SMJ // August 1980, Volume 73 - Issue 8
Editorial
THE OUTPATIENT BREAST BIOPSY
Acknowledgement
ACKNOWLEDGMENT
Announcement
GENERAL ANNOUNCEMENTS
Primary Article
Selective Approach to Outpatient Breast Biopsy
Despite several studies advocating the routine use of outpatient breast biopsy, most surgeons have been reluctant to adopt this practice. Selection of patients with low-risk lesions for outpatient biopsy is, therefore, proposed. Eighty-eight patients were divided into high-risk and low-risk groups using simple clinical criteria, including the size, consistency, and…
Primary Article
Indications for Exploring the Retroperitoneal Space
The retroperitoneal space is an area that deserves consideration in patients with serious bleeding problems. This area should be explored in all patients with a history of previous reconstructive vascular surgery of the abdominal aorta and iliac vessels and who subsequently present with gastrointestinal hemorrhage. It should also be considered…
Primary Article
Nonrepair of Exposed Frontal Bone After Mohs Surgery for Extensive Basal Cell Carcinoma
When it is necessary to expose frontal bone with or without periosteum after Mohs surgery for extensive carcinomas of the forehead, simple wound care will allow granulations to cover the bone and healing will be complete. In situations where it is not advisable to cover exposed frontal bone with or…
Errata
CORRECTION
Primary Article
Clinical Considerations in Unusual Colonic Obstructions
Colonic obstructions of uncommon cause may present challenging diagnostic problems that require prompt and correct treatment. Fifty such patients were studied and illustrate the problems that may be encountered. Clinical observations of importance include the need to distinguish a prostatic cancer obstructing the rectum, the mimicking of inoperable cancer by…
Primary Article
Small Bowel Tumors A Continuing Challenge
Small bowel tumors are difficult to diagnose and are frequently not identified at initial evaluation. We retrospectively reviewed 25 consecutive cases to assess the efficacy of procedures currently used in diagnosis. Barium contrast studies were diagnostic in 14 (56%) of the cases. Enteroclysis provided one diagnosis after the initial barium…
Primary Article
Improved Survival After Ruptured Abdominal Aortic Aneurysm
Rupture of an abdominal aortic aneurysm continues to be the most imminently catastrophic situation facing the peripheral vascular surgeon. Without emergency resection the mortality is 100%, and in the past, even with operation, few patients have survived. Numerous recent reports continue to show mortality rates exceeding 50%. Our survival rates…
Primary Article
Rhabdomyolysis Secondary to Drug Overdose and Prolonged Coma
Recent research has contributed to the understanding of nontraumatic rhabdomyolysis. In cases associated with coma, the pathophysiology is secondary to local pressure necrosis caused by compression from the patients own body. The local pressure results in an edema-ischemia cycle concluding with compartmental tamponade and muscle breakdown. Myoglobin released by the…
Primary Article
Yellow Nail Syndrome Complete Triad With Pleural Protein Turnover Studies
Lymphedema, pleural effusions, and yellow nails constitute the yellow nail syndrome, which commonly is associated with chronic lower respiratory infections and sinusitis. Of 50 cases reported, only 13 have had the complete triad; we report another. The patient has a history of bronchiectasis, bilateral leg lymphedema, and yellow nails since…
Primary Article
Analgesic Efficacy of Ibuprofen for Treatment of Primary Dysmenorrhea
Fifty-five women with primary dysmenorrhea were enrolled in a study in which each took ibuprofen (400 mg), propoxyphene hydrochloride (64 mg), or a placebo alternately in consecutive menstrual cycles for relief of pain. Fifty-one completed the study during three successive cycles in this triple-blind, crossover, randomized investigation. Ibuprofen was clearly…
Primary Article
Primary Carcinoma of the Male Urethra
Of 27 men with primary urethral carcinoma, 11 had tumors that rose at or anterior to the penoscrotal junction; 16 had tumors arising between the membranous urethra and the penoscrotal junction. Surgery was the only effective definitive therapy, and only palliative methods could be used for half of those patients…
Primary Article
Body Contouring
The prospect of surgical body contouring is a rather recent innovation for the surgeon. For underdeveloped or atrophic breasts, augmentation mammaplasty is reasonably successful. For ptosis and/or hypertrophy of the breast, reduction and elevation on the chest wall by making the breasts more conical and more projecting is a common…
Primary Article
Ectopic Pregnancy A Five-Year Experience
In the five-year period 1974 to 1978, there were 23,256 deliveries and 204 ectopic pregnancies at Fairfax Hospital. Forty-six patients (22.5%) had had previous pelvic surgery, including 14 salpingectomies for previous ectopic pregnancies. Only 27 patients (13.2%) had a history of salpingitis, but chronic salpingitis was evident in 91 patients…
Primary Article
Ultrasonic Diagnosis of Obstructed Renal Duplication and Ureterocele
The diagnoses of complete obstruction in a duplicated renal collecting system and ureterocele can be made with a high degree of confidence by ultrasound. Two children presenting with abdominal masses were examined by gray scale ultrasonography which demonstrated large cystic masses dorsal to and displacing the lower pole of the…
Primary Article
Characteristics of Patients With Chronic Pain
We describe the characteristics which patients with chronic pain ascribe to themselves and present some of the data we have gathered in the areas of demographics, economic and family problems, difficulty in rehabilitation, and the failure of treatment methods such as surgery and medications to provide relief. We compared the…
Primary Article
Etiology of Homosexuality
The range of expression of homosexuality and its association with certain cultural, environmental, and genetic factors are most consistent with the concept of a multifactorial trait. Additionally, genetic heterogeneity in this phenotype (alternative mutants corresponding to a single phenotype) is highly probable. In certain nonhuman and presumably in human species…
Primary Article
Clinical Use of Cimetidine in Acute Renal Failure After Resection of Abdominal Aneurysms
Gastrointestinal bleeding and infection are leading causes of mortality in patients with acute renal failure. Cimetidine, an H2 blocker, has been reported to be useful in the treatment of duodenal ulceration in patients undergoing hemodialysis.1 Sequential organ failure is common in patients who have had resection of dissecting abdominal aneurysms.2…
Primary Article
Depression in Family Practice Patients
Multiple factors have been described as significant contributors to depression in medical patients. This study attempts to asses the relative significance and interrelationship of variables associated with depression. A group of 199 family practice were studied. Using a multivariate research design, significant depressive symptoms were found in 41% of the…
Primary Article
Snoring
Primary Article
Heat Injuries Among Recreational Runners
With the increasing popularity of jogging and competitive running, more people are participating in races, particularly during the warm months. In the Southeastern United States, the combination of high temperatures and high relative humidity appears to be responsible for many heat-associated injuries. We studied the training, racing, and selected personal…
Primary Article
Duty to Recall
In the last few years there has been a dichotomy in the law vis-à-vis health care providers. The state legislatures are imposing statutory barriers which impede the ability of patients to bring malpractice suits against health care providers. On the other hand, the courts are increasing the spectrum of legal…
Primary Article
Prevalence of Drug-Induced Immunologic Changes in Hypertensive Jamaicans
Of 137 hypertensive black Jamaicans who took methyldopa for a mean period of 36 months, a positive ANA was found in 1.5% and a positive direct Coombs test in 0.7%. In 36 patients in whom hydralazine was included in the therapeutic regimen, a positive ANA was seen in only 6%….
Review Article
Systemic Chemotherapy for Advanced Gastrointestinal Cancer
The chemotherapeutic agents commonly used to treat malignant tumors of the digestive system are reviewed. Despite considerable experience with multidrug treatments, progress in the systemic treatment of advanced tumors of digestive organs has been limited. No single agent currently available has consistently given an overall response rate superior to 30%,…
