SMJ // May 1981, Volume 74 - Issue 5
Editorial
WHAT PRICE CONTRACEPTION?
Editorial
GENERAL ANNOUNCEMENTS
Editorial
Editors Note
Primary Article
Limitations of Ultrasonography in Evaluating Patients With Jaundice or Cholecystectomy
Abdominal ultrasonography has been shown to accurately distinguish medical (nonobstructive) jaundice from surgical (obstructive) jaundice. As occurs commonly with a new diagnostic procedure, initial evaluations are enthusiastic and emphasize the positive features of the technic. When further experience with the procedure is acquired, its negative features are recognized and reported….
Primary Article
Cellulitis Analysis of 101 Cases and Review of the Literature
A retrospective study of 101 patients with cellulitis of the head and neck and extremities showed that cellulitis, predominantly a disease of males, occurred at all ages; the lower extremities were affected more frequently in the elderly, whereas upper extremity involvement prevailed in young adults. A clinical prodrome, most often…
Primary Article
Acute Pulmonary Histoplasmosis Presenting as Adult Respiratory Distress Syndrome Effect of Therapy on Clinical and Laboratory Features
Three patients with acute pulmonary histoplasmosis presented with extensive, diffuse bilateral infiltrates on chest roentgenograms. Fungal elements were seen in the bronchial secretions of two patients; histoplasma capsulatum was grown from sputum from the third paitient and from soil from the patients workplace. Two patients were severely hypoxemic and required…
Primary Article
Psychogenic Purpura (Autoerythrocyte Sensitization)
A 41-year-old woman has had a long history of repeated episodes of recurrent painful ecchymotic lesions. Results of coagulation tests were normal other than a slight decrease in antithrombin III. Skin tests were positive in response to the patients own washed red cells. Light and electron microscopy of both the…
Primary Article
Contraceptives in Sickle Cell Disease
Choosing the proper method of contraception for patients with sickle cell disease is an empiric exercise. In this manuscript, the commonly used contraceptive methods are examined for their risk-benefit ratio. However, because of its extensive use and effectiveness, steroid contraception is examined in greatest depth. Physiologic and pathologic changes induced…
Primary Article
Adolescent Suicide Attempts and Borderline Personality Disorder clinical Features
Although suicide among adolescents has been increasing over the past decade, there are surprisingly few clinical studies regarding teen-agers who have attempted suicide. A previous study showed borderline personality disorder as the most common underlying personality problem among a group of predominantly hospitalized adolescents. This paper focuses on the clinical…
Primary Article
Method for Calculating Blood Loss at Vaginal Delivery
We describe a method for calculating blood loss at vaginal delivery using a special plastic drape. Blood loss is calculated from the sum of three components: (1) blood lost in sponges, (2) blood loss represented by clots, and (3) blood loss represented by unclotted RBC. The procedure has been used…
Errata
Correction
Primary Article
Acute Rheumatic Fever in Mississippi A Survey of Hospitalized Cases, 1964 to 1973
The incidence of acute rheumatic fever in Mississippi was estimated by reviewing the hospital charts of Mississippi residents with a discharge diagnosis of acute rheumatic fever from 1964 through 1973. The average annual incidence was 1.5 cases/100,000 population for primary attacks and 0.4 cases/100,000 population for recurrent attacks. The annual…
Primary Article
Echocardiography in Diagnosing and Managing Aortic Valve Endocarditis
During a 36-month period, 14 patients were admitted with endocarditis of the native aortic valve. Echocardiography made a specific contribution to the diagnosis and/or therapeutic management in ten of the 14 (71%). Thirteen patients had aortic valve replacement because of congestive heart failure; only two were stable enough to complete…
Primary Article
Trends of Lung Cancer in Northern Florida
Although the entire state of Florida has experienced an increase in lung cancer mortality during the present decade, a differential rise among white men has been observed in Duval, a county in its northeastern region. This increase is not explained by population changes or migration of cases. It is hypothesized…
Primary Article
Overview of Adolescent Health Problems
Primary Article
Prognosis In Metastatic Choroidal Melanoma
We reviewed the records of 73 patients with primary melanoma of the choroid and ciliary body with metastasis treated at M. D. Anderson Hospital and Tumor Institute between 1973 and 1979. At time of diagnosis of primary melanoma 71 of 73 patients had tumor localized to the eye and were…
Primary Article
Fatigue Fractures of the Medial Tibial Plateau
The effectiveness of a protocol for the detection of medial tibial plateau fatigue fractures using radiographs and delayed scintigraphs is evaluated. The high false-positive rate of early scanning generally requires delayed radiographs to make a definite diagnosis. If this lesion is suspected, however, early use of scans should be encouraged…
Primary Article
Diagnostic Strategies
A simple model of a universe of diseases is presented. It permits the numerical comparison of different diagnostic strategies. Those diagnostic strategies exclusively using laboratory tests of perfect sensitivity and perfect specificity are shown to be inferior to a diagnostic strategy that begins with clinical information of unknown, but imperfect,…
Review Article
Pleural Effusion Diagnostic Value of Measurements of PO2, PCO2, and pH
A review of the literature suggests that the measurement of the partial pressure of oxygen (Po2) and carbon dioxide (Pco2) and pH may provide additional diagnostic, therapeutic, and prognostic information in the management of pleural effusions. Parapneumonic effusions with a pH less than 7.2 indicate an impending empyema requiring tube…
Primary Article
BOOKS RECEIVED
Review Article
Caustic Injuries to the Esophagus A Pediatric Overview
Article
Surgery in Elderly Patients
Operations on patients over 65 years old are increasing steadily in number and complexity. Demographic trends indicate that future increases will be even greater. We reviewed patients having operations of diverse type and magnitude to determine results, with emphasis on the influence of age. Increased risk in older persons was…
Current Concepts
Afferent Loop Syndrome Revisited New Emphasis on Ultrasound and Computerized Tomography
Contemporary medicine has provided the clinician with two additional noninvasive diagnostic instruments—computerized tomography and ultrasound. Both modalities are accessible to most clinicians and are extremely valuable in diagnosing many abdominal diseases. A review of the afferent loop syndrome and a discussion of new diagnostic methods with these instruments are presented.
Medical Education
Demographic, Situational, and Scholastic Factors in Medical School Attrition
In an investigation of withdrawals and delays among students enrolled at the University of Tennessee College of Medicine over a four-year period, we found significantly higher rates of attrition among minority than nonminority students and among female than male enrollees. There were, however, no significant sex-related differences in the nature…
Our Medical Heritage
The “Jerks” Mass Hysteria or Epilepsy?
Hysterical “epidemics” of “epilepsy” are well known in Eastern and Western cultures. A unique situation in the United States in the 19th and 20th centuries was the American religious movement, the setting in which “the jerks” occurred. Descriptions of various types of “jerks,” including dancing, barking, laughing exercise, running exercise,…
