to be receiving ulcerogenic medications. Only 15% of patients had previous histories of ulcer disease. Parameters most suggestive of a neoplastic process included palpable abdominal mass…
Article
Reevaluafion of Neonatal Hemophilus influenzae Infections
ABSTRACT:Hemophilus influenzae infections are increasing in frequency in the general population. As a result this organism must be considered an etiologic agent of disease in the neonate. Proper culture technics must be routinely employed to isolate this fastidious organism, and appropriate antimicrobial therapy must be instituted in infants suspected of…
Article
Mammary Tuberculosis A Rare Modern Disease
ABSTRACT:Tuberculosis of the breast has become a rare disease since the advent of antituberculous chemotherapy. The incidence of tuberculous mastitis at Vanderbilt Hospital for the last two decades was 0.025% of surgically treated breast disease. This probably reflects its prevalence in economically developed parts of the world. The pathologic diagnosis…
Article
Social Effects of Leg Ulceration in Sickle Cell Anemia
ABSTRACT:The relationship between chronic leg ulceration and the education, employment, and familial relationships of adults with homozygous sickle cell disease was studied. There was a significant correlation between the age of onset of leg ulceration and educational attainment. Patients in the leg ulcer group demonstrated lower educational attainment, had greater…
Article
An Educational Program for the Rational Use of Antimicrobial Agents
ABSTRACT:A rational approach to the proper use of antibiotics must include knowledge of microbial sensitivities to various agents, proper alternative choices, pharmacologic considerations, and the cost to patient and hospital of drugs prescribed. A logical program for analysis of use of antibiotics and proper administration is presented. Since the largest…
Article
Venous Aneurysms
ABSTRACT:Primary venous aneurysms are rare lesions, but they can sometimes lead to serious complications. A report of a venous aneurysm in an unusual location is presented, with a review of the literature.
