SMJ // September 1983, Volume 76 - Issue 9
Retrospective
Insulin
Primary Article
Pregnancy and Breast Cancer
ABSTRACTTo examine the relationship of pregnancy to survival in patients with breast cancer, we reviewed the records of 120 women under 36 years of age over a ten-year period and found 15 who were pregnant or lactating when breast cancer was diagnosed or who became pregnant after treatment. All 15…
Primary Article
Breast Necrosis Complicating Anticoagulation Therapy
ABSTRACTTwo patients had breast necrosis after sodium warfarin (Coumadin) therapy. This well recognized, but rare, complication of anticoagulation therapy also occurs in other areas of the body. The cause is not known. We present these cases and discuss the literature.
Primary Article
Psychiatric Disturbance in Hodgkins Disease
ABSTRACTWe describe the onset of psychotic depression in a young man receiving intensive therapy for Hodgkins disease. We have found other examples of psychiatric disturbance in the course of reviewing the charts of 40 men with Hodgkins disease and 20 with testicular cancer. We propose that patients with oncologic disease…
Primary Article
Religious Life of Schizophrenics
ABSTRACTWe inquired into the religious beliefs and practices of groups of schizophrenic and normal subjects. In addition, we evaluated their parents methods of rearing the subjects. We found that, in the schizophrenics home, the religious emphasis was limited and based on obligation and threat, and that the father had less…
Primary Article
Combination of Internal Radiation Therapy and Hyperthermia to Treat Liver Cancer
ABSTRACTSixteen patients were treated for liver cancer (primary and metastatic) by a combination of internal radiation therapy with intra-arterial yttrium 90 microspheres and regional hyperthermia with electromagnetic radiation. Four patients have their liver disease apparently controlled; two had a partial regression of more than 50%; and two had a partial…
Primary Article
Abdominal Incisions Transverse vs Vertical Placement and Continuous vs Interrupted Closure
ABSTRACTA previous retrospective review of 2,006 emergency laparotomies had suggested that anesthesia and operative times could be reduced by using a continuous stitch closure for all layers of the incision. A prospective, randomized study was then implemented through use of odd/even digits in the last and next-to-last digits in the…
Primary Article
Complications of Parotidectomy
ABSTRACTParotidectomy, whether subtotal or total, is a surgical procedure associated with certain possible complications—namely, facial nerve injury, hemorrhage, infection, salivary fistula, seroma, keloid formation, greater auricular nerve anesthesia, gustatory sweating, and recurrent tumor. We review these complications to help the surgeon with preoperative patient counseling, as well as postoperative reassurance,…
Primary Article
Risk Factors for Cholecystectomy Analysis of 935 Patients
ABSTRACTWe evaluated 935 patients for risk factors of cholecystectomy. Factors assessed included reason for cholecystectomy, preoperative laboratory values, sex, age, weight, presence of associated disease, and pathologic findings. Evaluation revealed an overall significant complication rate of 10.50% and a mortality of 1.07%. Risk factors were age over 60 years, hypertension,…
Primary Article
Transluminal Angioplasty in a Community Hospital A Surgeons Viewpoint
ABSTRACTWe have found transluminal angioplasty to be a safe and effective procedure for the relief of arterial obstruction. In a community hospital over a 20-month period, we did 100 consecutive dilatation procedures, many involving multiple dilatations, with no morbidity or mortality. Iliac lesions were dilated successfully (74/80) more often than…
Primary Article
Conditional Probability in the Diagnosis of Coronary Artery Disease A Future Tool for Eliminating Unnecessary Testing?
ABSTRACTApproximately 30% of the 300,000 coronary arteriograms done annually in the United States yield normal results. To see if the use of conditional probability in the diagnosis of coronary artery disease (CAD) could aid in predicting these normal results, we retrospectively assessed 96 patients with chest pain but without prior…
Primary Article
Comparison of Intravenous and Topical Lidocaine in Attenuating the Cardiovascular Responses to Endotracheal Intubation
ABSTRACTWe administered lidocaine intravenously or topically to the larynx to compare the cardiovascular response to intubation between the two techniques and to determine if these responses were related to blood levels of lidocaine. Sixteen patients were randomly selected into group A (100 mg intravenous lidocaine) or group B (160 mg…
Primary Article
Ingested Foreign Material in Mentally Disturbed Patients
ABSTRACTAdvances in endoscopic technology and its enthusiastic clinical application have resulted in the capability of retrieving most ingested foreign objects from the upper gastrointestinal tract. Although endoscopic removal of foreign bodies is generally safe, it is not always clearly indicated. Foreign bodies in the esophagus usually required prompt intervention. In…
Primary Article
Self-Help and Self-Care in Chronic Illness
ABSTRACTSome cultural and epidemiologic factors leading to a new emphasis on self-care in chronic illness are reviewed and current applications of self-care in medicine are illustrated with examples. Emotional and behavioral aspects of self-care programs are detailed with special attention to compliance, family involvement, and new roles for health professionals….
Primary Article
Staphylococcus aureus Bacteremia A Prospective Study
ABSTRACTDuring a 22-month period, 47 patients with 49 consecutive episodes of Staphylococcus aureus bacteremia were identified and observed prospectively for the development of endocarditis and metastatic infection. Eighteen (37%) of the episodes were community-acquired and 31 (63%) were nosocomial. The mean patient age was 55 years, and all but nine…
Primary Article
Radionuclide Esophageal Transit An Evaluation of Therapy in Achalasia
ABSTRACTWe measured quantitative esophageal transit, expressed as percentage of esophageal retention, before and after pneumatic dilatation in two patients with achalasia. In the sitting position they ingested a 500 ml liquid meal containing 500 μ Ci technetium Tc 99m sulfur colloid. Radioactivity counts of the entire esophagus were plotted at…
Primary Article
Inflatable Penile Prosthesis Experience With 100 Patients
ABSTRACTThe experience with 100 consecutive patients in whom an inflatable penile prosthesis was implanted for the treatment of chronic erectile impotence over a two-year period is reported. Each patient was thoroughly evaluated by history, physical examination, psychologic investigation, and appropriate laboratory testing. Of these patients, the most common indication for…
Primary Article
Mucous Cysts of the Digits
ABSTRACTOur experience over a six-year period with 13 mucous cysts occurring in patients with osteoarthritis and inflammatory arthritis suggests that skin grafting is not routinely necessary, but that thorough excision of the cyst, its stalk, and a bit of capsule is mandatory. Debridement of osteophytes and their role in the…
Primary Article
Medial Meniscectomy A Prospective Clinical Study
ABSTRACTThis is a prospective clinical study of 41 consecutive patients with isolated tears of the medial meniscus who underwent meniscectomy by conventional arthrotomy. The results are presented in terms of length of hospitalization, complications, analgesic requirements during hospitalization, and ability to regain muscle control of the operated extremities. I believe…
Review Article
Delirium Diagnosis and Treatment
Current Concepts
Management of Cholestasis
Medical Education
On Pulsus Paradoxus
ABSTRACTAn abnormal amount of pulsus paradoxus may be produced in normal volunteers, for teaching purposes, by having them inspire and expire against resistance.
Article
Dizzy Medical Writing
Acknowledgement
BOOKS RECEIVED
Our Medical Heritage
Copernicus, Medicine, and the Heliocentric Concept
ABSTRACTWith his back to the academically poorly oriented times of medieval Europe, Copernicus, the medical man, led the world into a concept of infinite space. His revolutionary concepts of astrophysics formed a buttress for the efforts of his successors. He looked to the stars, but he also had time to…
