SMJ // November 1988, Volume 81 - Issue 11
Article
Morbidity of Hurricane Elena
ABSTRACT: On Sept 2, 1985, Hurricane Elena struck the Gulf Coast of Mississippi. We conducted a retrospective review of Emergency Department logs for a one-week period before and a two-week period after the storm to determine what additional support would be needed to manage such a disaster. There was a…
Article
Traumatic Perforation of the Diaphragm
ABSTRACT: To ascertain our experience with traumatic perforations of the diaphragm, we reviewed the charts of 72 patients treated over a ten-year period. From January 1975 through June 1984, 58 male patients and 14 female patients, ranging in age from 6 to 72 years, were treated for traumatic perforations of…
Article
High-Voltage Electrical Injuries Management and Outcome of 60 Cases
ABSTRACT: High-voltage electrical injuries, though uncommon, are not rare and make up approximately 3% of hospital admissions for burns. Our review of a seven-year experience including treatment of 60 patients indicates that the mortality for hospitalized patients is low, but the complication rate is significant. Sepsis or wound infection occurred…
Article
Chronic Acalculous Gallbladder Disease A Clinical Variant
ABSTRACT: A review of 228 cholecystectomies done over a two-year period revealed 15 cases (6.6%) in which gallstones were absent. These 15 patients were all characterized by colicky abdominal pain in the right upper quadrant, with a mean duration of eight months. Ultrasonographic examination was falsely positive for gallstones in…
Article
Routine Bile Cultures During Elective Cholecystectomy
ABSTRACTTo assess antibiotic usage and the value of routine intraoperative bile cultures, we retrospectively reviewed 79 patients who had elective cholecystectomy from January to December 1986. Forty patients (57%) received perioperative antibiotics, and 15 (19%) had positive intraoperative bile cultures. During follow-up, the only septic complications identified were wound infections…
Article
Transcutaneous Electrical Nerve Stimulation for Pain Control After Cholecystectomy Lack of Expected Benefits
ABSTRACT: We did a prospective study of two groups of patients having elective cholecystectomy through a right subcostal incision to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS). Of 64 patients, 30 received TENS postoperatively and 34 did not. Narcotic use in total dose or on a weight basis…
Article
Panretinal Photocoagulation in the Management of Neovascular Glaucoma
ABSTRACT: We report a retrospective evaluation of the role of panretinal photocoagulation in the primary treatment of neovascular glaucoma. Thirty-six eyes (32 patients) received aggressive argon laser panretinal photocoagulation beginning as soon as feasible after diagnosis of the developing neovascular glaucoma. Thirty eyes were stabilized by photocoagulation, though 25 required…
Article
Laryngeal Cancer Without Spread to the Neck Treatment Options and Outcome
ABSTRACT: We examined treatment and outcome variables in patients who had laryngeal cancer without clinical evidence of spread to the neck. In our patient population, there was a 24% overall recurrence rate for N0 laryngcal cancer. Initial manifestations, including stage and location of tumor, did not influence recurrence (P >…
Article
Methods of Vaginal Cuff Closure During Vaginal Hysterectomy
ABSTRACT: Over a 2.8-year period, I did 112 vaginal hysterectomies using five different techniques of cuff closure to examine the preservation of vaginal length associated with each closure. I conclude that all five methods are acceptable as long as there is proper vault support. Morbidity was minimal, vaginal depth was…
Article
Economic Impact of Total Hip Arthroplasty
ABSTRACT: Since the first successful total hip arthroplasty (THA) 28 years ago, this procedure has enabled millions of people to walk without pain. The overall incidence of THA has more than tripled in the last five years, now exceeding 196,000 cases annually. The direct and indirect costs of THA exceed…
Article
Tortuosity of the Right Common Carotid Artery Simulating Aneurysm
ABSTRACT: Among the problems that confront the vascular surgeon, a pulsatile, rightsided neck mass requires a careful and logical evaluation. It has long been known that tortuosity of the right common carotid artery, frequently associated with advanced hypertension, can physically mimic a right carotid aneurysm. The question, then, is whether…
Article
Surgical Implications of Jejunal Diverticula
ABSTRACT: To gain insight into the surgical significance of acquired jejunal diverticula, we reviewed the experience at the teaching hospitals in our city during the past ten years. An antemortem diagnosis of jejunal diverticulosis was made in 27 men and 59 women with a mean age of 69.6 years. In…
Article
Esophageal Biopsy Findings in the Acquired Immunodeficiency Syndrome (AIDS) Clinicopathologic Correlation in 20 Patients
ABSTRACT: We reviewed 20 esophageal biopsy specimens from 180 adult patients with the acquired immunodeficiency syndrome (AIDS). Ten (50%) showed superficial Candida infection, and four revealed esophagitis due to cytomegalovirus. Candida was never invasive, even though it was associated with significant ulceration. Esophageal candidiasis did not necessarily imply the presence…
Article
Measles Clinical and Laboratory Observations in Young Adults During an Epidemic
ABSTRACT: We describe the spectrum of clinical and laboratory findings in 130 young nonvaccinated adults who had measles during an epidemic, and give special emphasis to liver involvement. The data from these cases are compared to those of other selected groups of hospitalized young adults. Since measles seems to cause…
Article
Atenolol and Chlorthalidone Therapy for Hypertension A Double-Blind Comparison
ABSTRACTIn a randomized, double-blind, parallel-group study of 31 patients with mild to moderate hypertension, we compared a placebo regimen with a regimen of atenolol and chlorthalidone (Tenoretic). The study, which lasted seven weeks, began with a single-blind two-week placebo lead-in period, followed by a four-week double-blind treatment phase, and concluded…
Article
Evaluation of the Hypothalamic-Hypophysial, Thyroid, and Gonadal Axes Before and After Disulfiram Administration in Patients With Chronic Alcoholism
ABSTRACT: We studied 14 alcoholic men without evidence of liver damage. After two weeks of alcohol abstinence, the patients were divided into two groups of seven patients each. Hypothalamic-hypophysial, thyroid, and gonadal axis tests were done on group 1 patients before disulfiram administration, and the tests were later repeated while…
Article
Angina as a Symptom of Psychiatric Illness
ABSTRACT: We retrospectively studied all patients who had normal coronary angiograms at The Methodist Hospital during the year 1984 (8% of all angiograms). Patients were surveyed eight to 18 months after angiography. Of the 216 patients (83% of total sample), 130 were female and 86 male. Sixty-three percent of the…
Review Article
latrogenic Pleural Effusions
Current Concepts
Sleep Apnea and Hypothyroidism
ABSTRACT: Thyroid deficiency states arc now a well recognized cause of the sleep apnea syndrome. The spectrum of disease ranges from mild, asymptomatic hypothyroidism to severe myxedema, and the disorder is associated with both obstructive and central types of sleep apnea. A variety of factors may be involved, including upper…
