Issue - Southern Medical Association

Editorial

JOINING THE INFORMATION AGE

Editorial

LEARNING MEDICINE

Primary Article

Reflections From a Decade of Carotid Reconstructive Surgery

ABSTRACT: Carotid artery reconstructive surgery for atherosclerotic lesions of the extracranial cerebral circulation has become the most common operation in peripheral vascular surgery. A better understanding of the indications for operative intervention, enhanced monitoring during surgery, and more precise management of intraoperative anesthesia have all helped decrease the risks associated…

Primary Article

Graded Exercise Testing for Diagnosis of Coronary Artery Disease in Elderly Patients

ABSTRACT: We tested the clinical utility and predictive value of graded exercise testing in the diagnosis of coronary artery disease in 153 patients aged 65 years or more. Based on changes of the ST segment from baseline, the test was considered positive with 1 mm of depression lasting 0.08 seconds,…

Primary Article

Emergency Department Infraclavicular Subclavian Vein Catheterization in Patients With Multiple Injuries and Burns

ABSTRACT: We assessed the complications associated with emergency department placement of subclavian vein catheters in trauma and burn patients, reviewing the charts of all of the 441 patients admitted to the burn-trauma unit through the emergency department during 1983. Fifty-two patients (12%) had infraclavicular placement of subclavian catheters while in…

Primary Article

Bleeding Due to Portal Hypertension: The Role of Surgery

ABSTRACT: Several therapeutic options are available to stop acute variceal bleeding or prevent its recurrence. Sclerotherapy has emerged as the optimal method for stopping acute bleeding, and as primary therapy for preventing recurrence. Surgery is required for the 30% to 40% in whom sclerotherapy fails. Selective variceal decompression has emerged…

Primary Article

Renal Artery Reconstruction: Extended indications

ABSTRACT: Renal artery reconstruction has traditionally been limited to cases of documented renal artery hypertension. We report our experience with renal artery reconstruction on 32 arteries in 23 patients over a three-year period. These procedures were done for renovascular hypertension in nine patients, for renal preservation in seven patients, and…

Primary Article

Catheter Drainage of Ischiorectal Abscesses

ABSTRACT: We retrospectively reviewed the charts of 55 patients with ischiorectal abscesses treated from 1980 to 1983 at the Cleveland Clinic Foundation. The patients were treated by placement of a 10F to 16F soft latex mushroom catheter into the abscess cavity under local anesthesia as an office procedure. The end…

Primary Article

Syphilis in Pregnancy

ABSTRACT: The course and outcome of 356 pregnant patients who had a positive serologic test for syphilis and who had delivery at the LSU Medical Center between Jan 1, 1982 and Dec 31, 1984 were compared to those of our general obstetric population. Records of these women and their infants…

Primary Article

Diagnosis of Neurosyphilis: A Critical Assessment of Current Methods

ABSTRACT: Clinical features of 74 patients with neurosyphilis and 38 syphilitic patients with nonsyphilitic neurologic disorders were correlated with results of their serum and cerebrospinal fluid (CSF) VDRL and FTA tests, and with the WBC count and total protein level in the CSF. The most common clinical features in those…

Primary Article

Effect of Intravenous Glucagon on Intraoperative Cholangiography

ABSTRACT: Intravenous glucagon has been advocated as a useful adjunct to intraoperative cholangiography. Thirty patients scheduled for elective cholecystectomy were entered into a prospective, randomized, double-blind study to test the effects of glucagon on intraoperative cholangiography. All patients randomly received either glucagon or normal saline (control group) and had two…

Primary Article

Infantile Botulism

ABSTRACT We present the first two known cases of infantile botulism in Oklahoma. The first case was due to type B toxin; the second was due to type A toxin. Both cases demonstrate most of the classic features of what now appears to be the most common form of botulism….

Primary Article

Pneumonia Due to Aeromonas hydrophila-complex Epidemiologic, Clinical, and Microbiologic Features

ABSTRACT: Review of published data examining the various types of infections produced by strains of the Aeromonas hydrophila-complex demonstrates a paucity of information on lower respiratory tract infections due to this organism. Although it is rarely cited as a cause of pneumonitis, we have been able to collect epidemiologic, clinical,…

Primary Article

Ovarian Tumors in Children

ABSTRACT: Ovarian tumors in the pediatric age group, although rare, can be malignant and lethal; the most common is the germ cell tumor. Operation and chemotherapy with multiple drugs is recommended to improve survival. For children with benign ovarian tumors, preservation of ovarian tissue should be a priority. Thirty children…

Primary Article

Plasma Apolipoprotein C-III Levels in Children With Type I Diabetes

ABSTRACT: The serum concentrations of apolipoproteins C-III, B, and A-I were determined in children with type I diabetes mellitus to establish whether they correlated with the level of glycosylated hemoglobin (Hb A1) and to determine whether these values differ between diabetic children and a population of normal children. Triglyceride (TG),…

Primary Article

Brooks Fusion for Atlantoaxial Instability in Rheumatoid Arthritis

ABSTRACT: Atlantoaxial instability in rheumatoid arthritis has been recognized in the natural history of rheumatoid arthritis, but successful surgical stabilization has proven to be elusive. We review our experience using the Brooks technique of wedge compression arthrodesis combined with halo immobilization in five women with rheumatoid arthritis with symptomatic Cl-2…

Primary Article

Bone Mineral Content in Smokers

ABSTRACT: We did a cross-sectional evaluation of the effect of heavy cigarette smoking on bone mass using single photon absorptiometry (SPA) of the radius in 35 smokers (24 women, 11 men) and 35 nonsmokers (24 women, 11 men). Individuals from the two groups were carefully matched for sex, age, weight,…

Primary Article

Cartilage Tumors of the Larynx

ABSTRACT: Tumors of cartilage in the larynx arise either from the cartilaginous skeleton of the larynx or as metaplastic nodules in laryngeal soft tissues, unassociated with the hyaline cartilages of the larynx. Chondrosarcomas, nearly always histologically low-grade, make up the largest numbers of the neoplasms and arise principally from the…

Primary Article

Subtypes of Depression in Patients With Chronic Pain

ABSTRACT: Recent studies have shown that depression can be assessed in patients who have chronic pain. This study shows that various subtypes of depression can be differentiated in such patients using a standardized diagnostic schema for psychiatric disorders and a self-rating instrument for assessing the level of psychologic distress. In…

Primary Article

Communication Difficulty of Patients With Schizophrenia and Physical Illness

ABSTRACT:Our study was done to determine whether patients with schizophrenia and a coexisting physical disorder could adequately discuss the physical illness with a physician. We defined the minimal standard of adequate communication as the ability to acknowledge and name a physical problem during an index hospitalization. Of the 110 patients…

Review Article

Coagulase-Negative Staphylococci

ABSTRACT: Coagulase-negative staphylococci, long considered to be harmless commensals or contaminants, have emerged as major pathogens as medical technology has advanced. They are a major cause of intravenous-catheter-associated bacteremia, endocarditis, otitis media, and infection of joint prostheses, vascular grafts, cardiac pacemakers, cerebrospinal fluid shunts, postoperative wounds, the urinary tract, and…

Current Concepts

Initial Resuscitation and Assessment of Patients With Multisystem Blunt Trauma

Abstract: In the vast majority of blunt trauma victims, shock is due to blood loss. Whereas the diagnosis of circulatory collapse is clear-cut, the rapid identification and control of the bleeding source may not be. Such patients often have injuries to several body systems and thus have numerous possible sources…

Current Concepts

Adenotonsillectomy in Children: Indications and Contraindications

ABSTRACT: Adenoidectomy and tonsillectomy are the most common major operations done on children. The indications for tonsillectomy in certain clinical situations are constantly being debated in the literature and among professionals. We studied the efficacy (or lack of it) of adenotonsillectomy for chronic tonsillitis (recurrent throat infections), oral nasal obstruction,…

Commentary

ADENOTONSILLECTOMY IN CHILDREN

Case Report

Near-Total Gastric Necrosis Caused by Acute Gastric Dilatation

Case Report

Injury to the Abdominal Wall Musculature: The Full Spectrum of Traumatic Hernia

Case Report

Chronic Myelocytic Leukemia With Near-Total Pulmonary Microvascular Obstruction by Platelets

Case Report

Pulmonary Venous Obstruction After Atrioplasty for Partial Anomalous Pulmonary Venous Drainage

Case Report

Cyclic Neutropenia and Pregnancy

Case Report

Ventricular Tachyarrhythmias During Cesarean Section After Ritodrine Therapy: Interaction With Anesthetics

Case Report

Dizziness Due to Dysautonomia: Response to Specific Therapy

Case Report

Malignancy-Induced Lactic Acidosis

Case Report

Primary Pericardial Mesothelioma: Diagnostic and Therapeutic Challenges in Management

Case Report

Neonatal Refractory Supraventricular Tachycardia: Successful Treatment With Amiodarone

Case Report

Large Benign Virilizing Adrenal Adenoma

Case Report

Neuroleptic Malignant Syndrome Presenting as Adult Respiratory Distress Syndrome and Disseminated Intravascular Coagulation

Letter to the Editor

Heavy Metal Poisoning

Letter to the Editor

Orphenadrine Abuse

Letter to the Editor

A Bizarre Cause of IV Catheter Embolization

Letter to the Editor

Serial Measurements of Serum Angiotensin- Converting Enzyme and Steroid Therapy for Pulmonary Sarcoidosis