SMJ // July 1985, Volume 78 - Issue 7
Editorial
CONSIDERING A MEDICAL CAREER
Primary Article
Exercise, High-Density Lipoprotein-Cholesterol, and Cardiorespiratory Function in Climacteric Women
ABSTRACT: Fifty healthy women between the ages of 40 and 65 participated in a 12-week program of exercise, discussion sessions, or both. Levels of serum cholesterol, triglycerides, total high-density lipoprotein (HDL), HDL-cholesterol, and HDL-2b were monitored at baseline and at six and 12 weeks. Cardiorespiratory function was assessed at baseline…
Primary Article
Thyrotropin-Releasing Hormone Tests in an Outpatient Clinic
ABSTRACT: Measurement of thyroid-stimulating hormone (TSH) levels in various timed blood samples after administration of thyrotropin-releasing hormone (TRH) has become a standard part of the diagnostic armamentarium for suspected thyroid disease. We reviewed the records of 165 patients who received TRH tests in an endocrinology outpatient clinic to assess the…
Primary Article
Penetrating Wounds of the Pelvis
ABSTRACT: While penetrating wounds of the abdomen may selectively be managed conservatively in the absence of clinical signs or symptoms, we believe that in similar injuries of the pelvic area, exploration is mandatory. Regardless of their clinical presentation, 38 consecutive patients with penetrating injury to the pelvis had exploration, which…
Primary Article
Pulmonary Hemodynamics in Systemic Hypertension
ABSTRACT: We reviewed cardiac catheterization data and the medical records of 30 patients with systemic hypertension to establish their pulmonary hemodynamic profiles and the relationship between certain clinical and demographic variables and increased pulmonary vascular resistance. Mean systemic arterial pressure ranged from 110 to 210 mm Hg, and systemic vascular…
Primary Article
Thymic Epithelial Neoplasms
ABSTRACT: We studied 57 tumors of the thymus seen at Vanderbilt University Medical Center between 1957 and 1982. By applying current diagnostic criteria, the classification of 13 tumors was changed. There were 45 epithelial tumors of thymus, including 32 thymomas, two thymic carcinomas, eight carcinoids, and three germinomas. The gross…
Primary Article
Neurofibromas of the Head and Neck
ABSTRACT: Ten patients ranging in age from 7 to 47 years have been treated for neurofibromas of the head and neck at Vanderbilt University Hospital during the last 14 years. Three of them had a positive family history of von Recklinghausens disease; none has developed malignant degeneration. Serial subtotal excisions…
Primary Article
Large Opaque Hemithorax Due to Cardiomegaly and Atelectasis
ABSTRACT: We studied the clinical and radiologic features of five infants with a large opaque left hemithorax due to the combination of cardiomegaly and atelectasis. The causes of cardiomegaly were cardiomyopathy (two patients), congestive heart failure due to fluid overload, congenital mitral insufficiency, and idiopathic hypertrophic subaortic stenosis. In all…
Primary Article
24-Hour Ambulatory Manometry in Diagnosis of Esophageal Motor Disorders Causing Chest Pain
ABSTRACT: The clinical diagnosis of motor disorders of the esophagus leading to chest pain usually lacks documentation by manometry despite the use of sophisticated equipment as well as pharmacologic manipulation. We have developed an ambulatory manometry system that allows us to monitor motility in the esophagus on an outpatient basis…
Primary Article
Maintaining Body Temperature During Anesthesia With a Servo-Controlled Heated Humidifier
ABSTRACT: The Conchatherm III is a servo-controlled, easily assembled heated humidifier. We studied its effectiveness in preventing intraoperative fall in temperature in both pediatric and adult surgical patients. Despite operating room temperatures lower than 69.8 F (21 C), rectal temperature was well maintained at normal in both adults and children….
Primary Article
Evaluation of Ranitidine as an Oral Antacid in Outpatient Anesthesia
ABSTRACT: We studied the effects of preanesthetic ranitidine on gastric contents in 60 outpatients scheduled for elective surgery, with random allocation into three groups of 20 patients each. Patients in group 1 did not receive ranitidine and served as controls. Patients in groups 2 and 3 received ranitidine orally, 150…
Primary Article
Myotonic Dystrophy: Obstetric and Neonatal Complications
ABSTRACT: Myotonic dystrophy is a relatively common disorder. Since the clinical expression is highly variable, diagnosis is often made only after the birth of an infant with severe congenital myotonic dystrophy. Seven such cases are described. A history of obstetric complications was present in the six multiparous mothers. Neither the…
Primary Article
Inappropriate Admissions to Psychiatric Wards
ABSTRACT: Our seven clinical vignettes illustrate different mechanisms of inappropriate admissions to psychiatric wards and the circumstances and outcome of such admissions, with emphasis on the shared responsibility of psychiatric and nonpsychiatric physicians, the financial consequences, and the implications of such admissions on the professions public image. Inappropriate admissions create…
Primary Article
Acutely Psychotic Patients: A Treatment Approach
ABSTRACT: Treating acute psychosis by rapidly producing a neuroleptic state is safe and effective. Getting psychotic patients quickly out of the hospital, keeping them out, and enabling them to function maximally are the treatment goals. Many such patients respond to a trial of lithium therapy; responders are usually better able…
Primary Article
Preparation for Barium Enema: Comparison of a Commercial Formula Diet and Low-Residue, Clear-Liquid Diets in Inpatients
ABSTRACT: The barium enema examination is the most frequently done initial diagnostic evaluation for disease of the lower gastrointestinal tract. Adequate preparation of the colon is essential because inadequate preparation necessitates repetition, with patient discomfort, decreased caloric intake, and increased cost. A formula diet (Ensure) has been reported as superior…
Primary Article
Effects of a Raw Food Diet on Hypertension and Obesity
ABSTRACT: We examined responses to cooked and uncooked food in 32 outpatients with essential hypertension; 28 were also overweight. By varying cooked and uncooked food percentages and salt intake, patients acted as their own control subjects in this unblinded study. After a mean duration of 6.7 months, average intake of…