SMJ // February 1979, Volume 72 - Issue 2
Editorial
SYPHILITIC HEARING LOSS
Editorial
GENERAL ANNOUNCEMENTS
Editorial
Aseptic (Avascular) Necrosis of the Femoral Head in Psoriasis
ABSTRACTAseptic (avascular) necrosis of the femoral head associated with psoriasis is reported. The clinical histories of nine patients with avascular necrosis of the femoral head and one patient with bilateral humeral head osteonecrosis are summarized. Psoriasis was the only associated condition found in three of the patients. Only two patients…
Editorial
Conjunctival Biopsy in the Diagnosis of Sarcoidosis
ABSTRACTThe diagnosis of sarcoidosis with ocular involvement is often difficult and accompanied by a certain measure of uncertainty due to a paucity of additional physical signs. In the ophthalmic literature, it is controversial as to whether biopsy of a clinically normal conjuctiva should be done if sarcoidosis is suspected. Many…
Editorial
Cancer Associated With Collagen‐Vascular Disease
ABSTRACTTwo cases of cancer, each associated with a different collagen-vascular disease, are reported. The first patient, a 71-year-old white man, had a history of acute dermatomyositis and malignancy for a few weeks only. Death was associated with adenocarcinoma of the lesser curvature of the stomach with metastases to the liver…
Editorial
Septicemia in Children With Cancer
ABSTRACTBecause of the persistently high mortality from sepsis in cancer patients, a retrospective study was designed to identify the causative organisms and to determine the factors affecting the outcome of sepsis. A total of 84 episodes of septicemia in 61 children with cancer were studied. The more frequently isolated organisms…
Editorial
Typhoid Fever in Children A Forgotten Disease?
ABSTRACTAll indexed cases of typhoid fever occurring in children over a ten-year period in Jacksonville, Fla, were studied retrospectively. This review revealed that anorexia was the most common gastrointestinal complaint and that neurologic symptoms and signs were nearly as common as gastrointestinal signs. There was a significant delay in diagnosis…
Editorial
Influenza 1978
ABSTRACTDuring January and February 1978, an outbreak of respiratory infection occurred at Fort Sam Houston, Texas. Both influenza A/Texas and A/USSR were isolated in the hospitalized patients. Two different strains of influenza A have not previously been documented during a single outbreak. This raises the possibility of recombination with emergence…
Editorial
Tungiasis in Tennessee
ABSTRACTTungiasis, an infestation by a burrowing flea, may cause multiple, painful lesions which, if they become secondarily infected, may eventuate in death. With increasing air travel to tropical areas, American physicians should recognize the lesion of this intracutaneous parasite. The fully developed lesion resembles an abscess with a black center….
Editorial
Transport of the Neonate
ABSTRACTA regionalization program, initiated in 1973 at Vanderbilt University Medical Center, has included community hospital site visits, formal nursing courses, and neonatal transport. The neonatal transport program was designed not only to give initial medical care to the sick newborn, but also to develop the educational aspects of the regionalization…
Editorial
Low‐Dose Versus High‐Dose Insulin Therapy for Diabetic Ketoacidosis
ABSTRACTThe effects of low-dose continuous insulin therapy were compared to those of high-dose subcutaneous and intravenous insulin therapy in six episodes of diabetic ketoacidosis. Time for correction of acidosis, ketosis, and hyperglycemia were similar for both regimens. The high-dose method required more exogenous glucose and supplemental potassium to avoid hypoglycemia…
Editorial
Behavior Modification and Haloperidol in Chronic Facial Pain
ABSTRACTNeuralgiform pain and migrainous pain, both of which are amenable to drug therapy, comprise a relatively small percentage of the group of patients with facial pain who come to the practitioner's office. The largest group of facial pain patients are those with myofascial connective tissue disorders. A second group includes…
Editorial
Congenital Tuberculosis and Associated Hypoadrenocorticism
ABSTRACTTwo cases of probable congenital tuberculosis occurring in the ten-year period from 1966 to 1976 are reported. One infant with confirmed congenital tuberculosis also had symptomatic hypoadrenocorticism. Tuberculosis should be considered in the differential diagnosis of the seriously ill infant.
Editorial
Granulomatous Interstitial Nephritis A Complication of Heroin Abuse
ABSTRACTA 27-year-old man, a known heroin addict with previously diagnosed nephrotic syndrome, had a percutaneous renal biopsy for recurrent proteinuria. The biopsy revealed a glomerular lesion compatible with focal sclerosing nephropathy. The renal interstitium also demonstrated numerous active granulomas characterized by the presence of both multilamellated basophilic material and areas…
Editorial
Proximal Femoral Focal Deficiency A Clinical Appraisal
SUMMARYIn patients with unilateral proximal femoral focal deficiency, the leg length inequality is almost always greater than five inches at skeletal maturity. Consequently, prosthetic management should be planned before the patient walks. A standard plan of treatment of the patient with unilateral PFFD is not possible at this time, primarily…
Review Article
Cholesterol Embolism The Great Masquerader
ABSTRACTEmbolization of cholesterol crystals from ulcerated atheromatous lesions can produce distinct syndromes that mimic more common disease processes. Cholesterol emboli can present as renal failure, hypertension, spells of numbness, abdominal pain, and myocardial infarction, or as a multisystem disease that closely approximates the presentation, clinical course, and even biopsy picture…
Current Concepts
Cystic Fibrosis Diagnosis, Treatment, and Prognosis
Grand Rounds
Saturday Conference Renal Disease in the Juvenile Diabetic
ABSTRACTRenal disease, particularly glomerulosclerosis, is a major cause of morbidity and mortality in patients with juvenile-onset diabetes mellitus. Signaled by the onset of proteinuria after 15 or more years of insulin therapy, progressive renal insufficiency due to glomerulosclerosis terminates in uremia within five years. Although some patients have benefited from…
Article
Basic Pediatrics A New American Physician in an African Village Hospital
ABSTRACTThis communication presents a picture of medical practice, with an emphasis on pediatrics, in a rural hospital in the Transkei Republic of Southern Africa. The manner in which this setting appeared to and confronted a new graduate and his attempts to practice medicine are reported. An evaluation of the experience…
Article
Sharing the Burden
Article
Eponym Pancoast's Syndrome
Prominent among the clinical phenomena were pain around the shoulder and down the inner side of the arm, and often the ulnar side of the forearm, loss of power and wasting of the muscles of the hand, Homer's syndrome and signs mainly of dulness [sic] in the apex of the…
Case Report
Detection of Fetal Anencephaly Using Real‐Time Ultrasound
SUMMARYAnencephaly can be diagnosed using real-time ultrasonography. This enables visualization of the fetal movements and facilitates identification of the fetal parts, making certain the exact orientation of the fetus. Thus, the negative finding of the lack of fetal calvarium, as well as the positive finding of insufficient space for a…
Case Report
Telltale Mouth Flora A Clue to the Diagnosis of Factitious Recurrent Thigh Abscesses
SUMMARYA 27-year-old man had recurrent abscesses of the thigh caused by organisms typical of mouth flora. The unusual identity of these organisms from a thigh abscess led to the recognition that the illness was induced by self-injection with saliva, and that the patient had many of the characteristics of Münchausen's…
Case Report
Osteosclerosis (Punctate Form) in Multiple Myeloma
SUMMARYGeneralized punctate and nodular osteosclerosis associated with multiple myeloma is reported with review of the literature and differential diagnoses. This patient differs from some others reported earlier in the absence of any recognized osteolytic lesions either during life or at autopsy.
Case Report
Obstruction of the Abdominal Aorta by a Primary Retroperitoneal Tumor
SUMMARYAn angiographically demonstrated case of total occlusion of the abdominal aorta by a malignant retroperitoneal tumor is presented. Surgical exploration revealed a diffuse tumor of the retroperitoneum involving the wall and lumen of the abdominal aorta and vena cava, respectively. Histologic and ultrastructural evaluation of the tumor established a diagnosis…
Case Report
Idiopathic Scoliosis in Identical (Monozygotic) Twins
SUMMARYThe exact nature of the primary predisposing cause of idiopathic scoliosis is unknown. Hereditary and/or environmental factors may be responsible. Two sets of identical twins presenting in adolescence with concordant scoliotic curves were studied and lend support for a hereditary predisposition favoring a multifactorial inheritance.
Case Report
Giant Renal Calculus With Metastatic Carcinoma
SUMMARYA case of a massive renal calculus is described. The radiographic appearance is discussed, and attention is drawn to the more subtle radiographic finding of a metastatic tumor which proved fatal. No autopsy was done.
Case Report
Adult Respiratory Distress Syndrome Secondary to Diffuse Pulmonary Blastomycosis
SUMMARYWe have described diffuse pulmonary blastomycosis in a previously healthy 19-year-old man, which resulted in the adult respiratory distress syndrome (ARDS). Physicians must have a high index of suspicion for treatable causes of ARDS, and the use of open lung biopsy for early diagnosis is stressed.
Case Report
Giant Pulmonary Cyst
SUMMARYWe have described two cases of giant pulmonary cysts, with a brief comment on diagnosis and management. Both patients were treated successfully by operation.
Clinical Brief
“Smile You're on Candid Camera“
SUMMARYIn our experience A 450 mμ. OD measurements have shown a progressive decline during the latter half of gestation in pregnancies unaffected by fetal hemolytic disease. However, we have seen two Rh-negative patients in whom there was a rise in A 450 mμ; OD between 24 and 27 weeks' gestation…
Article
Congenital Retroperitoneal Hemangioendothelioma With Kasabach‐Merritt Syndrome
SUMMARYThis is the first documented congenital retroperitoneal hemangioendothelioma. The patient presented at birth with a retroperitoneal mass and thrombocytopenia. Postmortem examination revealed the tumor to be a hemangiaendothelioma, arising from the posterior abdominal wall. The association of an angiomatous tumor will thrombocytopenia represents the Kasabach-Merritt syndrome.
Article
Inadvertent Intracranial Placement of a Nasogastric Tube Through a Basal Skull Fracture
SUMMARYInadvertent intracranial placement of nasogastric tubes may occur during intubation of patients with severe maxillofacial trauma and basal skull fractures. Oral intubation, nasogastric intubation under fluoroscopy, or nasogastric intubation under direct vision will eliminate the possibility of this complication.
Article
Unusual Amniotic Fluid Spectral Analysis in Rh Sensitization
SUMMARYIn our experience Δ 450 mμ. OD measurements have shown a progressive decline during the latter half of gestation in pregnancies unaffected by fetal hemolytic disease. However, we have seen two Rh-negative patients in whom there was a rise in Δ 450 mμ OD between 24 and 27 weeks' gestation…
