SMJ // June 1978, Volume 71 - Issue 6
Editorial
DIAGNOSTIC AND THERAPEUTIC TENESMUS
Announcement
GENERAL ANNOUNCEMENTS
Commentary
Fund Raising The Ends Versus the Means
Primary Article
Recurrent Disseminated Histoplasmosis
ABSTRACTA patient who has had three distinct recurrences of disseminated histoplasmosis over 22 years is presented. Measurements of cellular and humoral immune response to histoplasmin antigens were compared with previously reported data. Although initially sulfisoxazole therapy led to regression of disease, over the past 13 years she has required three…
Primary Article
Admission Screening for Hepatitis B Surface Antigen in a University Hospital
ABSTRACTUpon admission to the hospital, 7,984 patients were tested for hepatitis B surface antigen (HBsAg) by radioimmunoassay. Seventy-one patients had sera positive for HBsAg. Twenty-four (34%) were possible asymptomatic carriers in whom liver function was not further evaluated and occult liver disease could not be excluded; 16 (23%) had either…
Primary Article
Rocky Mountain Spotted Fever Gastrointestinal and Laboratory Manifestations
ABSTRACTSixty-six cases of serologically documented Rocky Mountain spotted fever (RMSF) from North Carolina are reviewed. Gastrointestinal manifestations were present in 80% of these patients. Because other common expressions of RMSF occasionally do not accompany severe gastrointestinal dysfunction, improper diagnosis and therapy can result. Sixty percent of the patients had hyponatremia…
Primary Article
St. Louis Encephalitis in Memphis‐Shelby County, Tennessee, 1975 Epidemiologic Aspects of Human Cases
ABSTRACTAn epidemic of St. Louis encephalitis (SLE) occurred in Memphis-Shelby County, Tennessee, in the summer of 1975, as part of an outbreak involving large portions of the Eastern United States. A total of 187 suspected cases were reported, of which 62 were laboratory-confirmed or presumptive SLE. The overall attack rate…
Primary Article
Staphylococcal Endocarditis in Addicts
ABSTRACTWe retrospectively reviewed 55 episodes that fulfilled criteria for Staphylococcus aureus endocarditis in 50 drug addicts. The most common presenting symptoms were fever (90%), chest pain (58%), and cough (43%). All patients had evidence of right-sided heart involvement, and a murmur of tricuspid insufficiency was noted in 42%. Evidence of…
Primary Article
Multivalvular Vegetations in a Patient With Enterococcal Endocarditis Diagnosed by Echocardiography
ABSTRACTA patient with enterococcal endocarditis of 11 months' duration is presented, and the role of surgery and echocardiography is reviewed. Echocardiography revealed vegetations of the aortic and mitral valves. After appropriate antibiotic therapy the patient had successful aortic and mitral valve replacement with porcine heterografts. Enterococcal endocarditis is increasing in…
Primary Article
Traumatic Coronary Artery Fistula
ABSTRACTWe report certain diagnostic and therapeutic problems presented by patients with traumatic coronary arteriovenous or arteriocameral fistulas, based on our experience with one case and our review of cases which have previously been reported in detail.
Primary Article
Left Ventricular Aneurysms Caused by Blunt Chest Trauma
ABSTRACTThis report describes the case of a 25-year-old man who suffered blunt chest trauma with resultant development of an asymptomatic left ventricular aneurysm which was successfully resected. A review of the literature reveals 25 reported cases of left ventricular aneurysm due to blunt trauma since 1892. The clinical findings and…
Primary Article
Intravenous Procaine for General Anesthesia in Dogs A New Look at an Old Technic*
ABSTRACT: New anesthetics have been introduced during the last 25 years which are not without inherent disadvantages. They are expensive, and some produce nephrotoxicity and possibly hepatotoxicity. Although the use of procaine intravenously as an anesthetic has been discarded, probably because of a convulsive effect, it is believed this disadvantage…
Primary Article
VIGNETTES ON MEDICAL WRITING Subtle Discrimination in Language
Primary Article
Posterior Spinal Fusion With Harrington Instrumentation Using “Balanced” Anesthesia
ABSTRACTIn our experience nitrous oxide-oxygen-morphine-curare anesthesia has proved preferable because of the need for swiftly awakening patients after instrumentation to ascertain neurologic status. Adjunctively, doxapram has been used to awaken patients in a predictably short time span. To prevent massive blood loss, hypotension has been attained by pentolinium, trimethaphan camsylate,…
Primary Article
Intercostobrachial Nerve Entrapment Syndrome
ABSTRACTFive patients with intercostobrachial nerve entrapment syndrome are reported. The pain in this syndrome has three aspects: somatic stimulus, perceptual surround, and behavioral response. Each must be dealt with appropriately. The distribution of the pain, its anatomic basis, and its treatment are discussed.
Primary Article
Compensation for Work‐Related Injuries and Rehabilitation of Patients With Chronic Pain
ABSTRACTA group of 61 patients with problems of chronic pain were managed through a rehabilitation program based on the principles of operant conditioning. Of these patients, 35 were receiving compensation for work-related accidents, and 26 were receiving no financial compensation for their chronic pain. Of the patients not receiving compensation,…
Primary Article
Double‐Blind Comparison of Lidocaine and Etidocaine During Continuous Epidural Anesthesia for Vaginal Delivery
ABSTRACTEtidocaine 0.5% plain, etidocaine 0.5% with epinephrine 1:200,000 and lidocaine 1% with epinephrine 1:200,000 were compared in a series of patients receiving epidural anesthesia for vaginal delivery. Results, based on data from 48 patients, showed a significant increase in the duration of action (P < .01%), the degree of sensory…
Primary Article
Abdominal Pregnancy Pathogenesis, Diagnosis, and Treatment
ABSTRACTA ten-year survey of abdominal pregnancy was made regarding numbers, diagnosis, and treatment. The hazards of intraperitoneal infusion of concentrated saline, thought to be administered into the amniotic sac, in an attempt to produce abortion is discussed. A favorable result was obtained after laparotomy was done and the correct diagnosis…
Primary Article
Use of Doxycycline in Elective First Trimester Abortion
ABSTRACTElective first trimester abortion was performed in 263 patients, including 86 control patients and 177 patients receiving doxycycline as prophylactic antibiotic coverage. Abortions were, done by the same physicians, using a standard protocol. Control and study populations had similar courses, except that the incidence of major complications and total complications…
Primary Article
Changing Normal Values for Thyroid Uptake of Radioactive Iodine
ABSTRACTThe 24-hour radioactive iodine uptake remains a very useful clinical tool for evaluating the thyroid gland; however, the normal values have changed over the years. The traditional values of 15% to 45% are clearly not applicable today and the revised values of 9% to 32% are suspect in some areas…
Primary Article
Treatment of Constipation in Geriatric and Chronically Ill Patients A Comparison
ABSTRACTThe difficulties of adequately managing constipation, particularly in patients with impaired or limited mobility as a result of surgery, cardiovascular or cerebral disease, or advanced age, led us to evaluate the use of stool softeners in a homogeneous group of institutionalized patients. Comparison was made between dioctyl sodium sulfosuccinate (DSS)…
Article
Saturday Conference A Clinician Looks at the Aminoglycoside Antibiotics
ABSTRACTAminoglycoside antibiotics provide physicians with valuable drugs for coping with serious, often hospital-acquired gram-negative rod infections which are occurring with increasing frequency. Use of these agents may be advantageous and even lifesaving. There are potential hazards associated with their administration. Narrow therapeutic indices coupled with susceptibility to degradation by resistant…
