SMJ // May 1983, Volume 76 - Issue 5
Editorial
TOXIC ROT
Editorial
E.W.G. AND THE CONQUEST OF VIRUSES
Primary Article
Potential Toxicity Due to Dolomite and Bonemeal
Large amounts of dolomite and bonemeal are being consumed, especially by nutrition-conscious persons. The mineral content of commercial samples has been analyzed by different laboratories, and significant amounts of lead, arsenic, mercury, and other potentially toxic metals, which also exist in conventional vitamin-mineral and calcium supplements, were detected. Physicians must…
Primary Article
Ciguatera (Fish Poisoning)
Primary Article
Practical Experience With Percutaneous Nephrostomy Avoidance of Common Technical Pitfalls
In our 18-month experience with percutaneous nephrostomy (PCN) at Vanderbilt University Hospital and Veterans Administration Hospital (Nashville), a total of 47 PCNs were attempted with a success rate of 96%. The procedure is rapid, offers low morbidity, and has been readily accepted. Some variations of the standard procedure to avoid…
Primary Article
Ataxia in Listeria monocytogenes Infections of the Central Nervous System
From 1976 to 1981 Listeria monocytogenes was second only to Neisseria meningitidis as the cause of bacterial infections of the central nervous system in adults at our hospital. None of the patients with Listeria infection was immunosuppressed or had an underlying malignancy. Ataxia was an initial feature in five of…
Primary Article
Extraintestinal Infections Due to Halophilic Vibrios
To compare the clinical and epidemiologic features, we reviewed the hospital records and interviewed 18 patients with extraintestinal infections caused by three species of halophilic vibrios. Vibrio vulnificus, the organism most frequently isolated in Virginia during the six-year study period, caused primary septicemia in three patients. Fifteen patients had soft…
Primary Article
Beta-Hemolytic Streptococcal Pharyngitis Uncommon in Infectious Mononucleosis
Infectious mononucleosis (IM) and β-hemolytic streptococcal pharyngitis may present similar clinical pictures and may occur concurrently; however, recent studies have differed sharply with older ones that cited high rates of concurrent disease. Our study of 100 consecutive new patients meeing strict criteria for a diagnosis of IM found only 4%…
Primary Article
Nutritional Status and Anthracycline Cardiotoxicity in Children
The nutritional status of children in whom cardiomyopathy resulted from anthracycline chemotherapy was compared to that of a matched control group of patients who were treated similarly but who had no evidence of cardiac toxicity. Those with cardiotoxic reactions were found to be more often malnourished than were their matched…
Primary Article
The Condom Catheter Urinary Tract Infection and Other Complications
A retrospective study of 64 geriatric patients on an extended care unit at the VA Medical Center strongly suggested that long-term use of a condom catheter drainage system (CCDS) (mean use, 35 months) was regularly associated with urinary tract infection. Common nosocomial pathogens were found, particularly Proteus-Providencia. The CCDS was…
Primary Article
Continent Ileostomy
The continent ileostomy, consisting of a valve and a pouch, makes available an alternative system in which intestinal discharge can be stored and controlled after coloproctectomy. Earlier concerns regarding valve slippage with resulting malfunction have been largely eliminated by recent modifications in the technique of valve contruction. A continent ileostomy…
Primary Article
Gnat Sore Eyes Seasonal, Acute Conjunctivitis in a Southern State
In late summer 1981, a widespread outbreak of acute bacterial conjunctivitis occurred in southeast Georgia, affecting primarily grade-school children. This outbreak was similar to previously described seasonal conjunctivitis in the South. As suggested in previous studies, the eye gnat, Hippelates pusio, may serve as a mechanical vehicle in the transmission…
Primary Article
Ultrasonic Examination of Abdominal Wall and Groin Masses
Among 23 cases of obscure masses in the abdominal wall or groin exained by ultrasound, 91% had clinical confirmation of the ultrasonic findings, and in 39% of the cases, unsuspected conditions were diagnosed. All of the unconfirmed findings occurred through inability to distinguish inguinal adenopathy from inguinal abscesses.
Primary Article
When Do Patients With Chronic Obstructive Lung Disease Need Hospital Admission? Reflections Based on a VA Experience
Over a two-year period, the management of patients with chronic obstructive lung disease was observed in the walk-in clinic of a Veternas Administration Medical Center. Of 794 visits, 279 (35%) resulted in immediate hospitalization. Of 515 patients sent home, 229 (44%) relapsed, and of these, 165 (72%) eventually required admission….
Primary Article
Chest Pain, Dysphagia, and High Amplitude Esophageal Peristalisis A Clinical and Manometric Study
Recent literature has called attention to an esophageal motor abnormality characterized by high amplitude peristaltic contractions (HAPC). We characterized symptoms, manometric characteristics, and radiographic findings of 19 such patients and compared them to patients with other nonspecific esophageal motor disorders (NEMD). In the HAPC group, mean amplitude was 254 ±…
Primary Article
Subclavian Vein Thrombosis During Prolonged Catheterization for Parenteral Nutrition Early Management and Long-Term Follow-up
The purpose of this study was to determine the immediate and long-term complications of subclavian vein thrombosis occurring during prolonged catheterization for parenteral nutrition. Ten cases of subclavian vein thrombosis documented by venography were initially treated by catheter removal, systemic heparin, and upper extremity elevation. Although fever was common (N…
Primary Article
Replacement of Cervical Vertebral Body With a Tibial Bone Graft
Physicians in general medical practice or in emergency medicine are often confronted with injuries to the cervical spine. Although the extent of the injury might seem to be overwhelming, this paper demonstrates that severe cases of cervical injury can be dealt with effectively.
Primary Article
Midfacial Skeletal Profile in Early and Late Closure of the Hard Palate
The midfacial profile (anterior projection of the maxilla) was studied in 57 white children with cleft lip and palate and Veau type III clefts operated upon by one surgeon. These patients were divided into three groups delineated by the time of repair of the hard palate. One group had hard…
Primary Article
Failure of Thoracic Duct Drainage to Ameliorate Life-Threatening Physiologic Derangements of Acute Alcoholic Pancreatitis
In a prospective, randomized trial involving 11 patients, thoracic duct drainage failed to equal the immediate and reliable benefit gained by peritoneal dialysis in the treatment of severe alcoholic pancreatitis. Instead, patient management was perhaps even more complicated by such an approach.
Primary Article
Inoperable Stage III Carcinoma of the Breast
When seen initially, 10% to 29% of patients with breast cancer have locally advanced, nonresectable lesions without evidence of distant metastases. Radiotherapy offers significant palliation for these patients but has little influence on survival. Preoperative chemotherapy can be used to shrink many of these lesions and make them resectable. Adjuvant…
Primary Article
Athletic Activity and Menstruation
Menstrual dysfunction characterized by delayed menarche, irregular menses, or secondary amenorrhea often affects women who compete in athletics over a prolonged time. Loss of body fat and emotional stress are important predisposing factors. Under these circumstances, hypoestrogenism, an altered ratio of follicle-stimulating hormone to luteinizing hormone, and elevation of serum…
Primary Article
Pancreatic Imaging
Primary Article
Why We Need a Tax on Sleeping Pills
In the United States every year the total costs of giving sleeping pills can be estimated at $500 million to $1 billion. Many if not most of the prescriptions are inappropriate. Sleeping pill use, associated with a 50% increase in overall mortality, is especially dangerous for older people, who have…
