SMJ // May 1987, Volume 80 - Issue 5
Primary Article
Syncope
ABSTRACT: The isolated syncopal episode, most commonly a benign and self-limited event, may also represent serious neurologic or cardiologic disease. In evaluating patients with syncope, the clinician must differentiate the benign from the more serious etiology. Considerable progress has been made in the past 20 years in understanding the causes…
Primary Article
Differences Between Early and Late Onset of Substance Abuse: An Inpatient Experience
ABSTRACT: Of 100 consecutive patients admitted to an inpatient alcohol and drug abuse ward, approximately four fifths reported the onset of substance use before 18 years of age. The majority used both alcohol and drugs, and had a history of problems with school authorities and suicidal ideation. We found general…
Primary Article
Chronic Pain and Depression
ABSTRACT: Patients with chronic pain syndromes often have concomitant depression. In this paper we discuss the clinical and biologic characteristics of depression, and also briefly discuss the various subtypes of depression, potential modes in the development of depression, neuroendocrine markers of depression, and patient response to antidepressant medication.
Primary Article
Trauma Victims: Field Triage Guidelines
ABSTRACT: Trauma kills more Americans from age 1 to 34 than all diseases combined. Until recently, trauma care in the United States was delivered in a nonorganized, nonintegrated fashion, with trauma victims being transported to the medical facility closest to the scene of the accident. Many recent studies confirm an…
Primary Article
Resident and Faculty Clinical Experience in a Model Family Practice
ABSTRACT: This study compares the clinical experience of a resident and a faculty member in a model family practice over a three-year period. The resident had 1,565 encounters with 733 patients, and the faculty member had 2,837 encounters with 917 patients. The resident experienced continuity of care by managing his…
Primary Article
Hypercalcemia in Active Pulmonary Tuberculosis
ABSTRACT: We describe four cases of active pulmonary tuberculosis with hypercalcemia. The hypercalcemia developed three to eight weeks after the patients were admitted to the hospital, when clinical improvement due to specific drug therapy for the infection was also evident. The abnormality persisted for three to seven weeks and subsided…
Primary Article
Sternocostoclavicular Hyperostosis: Rheumatologic, Radiologic, and Dermatologic Characteristics
ABSTRACT: Two recently observed patients with sternocostoclavicular hyperostosis exemplify the characteristic presentation of this rheumatologic disorder. We describe its manifestations, review the literature on this subject, and discuss clinical and radiologic aspects, including the frequently associated dermatologic disorder palmoplantar pustulosis. Sternocostoclavicular hyperostosis is an increasingly common diagnosis, and practicing physicians…
Primary Article
Adolescent Sexual Activity and Pregnancy in South Carolina: Trends, Risks, and Practice Implications
ABSTRACT: Using South Carolina vital record data, we examined current trends in teenage pregnancy and the related pregnancy outcome risks for the period 1977 to 1984. A review of the eight-year trends in the pregnancy outcomes of teenaged mothers (less than 18 years old) indicated a significant decline (P <…
Primary Article
Oligohydramnios Sequence (Potters Syndrome) Case Clustering in Northeastern Tennessee
ABSTRACT: The oligohydramnios sequence (OS) is manifest in newborns when prolonged oligohydramnios has been present during pregnancy. The most important signs are an infant small for gestational age, with wrinkled skin, Potter facies, compression deformities of the limbs, and respiratory distress caused by pulmonary hypoplasia. The recurrence rate of kidney…
Primary Article
Pleural Empyema in Children: A Nationwide Retrospective Study
ABSTRACT: Military hospitals across the United States provided data for this study on pediatric patients with pleural empyema. Haemophilus influenzae tybe b (17%), Streptococcus pneumoniae (14%), and Staphylococcus aureus (11%) were the most common etiologic agents. Male patients predominated, except among blacks. The mortality was high in patients with hospital-acquired…
Primary Article
Direct Browplasty
ABSTRACT: To the facial plastic and reconstructive surgeon, direct browplasty is a useful adjunct to other facial rejuvenative procedures. Unlike other procedures designed to correct the ptotic brow, direct browplasty allows the surgeon to reposition the brow more accurately. In addition, use of a layered plastic closure results in an…
Primary Article
Enterobacter Pneumonia
ABSTRACT: Enterobacter species have not been well recognized as important lower respiratory tract pathogens. We describe 11 cases of Enterobacter pneumonia, seven diagnosed by transtracheal aspiration and four by simultaneous blood and sputum cultures. The infections were usually nosocomial, and were fatal in five patients. Our patients were old (mean…
Primary Article
Malignant Salivary Gland Tumors of the Base of the Tongue
ABSTRACT: We present a 41-year retrospective study of patients with malignant salivary gland tumors of the base of the tongue treated at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston. This report characterizes the patient group, documents their physical findings, analyzes survival, and draws some…
Review Article
Oral Rehydration Therapy
Current Concepts
Pruritus in Pregnancy
ABSTRACT: Pruritus occurs frequently during pregnancy; the reported incidence ranges from 3% to 14% of all pregnancies. Pruritis may occur with or without skin lesions, and may be an exaggerated response to a physiologic adaptation to pregnancy, a manifestation of a systemic disorder, or a primary skin disease. We review…
Grand Rounds
Saturday Conference: Management of Osteoarthritis
Our Medical Heritage
Joseph Jones, MD: An Early Clinical Investigator
Our Medical Heritage
Administration of the Medical Department of the Confederate States Army, 1861 to 1865
ABSTRACT: During its brief existence, the Confederate States of America created many new institutions. This paper concerns one of these, the Medical Department of the Confederate States Army. From a very small nidus of experienced physicians, this organization expanded to supervise thousands of officers, to build many huge hospitals, and…
