SMJ // February 1982, Volume 75 - Issue 2
Editorial
A GLOVE UPON THAT HAND
Commentary
SHORT-COURSE CHEMOTHERAPY FOR TUBERCULOSIS
Primary Article
Nine-Month Chemotherapy for Pulmonary Tuberculosis
ABSTRACTThere is extensive favorable worldwide experience with short-course chemotherapy (SCC) for pulmonary tuberculosis. It has not yet been shown, however, that daily, unsupervised SCC would be efficacious in the United States, especially in large urban centers where compliance rates are poor and alcohol abuse is common. From January 1977 to…
Primary Article
Clindamycin Versus Nafcillin or Methicillin in the Treatment of Staphylococcus aureus Osteomyelitis in Children
ABSTRACTThe treatment of osteomyelitis due to Staphylococcus aureus was evaluated by randomized trial in 12 children who received clindamycin and 13 children who received nafcillin or methicillin. In the nafcillin/methicillin group, the mean duration of intravenous (IV) therapy was 27 days (range 14 to 38 days) plus 3.7 weeks (range…
Primary Article
Staphylococcal Bacteremia in Cancer Patients Intravenous and Oral Antimicrobial Therapy
ABSTRACTEighteen adult cancer patients with 21 episodes of stahylococcal bacteremia were treated with sequential intravenous and oral antimicrobial agents. Adequacy of antimicrobial therapy was monitored with serum antibacterial activity studies. The mean duration of intravenous and oral therapy was nine and 25 days, respectively. Clinical and bacteriologic cures were achieved…
Primary Article
Blood Cultures in Bacteremia
ABSTRACTBlood cultures in a 700-bed hospital were examined for clinical relevance. During a six-month period 5,154 blood samples were drawn from 1,091 patients. Of the 124 patients with positive blood cultures, 7% had polymicrobic isolates. A review of hospital records for a three-year period revealed 162 charts with adequate documentation…
Primary Article
Violent Behavir Among Hospitalized Medical and Surgical Patients
ABSTRACTTo characterize violent behavior in hospitalized medical and surgical patients, we reviewed documented violant incidents at the San Francisco General Hospital during a two-year period. Twenty-nine incidents of verbal and physical violence occurred. One patient was gravely ill and three were delirious. All the incidents wer associated with increasing levels…
Primary Article
Roentgenographic Abnormalities in Rocky Mountain Spotted Fever
ABSTRACTRocky Mountain spotted fever (RMSF) is a tick-borne rickettsial disease which produces a widespread vasculitis. A mortality of 7% to 13% has been reported in the United States which is due at least in part to delay in diagnosis and appropriate treatment. The classic features of this disease include a…
Primary Article
Short-term Intubation in Children With Acute Epiglottitis
ABSTRACTManagement of the airway in acute epiglottitis is still controversial. One argument against intubation as opposed to tracheostomy is the increased complications from prolonged intubation. We described a study of 26 children treated for acute epiglottitis from 1971 to 1979. Included in this series are 16 consecutive patients who were…
Primary Article
Reversal of Female Sterilization
ABSTRACTSterilization reversal is performed more frequently since the innovation of microscopic technics in tubal surgery. We analyzed 40 consecutive cases of reversal of female sterilization performed at the Medical College of Georgia from 1973 through 1980. We used a temporary intraluminal 2–0 nylon splint. Microsurgical technic was used in 17…
Primary Article
HIDA Scanning and Ultrasonography in the Expeditious Diagnosis of Acute Cholecystitis
ABSTRACTRadionuclide hepatobiliary imaging (HIDA scanning), a pathophysologic modality, has become the diagnostic method of choice for suspected acute cholecystitis. The diagnosis is made quickly with this technic, which is simple, safe, and accurate. It is in widespread use and will soon be available for small community hospitals as well as…
Primary Article
Evaluation of a Tay-Sachs Screening Program on a College Campus
ABSTRACTA screening program for Tay-Sachs disease was done on a predominantly unmarried, university student population and later evaluated. Ten carriers were detected among a population of 390 screened. Voluntarily screened individuals were given a questionnaire at the time of screening and after their carrier status was revealed. In addition, individuals…
Primary Article
Apathetic Thyrotoxicosis Presenting as an Abdominal Emergency A Diagnostic Pitfall
ABSTRACTThyrotoxicosis may present with a hyperkinetic cllinical picture typically associated with Graves or Plumers disease, or in an apathetic form characterized by lethargy, weakness, and withdrawal. Both the hyperkientic and apathetic forms of thyrotoxicosis may be associated with or masked by predominantly extrathyroidal manifestations, occasionally referable primarily to the abdomen….
Primary Article
Effect of Repeated Succinylcholine Injections on Heart Rate Following Intramuscularly Administered Antimuscarinic Drugs Glycopyrrolate and Atropine
ABSTRACTThe possibility of using the longer acting antimuscarinic drug glycopyrrolate intramuscularly to prevent the bradycardia that sometimes results from successive doses of succinylcholine was examined. Atropine, in an equipotent dose, was given to another group of patients for comparison. Glycopyrrolate was as ineffective as atropine in preventing bradycardia. Later, a…
Primary Article
Dinitrophenol Poisoning A Diagnosis to Consider in Undiagnosed Fever
ABSTRACTA 32-year-old farmer had signs and symptoms of dinitrophenol poisoning after crop spraying with a herbicide containing derivatives of 2,4-dinitrophenol. Dinitrophenol causes toxicity by the uncoupling of oxidative phosphorylation in the mitochondria of cells throughout the body. In man the classic syndrome consists of lassitude, malaise, headache, increased perspiration, thirst,…
Primary Article
Improvement of Diabetic Peripheral Neuropathy With the Portable Insulin Infusion Pump
ABSTRACTA 16-year-old girl with insulin dependent (Type I) diabetes since age 9 and painful sensory neuropathy for two months was treated with a portable insulin infusion pump, allowing strict control of hyperglycemia. Within 28 days the distal motor latency in all nerves tested had improved and painful incapacitating dysesthesias disappeared….
Primary Article
Effect of Low-dose Heparin on the Platelet County
ABSTRACTThrombocytopenia has been associated wit the use of intravenous heparin, but the effect of low-dose, subcutaneously administered heparin on the platelet count is not known. We monitored the platelet counts in 50 patients admitted to a coronary care unit and given low doses of heparin for at least three days….
Review Article
Prostatic Cancer
ABSTRACTProstatic cancer is a common cause of morbidity and mortality in the United States. Although many new serologic and radiologic procedures are now used in its diagnosis, the rectal examination still remains the best diagnostic test. Staging is essential for effective treatment. Treatment of prostatic cancer varies, with observation in…
Article
Rationale Behind the Periodic Health Examination in Adults
ABSTRACTWe have outlined a comprehensive approach to the periodic examination of adults. We do not discuss reasons for excluding specific practices. The approach outlined eliminates many practices that have become part of the “routine examination” and focuses on specify key areas. Our recommendations are practical and somewhat more inclusive than…
Current Concepts
Pharmacologic Agents in the Management of Pheochromocytoma
ABSTRACTMedical management of pheochromocytoma involves the use of many therapeutic agents. Phenoxybenzamine HCl (Dibenzyline), an alpha-adrenergic blocking agent, at 40 to 80 mg per day can control the disease in most patients. Use of this drug up to the time of operation is controersial. Beta-adrenergic receptor blockade with propranolol is…
