SMJ // January 1985, Volume 78 - Issue 1
Primary Article
Ventricular Premature Complexes in the Early Diagnosis of Acute Myocardial Infarction
ABSTRACT: The morphology of ventricular premature complexes (VPCs) is useful in detecting old or recent myocardial infarction. Rarely, however, have VPCs provided the first objective evidence of transmural myocardial infarction. In two patients with chest pain, VPCs early in the hospital course revealed myocardial infarction, while normally conducted sinus beats…
Primary Article
Cheyne-Stokes Breathing During Sleep in Patients With Left Ventricular Heart Failure
ABSTRACT: Fifteen patients with left ventricular heart failure (LVF) without known breathing disorders during sleep had full-night recordings of sleep and breathing to study the incidence and impact of the apnea of Cheyne-Stokes breathing. This group showed a marked degree of sleep-related breathing abnormalities, 40% demonstrating Cheyne-Stokes breathing with five…
Primary Article
Diagnostic Limitations of the Dexamethasone Suppression Test in Screening for Depression
ABSTRACT: Research advancements in the use of laboratory testing to diagnose psychiatric conditions have recently led to certain misconceptions about the diagnostic accuracy of these tests. One such test, the dexamethasone suppression test (DST), was introduced as a laboratory test for melancholia (or “endogenous” depression). Because depressed patients are frequently…
Primary Article
Classical Heatstroke: Clinical and Laboratory Assessment
ABSTRACT: We reviewed the clinical and laboratory characteristics of 34 patients who had classical heatstroke during the Kansas City heat wave of 1980. The patients were elderly, predominantly black, and of low socioeconomic class. Overall mortality was 18%, with 9% of patients exhibiting severe residual neurologic deficit; 73% had full…
Primary Article
Correlates of Infant Death From Infectious Diarrhea in the Southeastern United States
ABSTRACT: Infectious diarrhea (ID) caused 242 infant deaths in South Carolina between 1970 and 1978, and is still a significant cause of death in the southeastern United States. Therefore, using South Carolina death certificates from 1970 to 1978 and the state’s linked birth/death certificate file, we sought prenatal and postnatal…
Primary Article
Reproductive Performance of Patients Treated With Clomiphene Citrate
ABSTRACT: From 1967-1980, 488 infertile women underwent induction of ovulation with clomiphene citrate at the University of Virginia Hospital. Conception occurred during treatment cycles in 209 women (group 1), but 279 women (group 2) failed to conceive. The outcome of pregnancy was defined in group 1, and the pregnancies that…
Primary Article
Does Preamputation Pain Influence Phantom Limb Pain in Cancer Patients?
ABSTRACT: Phantom sensation and phantom limb pain are two recognized sequelae of limb amputation. In most previous surveys, amputations were done for arteriosclerotic or trauma related conditions. We studied 25 patients who had lower extremity amputation for neoplasia. In studying the features of pain before and after amputation, we found…
Primary Article
The Arm as an Alternative Site for Vascular Access for Dialysis in Patients With Recurrent Access Failure
ABSTRACT: Patients with chronic renal failure requiring dialysis and in whom multiple attempts at vascular access have previously failed represent a challenge to vascular surgeons. In these difficult patients the arm offers an excellent site for either an autogenous fistula or a prosthetic shunt because of the relatively unharmed portion…
Primary Article
Sequential Bypass Grafting for Salvage of Lower Extremities
ABSTRACT: Since 1978, 12 patients at our institution have had distal sequential bypass grafting for limb salvage with either polytetrafluoroethylene (PTFE) or reversed saphenous vein and anastomoses to two different distal vessels. Seven patients had had previous vascular operations. One patient died of a stroke in the early postoperative period;…
Primary Article
Cephalexin in the Treatment of Acute and Chronic Maxillary Sinusitis
ABSTRACT: We evaluated the efficacy of cephalexin therapy in 104 patients with infectious maxillary sinusitis. Confirmation of diagnosis was made by x-ray film, antral puncture, and culture. Sixty-nine patients met all criteria for evaluation. The majority of patients received cephalexin, 1 gm/day in four divided doses for ten days, including…
Review Article
α1-Antitrypsin Deficiency and Liver Cirrhosis in Adults
ABSTRACT: Although cirrhosis of the liver caused by α1-antitrypsin deficiency is not uncommon in children, only a few cases have been described in adults. We have seen three such patients—one man and two women, ranging in age from 57 to 66 years. These cases show the wide spectrum of this…
