Issue - Southern Medical Association

Editorial

Acupuncture Update, 1984

Primary Article

Psychiatric Disorders in Geriatric Medical/Surgical Patients Part I

We reviewed psychiatric consultations (N = 195) for patients aged 60 years or more from a consecutive series of 1,000 psychiatric consultation requests. Consultations for geriatric patients were requested disproportionately less frequently than for nongeriatric patients and significantly more frequently for elderly women than for elderly men. The most frequent…

Primary Article

Use of Hypnosis for Improving Medication Compliance in Psychiatric Patients

Factors involved in failure to comply with medication regimens may be divided into four categories: patient characteristics, physician-patient relationship, psychosocial environment, and treatment regimen features. Although several methods aimed at improving medication compliance have been described in the literature, hypnosis was not among them. Three cases in which hypnosis was…

Primary Article

Medical Interview of Sexually Abused Children

Physicians seeing sexually abused children in their practices often fail to recognize the abuse. Recognizing the frequency of child sexual abuse and variety of presentations will alert physicians to seek explanation. Physicians should know the common behavior of perpetrators and how to encourage children to reveal and describe the abuse….

Primary Article

Biologic Implications of Steroid Hormone Receptors in Cancers of the Colon

In follow-up investigations on 41 patients with primary cancer of the colon that had been assayed for the presence of steroid-binding activity, six of eight patients whose tumors showed steroid-binding activity for at least one steroid were free of disease one to three years postoperatively. In contrast, only two of…

Primary Article

Retrograde Endoscopy of the Bypassed Stomach Segment After Gastric Bypass Surgery Unexpected Lesions

Surgical measures for the treatment of morbid obesity include gastric bypass of the stomach and duodenum. We endoscopically evaluated the bypassed segments in 51 patients three to 24 months after a standard gastric bypass procedure. Retrograde endoscopy was successful in 33 of the patients (65%). There was significantly more gastritis…

Primary Article

Hepatic Trauma Evaluation of Routine Drainage

Routine drainage of liver wounds created by trauma has recently been challenged, prompting a prospective, randomized trial of drainage via a Penrose dam versus no drain in patients having emergency laparotomy for abdominal trauma. We excluded cases in which definite bile leak was noted at operation. Of 167 patients studied,…

Primary Article

Treatment of the Ruptured or Exposed Carotid Artery A Rational Approach

Review of 15 cases of carotid artery exposure or rupture in patients with no recurrent tumor demonstrated several important principles. Irradiation was a risk factor in 90% of cases of carotid blowout. Only one of five patients (20%) with carotid exposure who had not had irradiation had carotid perforation. Immediate…

Primary Article

Effect of Nasal Surgery on Snoring

When 113 patients who had had nasal surgery for chronic obstruction were questioned about their snoring habits before and after operation, 42% said they had snored before nasal surgery. Of that group, 77% had either elimination or improvement of snoring after nasal surgery. Nasal obstruction is one of several factors…

Primary Article

Management of the Chronically Draining Ear

Management of the chronically draining ear requires careful assessment as to the source and predisposing factors leading to recurrent infections. Surgery should be planned to remove all irreversible disease and to seal the middle ear in a single operation, whether this requires a simple myringoplasty or extensive mastoidectomy, ossicular chain…

Primary Article

Esthesioneuroblastoma Diagnosis and Management

Esthesioneuroblastoma is an uncommon nasal tumor originating from cells of neural crest origin. An increased awareness of this neoplasm by clinicians and pathologists has led to an increase in its diagnosis. In the Department of Otolaryngology—Head and Neck Surgery at the University of Virginia Medical Center, 22 cases have been…

Primary Article

Do Brown Recluse Spider Bites Induce Pyoderma Gangrenosum?

Brown recluse spider bites are usually self-limited skin lesions that infrequently progress to bullae, ulceration, and scarring. We treated a patient with a documented brown recluse bite who had recurring lesions resembling pyoderma gangrenosum (PG) that persisted for months. Three other patients referred to Vanderbilt University because of probable brown…

Primary Article

Laser Iridotomy for Management of Angle-Closure Glaucoma

In this series, laser iridotomies were produced in 112 eyes, with a minimum of six months follow-up. Despite the need to reopen some laser-produced iridotomies, it has proved to be safe and effective therapy. When the cornea is clear, laser iridotomy is an alternative to surgical iridectomy and can be…

Primary Article

Chest Wall Masses in Children

A hard, fixed mass on the chest wall is usually considered to be malignant. Of 24 such lesions we have evaluated in children, only eight (33%) were malignant. Six of the eight children with malignant masses died of the disease. Benign lesions were often indistinguishable from malignant lesions by physical…

Primary Article

Computerized Tomographic Evaluation of Aortic Prosthetic Graft Complications

Computerized tomography has been found to be an accurate and sensitive method of diagnosing complications of synthetic aortic grafts. Complications in our series of four cases included aortoesophageal fistula, aortoduodenal fistula, pseudoaneurysm, and retroperitoneal hematoma.

Primary Article

Diagnosis of Bacterial Meningitis in Previously Treated Children

We reviewed the charts of 115 children with the clinical diagnosis of bacterial meningitis admitted to our hospital over a period of eight years. Of these, 47 patients had received antimicrobial agents before hospitalization and eight (17%) of them had negative cerebrospinal fluid (CSF) cultures. These eight children, however, had…

Primary Article

Segmental Spinal Instrumentation

Over a 21/2 -year period, I have treated 25 patients with segmental spinal instrumentation (SSI), using paired-wired Luque rods. Of 13 patients with unstable spinal fractures, seven were paraplegic. Nine had idiopathic scoliosis, and three had neurogenic scoliosis. Significant loss of correction after SSI occurred in five of the nine…

Primary Article

Intestinal Salmonella Carriage in Patients With Major Sickle Cell Hemoglobinopathies

The increased incidence of Salmonella osteomyelitis in patients with sickle cell disease has never been entirely explained. Problems such as cholelithiasis, intestinal infarction, and frequent antibiotic use in this population could possibly result in prolonged or chronic intestinal carriage of Salmonella after acute gastroenteritis. If prolonged carriage were a factor…

Primary Article

Primary Esophageal Motor Disorders Clinical

The effect of nifedipine on esophageal symptoms was evaluated in 20 patients with primary esophageal motor disorders. The patients were randomized to receive nifedipine (10 mg t.i.d;) or placebo for two weeks, and then crossed over to receive the other medication. Ten patients had hypertensive lower esophageal sphincter, four had…

Primary Article

Essential Vocal Tremor Clinical Characteristics and Response to Therapy

We evaluated four patients with an initial and predominant voice tremor. All were referred for evaluation for suspected parkinsonism, though vocal tremor was the only symptom. These three women and one man ranged in age from 37 to 59 years. Neurologic evaluation and laryngeal examination were unremarkable. No signs of…

Primary Article

Nephrotoxicity From Nonsteroidal Anti-inflammatory Drugs

We categorize the three types of renal dysfunction associated with the use of nonsteroidal anti-inflammatory drugs (NSAID): acute renal failure, acute interstitial nephritis, and hyperkalemia. The paper provides clinical examples of each type, discusses pathophysiology, and describes response to therapy, in addition to outlining the usefulness of labeled leukocyte nuclear…

Primary Article

Contraceptive Use in Georgia Estimation by Telephone Survey

Because household surveys are expensive and time consuming, determination of state or local family planning needs is based on national household survey estimates of contraceptive use rather than state-specific estimates. In June 1982, the University of Georgia Survey Research Center invited the Georgia Department of Human Resources (DHR) to add…

Current Concepts

Multiple Systems Organ Failure Is It a Specific Entity?

Multiple systems organ failure (MSOF) is a relatively new clinical syndrome that should be considered as a unified and identifiable clinical condition. In many ways it is a product of the technologic advances developed in the last few years to treat seriously ill patients. Failing respiratory, renal, and cardiovascular systems…

Article

Health Precautions for Travelers to Mexico

After Canada, Mexico is the most popular destination for Americans traveling outside the United States. As a developing country, Mexico presents numerous health hazards to American visitors, including the prevalent travelers diarrhea (turista), from which 40% will suffer, and the less common typhoid, dengue, rabies, malaria, taeniasis, cysticercosis, and trichinosis….

Medical Education

Foreign Medical Graduates The Door Should Never Close

Case Report

Gastric Antral Angiodysplasia An Unusual Cause of Occult Gastrointestinal Bleeding

Case Report

Hereditary Sensory Neuropathy With Macular Dystrophy

Case Report

Hyponatremia in the Syndrome of Inappropriate Secretion of Antidiuretic Hormone Rapid Correction With Osmotic Agents

Breif Report

Recurrent Jejunal Diverticulosis

Breif Report

Familial Trigeminal Neuralgia

Breif Report

Bacterial Endocarditis in Pregnancy Associated With Septic Renal Embolization

Breif Report

Klebsiella oxytoca Endocarditis After Transurethral Resection of the Prostate Gland

Breif Report

Bone Marrow Failure and Pancytopenia in Two Patients With Hypothermia

Breif Report

Hazard of a Postendarterectomy Intimal Flap in Carotid Artery Surgery

Breif Report

Peptococcus magnus Endocarditis

Letter to the Editor

simple method to predict digoxin serum concentrations

Letter to the Editor

Elevated Bleeding Time and Epistaxis Associated With Piperacillin Therapy

Letter to the Editor

Metronidazole and Trichomoniasis

Letter to the Editor

After Baby Doe

Letter to the Editor

Free Clinic

Letter to the Editor

Extreme Hyperkalemia Associated With Amiloride

Letter to the Editor

Osteomyelitis of the Femur Due to Fusobacterium mortifereum

Letter to the Editor

Emerald-Green Urine Associated With Cuprex Therapy

Letter to the Editor

Peritonitis Due to Pseudomonas paucimobilis During Ambulatory Peritoneal Dialysis