SMJ // October 1988, Volume 81 - Issue 10
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…
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…
