Issue - Southern Medical Association

Editorial

LITTLE DAVID, PLAY ON YOUR HARP

Editorial

FACSIMILE AND THE PRACTICE OF ELECTROCARDIOGRAPHY

Primary Article

Suicide Attempt: One Diagnosis, Multiple Disorders

ABSTRACT: Patients who intentionally injure themselves are a varied group, ranging from those who are unthinkingly agitated to those who are calculatingly manipulative to those who are truly suicidal; these patients require very different forms of management. If a manipulator is able to exploit the hospital in trying to solve…

Primary Article

Neurologic Disease as the Presenting Manifestation of Acquired Immunodeficiency Syndrome

ABSTRACT: Neurologic disease was the harbinger of the acquired, immunodeficiency syndrome (AIDS) in 26 (20%) of 132 patients and ultimately developed in 83 (63%). The most common neurologic disorder heralding AIDS was toxoplasmic encephalitis (17 cases) followed by cryptococcal meningitis (six), retinitis (three), progressive multifocal leukoencephalopathy (two), neuropathy (one), myopathy…

Errata

Correction

Primary Article

Borderline Immunodeficiency in Male Homosexuals: Is Life-style Contributory?

ABSTRACT: Results of our study suggest that white Southern male homosexuals without clinical evidence of AIDS who patronize “gay bars” may have significant zinc deficiency and moderately depressed T-helper/T-suppressor cell ratios. No single causative factor could be identified to explain the significantly low zinc and elevated copper levels measured in…

Primary Article

Preeclampsia and Reproductive Performance in a Community of Vegans

ABSTRACT: Studies at “the Farm,” a community of spiritually gathered young people in Summertown, Tenn, have shown that it is possible to sustain a normal pregnancy on a vegan diet. The source of dietary protein (ie, animal or vegetable) does not seem to affect birth weight, as long as vegans…

Primary Article

Testicular Defect: The Primary Abnormality in Gonadal Dysfunction of Uremia

ABSTRACT: Gonadal dysfunction is a common problem in end-stage renal disease. We decided to test the ability of the male gonads to respond to exogenous stimuli. The patients receiving chronic hemodialysis showed abnormally low levels of total testosterone and free testosterone in the presence of normal testosterone-binding globulin. Furthermore, the…

Primary Article

Influence of Needle Biopsy on Management of Thyroid Nodules: Reasons to Expand Its Use

ABSTRACT: We have implemented a fine needle biopsy program, evaluating 426 satisfactory biopsies in 436 patients with thyroid nodules. Benign disease was diagnosed in 345 patients (232 with benign nodular goiter, 98 with lymphocytic thyroiditis, three with granulomatous thyroiditis, and 12 with cysts). Neoplasm was diagnosed in 81 patients (61…

Primary Article

Prophylactic Treatment of Asymptomatic Patent Ductus Arteriosus in Premature Infants With Respiratory Distress Syndrome

ABSTRACT: Early treatment of premature infants with indomethacin has been proposed as a means of reducing the morbidity associated with respiratory distress syndrome complicated by symptomatic patent ductus arteriosus. We identified 26 infants less than 48 hours old with severe respiratory distress syndrome who had an asymptomatic patent ductus arteriosus….

Primary Article

Clinical Impact of Stool Cultures for Campylobacter in Adults With Acute or Chronic Diarrhea

ABSTRACT: Campylobacter jejuni has emerged as a frequent cause of diarrhea. During a 12-month period at the Houston Veterans Administration Medical Center, we isolated C jejuni from 3.4% of the 290 stool cultures from patients with diarrhea. This compared to an isolation rate of 4.1% for Salmonella and 3.1% for…

Primary Article

Community Outbreak of Adenovirus Type 7a Infections Associated With a Swimming Pool

ABSTRACT: In July 1982, an outbreak of pharyngitis caused by adenovirus type 7a occurred among children in a small town in western Oklahoma. Predominant symptoms were fever and sore throat (by case definition), headache(83%), abdominal pain (64%), and conjunctivitis (51%). At least 77 persons were identified whose symptoms met the…

Primary Article

Clinical Experience With Tetracycline Pleurodesis of Malignant Pleural Effusions

ABSTRACT: Because many patients with malignant pleural effusions could survive for months to years beyond its onset, definitive management must be safe and effective. Chemical pleurodesis with tetracycline has gained general acceptance as the therapy of choice, even though no large series confirming this viewpoint has appeared in the literature….

Primary Article

Theophylline Disposition in Tetraplegic Man

ABSTRACT: We studied the time-course of serum theophylline concentration after a 30-minute intravenous infusion of aminophylline (6 mg/kg) in 18 traumatic tetraplegic (nine smoking, nine nonsmoking) and in six control (nonsmoking) subjects. All study subjects were healthy men with normal renal function. Pharmacokinetic parameters were calculated from a linear regression…

Primary Article

Effect of Ketoconazole on the 11-Hydroxylation Step of Adrenal Steroidogenesis

ABSTRACT: We studied the effect of ketoconazole on glucocorticoid metabolism in three patients before and after a continuous four-hour infusion of ACTH. A single 400 mg oral dose of ketoconazole caused a decrease in serum cortisol concentration, while the concentration of 11-deoxycortisol and its ratio to cortisol increased. The decrease…

Primary Article

Alkalemia-associated Morbidity and Mortality in Medical and Surgical Patients

ABSTRACT: The difference in death rate among medical and surgical inpatients having alkalemia is incompletely defined. This prospective study was done to identify the incidence, mortality, and clinical factors that resulted in a poor outcome in both groups of patients. We screened a total of 10,811 consecutive arterial blood gas…

Primary Article

Incidence of Renal Artery Stenosis in a Population Having Cardiac Catheterization

ABSTRACT: Patients with renovascular hypertension comprise only a small percentage of those with hypertension. In our study 102 consecutive patients who had cardiac catheterization were screened at the time of the procedure for renal artery stenosis. Only 65 (64%) of the 102 patients were hypertensive, and 14 of the total…

Primary Article

Delayed Conjunctival Closure in Adjustable Sutures

ABSTRACT: We describe a technique for delayed conjunctival closure in adjustable strabismus surgery. It combines many of the advantages of the limbal and cul-de-sac approaches, while eliminating many of the disadvantages.

Review Article

Carcinoma of the Thyroid: Review of 304 Cases

ABSTRACT: From 1950 through 1976, 304 patients were treated for carcinoma of the thyroid at Sinai Hospital of Baltimore. This series clearly indicates that papillary cancer of the thyroid can be fatal, even after a five-year survival, even as long as 25 years later. This study also shows that a…

Review Article

Oslers Nodes and the Recognition of Infective Endocarditis: A Lesion of Diagnostic Importance

ABSTRACT: Oslers nodes are classic lesions strongly associated with infective endocarditis. Oslers original description placed them as a frequent finding (70%) in cases of endocarditis. Recent literature, however, has infrequently described these lesions, which in general are no longer found to be useful. We review the clinical syndromes of infective…

Article

The Charles Henderson Child Health Program: An Overview and Five-Year Summary of Progress

ABSTRACT: Charles Henderson was an extremely successful businessman, at one time governor of the State of Alabama, and a distinguished philanthropist who died in 1937 leaving in trust a considerable amount of money, the income from which ultimately reverted to the construction and operation of the Charles Henderson Child Health…

Medical Education

Clinical Performance of Interns After Being on Call

ABSTRACT: We assessed the effect of in-hospital call on clinical performance and emotional state in seven medical interns. Clinical performance was evaluated through the use of actors who were trained to pose as patients seeking consultation because of specific medical complaints. The physician-patient interaction was scored according to predetermined criteria….

Clinical Brief

Association of Barretts Esophagus and Scleroderma

Case Report

Haemophilus influenzae Pericarditis Successfully Treated by Catheter Drainage

Case Report

Bypass Arthritis and the Blind Intestinal Loop

Case Report

Diabetes Insipidus in Pregnancy Treated With Desmopressin Acetate

Case Report

Occult Pneumococcal Bacteremia and Empyema Without Preceding Pulmonary Parenchymal Involvement

Case Report

Atypical CT Pattern in Multiple Sclerosis

Case Report

Streptococcus pneumoniae Endocarditis

Case Report

Anomalous Origin of the Right Coronary Artery From the Main Pulmonary Artery: Incidental Finding in a Case of Dilated Cardiomyopathy

Case Report

Gastric Rupture and Death Caused by Ipecac Syrup

Case Report

Persistent Isolated Hyperphosphatasemia

Breif Report

Persistent Hyperamylasemia in a Patient With Ascites

Breif Report

Acute Orbital Pseudotumor: Ocular Emergency on a General Medical Service

Breif Report

Conversion Reaction Mimicking Quadriparesis in Children

Breif Report

Hemothorax Due to Vena Caval Erosion by a Subclavian Dual-Lumen Dialysis Catheter

Letter to the Editor

Vasopressin Infusion vs Surgery for Gl Hemorrhage in a Patient With Recent Myocardial Infarction

Letter to the Editor

Conversion of Percutaneous Endoscopic Gastrostomy to a Tube Colostomy

Letter to the Editor

Septic Scarlet Fever in 11th Decade of Life

Letter to the Editor

Medical Origins of Duke University