Issue - Southern Medical Association

Editorial

BRIDGES OVER TROUBLED WATERS

Editorial

PCP

Editorial

WHATS THE DIFFERENCE … AND WHAT DIFFERENCE DOES IT MAKE?

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

Recent Developments in Health Care in China

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…

Article

Aspirin Four Score and More

Article

Joseph Bell, MD, FRCS—Mr. Sherlock Holmes?

Case Report

Sporothrix schenckii Inoculation on the Abdomen

Case Report

DF-2 Septicemia After Splenectomy Epidemiology and Immunologic Response

Case Report

Atypical Endocarditis Due to Gram-negative Bacillus Transmitted by Dog Bite

Case Report

Communicating Hydrocephalus Caused by Aspergillus flavus

Case Report

Clostridium paraputrificum Sepsis in Sickle Cell Anemia

Case Report

Gonococcal Endocarditis

Case Report

Nutritionally Deficient Streptococcus investigation of the Hidden Culprit in Culture-Negative Endocarditis

Case Report

Osteomyelitis of the Pubis

Case Report

Complementary Use of 99mTc-HIDA and Upper Abdominal Sonography in Diagnosing a Cnoledochal Cyst

Case Report

Plasma Prekallikrein (Fletcher Factor) Deficiency in a Patient With Chronic Lymphocytic Leukemia

Case Report

Prolonged and Concurrent Lactic Acidosis and Hypoglycemia in a Patient With Monocytic Leukemia

Case Report

Progressive Hepatic Injury in Prolonged Parenteral Alimentation

Case Report

Hyperthyroidism and Medullary Carcinoma of the Thyroid

Case Report

Gallium Scans and Serum Angiotensin Converting Enzyme Levels in Talc Granulomatosis and Lymphocytic Interstitial Pneumonitis

Case Report

Contact Dermatitis Caused by ECG Electrode Paste

Case Report

Femoral Hypoplasia—Unusual Fades Syndrome and Chromosome X Trisomy

Clinical Brief

Parotid Tumors A Ten-Year Experience in a Community Hospital

Clinical Brief

Argon Laser Office Procedures

Breif Report

Recurrent Postpartum Painless Thyroiditis

Breif Report

Intramural Gastric Hematoma Secondary to Splenic Rupture

Breif Report

Elevated Amylase Creatinine Clearance Ratio and Normal Serum Amylase Levels in Chronic Relapsing Pancreatitis After Partial Pancreatectomy

Breif Report

Paraganglioma of the Hepatic Duct

Breif Report

Choledochal Cyst and Pancreatic Carcinoma Demonstrated Simultaneously by Endoscopic Retrograde Cholangiopancreatography

Article

ADJUVANT CHEMOTHERAPY OF BREAST CANCER