SMJ // September 1985, Volume 78 - Issue 9
Primary Article
Colonoscopy and the Barium Enema: A Radiologic Viewpoint
ABSTRACT: Adherents of colonoscopy are recommending that it replace the radiologic examination as the initial diagnostic study of the colon. We present the radiologic view, supporting the barium enema as a more practical approach to initial diagnostic evaluation. The radiologic examination is an equally reliable, less costly, and much safer…
Primary Article
Gastroplasty in Morbid Obesity: Observations in 300 Patients
ABSTRACT: Morbid obesity is associated with a number of life-threatening complications. Medical treatment of morbid obesity is rarely successful. Gastric reduction has replaced intestinal bypass as the surgical treatment of choice. Indications for operation are fairly standardized, and complications and results are similar in most large series. In our series…
Primary Article
Gallbladder Disease Related to Use of Oral Contraceptives and Nausea in Pregnancy
ABSTRACT: In our series of women with confirmed gallbladder disease, intolerance of oral contraceptives was remarkably high. Among women who did not tolerate oral contraceptives there was a remarkably high percentage of emesis gravidarum. The frequency of cholecystectomy declined substantially between 1971 and 1981. This decrement was especially pronounced in…
Primary Article
Methyldopa Therapy and Outcome in Cadaveric Renal Transplantation
ABSTRACT: Methyldopa therapy for hypertension after renal transplantation could affect graft outcome adversely, since methyldopa inhibits suppressor cells. To study effects of methyldopa on transplant outcome, we analyzed prospective data on 1,648 hypertensive, first-allograft recipients; 545 patients used methyldopa and 1,103 patients did not. One-year graft functional survival was 66%…
Primary Article
Fine Needle Aspiration of the Lung: A Study of 53 Consecutive Cases
ABSTRACT: We reviewed our fine needle aspirations of the lung and chest on 53 consecutive patients from January 1979 through June 1982. Almost all of the patients had been studied by sputum and bronchial cytology and many by bronchial or transbronchial biopsy, but none of the patients had a definitive…
Primary Article
Pancreatic Cancer: Unreliability of Frozen Section in Diagnosis
ABSTRACT: Thirty-two patients with a resectable mass in the head of the pancreas had pancreaticoduodenectomy for suspected or proven cancer. Twenty-eight proved to have cancer (15 periampullary and 13 pancreatic), and four had pancreatitis. The five-year survival for periampullary and pancreatic cancer was 25% and 0%, respectively. The operative mortality…
Primary Article
Compensatory Growth in Infants With Severe Failure to Thrive
ABSTRACT: We studied compensatory growth and caloric intake during an accelerated growth period of ten infants with severe failure to thrive (FTT). The mean age at diagnosis was 7.1 months (range 1.5 to 16.0 months). The average percentage of normal weight for age in this group was 54.9%, mean length…
Primary Article
Risk of Tuberculous Infection Among House Staff in an Urban Teaching Hospital
ABSTRACT: Physicians in training in our medical center were found to have a higher risk of tuberculous infection than other hospital employees. Their annual tuberculin conversion rate was 3.96%; in two of the 15 recent converters, active disease developed. There is a significant linear relationship between the acquisition of tuberculous…
Primary Article
Descriptive Epidemiology of Night Sweats Upon Admission to a University Hospital
ABSTRACT: Between March 1 and Sept 1, 1980, we interviewed a 25% random sample of patients admitted to medicine, surgery, and obstetric, and gynecology services to determine the frequency and descriptive characteristics of night sweats (NS). Seventy-two (41%) of 174 patients interviewed reported NS within three months before admission. Obstetric…
Primary Article
Bladder Cancer After Pelvic Irradiation for Cervical Cancer
ABSTRACT:Pelvic irradiation for gynecologic malignancy is associated with several late neoplastic and nonneoplastic complications in the irradiated field; however, this association has been infrequently recognized in primary care literature. We present two cases of bladder cancer that developed 16 and 19 years, respectively, after pelvic irradiation for cervical cancer. The…
Primary Article
Primary Aldosteronism: Computerized Tomography in Preoperative Evaluation
ABSTRACT: We reviewed the value of computerized tomography (CT) in the preoperative evaluation of 34 patients with primary aldosteronism. All 34 patients entered a standard protocol including saline suppression testing, abdominal CT scanning, and adrenal venous sampling. Surgical pathologic findings, biochemical determinations, and clinical response to adrenalectomy were the criteria…
Primary Article
Physician at the Scene of an Emergency
ABSTRACT: Growth and maturation in the delivery of prehospital emergency medical care has been dramatic in the past 15 years. The increased availability and use of emergency medical services (EMS) has led to more frequent interactions between providers of prehospital care and the medical practitioner. This paper reviews the training…
Primary Article
Failure of Cimetidine as an Immunomodulator in Cancer Patients and Normal Subjects
ABSTRACT: Our pilot study of cimetidine as an immunomodulator in cancer patients showed no effect at clinically used doses on total blood, neutrophil, lymphocyte, or monocyte count, quantitative immunoglobulin, percentage of E-rosetting cells, phytohemagglutinin responses or delayed hypersensitivity responsiveness. We concluded that in clinically used doses, cimetidine produces no significant…
Primary Article
Applanation Pneumotonometry in Screening for Glaucoma
ABSTRACT: Two pneumotonometers were compared to the Goldmann applanation tonometer for adequacy as intraocular pressure screening devices in terms of sensitivity and specificity. The Digilab Model 30D, with digital readout, produced fewer falsenegative results than the Model 30R, with graph readout, and was thus the more sensitive instrument. Although as…
