SMJ // June 1985, Volume 78 - Issue 6
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,…