Issue - Southern Medical Association

Editorial

JUGGLING THE CURRICULUM

Editorial

RETURN OF RICKETS

Primary Article

Anorexia Nervosa A Disorder With Severe Acid-Base Derangements

Fluid and electrolyte derangements occur frequently in patients with vomiting and anorexia nervosa and contribute to protracted morbidity and a mortality reported to be as high as 22%, probably from hypokalemia. Hypochloremic, hypokalemic metabolic alkalosis is characteristic, in conjunction with significant intravascular volume depletion and hypotension. Exceedingly low urinary chloride…

Primary Article

Performance of a Level II Nursery in a Neonatal Regional Program Part I. Patient Population and Role of the General Pediatrician

We examined the performance of a level II nursery in a regional neonatal program during a 30-month period. Of 3,851 live-born infants, 527 (13.7%) were admitted to the special care nursery and 70 (1.8%) were transferred to a level III nursery. There were 23 neonatal deaths, ten of them in…

Primary Article

Part II. Analysis of Transferred Patients and Criteria for Maternal Transfer

Our review of deliveries at a level II hospital for a 30-month period showed 3,851 live births and 23 deaths (NMR 6/1,000 LB); 527 neonates (13.7%) required admission to the Special Care Unit, and 70 (1.8%) required transfer to a level III nursery. The 70 transferred patients received 1,592 days…

Primary Article

Aerotolerance of Common Anaerobic Bacteria—Fact or Fancy?

Quantitative studies of cultures from mixed aerobic-anaerobic intra-abdominal infections in both human patients and experimental animals showed no significant reduction in the concentrations of anaerobic bacteria after exposure to room air for up to 24 hours. Clinically significant anaerobic bacteria appear to be relatively aerotolerant when present in a mixed…

Primary Article

Chemoprophylaxis in Cardiac and Orthopedic Surgery Comparison of Cephalothin and Cephapirin

In a retrospective sequential study we determined the rate of infection occurring despite cephalothin or cephapirin chemoprophylaxis in orthopedic and cardiac surgery done from 1973 to 1977. The incidence of infection after prosthetic hip placement or open reduction of hip fracture was 3.4% and 1.0% in patients receiving cephalothin or…

Primary Article

Rocky Mountain Spotted Fever in Pregnancy Differential Diagnosis and Treatment

Rocky Mountain spotted fever (RMSF) presents both diagnostic and therapeutic difficulties in the pregnant patient. Early clinical manifestations may be mistaken for normal pregnancy changes. Accurate diagnosis is essential, since several of the disorders in the differential diagnosis may have important obstetric implications. Antibiotics generally used to treat serious infections…

Primary Article

Cirrhosis, Variceal Bleeding, and Distal Splenorenal Shunt in Hemophilia A

Chronic liver disease has become a significant complication of the therapy of hemophilia disorders. We describe two patients with hemophilia A and hepatitis B virus hepatitis who progressed to cirrhosis with bleeding esophageal varices. Each underwent distal splenorenal shunt under plasma concentrate therapy without difficulty. One patient died 19 months…

Primary Article

Management of Cecal Volvulus in Debilitated Patients

We retrospectively evaluated ten cases of cecal volvulus. The average age of these patients was 57 years. Five patients were more than 60 years old and three were over 70. All patients had significant delays in coming to the hospital, and all had concomitant medical problems that made them poor…

Primary Article

Refined Carbohydrate as a Contributing Factor in Reactive Hypoglycemia

To assess the effects of diet on symptoms in patients with idiopathic reactive hypoglycemia, we obtained by dietary recall histories the dietary composition from eight of these patients. The data obtained represented the dietary content of each individual before and after instruction on a diet containing 100 gm of carbohydrate…

Primary Article

Delayed Cutaneous Hypersensitivity Testing

The topic of delayed cutaneous hypersensitivity testing is reviewed. When skin tests are used to determine whether an individual is anergic, T cell immunity is evaluated. Skin testing can be used to determine the causative organisms of infection or to discover an immunologic deficiency state. Characteristic skin lesions usually develop…

Primary Article

Comparison of Physician and Patient Perceptions of Communications Issues

Sixty-three adolescent cancer patients and 53 physicians participated in a study designed to compare physician and patient perceptions of (1) the delivery of information at diagnosis, (2) patient reactions to treatment-related concerns, and (3) physician utilization patterns. Both patients and cancer center physicians appeared comfortable with the designation of the…

Primary Article

Villonodular Synovitis Pigmented and Nonpigmented Variations

During the past 20 years, 34 cases of pigmented villonodular synovitis have been seen at Jackson Memorial Hospital, University of Miami Medical Center. There were 18 cases in the knee, eight in the hip, one in the elbow, two in the finger, three in the ankle, one in the wrist,…

Primary Article

Revascularization of Kidneys With Totally Occluded Renal Arteries

Nephrectomy has been the accepted treatment for renovascular hypertension due to an occluded renal artery but successful revascularization of occluded renal arteries has resulted in partial return of function and relief of hypertension. We performed aorticorenal bypass operations on four patients whose renal arteries were not patent. One graft failed…

Primary Article

Use of Subclavian Catheters for Hemodialysis

In 98 patients, we cannulated the subclavian and internal jugular veins with modified Shaldon catheters, using the Seldinger technic. Catheters were left for long periods, and multiple dialyses were accomplished with each catheter. The incidence of major complications was less than 5%. None of the catheters were believed to be…

Primary Article

Incidence of Malnutrition Among Patients Admitted to a VA Hospital

We studied 1,225 consecutive patients admitted to a large Veterans Administration Medical Center over an eight-week period to assess the degree of malnutrition. The parameters of malnutrition were visceral protein pool, lymphocyte count, delayed cutaneous hypersensitivity, and anthropometric measurements. More than one third of the patients had one or more…

Primary Article

Brachial Artery Reconstruction After Traumatic Disruption

We describe a series of 21 cases of traumatic disruption of the brachial artery that required surgical intervention. Stab wounds were most frequent (11), followed by gunshot wounds (six) and blunt trauma (four). Ten patients had associated upper extremity injuries including bone, nerve, and vein. Arterial repair with lateral sutures…

Review Article

Anorexia Nervosa Review of Current Treatment Practices

The etiology of anorexia nervosa has defied elucidation for over 100 years and no systematic treatment has yet been developed for the illness. We have reviewed some current findings that relate to both neuroendocrinologic and psychologic defects. Review of current treatment practices reveals that a variety of approaches are used,…

Article

Words

Medical Education

Undergraduate Medical Education for Primary Care A Case Study in New Mexico

To address the dual problems of maldistribution of physicians and an increasing need for physicians who are lifelong learners, an experimental curricular track was developed at the University of New Mexico School of Medicine. Increased student responsibility for learning is encouraged by student-centered, small-group, problem-based tutorial learning, and early, primary…

Case Report

Liver Tumors and Oral Contraceptives

Case Report

Echocardiographic Diagnosis of Left Atrial Myxoma

Case Report

Pyloric Atresia

Case Report

Malignant Hypertension Associated With Use of Amitriptyline Hydrochloride

Case Report

Two-Dimensional Echocardiography in the Diagnosis of Left Atrial Myxoma in a Child

Case Report

Noninvasive Documentation of Cardiovascular Involvement in a Neonate With Marfans Syndrome

Case Report

Transcatheter Embolization for Control of Bleeding After Prostatic Biopsy

Case Report

Neutropenia Associated With Vancomycin Therapy

Case Report

Nonbacterial Thrombotic Endocarditis as a Cause of Stroke in Mitral Valve Prolapse

Case Report

The Liver in Secondary Syphilis

Case Report

Parathyroid Cyst Medical Diagnosis and Therapy

Case Report

Drug Fever During Treatment of Pulmonary Edema

Case Report

Diabetes Insipidus Associated With Central Nervous System Leukemia

Case Report

Saphenous Vein Bypass to the Posterior Interventricular Vein An Unusual Complication of Coronary Artery Surgery

Case Report

Thrombocytopenia With Increased Bone Marrow Megakaryocytes in Two Patients With Viral Hepatitis

Case Report

Disseminated Infection With Aspergillus flavus in an Alcoholic Patient

Breif Report

Gunshot “Inoculation” Blastomycosis of the Nervous System

Breif Report

Idiopathic Pancreatic Stones Causing Pancreatic Ascites

Breif Report

Jejunal Perforation Associated With Slow-Release Potassium Chloride Therapy

Breif Report

Neonatal Appendicitis Mistaken for Necrotizing Enterocolitis

Breif Report

Retroperitoneal Actinomycosis A Rare Manifestation of an Uncommon Disease

Letter to the Editor

Response to This Issues Editorial

Letter to the Editor

Malabsorption of Sustained-Release Procainamide Tablets