Issue - Southern Medical Association

Editorial

IATROGENIC SENILITY: HAS THE WARRANTY EXPIRED?

Editorial

THE PHYSICAL EXAMINATION-AN ART

Primary Article

Coronary Thrombolysis in a Community Hospital: Experience With an Intravenous Streptokinase Protocol

ABSTRACT: To determine whether intravenous streptokinase can be delivered safely and effectively in a community hospital without acute angiography, we treated 120 patients with intravenous infusion of 1.5 million units of streptokinase shortly after arrival in the emergency room. Average time from onset of pain to treatment was 2.7 hours….

Primary Article

Hypertensive Concentric Left Ventricular Hypertrophy: When Is Ventricular Ectopic Activity Increased?

ABSTRACT: The Framingham Study has indicated that patients with left ventricular hypertrophy (LVH) have a greater risk of cardiovascular complications and sudden death than subjects with a normal heart. We have previously demonstrated that ventricular ectopy was more prevalent and complex in hypertensive patients with LVH by electrocardiographs (ECG) criteria…

Primary Article

Trachea–Innominate Artery Fistula: Retrospective Comparison of Treatment Methods

ABSTRACT: A fistula between the trachea and the innominate artery, a potentially fatal complication of tracheostomy, can be managed successfully. We have derived several guidelines from our experience with one such case and from a review of the 36 cases reported in the literature over the last decade. Diagnosis must…

Primary Article

Learning Curve for Carotid Endarterectomy

ABSTRACT: It is generally accepted that training and experience are necessary to obtain acceptably low perioperative mortality and permanent neurologic morbidity for carotid endarterectomy. To test this hypothesis I analyzed the results of 600 consecutive primary carotid endarterectomies that I performed over a 13-year period beginning with my senior residency….

Primary Article

Complications of Carotid Endarterectomy: The Influence of Case Load

ABSTRACT: We reviewed the records of 508 consecutive carotid endarterectomies done by 19 surgeons during a five-year period in one medical center to evaluate postoperative complications (stroke and death). Each of 16 surgeons did 32 operations or fewer, with case loads ranging from one to 32. Three surgeons did 70,…

Primary Article

Correlates of Cervical Cytologic Screening

ABSTRACT: We investigated factors associated with the frequency of Papanicolaou cytologic screening among women between the ages of 20 and 54 years in metropolitan Atlanta. In a sample of 393 women who had not had a hysterectomy, the frequency of screening was uniformly high for women aged 20 to 49…

Primary Article

Gastrostomy: A Simple and Effective Technique

ABSTRACT: To provide a comfortable and effective method for gastrointestinal decompression or feeding, we developed an alternate technique for gastrostomy. Under local or general anesthesia a No. 18 red rubber catheter with multiple openings cut into the distal 8 to 10 cm is passed through a stab wound in the…

Primary Article

Progressive Roentgenographic Appearance of Caustic Esophagitis

ABSTRACT: We observed progressive roentgenographic changes in five patients who had caustic esophagitis after accidental ingestion of a liquid alkali. Initial endoscopic examination showed moderate caustic esophagitis in all patients, and esophageal atony and poor distension were early roentgenographic observations. Esophageal strictures developed 13 to 44 days after caustic ingestion…

Primary Article

Systemic Mastocytosis and Mastocytosis-Like Syndrome: Radiologic Features of Gastrointestinal Manifestations

ABSTRACT: Mastocytosis is a disorder of unknown etiology characterized by an abnormal proliferation of tissue mast cells, and/or by degranulation of abnormally behaving mast cells that show no proliferation, but release myriad active metabolites. This results in a wide spectrum of signs and symptoms that fluctuate considerably. The presently available…

Primary Article

Antecedent Factors in Urinary Tract Infections Among Nursing Home Patients

ABSTRACT: By a retrospective relative risk analysis for conditions associated with urinary tract infection over a four-year period in a defined teaching nursing home population (n=97), we reached the following conclusions: (1) UTI was associated with cerebrovascular accident (relative risk 2.2, 95% confidence interval 1.4 to 3.2), decreased activities of…

Primary Article

Treatment of Keloids by Single Intraoperative Perilesional Injection of Repository Steroid

ABSTRACT: Keloid management remains controversial, and recurrence and untoward side effects limit the use of many techniques. During a seven-year period, I surgically treated 19 children, aged 3 to 17 (mean 10.5 years), with a total of 28 keloids. After aseptic skin preparation, the interface between the keloid and normal…

Primary Article

Complications of Endotracheal Intubation

ABSTRACT: Tracheal intubation for airway control, once done only by anesthesiologists during surgical procedures, is now being done by physicians in other specialties and by nurses, technicians, and paramedics in areas other than the operating room. Intubation, however, does not always assure a patent airway. Unrecognized esophageal placement of endotracheal…

Primary Article

Assessment of Psychosocial Functioning of Patients With Sickle Cell Disease

ABSTRACT: The Chronic Illness Problem Inventory (CIPI) was used to assess level of psychosocial functioning in 89 patients with sickle cell disease. The results indicated that sickle cell patients have significant psychosocial distress in the areas of employment and finances, sleeping and eating, and performance of normal daily activities. Fear…

Article

STATE MEDICAL ASSOCIATIONS IN THE SOUTHERN REGION ANNUAL MEETINGS

Review Article

Ganglions of the Hand and Wrist

ABSTRACT: The ganglion is the most common soft tissue tumor of the hand and wrist, originating from the joint capsule or tendon sheath. Accurate diagnosis and proper treatment of these entities require a thorough knowledge of the anatomy of the wrist and hand as well as of the ganglion itself….

Current Concepts

Treatment of Asthma With Glucocorticosteroids

ABSTRACT: Glucocorticosteroids (GCS) are used to treat asthma that does not respond to accepted first-line therapy. Because they have potent anti-inflammatory properties, facilitate β-adrenergic responsiveness, suppress the late-phase reaction and reduce secretion of mucus, GCS are indicated in the treatment of severe acute asthma and chronic asthma not responsive to…

Article

Physical Examination: A Revered Skill Under Scrutiny

ABSTRACT: Clinicians in the 1980s rely on the physical examination to a lesser degree than their predecessors in making diagnostic and therapeutic decisions. The major criticisms are that the physical examination lacks sensitivity for many common diseases and has not been subjected to the same scientific scrutiny afforded laboratory testing….

Our Medical Heritage

Brickell VS CartWright: Confrontations in the Antebellum Medical Literature

Case Report

Bacteroides fragilis Endocarditis

Case Report

Combined Surgical Management of Myasthenia Gravis and Graves Disease

Case Report

Unilateral Lower Extremity Hypertrophic Osteoarthropathy Associated With Aortic Graft Infection

Case Report

“Bicycle Kickstand” Phenomenon: Prolonged Erections Associated With Antipsychotic Agents

Case Report

Desmoid Tumors: Experience With New Modes of Therapy

Case Report

Pseudomonas paucimobilis Empyema After Cardiac Transplantation

Case Report

Hyperkalemia Induced by Indomethacin and Naproxen and Reversed by Fludrocortisone

Breif Report

Campylobacter fetus Endocarditis on a Prosthetic Heart Valve

Breif Report

Acute Large Bowel Obstruction Complicating Acute Pancreatitis

Breif Report

Large Luteinized Follicular Cyst of Pregnancy and Puerperium

Letter to the Editor

“I Swear by Apollo the Physician…”

Letter to the Editor

UGI Studies: Radiologic vs Endoscopic

Abstract

UGI Studies: Radiologic vs Endoscopic Reply