SMJ // December 1980, Volume 73 - Issue 12
Editorial
PCP
Commentary
APPENDICEAL PERFORATION
Primary Article
Appendicitis Factors That Influence the Frequency of Perforation
The mortality from perforating appendicitis has decreased, but the incidence of perforation has not changed in 30 years. We found that among 335 consecutive patients treated for acute appendicitis, 108 (32%) had evidence of perforation. No significant differences between the groups were noted with respect to race, sex, educational level,…
Primary Article
Heat Treatment for Certain Chronic Granulomatous Skin Infections
Four cases of chronic granulomatous skin infections (two due to Sporothrix schenckii and two to Mycobacterium marinum) were treated primarily by the intermittent application of local hyperthermia. This treatment was initiated either because of intolerance to conventional iodide therapy for sporotrichosis or as interim therapy while awaiting diagnosis of the…
Primary Article
Pneumocystis Pneumonia in Hospitals Outbreaks or Improved Recognition?
A presumed outbreak of Pneumocystis carinii pneumonitis occurred at a large teaching hospital. The diagnosis was made by lung biopsy or at autopsy in seven patients over a 221/2-year period and only by percutaneous lung aspirate in seven patients over a 21/2-year period. Apparent outbreaks may be related to both…
Primary Article
Hepatitis B in United States Soldiers in Korea
We studied US soldiers hospitalized in Korea during 1977 because of acute icteric hepatitis. The clinical characteristics of this illness were similar to those noted in previous studies of this population. In contrast to earlier reports, however, hepatitis B virus was shown to be the single most important cause. Of…
Primary Article
Breast Cancer and Retroperitoneal Metastasis
Retroperitoneal fibrosis is an uncommon disease of diverse etiology. Carcinoma of the breast is rarely considered as a cause of retroperitoneal metastasis or fibrosis. This paper describes five patients with retroperitoneal fibrosis secondary to breast cancer. The mean duration from initial diagnosis to onset of symptoms was greater than ten…
Primary Article
Low Complication Rate of Colostomy Closures
Colostomy closure, a procedure often relegated to the less experienced member of the surgical team, is not a benign procedure. Early reports in the literature have clearly indicated that colostomy closure is attended by an exorbitantly high complication rate. The complication rate of 12% at the Medical Center of Central…
Primary Article
Reconstructing Colonic Continuity After the Hartmann Operation
We present our experience in a series of 25 cases involving reconstruction of bowel continuity after the Hartmann operation for perforated diverticulitis. The term “colostomy closure” has been judiciously avoided because in no way are these procedures comparable. Careful timing and restraint are encouraged to allow adequate recovery from the…
Primary Article
Vaginal Tubal Ligation
This is a review of 121 cases of interval vaginal tubal ligations done by fimbriectomy between 1971 and 1979. The technic has proved to be effective, economical, rapid, safe, and simple, and requires only a short convalescence. There have been no subsequent pregnancies or serious postoperative febrile complications.
Errata
Corrections
Primary Article
Safety and Efficacy of Long-term Diazepam Therapy
Clinical evidence of withdrawal phenomena and efficacy was studied in 23 long-term users of diazepam (15 to 60 mg daily). No withdrawal reactions were observed in the ten patients who received placebo in a double-blind fashion for a two-week period. Changes in anxiety scores of both patients who received placebo…
Primary Article
Treatment of Chronic Pain With Tricyclic Antidepressants
Tricyclic antidepressants are increasingly being used to treat chronic pain. A review of the literature supports their use in a variety of conditions and sheds some light on the question as to whether they exert a direct analgesic effect or act indirectly, by first alleviating an intercurrent depression. Their use…
Primary Article
Pseudoaneurysms and Related Complications of Aortic Bypass Grafts
During a recent five-year period 14 patients had pseudoaneurysms as late complications of aortic bifurcation grafts. Severe atherosclerosis had been present at the time of the aortic grafts, and subsequent progression of arterial disease appeared to be the usual cause of the pseudoaneurysms which occurred from two to 14 years…
Primary Article
Evaluation of the Biliary Tree A Comparison of Percutaneous Transhepatic Cholangiography and Ultrasonography
After we examined 45 patients with jaundice, using both percutaneous transhepatic cholangiography and ultrasonography, our results suggest that ultrasound is useful as an early screening procedure in evaluating patients with jaundice.
Primary Article
Improving Physical Fitness by Exercise Training Programs
Thirteen young men completed a ten-week exercise training program on bicycle ergometers. Training sessions were conducted five days per week, with eight men randomly assigned to low-effort (LE) and five to high-effort (HE) regimens. LE participants worked continuously at 50% of their maximal oxygen intake (exercise HR ≃ 135 BPM);…
Primary Article
Diagnosis on Death Certificates of Sudden Death Due to Ischemic Heart Disease
This study was undertaken to evaluate the quality of diagnoses of sudden death (SD) caused by ischemic heart disease (IHD) on death certificates. A random sample of 10% (100 cases) was drawn from all such deaths which occurred in 1970 among Oklahoma City residents. The medical records of each case…
Primary Article
Sexual Dysfunction in Chronic Renal Failure
Sexual dysfunction in end-stage renal disease is a troublesome, multifactorial disorder. Abnormality of the hypothalamo-pituitary-gonadal axis is but one of the causes leading to the impotence and infertility commonly encountered in chronic renal failure. Short of kidney transplantation, no therapy is available. Though infertility is the rule in end-stage renal…
Review Article
Childhood Allergy
The practicing pediatrician is often expected to make informed recommendations concerning the role of dietary and environmental prophylaxis against childhood atopic diseases. These allergic conditions are commonly seen in general pediatric practice and may have a substantial adverse effect on the family. This review, prepared for pediatricians, presents an update…
Review Article
Agoraphobia A Review for the Physician
Current Concepts
Pulmonary Sporotrichosis
Sporotrichosis is frequently primary in the lungs, caused by inhalation or aspiration of spores of Sporothrix schenckii. The clinical features and roentgenographic changes are nonspecific and usually indistinguishable from reactivated pulmonary tuberculosis. Therefore, pulmonary sporotrichosis should be considered when the tuberculin test and sputum cultures for Mycobacterium tuberculosis are persistently…
Current Concepts
Surgery for Vertigo
Article
Hospital Psychiatry Review and Survey
The Psychiatric Institute of Washington commissioned a study of the “state of the art” of hospital psychiatry. The project included a review of the literature, visits to 29 representative and distinguished facilities, reports oh 17 aspects of hospital psychiatry, and study of the Psychiatric Institutes own units. Medical psychiatry, precise…
