SMJ // June 1982, Volume 75 - Issue 6
Editorial
AUTHORS TAKE NOTE
Acknowledgement
ACKNOWLEDGMENT
Primary Article
Vascular Reconstruction in the Octogenarian
The octogenarian has usually been considered too old to have resection of a 6 cm abdominal aortic aneurysm, which is as life-threatening as a carcinoma of the colon. Other vascular lesions can also be a threat to the mobility of the elderly person. Our approach to debilitating lesions such as…
Primary Article
Thoracic Aortic Rupture in Patients With Multisystem Injuries
This report attempts to delineate management priorities in patients with thoracic aortic tears and severe multisystem trauma. Nineteen patients with a mean age of 40 years were treated after motor vehicle accidents. An average of five major systems were injured and the majority of patients sustained head injury, severe intra-abdominal…
Primary Article
Natural History of the Retained Surgical Sponge
Retained surgical sponge is an infrequently reported condition that may be recognized incidentally during the early postoperative period, produce serious complications, or remain dormant for years. Clinical manifestations of the retained surgical sponge are a function of bacterial contamination and of the location of the sponge within the body cavity….
Primary Article
Hormonal Status of Patients With Primary Malignant Melanoma A Review of 313 Cases
We studied 313 patients with a confirmed diagnosis of primary malignant melanoma who presented to The University of Texas System Cancer Center between 1976 and 1980, to determine the relationship of endocrine status to the presentation of this tumor. There were 171 women and 142 men, a ratio of 1.20:1….
Primary Article
Pulmonary Sclerosing Hemangioma Sometimes a Form of Pulmonary Hamartoma
Previous light and electron microscopic examinations of sclerosing hemangiomas of the lung have raised questions regarding their varying microscopic patterns and cells of origin. We describe two additional cases: one studied by light microscopy revealed the classic pattern of a sclerosing hemangioma of endothelial origin, and a second, studied by…
Primary Article
Results of Radiotherapy for Stage I and II Hodgkins Disease
Fifty-six patients with pathologically staged I and II (A and B) Hodgkins disease were treated with radiation therapy. Three-year relapse-free survival, total survival, and complications were analyzed. Chemotherapy was valuable as rescue treatment and as part of the initial treatment in patients with stage IIB disease. Complications were minimal.
Primary Article
Antrochoanal Polyps
Inflammatory polyps that arise in the maxillary antra may extend into the nasal cavity and result in nasal obstruction. In some instances a combination of roentgenographic findings is helpful in diagnosis. This combination includes diminished aeration of the involved maxillary antrum, expansion of the antrum, and a soft tissue mass…
Primary Article
Multiple Cholesterol Emboli Syndrome
Of four patients with the syndrome of multiple cholesterol emboli (MCES), three had acute renal failure. One patient recovered stable renal function. A radiocontrast study preceded three of the cases. All four patients exhibited the “purple toe” livido reticularis syndrome. Three had a previously unreported finding—necrosis of the scrotum and…
Primary Article
Mechanical Bull Syndrome
Although the mechanical bull was originally designed to train cowboys for the rodeo, nearly 1,000 of these machines are in use in night clubs and amusement parks throughout the United States. We have treated 84 mechanical-bull-related injuries in our institution, the most common to the groin and the lower extremity…
Primary Article
Incentive Spirometer for Bedside Studies
We evaluated an incentive spirometer (IS) for monitoring changes in lung function in hospitalized patients. Accuracy and reproducibility of IS measurements of known volumes were adequate (r = 0.87). Flow dependency was demonstrated but was not significant in the clinically useful range. Reproducibility of IS measurements in five normal subjects…
Primary Article
Systemic Vasopressin Therapy for Mallory-Weiss Bleeding
Over a period of one year, five of 101 patients admitted to our center because of upper gastrointestinal bleeding were found to have a Mallory-Weiss tear. This condition usually responds to conservative management. Torrential bleeding necessitating surgery is uncommon. Three of the patients, reported here, bled torrentially and were considered…
Primary Article
New Perspectives on Coronary Artery Disease in Hemodialysis Patients
Between July 1, 1979, and July 1, 1980, we treated 64 patients with long-term maintenance hemodialysis. Of these, 11 (17%) had angina pectoris, four of them (6%) chronic stable angina and seven (11%) new onset of crescendo angina. The most common risk factors in the group with unstable angina were…
Primary Article
Critical Care Medicine in a Private Hospital
Technologic advances in the past ten years, coupled with the advent of a new specialty of critical care medicine, have made it possible for patients to survive major surgical procedures and critical illnesses which, ten years ago, would have resulted in certain death. In 1979, a group of emergency physicians,…
Errata
Correction
Primary Article
Automated Neonatal Hearing Test in a Community Hospital
A program to screen the hearing of newborn infants in a community hospital was instituted over a two-year period to determine if an automated program could function compatibly with a normal newborn nursery routine and still yield data as accurate as those reported in large-scale investigations done in academic medical…
Primary Article
Posttraumatic Stress Disorder in Vietnam Veterans A Review
Primary care physicians may encounter patients having posttraumatic stress disorder (PTSD) related to combat experience before they come to the attention of the mental health system. Specific criteria for making the diagnosis of PTSD are now available. Effective psychiatric treatment, particularly group therapy and pharmacotherapy, is now available. Posttraumatic stress…
Primary Article
Dementia The Search for Treatable Causes
Of 100 consecutive cases of dementia, 23 were found to be of treatable or reversible causes. Many of these patients had been labeled as having “senile dementia” and some were en route to chronic care facilities. The implications of overlooking a treatable cause of dementia are obvious but cannot be…
Primary Article
Elevation of Serum Amylase Levels After Narcotic Administration
Hyperamylasemia after narcotic administration is found in some patients. To determine the source of the amylase, serum isoamylases were separated by column chromatography in a group of patients with response to a Prostigmin-morphine challenge. The increment of amylase activity was pancreatic amylase.
Review Article
Clonidine Hydrochloride
Clonidine hydrochloride (Catapres), a potent antihypertensive agent, has been in clinical use since 1974 in the United States. Clonidine, an α-adrenergic receptor agonist, stimulates central alpha receptors in the depressor site of the vasomotor center of the medulla oblongata and hypothalamus, which diminishes efferent sympathetic tone to the heart, kidneys,…
Current Concepts
Pediatric Transfusion Considerations by Age and Blood Component
Transfusion in the pediatric age group requires careful consideration of the patients weight and age because of potential problems with intravascular volume and difficulty with administration of the blood product. Different age groups have varied disease processes that require specific blood components. A correct diagnosis is essential for their proper…
Grand Rounds
Saturday Conference Steroid withdrawal Syndromes
Case Report
Lithium Intoxication and Its Clinical Management
Case Report
Hyperthyroid-induced Urticaria
Case Report
Eosinophilic Gastroenteritis
Case Report
Neonatal Coronary Thrombosis
Case Report
Invasive Disease Due to Nontypable Haemophilus influenzae in Children
Its virulence factors, immune responses, and sites of isolation characterize nontypable Haemophilus influenzae as a pathogen of mucosal surfaces which rarely causes invasive disease. We isolated nontypable H influenzae in pure culture from thoracentesis fluid in a child with pneumonia. An extensive review of the literature in which serotyping of…
