SMJ // February 1984, Volume 77 - Issue 2
Primary Article
Child Abuse in Jackson, Mississippi
ABSTRACT: During an 18-month period, 148 children examined in the emergency room at the University of Mississippi Medical Center were suspected of having been the victims of child abuse. Physical abuse was suspected in 42.5%, sexual abuse in 38.5%, and neglect in 24.0%. The high prevalence of sexual abuse, particularly…
Primary Article
Influence of Age on Lithium Therapy
ABSTRACT: Contradictory information exists with respect to lithium dosage in elderly patients with affective disorders. To determine the relationship between age and lithium blood levels, we studied 66 outpatients in stable condition and receiving maintenance lithium therapy. The salient question was whether the same dosage of lithium will produce similar…
Primary Article
Combined Aortic and Renal Arterial Reconstruction
ABSTRACT: Vascular surgeons often suggest that combining renal arterial procedures with aortic replacement greatly increases morbidity and mortality. To evaluate this hypothesis we retrospectively reviewed 102 consecutive primary operations involving both renal arterial and aortic reconstruction. The patient population included 69 men and 33 women with an average age of…
Primary Article
Accuracy of Staining Technique for Detecting Mycobacterial Infection
ABSTRACT: The acid-fast smear has been regarded as a poor screening technique of decreasing reliability for correct identification of diseased patients in representative hospital populations. In this report, laboratory data are reviewed from three institutions: a tertiary care facility, a regional reference laboratory, and a suburban community hospital. The acid-fast…
Primary Article
Significance of Serum Antibodies to Histoplasma capsulatum in Endemic Areas
ABSTRACT: To evaluate the specificity of serologic tests for histoplasmosis in an endemic area, we studied sera from 104 consecutive healthy blood donors, testing for antibodies to either histoplasmin or Histoplasma yeast antigen, using complement fixation (GF), radioimmunoassay (RIA), and radial immunodiffusion (ID). Twenty-five subjects (24%) had CF antibody titers…
Primary Article
Should Sputum Isolates of Haemophilus influenzae Be Serotyped?
ABSTRACT: In a patient with pneumonia, sputum culture revealed ampicillin-resistant Haemophilus influenzae, type b. Although nontypable H influenzae is a normal inhabitant of the upper respiratory tract and should be considered normal flora, typable H influenzae is found in less than 5% of healthy persons. Although only 1.8% of sputum…
Errata
Correction
Primary Article
Salmonellosis Outbreak at a Vermont Hospital
ABSTRACT: An outbreak of gastrointestinal illness occurred at a hospital in northern Vermont during September 1981. Of the 292 hospital employees surveyed, 43 had diarrheal illness; 12 of them had positive cultures for Salmonella, serotypes chester, tennessee, or habana. In addition, three individuals who were culture-positive but did not have…
Primary Article
Multidrug-Resistant Serratia marcescens Bacteriuria Related to Urologic Instrumentation
ABSRACT:An outbreak of urinary tract infections caused by multidrug-resistant Serratia marcescens lasted for 12 months and was found to be related to urologic instrumentation. Thirty-four patients had primary infections; four had cross-infections. Only six patients had indwelling bladder catheters. The median interval between instrumentation and initial isolation of Serratia was…
Primary Article
Safety of Anterior Cement Fixation in the Cervical Spine: In Vivo Study of Dog Spine
ABSTRACT: There is increased use of methylmethacrylate in the treatment of neoplastic lesions of the spine. The advantage of this treatment is immediate stabilization, thus avoiding prolonged immobilization. In vivo study using a dog model showed that anterior fixation with cement, with or without Gelfoam as insulation material, produced no…
Primary Article
Balanced Anesthesia: A Comparison of Butorphanol and Morphine
ABSTRACT: We did a retrospective study to compare butorphanol with morphine for use in a balanced anesthetic technique with nitrous oxide, oxygen, and neuromuscular relaxants. Patient records were reviewed for preoperative, intraoperative, and postoperative arterial blood gas values and vital signs; postoperative analgesia, nausea, vomiting, hallucinations, and dysphoria; and patient…
Primary Article
Carotid Ultrasonography in Carotid Artery Disease
ABSRACT:Real-time high resolution carotid ultrasonography was performed in 1,300 patients of whom 294 also had carotid arteriography, allowing evaluation of 586 extracranial carotid vessels. Of the 586 extracranial vessels studied, 411 were normal by arteriography; of these, 381 (93%) were also normal by ultrasonography or showed only superficial plaques. Of…
Primary Article
Radiation Therapy for Early Glottic Carcinomas
ABSRACT:From 1973 to 1978, 30 cases of early glottic cancers (TINOMO) were treated in the Department of Radiation Therapy, University of Kansas Medical Center. All 30 patients have a minimal follow-up of three years with a mean of 50.2 months, and 26 (86.7%) are alive with no evidence of disease….
Primary Article
Mucoepidermoid Carcinoma of the Larynx: A Light and Electron Microscopic Study With Emphasis on Histogenesis
ABSTRACT: Using light and electron microscopy, we recently studied a mucoepidermoid carcinoma of the larynx and reviewed 66 cases reported in the literature. Histologic features showed the origin of the tumor from the ductule of submucosal seromucous glands. The tumor was characterized by a mixed pattern of adenocarcinoma and squamous…
Primary Article
Percutaneous Dissolution of Renal Calculi Using Ultrasonic Litholapaxy
ABSTRACT: The surgical treatment of renal calculi has been markedly changed by percutaneous manipulation and ultrasonic dissolution. The low morbidity and decreased cost of this procedure make it an obvious choice over classic surgical operations. We report our experience with percutaneous ultrasonic stone dissolution in 23 patients.
Primary Article
Complications of Megavitamin Therapy
ABSRACT:A patient with pancytopenia, severe sensory neuropathy, and a six-year history of excessive vitamin intake showed portal hypertension on evaluation. A liver biopsy revealed hypervitaminosis A. His sensory findings were characteristic of a recently described syndrome of sensory neuropathy secondary to megadoses of vitamin B6. The patients neuropathy has improved,…
Review Article
Emergent Burn Care
ABSRACT:The estimated 32,600,000 fires that occur annually in the United States produce over 300,000 injuries and 7,500 deaths. Ten percent of hospitalized burn victims die as a direct result of the burn. Initial evaluation and management of the burn patient are critical. The history should include the burn source, time…
Article
Therapeutic Value of Hope
ABSTRACT:This paper discusses the therapeutic value of hope in the patient-caregiver relationship. Hope and hopelessness are viewed as a process involving the expectations of the patient and the caregiver. Hope must be realistic to be a positive factor in the healing process. While hope has therapeutic value, it also has…
Current Concepts
Endocrine Metabolic Emergencies
ABSTRACT:Endocrine metabolic emergencies are common clinical entities seen by most health care professionals in acute care medicine. Except for cardiopulmonary arrest, few situations require such rapid institution of immediate drug therapy to reverse life-threatening metabolic imbalances. To safely guide patients through these situations, the physician requires a basic knowledge and…
