SMJ // October 1982, Volume 75 - Issue 10
Editorial
PASSING THE BUCK
Primary Article
Religious Life of Narcotic Addicts
ABSTRACTBecause of the unstructured life-style of most narcotic addicts, we have inquired into the religious and social backgrounds and experiences of a group of narcotic addicts. It was observed that the subjects parents were far less involved in religious practices than were a group of parents of nonaddicts. The addicts…
Primary Article
Chronic Back Pain Does Elective Surgery Benefit Patients With Evidence of Psychologic Disturbance?
ABSTRACTThirty-five patients with chronic low back pain responded to a follow-up survey 18 months after being discharged from the hospital. All patients had objective (MMPI) evidence of psychologic disturbance during hospitalization. Seven patients subsequently obtained additional elective back surgery; the remaining 28 did not. Follow-up data indicated that patients who…
Primary Article
Attitudes of Postpartum Mothers Concerning Children and Child Rearing
ABSTRACTTo assess contemporary maternal attitudes about children, child rearing, and family life, a 32-item attitude scale—the Parent Attitude Scale (PAS)—was developed and given to 523 postpartum mothers. The PAS was shown to be a highly reliable attitude assessment instrument. Maternal attitudes generally were pro-child in nature. Variations in total and…
Primary Article
Heart Disease in a Total Population of Children The Bogalusa Heart Study
ABSTRACTA cross-sectional survey of a total semirural biracial population of children was conducted to determine the prevalence and types of cardiac disease. Of 4,074 children examined, 146 were thought to have significant cardiac murmurs. One hundred thirteen of these participated in a follow-up study in which they received a physical…
Primary Article
Natural History of Sinus Node Dysfunction After Permanent Pacemaker Implantation
ABSTRACTTo explore the natural history of symptomatic sinus node dysfunction after permanent pacemaker implantation, we followed up 71 patients (27 with sinus arrest, 27 with unexplained sinus bradycardia, 14 with the bradycardia/tachycardia syndrome, and three with sinoatrial block) for four to 14 years after placement of a permanent ventricular pacemaker….
Article
Catheterization Diagnosis, Treatment, and Prevention
ABSTRACTAir embolism associated with central venous catheterization carries with it a significant morbidity and mortality. The diagnosis should be suggested by sudden alterations in cardiovascular, respiratory, or central nervous system function in a patient with a central venous catheter. A “mill wheel” cardiac murmur is characteristic. Placing the patient in…
Article
Diagnosis of Aortic Insufficiency Comparison of Auscultation and M-Mode Echocardiography to Angiography
ABSTRACTWe compared auscultation and M-mode echocardiography to supravalvular aortography in 75 patients with chronic aortic insufficiency. Angiographic evidence of aortic insufficiency was present in 66 patients and absent in nine. Auscultation had a sensitivity of 72.7% (48/66) and a specificity of 77.8% (7/9). Echocardiography had a sensitivity of 75.8% (50/66)…
Article
Sexual Function After Surgical and Radiation Therapy for Cervical Carcinoma
ABSTRACTOne hundred women treated for carcinoma of the cervix were interviewed more than one year later to establish the effects of radiation or surgical therapy on sexual function. Forty-three had received irradiation, 44 nonradical surgery, six combined surgery and irradiation, and seven radical surgery. The irradiation and nonradical surgery groups…
Article
Postmenopausal Breast Abscess
ABSTRACTEighteen postmenopausal women with breast abscess were treated at Grady Hospital between 1975 and 1978. Breast abscess was remarkable for its characteristic lack of inflammation, as well as its rarity, in this age group (median, 59 years). Only 17% of patients reported fever and/or breast pain. On initial examination, 33%…
Article
Endoscopic Cytology and Biopsy Diagnosis of Esophageal Carcinoma
ABSTRACTWe examined 107 cytology and biopsy specimens taken simultaneously from 103 patients to determine the efficacy of cytologic esophageal brushing in the diagnosis of esophageal carcinoma. After review of all material, cytology was positive in 84% of cases, biopsy in 86%, and combined specimens (cytology and biopsy) in 94%. However,…
Article
Spur Cell Anemia
ABSTRACTThe clinical and laboratory findings in eight patients with spur cell anemia are presented and compared with other cases gathered from the literature. Although there is no specific clinical or laboratory abnormality, the condition can be recognized by a constellation of findings. The majority of patients have a long history…
Article
Questionable Value of Renal Arterial Embolization Before Radical Nephrectomy
ABSTRACTExperience with arterial embolization in six patients has shown little substantive benefit, a major complication, and few measurable advantages in a variety of patients with hypernephroma.
Article
Choledochal Cysts in Children Radiologic Features
ABSTRACTCholedochal cysts, although uncommon, are found most frequently in children. Radiologic studies have always played an important role in diagnosis because of the nonspecific clinical features. The abdominal roentgenogram may show in the right upper abdomen a mass, the cystic nature of which can be demonstrated by intravenous urography, hepatic…
Article
Osteogenesis Imperfecta and Associated Hearing Loss in Five Kindreds
ABSTRACTWe examined audiometric data of 30 medically confirmed cases of osteogenesis imperfecta, evaluating pure tone threshold and impedance data to determine the prevalence, type, and degree of hearing loss in five kindreds. Nineteen of the 30 individuals evaluated had normal hearing bilaterally, while 11 had hearing losses of various types…
Article
The Middle Ear in Long-term Dialysis
ABSTRACTWhen fluctuating middle ear fluid was observed in patients receiving long-term dialysis, the dialysis was suspected as the potentiating factor. In a statewide survey, a significant number of ear, nose, and throat specialists were undecided about etiology. They were also uncertain about treatment choice and delivering services without consulting the…
Article
Lidocaine Analgesia in Peripheral Angiography A Confirmation of Effectiveness
ABSTRACTA prospective double-blind randomized study of 34 patients, using both subjective and objective evaluation, showed lidocaine to be effective for analgesia in peripheral angiography. The methods, materials, and results of this study are compared to previous studies, with the differences noted.
Article
Pyogenic Arthritis Emphasis on the Need for Surgical Drainage of the Infected Joint
ABSTRACTA ten-year retrospective review of patients with acute hematogenous pyogenic arthritis at the Duke University Medical Center yielded 14 affected joints in the pediatric group and 32 in adults. Follow-up ranged from six months to eight years. Analysis of factors possibly affecting end results included the joint involved, organism, duration…
Article
Treated Maternal Gonorrhea Without Adverse Effect on Outcome of Pregnancy
ABSTRACTInfants born to mothers with gonorrhea are at risk for neonatal gonococcal infection, primarily ophthalmitis. To determine whether gonorrhea during pregnancy may have other adverse effects, we compared the outcome of pregnancy to gonorrheal status for all women who were delivered of infants at Grady Memorial Hospital in 1976 and…
Review Article
Analgesics and Asthma
ABSTRACTAspirin and many other analgesics may be hazardous for some patients with asthma. These patients, numbering approximately 10% to 15% of all asthmatics, have a clinical course that has been well characterized. The diagnosis is usually made from the history, but sometimes it requires analgesic challenge tests. The pathogenesis remains…
Article
Law and the Minor Patient
Our Medical Heritage
Primary Cardiac Tumors Historically Elusive Lesions
Medical Education
Evaluation of Educational Methods in a Comprehensive Cost-Containment Project in Ambulatory Care
ABSTRACTThe cost of medical care in the United States is a matter of great concern to many health policy makers and physicians as well as to the seekers of care. At the University of New Mexico, a comprehensive cost-containment education program was devised and put into effect with residents from…