SMJ // August 1986, Volume 79 - Issue 8
Primary Article
Marijuana Use Among Middle-Class Adolescents
ABSTRACT: One hundred sixty-two adolescents being seen for sick or well visits at two suburban private pediatric practices completed an anonymous, written questionnaire about drug habits. The respondents ages ranged from 14 to 17 years; all were white and from middle-class or upper-middle-class families. The adolescents reported high self-esteem, good…
Primary Article
Cancer of the Large Bowel in Children
ABSTRACT: We present the morphologic and clinical features of large bowel carcinoma in 22 patients seen over 18 years at St. Jude Childrens Research Hospital. We saw 18 cases of mucinous adenocarcinoma, three of well differentiated adenocarcinoma, and one case of poorly differentiated adenocarcinoma. The patients ranged in age from…
Primary Article
Lateral Pancreaticojejunostomy for Pain Relief in Chronic Pancreatitis: Analysis of Effectiveness in 19 Patients
ABSTRACT: To assess the relief of pain provided by a side-to-side lateral pancreaticojejunostomy (LPJ), we analyzed 19 patients with chronic pancreatitis operated on from 1973 to 1983. Fourteen patients were chronic alcoholics; abdominal pain was the indication for the operation in most patients; one patient died postoperatively. The pain was…
Primary Article
High-Frequency Jet Ventilation: Applications for Endoscopy and Surgery of the Airway
ABSTRACT: Twenty-four patients underwent endoscopic procedures under general anesthesia and mechanical ventilation by high-frequency jet ventilation, provided by a catheter inserted through the cricothyroid membrane and connected to an IDC-VS600 ventilator. The arterial blood gas values, arterial blood pressures, and heart rates observed were within acceptable clinical levels. In some…
Primary Article
Diffuse Interstitial Lung Disease in Neurofibromatosis
ABSTRACT: An association of neurofibromatosis with diffuse interstitial lung disease is thought to exist, though there have been relatively few large studies of it. The pulmonary manifestations consist of diffuse interstitial fibrosis or formation of bullae, or a combination of both. Our experience with this disease process during a ten-year…
Primary Article
Chronic Osteomyelitis Caused by Staphylococcus aureus: Controlled Clinical Trial of Nafcillin Therapy and Nafcillin-Rifampin Therapy
ABSTRACT A controlled trial of treatment of chronic osteomyelitis caused by Staphylococcus aureus compared nafcillin alone with nafcillin plus rifampin for a six-week period. Treatment was well tolerated, the only adverse effect being mild neutropenia in four of 18 patients; no toxicity was observed from rifampin. Eight of ten patients…
Primary Article
Group F Streptococci in the Pharynx: Pathogens or Innocent Bystanders?
ABSTRACT: β-Hemolytic streptococci (BHS) of Lancefield group F were isolated in moderate to heavy growth from throat cultures taken from 46 children and adolescents with symptomatic pharyngitis. In most instances, oxygen deprivation by means of an anaerobe jar was required for these β-hemolytic organisms to grow. In relation to a…
Primary Article
Expectant Management of Rupture of Membranes at Term
ABSTRACT: We conducted a prospective randomized study involving 317 patients with term gestations (>36 weeks) and premature rupture of membranes (PROM). Eighty-five percent of the 167 patients managed conservatively began labor within 48 hours. The cesarean section rate in this group was 7% as opposed to 21% in the group…
Primary Article
Pregnancy Outcome in Renal Transplant Recipients: Experience at the Medical College of Georgia and Review of the Literature
ABSTRACT: Between 1970 and 1982, 13 renal transplant recipients had 17 pregnancies with follow-up at the Medical College of Georgia (MCG). Nine patients received related donor grafts and four received cadaver kidneys; 11 mothers survived their pregnancies. Preeclampsia, urinary tract infections, and preterm labor were frequent complications. Perinatal complications were…
Primary Article
Rhinitis of Pregnancy
ABSTRACT: Nasal stuffiness as a consequence of pregnancy has been accepted as a distinct pathologic entity for years. Although estrogen can produce nasal mucosal edema through a cholinergic action, other factors may also cause or influence nasal congestion associated with pregnancy. These include allergy, infection, stress, and rebound rhinitis. A…
Primary Article
Prevention of Acute Tubular Necrosis After Transplantation: Effect of Pretransplantation Volume Expansion
ABSTRACT: We reviewed our experience with 100 consecutive cadaveric transplants of kidneys from satisfactory donors with respect to immediate function after transplantation. The management was the same in all patients except that 66 of them received 1,000 ml of 0.9 N saline IV preoperatively. The overall incidence of acute tubular…
Primary Article
Percutaneous Nephrolithotomy in 86 Patients: Analysis of Results and Costs
ABSTRACT: We reviewed the hospital records of the first 86 patients having percutaneous nephrolithotomy at University Hospital (Birmingham, Ala) between 1983 and 1985. Variables such as stone location, chemical composition of the stone, history of previous renal surgery, and stone size were examined to determine their effect on complication rate,…
Primary Article
Clinical Evaluation of Patients With Metastatic Squamous Carcinoma of the Neck With Occult Primary Tumor
ABSTRACT: Between 1976 and 1982, we systematically evaluated 33 patients with a diagnosis of metastatic squamous carcinoma of the neck (excluding the supraclavicular fossa) from an occult primary tumor. In 11 patients the primary lesion was identified by physical and indirect mirror examinations, in four by examinations done under anesthesia…
Current Concepts
Assessment of Therapeutic Plasmapheresis in Demyelinating Neurologic Disorders
ABSTRACT: Considerable controversy exists with regard to therapeutic efficacy of plasmapheresis in the immune-mediated demyelinating disorders of the peripheral and central nervous system: acute inflammatory polyneuropathy (Guillain-Barré syndrome), chronic inflammatory demyelinating polyneuropathy, and multiple sclerosis. In an effort to establish specific situations where plasmapheresis was of therapeutic value, we reviewed…
Article
Patient Education Before Discharge From the Hospital
ABSTRACT: Hospitalized patients perception of their physicians effectiveness as a patient educator was surveyed, using three basic areas of doctor-patient communication: diagnoses, medications, and follow-up plans. The survey instrument, a questionnaire designed and administered by medical students, was designed to ascertain (1) the patients satisfaction with their hospital stay, (2)…
Article
Making Doctors
Medical Education
Visiting Clinician Program in Primary Care Internal Medicine
ABSTRACT: As part of a primary care internal medicine training program, a visiting clinician program was created to improve house staff education, provide an ongoing critique of the training program, and improve communication between program faculty and other institutions. Thirty-one visitors participated in the program during the two years covered…
