SMJ // July 1988, Volume 81 - Issue 7
Editorial
BEEPER MEDICINE
Commentary
RELIGION IN HEALING
Primary Article
Adult Burn Patients: The Role of Religion in Recovery
ABSTRACT: Patients who have had a severe physical injury, such as a burn, show wide variations in their abilities to cope with the stress of hospitalization and recovery. Clinical experience has consistently shown that some of these patients have remarkable emotional resilience, while others are more seriously affected. Many researchers…
Primary Article
Positive Therapeutic Effects of Intercessory Prayer in a Coronary Care Unit Population
ABSTRACT: The therapeutic effects of intercessory prayer (IP) to the Judeo-Christian God, one of the oldest forms of therapy, has had little attention in the medical literature. To evaluate the effects of IP in a coronary care unit (CCU) population, a prospective randomized double-blind protocol was followed. Over ten months,…
Primary Article
Alprazolam Dependency: Use of Clonazepam for Withdrawal
ABSTRACT: Ten alprazolam-dependent patients were studied with clinical and biologic variables after equal doses of clonazepam were substituted for alprazolam. Withdrawal was accomplished over a seven-day period. Anxiety and plasma cortisol levels were measured and found not to be significantly different between the withdrawal period and the postwithdrawal medication-free period.
Primary Article
Sphenopalatine Ganglion Blocks for the Treatment of Nicotine Addiction
ABSTRACT: The purpose of this study was to investigate the effects of sphenopalatine ganglion block upon the physical symptoms of nicotine withdrawal in a double-blind placebo-controlled study. Seventeen patients completed a course of treatment which involved daily intranasal application of local anesthetic (bupivacaine or cocaine) or saline over the sphenopalatine…
Primary Article
Abnormal Urine Color: Differential Diagnosis
ABSTRACT: An unusual urine color can occasionally be alarming to patient or physician. Abnormal urine color may indicate a range of normal or pathologic conditions. Variables that affect urine color include concentration, pH, ingested substances, and various metabolic abnormalities. Most causes can be determined by a careful history focusing on…
Primary Article
Altered Sensorium, Confusion, and Vertical Gaze Paresis: The Top of the Basilar Syndrome
ABSTRACT: The term “top of the basilar” has been used in reference to a group of signs and symptoms of midbrain, diencephalic, and posteroinferior hemispheric dysfunction. It has been attributed to ischemia in the territory of second- and third-order vessels that arise from the uppermost portion of the basilar artery….
Primary Article
Benign Mucor Colonization (Fungus Ball) Associated With Chronic Sinusitis
ABSTRACT: Mucormycosis of the nasal cavity and paranasal sinuses is an aggressive, life-threatening condition characterized by fulminant destruction of soft tissues and bone, vascular invasion, and thrombosis. Patients who have this infection generally are immunosuppressed or diabetic. The most effective treatment is immediate surgical debridement of all involved tissue, along…
Primary Article
Gonococcal Infections in Women Attending the Venereal Disease Clinic of the Nashville Davidson County Metropolitan Health Department, 1984
ABSTRACT: During the first six months of 1984, slightly more than a third (34.1%) of the 1,549 women who attended the Venereal Disease Clinic of the Nashville Davidson County Health Department in this study were found to be infected with Neisseria gonorrhoeae. Infection prevalence was 36.7% for black women and…
Primary Article
Multiple Myeloma: Infectious Complications
ABSTRACT: We review a ten-year experience in treating 60 patients with multiple myeloma. Infectious episodes occurred in 33 patients. Urinary tract infections caused by gram-negative organisms were the most frequent infections, and most of these were the result of catheterization. Pneumonia due to Streptococcus pneumoniae was encountered infrequently. This series…
Primary Article
Campylobacter Gastritis and Associated Disorders
ABSTRACT: Our review of evidence that Campylobacter pylori is an important factor in gastritis, peptic ulcer disease, and “nonulcer dyspepsia” suggests that C pylori is the most common cause of chronic active gastritis. The association between C pylori gastritis and duodenal ulcer, which approaches 100%, leads to the suggestion that…
Primary Article
Insufficiency Fractures of the Femoral Neck in Association With Chronic Renal Failure
ABSTRACT: The femoral neck is a relatively uncommon location for stress fractures. As with other stress fractures, those occurring in the femoral neck can be divided into fatigue and insufficiency fractures. Chronic renal failure (CRF) is an underlying condition that can predispose patients to insufficiency fractures of the femoral neck….
Primary Article
Conventional Immunosuppressive Therapy in Modern Renal Transplantation
ABSTRACT: Conventional immunosuppression has been replaced by cyclosporine protocols for renal transplantation in most centers. Some centers have continued using conventional immunosuppression in certain instances. In our series, 104 patients received 105 kidney allografts (58 cadaver, 47 living donor) in 1983 and 1984. No patient was treated with cyclosporine. Patient…
Primary Article
Distal Tuboplasty:Is It Appropriate?
ABSTRACT: We retrospectively analyzed the results of distal tuboplasty (fimbrioplasty, salpingostomy, and salpingoneostomy) in 64 patients who had 70 operations from 1974 to 1984. The postoperative pregnancy rate was 19%, and the ectopic pregnancy rate 21%. It is difficult to compare results obtained in this study with those reported in…
Review Article
Cancer of the Esophagus:The Environmental Connection
ABSTRACT: Cancer of the esophagus poses a unique challenge for students of cancer prevention. The role of nutritional determinants and other environmental factors in modulating esophageal cancer has received increasing support from data collected during the last decades. Ecologic, geograhic, economic, and cultural variables appear to be collectively operational in…
Article
Acupuncture Today
Current Concepts
Neuroleptic Malignant Syndrome:Guidelines for Treatment and Reinstitution of Neuroleptics
ABSTRACT: The neuroleptic malignant syndrome (NMS) is a dangerous, often fatal, idiosyncratic disorder presumably of the basal ganglia and hypothalamus. It is usually associated with neuroleptic medications, and it is believed to be related to blockage of dopamine receptors in the brain. The NMS has also been reported in patients…
Current Concepts
Current Management of the Poisoned Patient
ABSTRACT: Management of the poisoned patient is a common and difficult problem for many practitioners. I present a clinical approach to the management of these patients, with emphasis on recent advances and controversies. Efficacy of gastric emptying, activated charcoal, manipulation of urinary pH, and indications for dialysis are discussed. Poisonings…
Medical Education
Improving and Sustaining Outpatient Cancer Screening by Medicine Residents
ABSTRACT: The sustained effectiveness in improving resident performance of breast, cervical, and colorectal cancer screening examinations in the medicine outpatient department (OPD) was studied. Residents were divided into two groups: an intervention group, which received lectures presenting cancer screening rationale and recommendations, followed by chart reminders for three months, and…
Article
Old Parr: Or How Old Is Old?
ABSTRACT: In 1635, the noted physician Sir William Harvey performed an autopsy on the body of Thomas Parr who was reported to have been 152 years old. Although there is little evidence to support Parrs age, historians agree that he had indeed reached an advanced age and was probably a…
