Issue - Southern Medical Association

Editorial

EKG TECHNICIANS AND HEALTH CARE

Editorial

THOUGHTS FOR INDEPENDENCE DAY

Editorial

Duration of Intubation and ICU Stay After Open Heart Surgery

One hundred four consecutive patients undergoing open heart surgery were studied to determine the duration of intubation and ICU stay associated with an anesthetic management protocol designed to avoid prolonged postoperative respiratory depression. The results document the feasibility and safety of early extubation and shortened ICU stay in patients having…

Editorial

Variant Angina in the Setting of Hypothyroidism and Beta Blockade A Proposed Mechanism

Coronary artery spasm can occur in the presence of excessive alpha-adrenergic tone. A decrease in protective coronary vasodilator substance and enhanced alpha-adrenergic responsiveness, which occurs in the setting of hypothyroidism and beta blockade, predisposes to coronary artery spasm. The case presented supports these concepts.

Editorial

Analysis of Factors Influencing the Renin‐Aldosterone System in a Patient With Bartter's Syndrome

The response to indomethacin of a patient with Bartter's syndrome and proximal tubular sodium wasting is described. The patient had evidence of excessive prostaglandin activity (elevated urinary prostaglandin E metabolite [PGE-M] excretion) which returned to normal with indomethacin therapy. Indomethacin administration corrected the defect in proximal tubular sodium resorption, but…

Editorial

Air Embolism From Mechanical Ventilation in Respiratory Distress Syndrome

Three cases of air embolism secondary to mechanical ventilation in premature infants with respiratory distress syndrome are presented, and its mechanism is discussed. A plausible mechanism for air in the hepatic veins occurring in most of these cases is also discussed. Many sudden unexplained deaths in premature infants on mechanical…

Editorial

Metabolic Alkalosis Complicating Weaning From Mechanical Ventilation

Metabolic alkalosis was identified and confirmed as a precipitator of acute hypercapnea. As a result, weaning from mechanical ventilator therapy was delayed. Correction of alkalosis followed by reduction of Pco2 confirmed the compensatory mechanism during alkalosis, and weaning from intermittent mandatory ventilation then proceeded at an appropriate rate.

Editorial

Pathologic Fractures of Long Bones

Sixty-two cases of pathologic fractures occurring in 53 patients treated at Scott and White Memorial Hospital from 1966 to 1976 are reviewed and analyzed with regard to type of neoplastic lesion, location, mode of therapy initiated, functional stability of therapy selected, and average length of survival after orthopedic procedure. Pertinent…

Editorial

Follow‐up Study on Hemiarthroplasty of the Hip

This follow-up study on hemiarthroplasty of the hip evaluates the effectiveness of the treatment in various hip conditions. A total of 169 hemiarthroplasties of the hip were performed at the Medical College of Georgia from 1966 to 1972. Fifty-two patients were available for follow-up study in 1975. Hips were evaluated…

Editorial

Double‐Blind Comparison of Hydrochlorothiazide Plus Triamterene Therapy Versus Chlorthalidone Therapy in Hypertension

Effects of two dosage strengths of hydrochlorothiazide and triamterene in combination and chlorthalidone on blood pressure and serum potassium were compared in 126 patients in a double-blind, placebo-controlled study. Each drug regimen was administered once a day. All three regimens had significantly reduced blood pressure at each of the eight…

Editorial

Vascular Access for Cancer Chemotherapy

A persistent problem in caring for patients receiving long-term intravenous chemotherapy for cancer is the maintenance of access to the vascular system. At Emory University Hospital between January 1975 and December 1977, 48 cancer chemotherapy patients had upper-arm bovine arteriovenous fistulas created for vascular access. The heterografts were inserted from…

Vignette on Medical Writing

Commas in a Series

Article

Secondary Renal Neoplasms An Autopsy Study

The records of 11,328 autopsies performed on patients who died of malignant disease between March 1944 and August 1974 were reviewed, and 816 cases (7.2%) demonstrated renal metastases. The most common primary tumors in decreasing order of frequency were lung, breast, skin (melanoma), and tumors of the genitourinary, gastrointestinal, and…

Article

Factors Influencing the Occurrence of Advanced Cervical Carcinoma

The continued occurrence of advanced cervical carcinoma (stage II, III, IV) was studied. Patients were evaluated with regard to age, racial origin, socioeconomic status, geographic distribution, and presenting symptoms. Particular emphasis was placed on the role of screening in disease detection. The disturbing finding was that of the 170 patients…

Article

Colposcopy in Gynecologic Practice

We review the role of colposcopy in the setting of a private gynecologic practice and present the data regarding 418 patients. The practicality and propriety of using colposcopy to evaluate patients with abnormal results of cytology, gross cervical lesions with or without postcoital bleeding, or a history of intrauterine exposure…

Article

Group III Atypical Mycobacterial Infections

We retrospectively and prospectively examined the clinical presentation, course of disease, and response to therapy in 63 patients whose mycobacterial isolates were identified as Runyon group III atypical mycobacteria. All of the patients except four had pulmonary disease similar to typical pulmonary tuberculosis. The others had scrofula or abscess. There…

Article

Classic Migraine With Cerebral Cortical Infarction Causing Permanent Hemianopia

A patient with typical classic migraine, including clear-cut visual auras, who had been followed up clinically for more than 15 years developed permanent right homonymous hemianopia. The underlying cause of this clinical syndrome was established by computerized axial tomography as vascular infarction or ischemia, involving the contralateral visual cortex.

Article

Postoperative Beta Irradiation in the Treatment of Pterygium

High recurrence rates are reported after surgical treatment of pterygia. With the use of beta irradiation, the recurrence rate drops dramatically. This paper describes technic and dosage used in a group of patients receiving postoperative beta irradiation. Two thirds of these patients, however, had at least two surgical procedures. A…

Article

Tendon Rupture After Local Steroid Injection

Thirteen patients who developed 15 ruptured tendons subsequent to injection of a depository steroid in or about the tendons are described. Eight were treated surgically. Ruptures were encountered in three Achilles tendons, two supraspinati, one lateral epicondylar attachment at the elbow, eight tendons of the long head of the biceps…

Article

Inguinal Herniorrhaphy Reduced Morbidity, Recurrences, and Costs

Costs, morbidity, and recurrences have been reduced in the repair of inguinal hernias. In 18 months 135 repairs were done using local anesthetics, prompt ambulation, and minor variations in the Shouldice technic. Men and women aged 22 to 84 years were operated upon. No recurrences have been reported, and urinary…

Article

Serum Gamma‐Glutamyl Transpeptidase Its Specificity and Clinical Value

The clinical import of the serum gamma-glutamyl transpeptidase (GGTP) level was evaluated in 162 prospectively studied patients. GGTP is helpful in determining the origin of alkaline phosphatase (AP); it clearly separates increased AP of bone and placental origin from that of liver origin. The GGTP level closely parallels the AP…

Acknowledgment

BOOKS RECEIVED

Acknowledgment

Combined Oral L-Dopa and Propranolol for Growth Hormone Provocation

A convenient test of growth hormone (GH) provocation using oral doses of L-dopa and propranolol (L+P) is compared with insulin-induced hypoglycemia (IIH) in 28 children and adolescents with short stature. In eight of these children, growth hormone deficiency was diagnosed when GH failed to rise above 7 ng/ml. The GH…

Acknowledgment

Pain Clinics Their Value to the General Practitioner

Physicians in general practice frequently encounter patients with chronic pain; such patients pose a difficult management problem. A new approach to treatment is offered by the Pain Center at the University of Tennessee Center for the Health Sciences. The Pain Center, with a staff drawn from a number of medical…

Acknowledgment

Physician Attitudes Toward Relicensure The Simulated Patient Option

Primary care physicians in one Southern city were asked to return a mail questionnaire stating their attitudes toward relicensure issues. Respondents overwhelmingly preferred continuing education as the method of creditation for relicensure, but as a second choice preferred the simulated patient procedure to formal examinations. Nearly one half of the…

Acknowledgment

Practice Monitoring as a Means to Direct Individual Continuing Medical Education

Methods of practice monitoring currently available and requiring little of the physician's time are discussed. The application of these tools to direct individual continuing medical education efforts and to examine and improve patient care are illustrated from my experience and that of the Department of Family Practice of the Medical…

Review Article

Cytomegalovirus Infections

Current Concepts

Computers in the ICU

Article

The Complete Health Checkup Fad, Fiction, or Fact

The ritual of the annual physical examination is scrutinized with respect to its clinical value. The periodic physical examination is not usually a health examination, because it does not include all components that affect a person's total health. The annual physical examination is usually not of importance to the physician…

Article

Adolescent Pregnancy

This paper reviews the literature of the past seven years concerning adolescent pregnancy. Social and motivational factors leading to pregnancy are discussed and weighed. Obstetric aspects of adolescent pregnancy are reviewed as well as the repercussions of this event. Goals and objectives are proposed, including: (1) assurance of health education,…

Case Report

Blind‐Ending Branch of a Bifid Ureter

Case Report

Iatrogenic Superior Vena Cava Syndrome With Spontaneous Improvement

Case Report

Ultrasonic Demonstration of Carcinoma of the Pancreas With Normal Angiographic Findings

Case Report

Rate‐Related Left Bundle Branch Block Secondary to Intra‐His Block

Case Report

Endocarditis Involving a Left Ventricular Apicoaortic Valve‐Bearing Conduit

Case Report

Multifocal Eosinophilic Granuloma Description of an Unusual Case

Clinical Brief

Posthypercapnic Metabolic Alkalosis Common and Neglected Cause

Article

Meckel's Diverticulitis Secondary to Orange Pulp Bezoar

Article

Septicemia During Antibiotic Therapy in Neutropenic Patients

Article

Acute Hyperthyroidism Precipitated by Trauma

Article

Primary Liver Amyloidosis Producing Obstructive Jaundice

Article

Exsanguination From Esophageal Rupture of an Atherosclerotic Aortic Aneurysm in a Patient With Treated Tuberculosis

Article

Antenatal Intestinal Perforation and Meconium Peritonitis Associated With the Neonatal Small Left Colon Syndrome

Article

Antidiuretic Hormone Effect of Vasopressin Therapy for Gastrointestinal Hemorrhage

Article

Systemic Lupus Erythematosus An Unusual Cause of Bilateral Hilar Lymphadenopathy

Article

Paecilomyces Cellulitis in a Renal Transplant Patient Successful Treatment With Intravenous Miconazole

Letter to the Editor

Furosemide, Cirrhosis, and Hypercalcemia

Letter to the Editor

HDL and LDL

Letter to the Editor

Additional Side Effects of Propranolol

Letter to the Editor

Do Common Duct Stones Recur?

Letter to the Editor

Holism

Announcement

GENERAL ANNOUNCEMENTS