SMJ // August 1979, Volume 72 - Issue 8
Primary Article
Controversies and Hazards in the Treatment of Pit Viper Bites
ABSTRACTThis paper discusses the pathology produced by pit viper venom and the pharmacologically active substances released by the action of venom on human tissue. The risks of many of the popular methods of treatment such as tourniquets, cryotherapy, incisions, excisions, and cortisone are also discussed. A prospective treatment plan was…
Primary Article
Attending the Child “Rape” Victim
ABSTRACTIn view of the increase in the crime of child “rape,” it well behooves physicians to know the subtle differences between interviewing and examining an adult and a child.
Primary Article
Strategies for Using and Evaluating Physician Assistants and Family Nurse Practitioners
ABSTRACTNew health practitioners are no longer new on the medical scene, but they still present a radical innovation in the provision of medical care. As such, they pose both rational and emotional threats to physicians, nurses, and administrators. Two pivotal questions related to their acceptance and use will be discussed…
Primary Article
Surgical Face Lift
ABSTRACTThe growing importance of the face lift and related procedures to improve the aging face and the increasing demand by both men and women for these procedures is largely due to the prolonged good health, active life, and extended working years of many people. The technic described emphasizes support of…
Primary Article
Symptomatic Lower Esophageal Ring Treatment of 24 Patients*
ABSTRACTThe lower esophageal ring, or Schatzki's ring, consists of a thin, submucosal, circumferential scar which forms a thin incomplete diaphragm in the lower esophageal lumen. The symptoms may be either episodic aphagia or progressive dysphagia, and the severity of symptoms is related to the diameter of the ring. Between 1970…
Primary Article
Parotid Fistula Current Management*
ABSTRACTThe most common cause of parotid fistula is trauma. Other causes include operative complications, infection, and malignancy. In the acute phase of ductal injury, primary reconstruction, if possible, is the treatment of choice. Acute parenchymal injury is treated by tight closure and expectancy. When diverting or flow-blocking measures fail to…
Primary Article
Hemiagenesis of the Thyroid
ABSTRACTCongenital absence of a lobe of the thyroid gland is discussed and the literature is reviewed. Sixty-six cases have been gathered from the literature in approximately the past 100 years, and another six have been documented. Although no particular explanation has been forthcoming for the development of this anomaly, left…
Primary Article
Carcinomatous Meningitis in Gastrointestinal Malignancies
ABSTRACTWith the development of the Millipore filter, meningeal metastases are being identified more frequently as a complication of many types of carcinoma, including breast, lung, pancreas, stomach, and prostate. Regardless of the primary source, adenocarcinoma cells appear to have a propensity to metastasize to this site. In recent years, carcinomatous…
Primary Article
Cervical Cerclage Twenty Years' Experience*
ABSTRACTDuring a 20-year period, 40 pregnancies were managed in 32 patients with a diagnosis of an incompetent cervix, a ratio of 1:775 deliveries. Diagnosis before development of symptoms produced a 92% fetal salvage, with 68% reaching 36 weeks of gestation. Development of symptoms before cerclage resulted in only a 40%…
Primary Article
Conservative Management of Vesicouterine Fistulas
ABSTRACTTwo patients with vesicouterine fistulas after cesarean section were successfully treated with a nonsurgical, conservative approach, using a three-way Foley catheter with continuous normal saline drip via uromatic genitourinary bag.
Primary Article
Ligation of the Superior Vena Cava for Recurrent Pulmonary Emboli
ABSTRACTA patient with polycythemia vera developed chronic thrombosis of the superior vena cava and had life-threatening pulmonary emboli despite anticoagulation and chemotherapy for the blood dyscrasia. After angiographic evaluation, the superior vena cava was ligated cephalad to the azygous vein. There have been no further clinical embolic episodes nor adverse…
Primary Article
Percutaneous Transhepatic Portal Venography in the Diagnosis and Management of Gastroesophageal Varices
ABSTRACTPercutaneous transhepatic portal venography is a relatively safe method of obtaining both physiologic and morphologic information in patients with portal hypertension. Precise “road mapping” is performed, as well as measurement of free portal pressure. Additionally, transcatheter obliteration of gastroesophageal varices may produce effective cessation of hemorrhage in patients bleeding from…
Primary Article
Pulmonary Function Tests in a Community Hospital
ABSTRACTThe purpose of this study was to determine the incidence of obstructive lung disease in a surgical population. Screening spirometric pulmonary function tests were performed in 300 consecutive ambulatory patients in a community hospital. A high incidence of moderate to very severe chronic obstructive lung disease was found, 66% of…
Vignette on Medical Writing
Latin Plurals
Primary Article
Parenthood After Renal Transplantation
ABSTRACTParenthood in renal allograft recipients is no longer rare. Rational guidelines are needed since there are no absolute medical contraindications to parenthood in recipients of either sex. This report by the patient and her physician describes the clinical course of the recipient of a cadaveric renal allograft, including a normal…
Primary Article
Antihistamines and Alpha‐Adrenergic Agents in Treatment of Otitis Media
ABSTRACTStudies are not available to support the common use of alpha-adrenergic agents and/or antihistamines in the treatment of acute otitis media. A total of 378 patients with acute otitis were entered in a double-blind study comparing treatment results with antibiotics and either placebo, pseudoephedrine, triprolidine, or a combination of these;…
Primary Article
Correlation of Intraoperative Electroencephalography With Neurologic Deficit After Carotid Endarterectomy*
ABSTRACTIn an attempt to prevent morbidity and mortality in carotid endarterectomy, we monitored 47 operations with intraoperative EEG to determine which patients should have a shunt during endarterectomy. The EEG was recorded for up to five minutes during test carotid cross-clamping. When EEG asymmetry between the cerebral hemispheres occurred, the…
Primary Article
Hemodialysis and Renal Transplantation in Patients With Hypernephroma
ABSTRACTOf five patients with hypernephroma who were maintained on hemodialysis after nephrectomy, four died with metastatic disease after having been on hemodialysis for an average of 13.7 months (range 8 to 19). The fifth patient had no evidence of malignancy after 21 months of dialysis; he then received a renal…
Primary Article
Resection of Posterior Ventricular Aneurysm, Replacement of Mitral Valve, and Coronary Bypass
ABSTRACTA 58-year-old man had sudden and progressive heart failure after a severe myocardial infarction. Aggressive medical treatment consisting of diuretics, vasopressors, and digitalis failed to improve his condition significantly. Cardiac catheterization disclosed a critical stenosis in the left anterior descending branch of the left coronary artery, a large posterior left…
Primary Article
A New Problem in Adolescent Gynecology
ABSTRACTAs more abortions are being done in teen-age girls than ever before, an unusually large number of complications are being seen by some private practitioners. Because many of these adolescent patients in whom complications develop do not return to the physicians who did the abortions, accurate data on the incidence…
Primary Article
Diagnostic Exploratory Celiotomy An Outdated Concept in Blunt Abdominal Trauma
ABSTRACTDiagnostic exploratory celiotomy as the primary procedure in the trauma patient is rarely indicated since the validation of peritoneal lavage as a diagnostic technic. The accuracy of diagnostic peritoneal lavage is clearly superior to that of initial or repetitive clinical evaluation of trauma patients, and its cost is miniscule compared…
Review Article
Corticosteroids as Adjunctive Therapy for Acute Bacterial Meningitis
ABSTRACTAlthough anecdotal reports and the results of clinical trials suggest that corticosteroids may be efficacious in the treatment of acute bacterial meningitis, controlled and double-blind studies fail to support this view with the exception that corticosteroids may be of benefit for patients with pneumococcal meningitis. Corticosteroids may also be of…
Review Article
Umbilical Anomalies
ABSTRACTDuring intrauterine development the primordia of the developing gastrointestinal and urinary tract come into close proximity in the umbilicus where the communication of these structures with the external environment is usually obliterated. In a small percentage of patients the omphalomesenteric duct and/or urachus may remain completely or partially patent. When…
Medical Education
Paramedical Programs in Rural Bangladesh*
ABSTRACTTwo programs using locally trained paramedical personnel provide health care to villagers in Bangladesh. The general level of care rendered appears to be above average for the country, but varies with the individual paramedical worker. Field supervision is crucial to quality of care. The structure of the two programs places…
