SMJ // November 1986, Volume 79 - Issue 11
Editorial
GERIATRICS AND THE SENIOR CITIZENRY
Primary Article
Burnout and Other Stress Syndromes
ABSTRACT: Psychiatry has long recognized stress syndromes. The acute posttraumatic stress syndrome occurring in war is well known. Those occurring as a result of accidents in civilian life are less well known. Burnout is a recently described addition to this group of illnesses. The stress that is etiologic differs in…
Primary Article
Pocket Computer For Real-Time Ultrasound
ABSTRACT: Real-time ultrasound has proved to be of value in fetal age determination, but calculation and interpretation of multiple parameters is time consuming and tedious. We present a program for use with the TRS 80 PC-2 or Sharp 1500 pocket computer and printer to provide rapid results of obstetric ultrasound…
Primary Article
Preoperative Localization of Parathyroid Adenomas Using Thallium-Technetium Subtraction Scintigraphy
ABSTRACT: Primary hyperparathyroidism can be diagnosed by laboratory values, yet localization of the adenomas preoperatively has always presented difficulties. Dual isotope scintigraphy with technetium Tc 99m sodium pertechnetate and thallium Tl-201 chloride has recently been used for the localization of parathyroid adenomas. In this paper, we review our experience with…
Primary Article
Preoperative Barium Contrast Enema in Patients With Inguinal Hernia
ABSTRACT: Whether patients over age 40 should have a barium contrast enema (BCE) examination for possible identification of an unsuspected colon carcinoma before elective inguinal herniorrhaphy remains an unanswered question. We reviewed the medical records of all patients over age 40 who had inguinal herniorrhaphy at our institution between January…
Primary Article
Spectrum of Biliary Disease in Childhood
ABSTRACT: Obstructive biliary disease in childhood is not common, but should be considered in the differential diagnosis of a child with jaundice, abdominal pain, or an abdominal mass. We have reviewed the experience at Vanderbilt Childrens Hospital from 1970 to 1985, during which 87 children 18 years of age or…
Primary Article
Paraplegia Associated With Epidural Anesthesia
Primary Article
Pharmacologic Reduction of the Risk of Aspiration
ABSTRACT: Parameters for significant risk of aspiration have been defined as a gastric pH less than 2.5 and/or a volume greater than 25 ml. We investigated the effects of metoclopramide and cimetidine, alone and in combination, on the pH and volume of gastric contents of patients taking nothing by mouth…
Primary Article
Branhamella catarrhalis Pneumonia in Patients With Immunoglobulin Abnormalities
ABSTRACT: The importance of Branhamella catarrhalis pneumonia has only recently been appreciated. Predisposing underlying illnesses associated with this organism have not yet been clarified. We report five cases of Branhamella catarrhalis pneumonia occurring in patients with diseases associated with documented quantitative immunoglobulin deficiencies. Normal immunoglobulins appear to be important host…
Primary Article
Flexible Bronchoscopy in the Diagnosis of Pneumocystis carinii Pneumonia in Patients With Acquired Immune Deficiency Syndrome
ABSTRACT: Seventy-seven patients with acquired immune deficiency syndrome (AIDS) and suspected of having Pneumocystis carinii pneumonia (PCP) had flexible bronchoscopy. The diagnosis was established in 52 of the 54 patients (96%) who proved to have PCP. There was one false-positive result. The remaining 22 patients and the patient with the…
Primary Article
Recurrent Pulmonary Infections in Patients With Chronic Lymphocytic Leukemia and Hypogammaglobulinemia
ABSTRACT: We describe two patients with concomitant recurrent pulmonary infections due to encapsulated organisms and chronic lymphocytic leukemia and hypogammaglobulinemia. We discuss the cases as a subset of acquired hypogammaglobulinemia in adults, focusing on the possible role of impaired defense mechanisms and emphasizing the importance of aggressive therapy with gamma…
Primary Article
Serotyping of 1,458 Pneumococcal Isolates With Analysis of Bacteremia in 84 Patients
ABSTRACT: During a 61-month period, 1,458 pneumococcal isolates (including 87 bacteremia strains) were collected at the Albany Veterans Administration Medical Center and serotyped with the use of the typing system of the New York Department of Health Laboratories. Fifty percent of all isolates were of types in the 14-valent vaccine,…
Primary Article
Natural History of Klüver-Bucy Syndrome After Treated Herpes Encephalitis
ABSTRACT: We present the natural history of three patients with features of Klüver-Bucy syndrome after treated herpes encephalitis. Although cognitive and behavioral disturbances following herpes encephalitis are often severe, improvement can occur over an extended period, and chronic residual sequelae may be relatively mild. The pattern of memory impairment is…
Primary Article
Coagulase-Negative Staphylococcal Endocarditis A View From the Community Hospital
ABSTRACT: Review of our experience with infectious endocarditis at a single community hospital showed coagulase-negative staphylococci to be our leading cause of endocarditis. The pathogenesis of coagulase-negative staphylococcal endocarditis (CNSE) involved either hematogenous seeding of native or prosthetic valves, or direct implantation at surgery. Cases involving native valves demonstrated an…
Primary Article
Management of Pterygia 20 Years Later
ABSTRACT: Over a 20-year period, I excised 205 pterygia. A single, low dose of beta irradiation applied to the site of excision before surgical closure of the conjunctiva significantly reduced the rate of recurrence. Follow-up for as long as 20 years in this series revealed no complications. I discuss possible…
Primary Article
Reacting Appropriately to Thrombocytopenia in Pregnancy
ABSTRACT: The lower limit of normal for the platelet count is considered to be 150,000/cu mm in both pregnant and nonpregnant normal adults. In the absence of preeclampsia, sepsis, drugs, or other apparent causes, the finding of asymptomatic mild thrombocytopenia in pregnant women is compatible with previously unrecognized immune thrombocytopehic…
Primary Article
Needle-Catheter Jejunostomy for Postoperative Nutritional Support
ABSTRACT: Use of the needle-catheter feeding jejunostomy at Richland Memorial Hospital and the Dorn Veterans Administration Hospital, both clinical teaching institutions of the University of South Carolina School of Medicine, has been evaluated in 114 patients ranging from 20 to 90 years old. The results of this survey span a…
Review Article
Clostridial Infections of the Lungs and Pleura
Current Concepts
Recent Advances in Moist Wound Healing
Current Concepts
Metastatic Disease of the Spine: Diagnosis and Management
ABSTRACT: This paper reviews the pathophysiology, clinical presentation, work-up, and management of epidural spinal cord compression by metastatic tumor. Included are descriptions detailing clinical syndromes of cervical, thoracic, cauda equina, and conus medullaris compressions. Indications for plain x-ray films, myelography, and CT scanning as well as a discussion of radiation,…
Our Medical Heritage
Pulmonary Tuberculosis: Contributions of Radiology in Diagnosis and Treatment
ABSTRACT: This review records the important place that radiologic examinations have had in the diagnosis and treatment of pulmonary tuberculosis in the past nine decades. Very soon after the discovery of x-rays it became apparent that chest roentgenograms would be a help in identifying pulmonary lesions. As the quality of…
Case Report
Benign Symmetrical Lipomatosis
From the Departments of Surgery and Pathology, Mount Sinai Services and City Hospital Center at Elmhurst, Mount Sinai School or Medicine, New York, NY.
