SMJ // November 1987, Volume 80 - Issue 11
Editorial
SERENDIPITY
Editorial
Spontaneous Bacterial Peritonitis: Variant Syndromes
ABSTRACT: Spontaneous bacterial peritonitis (SBP), a fascinating disease that had been reported perhaps 50 times in varying guises over the preceding century, suddenly burst forth in the 1960s and was recognized in clusters of cases almost simultaneously in Paris, London, and West Haven, Connecticut. The spectrum of the disease has…
Primary Article
Interpretation of Chest Roentgenograms by Primary Care Physicians
ABSTRACT: In a prospective study, radiologists judged chest x-ray interpretations of family practice physicians. Though discrepancies were frequent, they led to no demonstrable clinical consequences. Potentially significant misreadings did occur, and clinically insignificant errors may still be worth noting for academic as well as patient advocacy reasons.
Primary Article
Inflammatory Aneurysm of the Abdominal Aorta: Diagnosis by Computerized Tomography and Ultrasonography
ABSTRACT: We correctly diagnosed seven cases of inflammatory aneurysm of the abdominal aorta preoperatively by computerized tomography (CT) and ultrasonography (US). Excessive thickening of the aneurysmal wall and conspicuous enhancement on CT are the characteristic features that led to the correct diagnosis. Ultrasonographic findings are nonspecific, but US is the…
Primary Article
Effect of Selective Thromboxane Synthetase Inhibitor on Vein Grafts
ABSTRACT: We evaluated the effect of a selective thromboxane synthetase inhibitor (TSI) on the patency of autogenous vein grafts in dogs. Treatment involved oral dosing (10 mg/kg bid) of TSI or placebo, combined with local treatment of the graft with TSI or placebo (papavarine) at the time of implantation. At…
Primary Article
Hypoprothrombinemia Associated With Cefoperazone Therapy
ABSTRACT: Cefoperazone, a β-lactam antibiotic with a methylthiotetrazole side chain,has been reported infrequently to cause hypoprothrombinemia and hemorrhage. We retrospectively analyzed the records of 80 patients who had been given this drug for more than 72 hours. Nine patients received vitamin K1 (phytonadione) prophylaxis and had no evidence of hemorrhage….
Primary Article
Pelvic Inflammatory Disease During Pregnancy
ABSTRACT: Pelvic inflammatory disease associated with pregnancy is not commonly reported. We present three illustrative cases at ten, 13, and 26 weeks of gestation. Unlike pelvic abscess, which may be discovered at any stage of gestation, acute salpingitis during pregnancy occurs more commonly in the first trimester. Both processes are…
Primary Article
Evaluation of Coronary Artery Disease in Patients Having Noncardiac Surgery
ABSTRACT: Perioperative myocardial infarction and cardiac death are feared complications of noncardiac surgery. Preoperative risk assessment begins with clinical variables. There is no formula for determining who needs further evaluation. In selected patients, thallium scintigraphy or coronary arteriography is needed to define preoperative risk.
Primary Article
Hepatic Metastasis From Neuroblastoma
ABSTRACT: Neuroblastoma is a common solid tumor of infancy and childhood. From 1967 to 1986 we evaluated and treated 58 children with neuroblastoma; in ten (17%) of these children, symptomatic hepatic metastasis developed. The ten children ranged in age from 2 days to 2 years 3 months. The most common…
Primary Article
Body Contouring Surgery After Weight Reduction
ABSTRACT: I reviewed the cases of 50 consecutive patients who had a total of 75 plastic surgery procedures after weight reduction.. The average weight loss was 126 lb. There were 28 women and 22 men. The 75 operations were abdominoplasty (24), face-lift (18), reduction mammaplasty (ten), blepharoplasty (eight), mastopexy (eight),…
Primary Article
Pulse Oximetry in the Management of Pediatric Airway Disorders
ABSTRACT: The management of pediatric upper airway disorders requires rapid assessment of the patients status and prompt airway support. The recent development and popularity of pulse oximetry in the management of patients haying general, anesthesia for surgical procedures has proved the efficacy of this technology. The University of South Alabama…
Review Article
Preoperative Medical Consultation and Evaluation of Surgical Risk
ABSTRACT: Internists are frequently asked to assess the surgical risk of patients with various medical problems. Numerous recent prospective studies have defined specific risk factors for increased morbidity and mortality in the preoperative evaluation of surgical patients. Careful attention to such factors as age, type of operation and anesthesia,underlying pulmonary,…
Review Article
The Novelty of Stress
Current Concepts
Fungal Endocarditis Complicating Treatment of Prosthetic Valve Bacterial Endocarditis: Value of Prophylactic Oral Nystatin
ABSTRACT: We describe two patients in whom fungal endocarditis occurred during antibiotic therapy for prosthetic valve bacterial endocarditis. Successful management of both patients was eventually achieved with antifungal therapy and replacement of the prosthetic valves. These cases and review of the literature suggest that (1) high-dose antibacterial therapy predisposes to…
Current Concepts
Tricyclic Antidepressant Overdose: Pharmacology and Treatment
Medical Education
House Staff Manuals: A Survey of Pediatric Residency Programs
ABSTRACT: To determine the role of house staff manuals in residency training, we did a survey of the pediatric residency directors in the United States. Questionnaires were returned from 77% of the programs (179/232). Sixty percent of respondents provided written administrative and medical guidelines to their house staff. Neonatal or…
