Issue - Southern Medical Association

Editorial

DER WACHT AM RHINE, OR, CREEPING SHADOWS

Primary Article

Neoplasia in Immunosuppressed Renal Transplant Patients: A 20-Year Experience

ABSTRACT: This review examines a 20-year experience in renal transplantation at our center to determine the effects of immunosuppression on the subsequent development of malignancies. Twenty patients had 21 malignancies from primary sites other than skin, yielding an incidence of 2.5%. There were 0.65 malignancies for each 100 cumulative patient…

Primary Article

Renal Carcinoma and Dialysis in End-Stage Renal Disease

ABSTRACT: We describe five patients receiving long-term hemodialysis (mean duration of 6.4 years) in whom eight renal carcinomas were found. In four patients, the carcinoma was confirmed by tissue pathology, while the fifth patient had multiple (four) areas of neovascularity on selective renal arteriography. Two patients died of metastases. In…

Primary Article

Complications of Vascular Access for Hemodialysis

ABSTRACT: This study of 533 vascular access sites for long-term hemodialysis in patients with end-stage renal disease, accumulating more than 12,000 patient months, indicated that primary arteriovenous fistula (AVF) is the procedure of choice. The group receiving primary AVF had the greatest duration of patency: 84% at three years compared…

Primary Article

Extracranial Carotid Vascular Disease: Detection by Real Time B-Mode Ultrasonography

ABSTRACT: Real time B-mode ultrasonography is a currently popular technique used to screen patients with suspected carotid vascular disease and identify those who need cerebral angiography. From September 1981 through February 1983, 1,205 patients had carotid ultrasonography in the Vascular Laboratory at Erlanger Medical Center. Retrospective review of these patients…

Primary Article

Poland-Möbbius Syndrome: Evaluation by Computerized Tomography

ABSTRACT: The Poland-Möbbius syndrome is the combination of two rare congenital disorders and has been reported previously in only 13 patients. We report two additional cases with an evaluation of the findings and possible pathogenesis, and discuss the role of computerized tomography in evaluating the brain, pons, orbits, and facial…

Primary Article

Parathyroid Cyst

ABSTRACT: Although parathyroid cyst has been infrequently reported until the past decade, its presumed rarity is attributed to nonrecognition. First reported in 1905, only 58 cases of parathyroid cyst had been documented in the world literature by 1967. Since then, however, substantial literature about this entity has been accumulating. The…

Primary Article

Jejunal Diverticulosis: Medical and Surgical Management

ABSTRACT: Jejunal diverticulosis, a marker of disordered small intestinal motility, presents varied clinical manifestations. It is important to consider this disorder in elderly patients with unexplained abdominal discomfort accompanied by signs of intermittent small bowel obstruction and malabsorption. Diagnosis can be made by a small bowel follow-through x-ray film obtained…

Primary Article

Complications Requiring Operative Intervention After Gastric Bariatric Surgery

ABSTRACT: In a series of 565 morbidly obese patients having one of five gastric bariatric procedures done at North Carolina Memorial Hospital between May 1975 and December 1982, 55 patients had 58 complications requiring reoperation. These complications included a leak from the stomach or anastomosis, stomal obstruction, and subphrenic abscess….

Primary Article

Surgical Control of Pelvic Hemorrhage: Bilateral Hypogastric Artery Ligation and Method of Ovarian Artery Ligation

ABSTRACT: Hypogastric artery ligation and internal iliac artery ligation are the same procedure. It has been several years since extensive work on this procedure has been reported in the literature. Since this has proved to be a potentially life-saving technique in serious obstetric and pelvic hemorrhage, it is somewhat surprising…

Acknowledgement

BOOKS RECEIVED

Primary Article

Effects of Sterilization on Menstruation

ABSTRACT: We surveyed 551 women more than a year after they or their husbands had had a sterilization operation. According to menstrual data from before and after the operation, a much greater proportion of women who had been sterilized had longer periods after the operation than before, but so did…

Primary Article

Plasma Prolactin Concentrations and Pregnancy-Induced Hypertension

ABSTRACT: Human prolactin (PRL) has been related to various pathologic disorders known to be associated with osmoregulation and hypertension. In this study, we compared changes in plasma PRL concentrations in normal pregnant patients to those in patients with severe pregnancy-induced hypertension (PIH). Comparison of plasma PRL concentrations collected antepartum, at…

Primary Article

Supplemental Food Program: Effects on Health and Pregnancy Outcome

ABSTRACT: To determine the effect of participation in the Special Supplemental Food Program for Women, Infants, and Children on use of health care, health-related practices, health knowledge, and pregnancy outcome, a total of 519 pregnant women were interviewed during public health department clinics in six Alabama counties. Of the sample,…

Primary Article

Insomnia: Nonpharmacologic Management by Private Practice Physicians

ABSTRACT: We report a survey investigation on the perceived value of behavioral assessment and the use of nonpharmacologic treatment of insomnia by 159 physicians in private practice in Davidson County, Tennessee. They generally attributed limited value to behavioral assessment, and reported infrequent use of nonpharmacologic treatment. However, the more patients…

Primary Article

Digitalis Toxicity at Duke Hospital, 1973 to 1984

ABSTRACT: In a review of the records of 81 patients with the discharge diagnosis of digitalis toxicity, I found a preponderance of very old patients, many of whom had anorexia, nausea, and prerenal azotemia. Arrhythmias were common (93%) and reflected enhanced automaticity, enhanced AV block, or both. Atrial fibrillation with…

Primary Article

Comparative Study of Mexiletine and Quinidine in the Treatment of Ventricular Ectopia

ABSTRACT: Mexiletine is an antiarrhythmic agent, structurally similar to lidocaine, but useful orally as well as intravenously. The safety and efficacy of mexiletine was compared with quinidine in a double-blind, parallel, randomized study of patients with chronic ventricular ectopia of various causes. Mexiletine was statistically more effective (P < .05)…

Primary Article

Meniscectomy for Damaged Disks of the Temporomandibular Joint

ABSTRACT: Internal derangements of the temporomandibular joint are now known to be a common cause of pain in the joint area. Several specific surgical treatments for this disorder are advocated, but none is yet well established. Meniscectomy has been one of the more commonly done procedures. While published results of…

Review Article

Recurrent Bacterial Pneumonia: A Contemporary Perspective

ABSTRACT: Numerous clinical disorders predispose to “recurrent bacterial pneumonia.” Identification and treatment of some of these predisposing conditions will reduce associated morbidity, mortality, and health care expenditures. In young adults these disorders include cystic fibrosis, the immotile-cilia syndrome, Youngs syndrome, pulmonary sequestration, and bronchiectasis. Disorders enhancing recurrent bacterial pneumonia in…

Current Concepts

Current Status of Magnetic Resonance Imaging

Article

Importance of Satisfactory Reporting in the Care of Patients Covered by Workers Compensation

ABSTRACT: The workers compensation system has become an increasingly important part of our medical care system. That this system presents problems to attending physicians is apparent. Most of these problems result from ignorance on the part of physicians, born of the lack of effective training in this area and its…

Medical Education

Medical Education for an Uncertain Future

Case Report

Primary Cardiac Fibrosarcoma

Case Report

Apathetic Thyrotoxicosis Due to Hemorrhage into a Hyperfunctioning Thyroid Nodule After Excessive Anticoagulation

Case Report

Noncardiogenic Pulmonary Edema After Charcoal Hemoperfusion

Case Report

Electroconvulsive Therapy in a Patient With Unsuspected Pheochromocytoma

Case Report

Variant of Congenital Dyserythropoietic Anemia

Case Report

Arnold-Chiari Malformation in a Geriatric Patient

Clinical Brief

Deferred Rectal Examination

Breif Report

Hereditary Hemorrhagic Telangiectasia and Factor VIII Inhibitor

Breif Report

Pulmonary Vasculitis Complicating Ulcerative Colitis

Letter to the Editor

Dirty Fingers?

Abstract

Dirty Fingers?, Reply

Letter to the Editor

Medical Fallibility

Letter to the Editor

Transient Fungemia Due to Candida lusitaniae

Letter to the Editor

Metronidazole and Panic Attacks