Issue - Southern Medical Association

Editorial

EVERYTHING’S UP TO DATE

Editorial

REFLECTIONS ON RACHEL

Primary Article

Human Insulin: A Double-Blind Clinical Study of Its Effectiveness

ABSTRACT: Over a two-year period, 88 patients were evaluated in a double-blind study of human insulin (recombinant DNA origin) and Iletin II pork insulin. Patient follow-up was done throughout the program by glycohemoglobin assays and self-monitoring of blood glucose levels. The C peptides were studied before and after a test…

Primary Article

Increased Levels of HDL-Cholesterol and Apolipoprotein A-I After Intensified Insulin Therapy for Diabetes

ABSTRACT: Sixteen subjects with insulin-dependent diabetes mellitus were studied to determine whether changes in plasma lipids and apolipoproteins follow intensified control using preprandial doses of regular insulin with an additional dose of NPH insulin before bedtime.The mean total daily dose of insulin was increased from 1.03 ± 0.09 to 1.17…

Primary Article

Infective Complications of Prolonged Central Venous (Hickman) Catheterization

ABSTRACT: We reviewed infectious complications during 7,671 days of central venous (Hickman) catheter use in 47 patients receiving intensive cytotoxic and supportive therapy for malignant disease. Colonization of the catheter was identified in eight cases of septicemia, two associated with endocarditis. Septicemia was successfully treated in four of five patients…

Primary Article

β-Lactamase-Positive Strains of Haemophilus influenzae: Susceptibility to and Inactivation of β-Lactam Antibiotics

ABSTRACT:Susceptibility and time-kill studies were done with low and high inocula of both β-lactamase-positive and -negative strains of Haemophilus influenzae with cefamandole, ampicillin, cefoperazone, mezlocillin, moxalactam, and ceftriaxone. Bioassay was done to test for antibiotic inactivation by β-lactamase-positive strains. All six antibiotics were highly active against the low inoculum (104…

Primary Article

Acinetobacter calcoaceticus Septicemia in Patients With Cancer

ABSTRACT At our institution, 95 cases of Acinetobacter septicemia occurred over a ten-year period (1973 to 1982) in patients being treated for cancer. In 24 patients the infection was polymicrobial, while Acinetobacter ssp was the only offending pathogen in 71 patients. In 76 patients (80%), the infection was related to…

Primary Article

Oral Malignancy: A Regional Incidence Observed Over a 13-Year Period

ABSTRACT: In this study slightly more than two out of every 100 biopsy specimens from the set population of 10,414 specimens showed malignant oral lesions. The most common sites for oral malignancy were the floor of the mouth and the alveolar ridge, respectively. Lesions were most common during the fifth…

Acknowledgement

BOOKS RECEIVED

Primary Article

Vital Statistics Data as a Measurement of Perinatal Regionalization in Alabama, 1970 to 1980

ABSTRACT: Although regionalization of perinatal health care services has received credit for much of the recent improvement in neonatal mortality, until now no measurement of regionalization has been proposed. The measurement presented in this paper—the average of the percentage of infants of very low birthweight and neonatal deaths occurring among…

Primary Article

Direct Fetal Therapy: The Multidisciplinary Team Concept

ABSTRACT: A multidisciplinary medical and surgical team is essential to direct fetal therapy. This group of skilled specialists is usually available only in university hospitals. Through the use of recently developed technology and a high degree of skill, the team composed of nonphysician and physician members can detect, evaluate, and…

Educational Opportunities

Educational Opportunities

Announcement

We Are Pleased to Welcome Our New SMA Members

Primary Article

Disguises of Delirium

ABSTRACT: In four patients, each of whom displayed overt signs and symptoms of a delirious state, the delirium was overlooked. We describe in detail the features of delirium because this syndrome is protean in its etiology and clinical presentations. It can be lifethreatening, and it may not be recognized because…

Primary Article

ST Segment Depression in Acute Anterior Myocardial Infarction

ABSTRACT: We initiated a retrospective study to determine whether ST segment depression seen in inferior leads (II, III, and aVF) during acute anterior myocardial infarction (MI) is a reciprocal change or an independent sign of ischemia of additional myocardium. We selected 20 patients with anterior MI and attempted to compare…

Primary Article

Thrombotic Thrombocytopenic Purpura in Pregnancy: Response to Plasma Manipulations

ABSTRACT: We present three cases of thrombotic thrombocytopenic purpura (TTP) and one case of the hemolytic-uremic syndrome (HUS) occurring during pregnancy. All patients and their offspring survived, and none of the infants had TTP or HUS. Plasma manipulations (exchange and infusions) were the effective therapeutic measures in all patients. The…

Primary Article

Spinal Tuberculosis Revisited

ABSTRACT: Although the incidence of tuberculosis is decreasing, spinal tuberculosis is still an important disease. Delay in diagnosis and treatment results in long-term disability. We reviewed our cases of spinal tuberculosis diagnosed between 1975 and 1982, with special reference to those features that permit early diagnosis. Among the nine cases…

Primary Article

Value of Ultrasonography, Fine Needle Aspiration, and Percutaneous Drainage of Perinephric Abscesses

ABSTRACT With the advent of ultrasonography, perinephric fluid collection can be easily diagnosed and confirmed by fine needle aspiration. In the past these cases sometimes went undiagnosed for several months. We did fine needle aspiration under the guidance of ultrasonography in 16 patients without complications. The aspirant in 12 patients…

Primary Article

Digital Intravenous Subtraction Angiography for Investigating Renovascular Hypertension: Comparison With Hypertensive Urography

ABSTRACT: We used digital intravenous subtraction angiography (DSA) to evaluate 105 patients with suspected renovascular hypertension. Unilateral renal artery stenoses were identified in 14 patients, two of whom had previously had contralateral nephrectomy. In addition, one of three renal transplant recipients was found to have stenosis of the nutrient artery….

Primary Article

Treatment of Poisonous Snakebite With Emphasis on Digit Dermotomy

ABSTRACT Despite the remarkably low mortality from poisonous snakebites in the United States during the past few years, there has been little improvement in preventing deformities of digits. Using a retrospective study of 207 cases of poisonous snakebite, I present a method that has been highly successful in avoiding deformities,…

Primary Article

Respiratory Cytology: Significance of “Suspect” Results in a Series of 435 Patients

ABSTRACT: We reviewed all “suspect” results of respiratory cytology obtained over a ten-year period at our medical center. There were 435 patients with one or more “suspect” respiratory cytology determinations who were classified as having benign or malignant respiratory tract disease by using a system of detailed, reproducible verification criteria;…

Primary Article

Brain Abscess: Recent Experience at a Community Hospital

ABSTRACT: Brain abscess is a formidable diagnostic and therapeutic problem with mortality ranging from 35% to 65%. It may occur at any age, and there is a male:female ratio of 2:1. Brain abscess arises from a contiguous focus of infection, direct implantation due to trauma, or hematogenous spread from a…

Primary Article

Fluid-Containing Bullae in the Lung

ABSTRACT: Eight patients had air-fluid levels in the lung as a result of fluid accumulation in preexisting bullae. In four cases the cause was peribullous pneumonitis; in the other four cases the cause could not be determined. All patients had a favorable clinical course while intrabullous fluid was present. The…

Primary Article

Trimethoprim-Sulfamethoxazole, Pseudomembranous Colitis, and Spinal Cord Injury

ABSTRACT: Antibiotic-associated colitis (pseudomembranous colitis) developed in four patients with spinal cord injury and taking oral trimethoprim-sulfamethoxazole. One hundred forty-eight (59%) of 251 patients with spinal cord injury who were evaluated had received this drug. Two of the four patients with pseudomembranous colitis did not promptly respond to therapy, and…

Review Article

Isoniazid Interactions

ABSTRACT: Isoniazid is an antitub.erculous drug that is usually administered for nine to 12 months. The potential for clinically important interactions exists because this drug is a potent inhibitor of drug metabolism. Studies and case reports have shown that isoniazid inhibits the metabolism of several drugs, including phenytoin, carbamazepine, anticoagulants,…

Abstract

Chronic Pain: Economic, Psychosocial, Ethical, Preventive, and Medical Aspects

Our Medical Heritage

Reginald Fitz and Appendicitis

Case Report

Successful Treatment of Gram-Negative Bacillary Meningitis With Imipenem/Cilastatin

Case Report

Variceal Bleeding From an Ileostomy Stoma

Case Report

Familial Nasal Acilia Syndrome

Case Report

Pulmonary Hypertension, Hypoxemia, and Death in a Patient With Scleroderma

Case Report

Cardiac Defects in a Patient With Congenital Contractural Arachnodactyly

Case Report

Thorium Dioxide: Still Around

Case Report

β-Thromboglobulin and Platelet Factor 4 Levels in a Case of Acute Thrombotic Thrombocytopenic Purpura

Case Report

Paraurethral Cysts in the Newborn

Clinical Brief

Human Infestation by Amblyomma americanum Larvae (“Seed Ticks”)

Breif Report

Enteral Hyperthermia

Breif Report

Ruptured Umbilical Hernia in Cirrhotic Patients: Management With Peritoneovenous Shunting and Herniorrhaphy

Breif Report

Severe Hyperkalemia Caused by Indomethacin and Potassium Supplementation

Breif Report

Pulmonary Tumor Microembolism

Breif Report

Haemophilus influenzae Endocarditis

Letter to the Editor

Amoxapine-Associated Acute Renal Failure

Letter to the Editor

Drug Abuse With Vicks Nasal Inhaler

Letter to the Editor

Iron Deficiency Anemia With T3 Toxicosis