SMJ // April 1981, Volume 74 - Issue 4
Editorial
BLANKETY-BLANK BARBARISMS
Commentary
THE FLUORIDATION CONTROVERSY
Primary Article
Anaplastic Malignant Neoplasms Diagnosis and Treatment
We studied 35 patients referred to M.D. Anderson Hospital and Tumor Institute with a histologic diagnosis of undifferentiated malignant neoplasms. Further subclassification of the tumors based on elements suggestive of tumor differentiation detected on light and electron microscopic examination was possible in 22 of the 35 patients. The stage of…
Primary Article
GENERAL ANNOUNCEMENTS
Primary Article
Benign Hepatocellular Tumors A Regional Survey
A survey of benign hepatocellular tumors in a metropolitan area included six cases of hepatocellular adenoma, eight of focal nodular hyperplasia, and two of nodular transformation. Two thirds of the adenomas occurred in women using oral contraceptives; two had life-threatening complications. The focal nodular hyperplasias were generally asymptomatic tumors occurring…
Primary Article
Unusual Inflammatory Processes Involving the Colon
Six patients with unusual inflammatory lesions of the colon are presented. Several of these cases demonstrated unusual presentations of an unusual disease. The clinical and radiologic features (which together are of paramount importance in suggesting the correct diagnosis) are discussed. Important differential diagnostic considerations are listed.
Primary Article
Overcompensation Syndromes
As a result of severe injury or illness, a complex series of metabolic changes takes place in the body to enable it to cope with the stress and recover. Although these changes are beneficial and necessary, at times they are more extensive than desirable and may result in metabolic alkalosis,…
Primary Article
Glycosylated Hemoglobin in Diabetic and Nondiabetic Pregnancies
Fasting serum glucose and hemoglobin A1 (HbA1) levels were lower in diabetic and nondiabetic patients during the third trimester of pregnancy than in similar groups of nonpregnant subjects. HbA1 levels decreased in nine of 15 nondiabetic subjects and in nine of ten diabetic patients as pregnancy advanced. The change in…
Primary Article
Impact of a Colposcopy Satellite Clinic
A community educational program and the introduction of a colposcope in Decatur, Alabama, led to a dramatic decrease in the relative percent of patients evaluated by conization after a positive Pap smear, and a corresponding increase in the relative percent of colposcopic evaluations. The percent of negative or dysplastic tissue…
Primary Article
Clinical Trial of Amitriptyline and Fluphenazine in Diabetic Peripheral Neuropathy
Ten adult insulin-dependent diabetics with symptomatic peripheral neuropathy were treated with amitriptyline alone or in combination with fluphenazine hydrochloride. Nine of the subjects had a good result within 48 to 72 hours. Two patients reacted adversely to the medication. These medications appear effective in treating the discomfort associated with diabetic…
Primary Article
Percutaneous Nephrostomy by Pigtail Catheter in Children
Percutaneous nephrostomy in children with the use of the pigtail catheter is discussed as a useful, noninvasive, rapid technic in cases of pediatric obstructive uropathy or in children in whom immediate surgical intervention would be undesirable. Three cases are presented, as well as technical notes.
Primary Article
Acute Obstructive Uric Acid Nephropathy After Treatment of Neoplastic Adenopathy
Patients with lymphoma and leukemia are at increased risk of therapy-related sudden increase in the serum uric acid level, with resultant precipitation and obstruction in the more acidic and concentrated distal nephron. Appropriate pretreatment measures can prevent intrarenal crystal formation. The acute obstruction responds well to treatment, and aggressive measures…
Primary Article
Fractures of the Tibia Treated With Lottes Nail Fixation
We have reviewed 60 consecutive cases, occurring in 57 patients, of intramedullary fixation of fractures of the midshaft of the tibia done over a ten-year period with the Lottes nail. Of 50 acute fractures, 38 were open fractures, nailed after adequate irrigation and debridement; the other 12 were closed fractures….
Primary Article
Myocardial Abscesses Unassociated With Infective Endocarditis
Review of 3,084 autopsies from 1967 to 1977 at Grady Memorial Hospital yielded 14 cases of myocardial abscess unassociated with infective endocarditis acceptable for our study. No case was diagnosed ante mortem. Gram-negative organisms, fungi, and Staphylococcus aureus were isolated. Underlying conditions included alcoholic hepatitis, acute myocardial infarction, systemic lupus…
Primary Article
Field Recognition of Eastern Poison Oak With Emphasis on Plants in Alabama
Eastern poison oak, Toxicodendron toxicarium, is a nonclimbing shrub whose- leaves have three leaflets. The leaflets with their numerous round lobes resemble somewhat the leaves of some oaks in the white oak groups. The plant grows in nutritionally poor, sandy soil, and especially in dry pine-oak woodland. Deposits resembling black…
Primary Article
Psychiatric Disturbances Seen in Primary Care When to Treat and When to Refer
Recent advances and changes in diagnosis and treatment of various psychiatric disturbances have both increased cooperation between psychiatrists and primary care physicians and better integrated psychiatry with the remainder of medicine. With increasing emphasis on the holistic approach to patient care and more appreciation of emotional components of various physical…
Review Article
Cantharidin Poisoning
Cantharidin, or Spanish fly, is a lipid soluble irritant extracted from the blister beetle. Manifestations of cantharidin poisoning range from local vesiculobullous formation to gross hematuria, myocardial damage, denudation of the gastrointestinal tract, and occasionally death. Despite the wide spectrum of clinical symptomatology, the available information on this subject is…
Current Concepts
Renal Preservation Technics
This paper discusses modern renal preservation technics, presenting historic background, advantages, and clinical methods. The monitoring of perfused kidneys, methods of in situ hypothermia, the uses of renal preservation in extracorporeal surgery, and the results of cadaver kidney preservation at the Medical University of South Carolina are highlighted.
Current Concepts
Ultrasonic Findings in Silicone-Augmented Breasts
The sonographic and clinical findings in four patients with silicone-augmented breasts are presented. The ultrasonographic differences between breasts with silicone injections and breasts with silicone prosthesis are emphasized. Breast sonography may play a role in evaluation of silicone-augmented breasts. Awareness of this diagnostic procedure may help in evaluating these patients.
Article
Quincke, de Musset, Duroziez, and Hill Some Aortic Regurgitations
Four peripheral signs of aortic insufficiency are considered in terms of their original descriptions, their present popularity, and their potential future clinical contribution. It is concluded that: (1) Quinckes capillary pulse sign is not useful. (2) de Mussets head bobbing sign is of undetermined but apparently low sensitivity and specificity….
Article
Decision Theory for Clinicians Uses and Misuses of Clinical Tests
There is no clear cutoff between normal and abnormal for most clinical measurements and laboratory tests. Since normal limits for many laboratory tests are established by statistical methods, it is imperative that the clinician base his interpretation of the laboratory results on the clinical situation. In addition, a clinician should…
