SMJ // March 1983, Volume 76 - Issue 3
Editorial
INTO THE BRIER-PATCH
Retrospective
Plague of Pellagra
Retrospective
Whipples Disease Pathogenetic Considerations
ABSTRACTA typical case of Whipples disease was manifested by malabsorption and nondeforming peripheral arthritis for five years. A definite diagnosis was made by duodenal mucosal biopsy which revealed the characteristic histologic features by light microscopy, intracellular and extracellular Whipples bacilli by electron microscopy, and a typical immune cross-reactivity pattern by…
Retrospective
Mucocutaneous Lymph Node Syndrome in North Louisiana Review of 15 Cases
ABSTRACTMucocutaneous lymph node syndrome (MLNS) is being more frequently reported in the United States, and it appears to be an important disease of childhood. Fifteen infants and children with MLNS were treated at the Louisiana State University teaching hospitals in Shreveport and Monroe between August 1978 and January 1981. A…
Retrospective
Marine Noncholera Vibrio Infections in Florida
ABSTRACTIn the past decade, there has been a dramatic increase in the number of reported cases of clinical illness from noncholera (marine) vibrio infections, leading to a greater recognition of this potentially lethal disease. The wide spectrum of pathogenicity of this organism is reflected in the six cases in this…
Retrospective
Diagnosis and Treatment of Echinococcal Cyst of the Liver
ABSTRACTUltrasonography and computerized tomography now allow quick and accurate diagnosis of hydatid disease of the liver. A case diagnosed by these means and confirmed surgically is presented. The clinical features, diagnosis, and treatment of this disease are reviewed.
Retrospective
Wringer Injuries of Extremities
ABSTRACTThe manifestations of injuries caused by wringer washing machines were examined in 24 children with a total of 26 injured extremities. The extent of injury was almost always determined at admission and delays of four hours or more from injury resulted in longer hospitalization. The majority of the injuries were…
Retrospective
Posttraumatic Osteolysis of the Clavicle
ABSTRACTPosttraumatic osteolysis of the distal clavicle should be considered when continued pain follows trauma. The osteolysis and accompanying symptoms can be partially alleviated by immobilization of the shoulder joint. The pathology is poorly understood, but synovial hyperplasia appears to play an integral part in the resorptive process.
Retrospective
Retinal Reflex Photometry as a Screening Device for Amblyopia and Preamblyopic States in Children
ABSTRACTAberration in the physical structure or alignment of the eyes may produce pathologic neurocompensatory changes in the brain that, if left unattended, become irreversible. Two common examples of this abnormal state are accommodative esotropia and amblyopia. Both have a large optic component in their etiology and in most cases are…
Retrospective
Bulimia Diagnostic Clues
ABSTRACTBulimia is an eating disorder characterized by the ingestion of large amounts of food, usually followed by self-induced vomiting or laxative abuse. Although sometimes a symptom of obesity or anorexia nervosa, bulimia is often associated with borderline weight and nutritional status and thus may be difficult to detect. Since secrecy…
Retrospective
MMPI Evaluation of Patients With Chronic Pain
ABSTRACTTo determine the usefulness of the MMPI as part of the multidisciplinary evaluation process, we reviewed the records of 21 patients who had had psychologic assessment at the Medical College of Virginia Pain Center. The four case histories selected illustrate the value of data obtained from MMPI profiles.
Retrospective
Hypnosis in the Treatment of Chronic Pain
ABSTRACTChronic pain can be treated by combining hypnosis with brief psychotherapy. Hypnosis alone, though useful for acute pain, is seldom effective in relieving chronic pain because it does not address the significant psychologic components in the patients illness. Treatment using self-hypnosis in conjunction with brief psychotherapy, however, can enable the…
Retrospective
Cerebrospinal Fluid Pleocytosis After Seizures
ABSTRACTCerebrospinal fluid (CSF) pleocytosis after seizure activity has been anecdotally reported for many years, but it has not been well documented. We reviewed the records of all adult patients admitted to Grady Memorial Hospital from November 1979 through October 1980 with die diagnosis of seizure. Of 102 patients whose CSF…
Retrospective
Effect of Written Information on Physicians Knowledge of Drug Prices
ABSTRACTFifty-four residents in internal medicine and primary care medicine were surveyed before and after receiving a prescription drugs price guide booklet to determine whether providing written price information to the residents would improve their knowledge of drug costs. Results indicated that the pricing information did not improve the residents knowledge…
Retrospective
Esophageal Perforation Associated With Combined Use of the Thumper Resuscitator and Esophageal Airway
ABSTRACTEsophageal perforation is an uncommon but catastrophic complication of resuscitation with the esophageal obturator airway. Three cases of esophageal perforation are reported associated with combined use of an obturator airway and Thumper mechanical resuscitator. The possibility of increased risk when these devices are used together has not been previously discussed…
Retrospective
Effect of Therapy on the Neutropenia of Hyperthyroidism
ABSTRACTObservations in a patient with recurrent hyperthyroidism, each time associated with neutropenia which resolved after therapy, prompted a chart review of other patients referred for radioactive iodine therapy. Of 99 untreated patients, 18 had neutrophil counts of less than 2,000/cu mm. After therapy with either thionamides or 131I, 41 of…
Retrospective
Efficacy of Technetium Tc 99m Pyrophosphate Imaging in Patients With Equivocal Myocardial Infarction
ABSTRACTWe studied the efficacy of technetium Tc 99m pyrophosphate imaging in patients with equivocal evidence of acute myocardial infarction. Only patients with positive enzyme findings (regardless of ECG findings) had scans with ≥2 + focal uptake. None of 26 patients with negative or equivocal enzyme findings (regardless of ECG findings)…
Retrospective
Comparison of Various Methods of Diagnosis of Renal Cystic Masses
ABSTRACTTwo hundred fifty patients with renal cystic masses were evaluated by several diagnostic modalities, including sonography, angiography, cystography, and cytology. This presentation demonstrates the relative advantages of these methods as well as their relative level of confidence and diagnostic accuracy. When the lesion fulfilled all of the sonographic criteria for…
Review Article
Systemic Effects of Topical Ophthalmic Medications
ABSTRACTOphthalmic drugs topically applied have significant systemic absorption, which may result in widespread adverse side effects. All physicians involved in the care of patients receiving these drugs should be cognizant of such actions, interactions, and toxic effects. They should also be familiar with the prevention, diagnosis, and treatment of these…
Review Article
Cardiovascular Involvement in Kawasaki Syndrome
ABSTRACTDeath occurs in a small but significant percentage of patients with Kawasaki syndrome. Cardiovascular involvement is the major cause of death, which may be delayed and sudden. Much has been written about diagnosis and medical and surgical therapy. We reviewed the current understanding of this disease and its cardiovascular manifestations…
Abstract
Intensive Care
Current Concepts
Use and Interpretation of Serologic Tests for the Diagnosis of Syphilis
ABSTRACTSyphilis has become a disease of low prevalence in the general population of the United States. In addition, serologic tests for syphilis are not as specific as commonly believed. These two facts cast doubt on a diagnosis of syphilis based solely on serologic evidence. However, ordering tests selectively on the…
Article
Psychologic Effects of Residency
ABSTRACTThe intense situational and physiologic stresses that accompany postgraduate training may have serious psychosocial ramifications. Although only a small proportion of residents have overt psychiatric illness, virtually all display some psychologic impairment. Contributing factors include life-changes, stresses associated with providing patient care, loss of social support, long working hours, sleep…
