SMJ // October 1987, Volume 80 - Issue 10
Primary Article
Troublesome Aspects of the Patient-Physician Relationship A Study of Human Factors
ABSTRACT: We investigated three onerous aspects of the patient-physician relationship using contemporary psychosocial research methods. A “hassle index” identified three dimensions of vexation in practice: problems with running a practice, medical conditions of patients, and social characteristics of patients. In general, hassle was found to be dependent on the type…
Primary Article
Comparison of Dietary Intake of Urban and Rural Elderly Patients in Family Practice Centers
ABSTRACT: To compare dietary intake of urban and rural patients, we interviewed 50 patients over age 64 at each of two family practice centers, one urban and one rural, using the 24-hour dietary recall method for nutrient comparison. A deficiency of calcium was evident in the intake of both elderly…
Primary Article
Comparison of Hypertension Prevalence and Control in 5,237 Rural and Urban Alabama Residents
ABSTRACT: Selected urban and rural Alabama populations were compared by age, sex, and race on the prevalence of hypertension and uncontrolled hypertension and the percentage of treated hypertensives with controlled blood pressure. We found the following results: (1) Rural women had a significantly higher prevalence of hypertension than urban women….
Primary Article
Essential Arterial Hypertension Plasma and Urinary Aldosterone Alterations
ABSTRACT: We studied 52 patients with mild to severe essential arterial hypertension and ranging in age from 30 to 60 years (average, 44). Various biochemical and endocrinologic parameters were studied, with special emphasis on plasma aldosterone and urinary aldosterone. At the same time, a control group of 30 normal subjects…
Primary Article
Old Age A Sign of Poor Prognosis in Patients With Chronic Myelogenous Leukemia
ABSTRACT: Fifty-four patients aged 60 years or older with a diagnosis of chronic myelogenous leukemia were referred to University of Texas M. D. Anderson Hospital between 1965 and 1982. Patients in this age group had a significantly shorter median survival than that of the 249 patients younger than 60 seen…
Primary Article
Successful Medical Management of Neutropenic Enterocolitis in Adults With Acute Leukemia
ABSTRACT: Seven adults with acute leukemia had a clinical and radiologic diagnosis of neutropenic enterocolitis. Six of the seven patients had granulocyte counts less than 500/µl. All seven patients responded to intensive medical therapy, including bowel rest, broad spectrum antibiotics, and white blood cell transfusions, and recovered from the neutropenic…
Primary Article
Obesity Is It Really a Risk Factor in Thrombophlebitis?
ABSTRACT: Obesity is assumed to be a risk factor in the occurrence of thrombophlebitis. We studied 168 consecutive patients retrospectively; 33 were men and 135 women, with an average age of 34 (range 27 to 41) years. All patients had a gastric bypass because of obesity, with a minimum of…
Primary Article
Central Venous Cannulation Done by House Officers in the Intensive Care Unit A Prospective Study
ABSTRACT: Central venous cannulation (CVC) is a procedure frequently performed by house staff in the intensive care units of teaching hospitals. In the medical ICUs of our two hospitals, CVC was successfully done by house officers in 172 cases requiring 231 attempts (one operator at one insertion site), for a…
Primary Article
Superior Vena Cava Syndrome Experience in a Teaching Hospital
ABSTRACT: Between 1972 and 1985, 39 patients with superior vena cava syndrome were admitted to the Medical College of Georgia Hospitals. I have reviewed the hospital courses of these patients and compared clinical and laboratory findings with those reported in previous series. The syndrome was malignant in 34 patients (mean…
Primary Article
Thrombocytopenia and Cancer Use of the Kim-Ray Greenfield Filter to Prevent Thromboembolism
ABSTRACT: The association of hypercoagulation and cancer, a well established pattern of disease, often leads to pulmonary emboli in an already compromised patient. Anticoagulation therapy in these patients is occasionally complicated by several factors including thrombocytopenia, which may result in a life-threatening situation of hemorrhage versus pulmonary emboli. Mechanical intervention…
Primary Article
Cause of Death in Systemic Lupus Erythematosus A Pattern Based on Age at Onset
ABSTRACT: We reviewed the causes of death in 50 patients treated for systemic lupus erythematosus at the University of Mississippi Medical Center between 1973 and 1985. Two groups of patients could be distinguished based on the age at onset but not on the duration of disease. Younger patients more often…
Primary Article
Subdural Empyema and Epidural Abscess Recent Experience in a Community Hospital
ABSTRACT: We treated 31 cases of localized central nervous system infection over a seven-year period in our community hospital. The causes included brain abscess in 18 cases (58%); cranial subdural empyema (CSE) in six cases (20%); spinal epidural abscess (SEA) in four cases (13%); cranial epidural abscess (CEA) in two…
Primary Article
Bile Acids in Radiation-Induced Diarrhea
ABSTRACT: Radiation-induced bowel disease manifested by debilitating diarrhea is an unfortunate consequence of therapeutic irradiation for pelvic malignancies. Although the mechanism for this diarrhea is not well understood, many believe it is the result of damage to small bowel mucosa and subsequent bile acid malabsorption. Excess amounts of bile acids,…
Primary Article
Continent Intestinal Reservoir
ABSTRACT: In this series, 170 patients have received a continent intestinal reservoir, with follow-up of one to eight years. In 126 a conventional ileostomy was converted to a continent intestinal reservoir, 38 at the time of coloproctectomy. Six had an unsatisfactory ileoanal or ileorectal anastomosis initially, and 26 (15%) required…
Review Article
Pulmonary Embolism Complications of Therapy
Abstract
Encephalopathy in a 68-Year-Old Man
Current Concepts
Medium-Chain Triglycerides and Total Parenteral Nutrition in the Management of Infants With Congenital Chylothorax
ABSTRACT: Enriched MCT (medium-chain triglycerides) formula has been used in the management of infants with congenital chylothorax (CC). Administration of total parenteral nutrition (TPN) has also been suggested. I evaluated the effect of these two regimens on the course of infants with CC described in the literature, in addition to…
