Issue - Southern Medical Association

Editorial

DOWN TO THE WIRE

Editorial

FEELINGS

Article

Marijuana as a Potential Respiratory Tract Carcinogen A Retrospective Analysis of a Community Hospital Population

ABSTRACTSurgical pathology reports for the last four years were scanned for patients under the age of 40 with the diagnosis of respiratory tract carcinoma. A total of ten patients were identified and subsequently investigated for a history of marijuana use. Among these, seven revealed a history for significant exposure; five…

Article

Disruption of the Posterior Pelvic Ring Caused by Vertical Shear

ABSTRACTDisruption of the posterior pelvic ring caused by vertical shearing forces is associated with significant morbidity and mortality. We reviewed the intermediate results in 18 patients who had 20 disruptions of the posterior pelvic ring. Depending on the location of the injury, patients were treated by either skeletal traction or…

Article

Clinical Efficacy of Temporal Artery Biopsy in Nashville, Tennessee

ABSTRACTA retrospective study of temporal artery biopsies done over one decade in four Nashville hospitals yielded 412 procedures on 394 patients. Diagnosis was obtained in 17%, and the procedure was helpful in 21% of patients. Only two complications were recorded. There was no correlation between length of biopsy specimen and…

Article

Percutaneous Fine Needle Aspiration in the Diagnosis and Management of Mediastinal Cysts in Adults

ABSTRACTManagement of asymptomatic mediastinal cysts in adults is controversial. In the past, these cysts were excised primarily to establish a diagnosis. Presently, computerized tomography (CT) of the chest can diagnose the majority of mediastinal cysts, based on their smooth contour and low density; however, CT diagnosis of a mediastinal cyst…

Article

Abnormalities of Urine Urobilinogen and Urine Bilirubin Assays and Their Relation to Abnormal Results of Serum Liver Function Tests

ABSTRACTA prospective observational study of 324 cases was conducted in a busy ambulatory care setting to evaluate the sensitivity, specificity, predictive values, and accuracy of spot urine urobilinogen and urine bilirubin assays as screening tests for serum liver function test (LFT) abnormalities. High positive predictive values (88% for at least…

Article

Cecal Volvulus Review of 12 Cases

ABSTRACTWe reviewed the records of patients with cecal volvulus at three affiliated hospitals of Eastern Virginia Medical School to elucidate its incidence, patterns of presentation, and current methods of surgical management. We identified 109 patients in whom a discharge diagnosis of intestinal obstruction due to volvulus was made from 1966…

Article

Penetrating Trauma to the Buttock

ABSTRACTPenetrating trauma to the buttock is an injury with potential impact on multiple body systems. The purpose of this study was to review our experience with penetrating trauma to the buttock, to establish the frequency of system injury and related morbidity and mortality, and to make recommendations for the evaluation…

Article

Intracranial Tuberculoma in Children A New Look at an Old Problem

ABSTRACTIntracranial tuberculoma has become a rare cause of space-occupying intracranial lesions in childhood, but it must still be considered in the differential diagnosis. Tuberculosis remains a significant disease in developing countries and in the United States, and tuberculoma is a well known presentation of childhood tuberculosis. This diagnosis must be…

Article

Noninvasive Evaluation of Ischemic Stroke With SPECT

ABSTRACTTechnetium Tc 99m DTPA single photon emission computerized tomography (SPECT) brain scans of 20 patients with acute ischemic stroke were reviewed retrospectively and compared with clinical and radiologic (CT) data. Fourteen of the patients had abnormal SPECT studies. The abnormal findings were demonstrated by static views in eight patients, by…

Article

Headache After Lumbar Puncture Review of the Epidural Blood Patch

ABSTRACTThe incidence of accidental dural puncture during epidural block is 2.9%; headache follows in as many as 76.5% of these patients. Treatment by injection of autologous blood into the epidural space has gained wide acceptance since its introduction in 1960, though it is contraindicated by blood dyscrasias, anticoagulant therapy, bleeding,…

Article

Postoperative Ketamine Analgesia in Children Efficacy and Safety After Halothane Anesthesia

ABSTRACTThis study was done to investigate the effectiveness and safety of ketamine analgesia after halothane anesthesia for surgery in children. After completion of a surgical procedure, ten children had ketamine (1 mg/kg) injected intravenously during maintenance of anesthesia with 1% halothane in a 60:40 nitrous oxide-oxygen mixture. Cardiovascular parameters measured…

Article

Cardiopulmonary Effects of the Head-Down Tilt Position in Elderly Postoperative Patients A Prospective Study

ABSTRACTWe studied the use of the head-down tilt position (Trendelenburg) in elderly postoperative patients in the intensive care unit to determine its effect upon cardiac and pulmonary function. Twenty-two patients (mean age 68.4 years) were placed in a 12° head-down tilt position for 15 minutes. No deterioration was shown in…

Article

Evaluation and Management of Self-mutilation

ABSTRACTInstances of deliberate self-injury are observed in both psychotic and nonpsychotic individuals. Patients with command hallucinations, religious preoccupations, substance abuse, and social isolation are the most vulnerable. Persons who request unnecessary surgical procedures for bizarre reasons also are at high risk. Such behavior constitutes a medical, surgical, and psychiatric emergency….

Review Article

Pancreatic Heterotopia A Reappraisal and Clinicopathologic Analysis of 32 Cases

ABSTRACTA total of 32 histologically documented cases of heterotopic pancreas was found in a review of the records of the department of pathology at the Chang Gung Memorial Hospital between 1977 and 1987. This review was done to ascertain the clinical significance of this uncommon entity. In 14 patients (44%),…

Current Concepts

Thrombophilia New Ideas About Old Problems

ABSTRACTPatients with recurrent thrombosis may have one of the thrombophilias described in recent literature. These clotting disorders may involve abnormalities in platelets, fibrinogen, plasminogen, protein C, protein S, or antithrombin III. There is usually a family history of clotting disorders, since most of these are inherited in an autosomal dominant…

Article

The Physicians Obligation to Treat AIDS Patients

ABSTRACTMedicines triumph over contagious disease through improved techniques of prevention and treatment in the decades before the appearance of the acquired immunodeficiency syndrome (AIDS) left physicians with little impetus to explore their feelings regarding the acceptance of personal risk in the course of patient care. The rapid expansion of the…

Article

The Right to Privacy and the Duty to Protect

Medical Education

Computer-Assisted Learning Compared With Weekly Seminars for Teaching Fundamental Electrocardiography to Junior Medical Students

ABSTRACTThis study was designed to assess whether a self-study interactive computer program is more effective than weekly seminars for teaching fundamental skills of electrocardiographic interpretation to junior medical students. Forty-two students were assigned to the computer and 41 to the seminar group. A test was given to each participant at…

Evagations

THERE OUGHTTA BE A LAW

Case Report

Marshall-Smith Syndrome Further Delineation

Case Report

Unicameral Bone Cyst of the Tibia Complicated by Genu Valgum

Case Report

Complex Interaction of Rifampin and Warfarin

Case Report

Ventral Hernia in a Massively Obese Patient Diagnosis by Computerized Tomography

Case Report

Secondary Mania From Cerebral Embolization With Nonfocal Neurologic Findings

Case Report

Abdominal Pain and Sicklemia in a Patient With Sickle Cell Trait

Case Report

Necrotizing Fasciitis in a Renal Transplant Patient

Case Report

Primary Extraosseous Osteogenic Sarcoma of the Mediastinum Clinical, Pathologic, and Radiologic Correlation

Case Report

Microangiopathic Hemolytic Anemia Associated With Metastatic Carcinoma of the Colon

Case Report

Large Fluid-Filled Thoracic Mass in a Young Man

Case Report

Pulmonary Hemorrhage and Glomerulonephritis in the Absence of Anti-Glomerular Basement Membrane Antibody

Clinical Brief

Hydroxychloroquine Sulfate and Retinopathy

Breif Report

Binswangers Disease A Cause of Dementia in the Elderly

Breif Report

Plasmacytic Neoplasm of the Gastrointestinal Tract in a Patient With Long-standing Monoclonal Gammopathy

Letter to the Editor

“I Swear by Apollo”

Letter to the Editor

Upper Airway Obstruction Associated With Large Bore Nasogastric Tubes

Letter to the Editor

On Death and Dying

Letter to the Editor

Myasthenia Gravis and Graves Disease

Letter to the Editor

Roger L. Mell, MD