SMJ // September 1988, Volume 81 - Issue 9
Editorial
ACKNOWLEDGMENT
Primary Article
Tobacco Addiction as a Psychiatric Disease
ABSTRACT:Tobacco is the most widely used addictive substance in the world. Since the Surgeon Generals 1964 report, medicine has sought out the genesis of tobacco addiction (TA) and has evolved methods of treatment and prevention. Psychiatry was slower than other medical specialties to acknowledge TA as a legitimate area for…
Primary Article
Smokeless Tobacco Health Hazard on the Rise
ABSTRACT:There are an estimated 22 million users of smokeless tobacco in the United States, 3 million of them under age 21. We surveyed physicians and patients to determine whether the health hazard of smokeless tobacco was recognized and whether preventive measures were being implemented. Although more than 80% of physicians…
Primary Article
Neonatal Withdrawal Symptoms After Chronic Maternal Ingestion of Caffeine
ABSTRACT:We have identified eight infants born to mothers who were heavy users of caffeine during pregnancy. These infants exhibited unusual behavior in the immediate newborn period. Predominant symptoms were irritability, jitteriness, and vomiting. The eight infants had extensive diagnostic studies and none of the usual causes for their symptoms were…
Primary Article
Nephrotoxicity in Leukemic Patients Receiving Empirical Amphotericin B and Aminoglycosides
ABSTRACT:Twelve leukemic patients (19%) receiving amphotericin B and aminoglycosides had nephrotoxicity (creatinine value > 2.0 mg/dl). Patients with nephrotoxicity tended to be older than patients without nephrotoxicity; gender and total amphotericin B dose were not related to nephrotoxicity. Sodium administration has previously been shown to reverse amphotericin B nephrotoxicity. In…
Primary Article
Carbamazepine in the Treatment of Phantom Limb Pain
ABSTRACT:The successful use of carbamazepine in treating a case of severe phantom limb pain prompted me to review this condition and its experiential treatment with carbamazepine, as well as the drugs possible mechanism of action on phantom limb pain. Experience to date indicates the need for controlled double-blind crossover studies…
Primary Article
Clonazepam, Haloperidol, and Clonidine in Tic Disorders
ABSTRACT:We reviewed the treatment outcomes of 81 patients with multifocal tic disorders followed in our movement disorders clinic. From the three drugs used, rank orders of effectiveness were haloperidol, clonazepam, and clonidine. Because of the risk of tardive dyskinesia, we suggest first a trial with clonazepam, later combined with clonidine…
Primary Article
Intraoperative Endoscopy for Recurrent Gastrointestinal Bleeding
ABSTRACT:We report a case series of patients with significant recurrent gastrointestinal bleeding. All forms of nonoperative investigation, diagnostic celiotomy, and even resection of portions of the gastrointestinal tract were used unsuccessfully to find the lesions. Using a modification of Bowdens technique of intraoperative endoscopy with transillumination, the nonpalpable lesions were…
Primary Article
Breast Cancer Metastatic Patterns and Their Prognosis
ABSTRACT:From 1969 to 1977, metastatic disease developed in 145 of the 558 patients treated for breast cancer at the University of Maryland Medical System. The most common first site of distant spread was bone (51%), followed by lung (17%), brain (6%), and liver (6%). The remaining 10% of patients had…
Primary Article
Cosmetic Surgery and Criminal Rehabilitation
ABSTRACT:The contribution of physical appearance to criminal behavior has long been a matter of general interest. We investigated the influence of cosmetic surgery on recidivism rates in the Texas state prison system. The baseline prison population recidivism rates have been 14%, 32%, and 36% at one, two, and three years,…
Primary Article
Strangulated Obturator Hernia Can Mortality Be Reduced?
ABSTRACT:We describe two patients with strangulated obturator hernia to enhance clinical awareness of the varied presentations of this uncommon hernia, which occurs especially in elderly women with either recurrent abdominal pain or partial intestinal obstruction, a positive Howship-Romberg sign, and an absent thigh adductor reflex. Early laparotomy for unexplained bowel…
Primary Article
Surgical Management of Glomus Tumors Endocrine-Active Tumors of the Skull Base
ABSTRACT:The surgical management of glomus jugulare tumors involving the temporal bone and skull base is determined by the extent of the disease process. These highly vascular tumors also have the capability of producing vasoactive amines, which may complicate surgical management by causing widely fluctuating blood pressures. I present my experience…
Primary Article
Immunoradiometric Assay for Basal Thyroid-Stimulating Hormone Levels Strategy for the Management of Thyroxine Replacement
ABSTRACT:Basal levels of thyroid-stimulating hormone (TSH) as determined by a highly sensitive immunoradiometric assay (IRMA) were evaluated in 30 clinically euthyroid patients receiving levothyroxine (T4) replacement therapy for primary hypothyroidism. In each patient, the serum TSH level had been normal as determined by conventional TSH radioimmunoassay while the patient had…
Review Article
Hematologic Effects of Heavy Metal Poisoning
ABSTRACT:Heavy metal poisoning can cause a variety of hematologic disorders. Exposure to heavy metals is ubiquitous in the industrial environment and must be considered in the differential diagnosis of many types of anemia. The heavy metals most commonly associated with hematologic toxicity are arsenic and its derivative arsine, copper, gold,…
Current Concepts
Efficacy of the Lateral Decubitus Position in Preventing Pneumothorax After Needle Biopsy of the Lung
ABSTRACT:We evaluated the efficacy of the lateral decubitus position in preventing the development of pneumothorax after percutaneous needle biopsy of a well defined lung lesion. Fifty patients had such a procedure and were immediately placed in the lateral decubitus position for ten minutes, with the biopsied lung below. A chest…
Medical Education
Dyslexic Doctors A Resource in Need of Discovery
ABSTRACT:Dyslexic students are applying for admission to medical school. In most cases they have worked hard in college, and their credentials are good (with the likely exception of a low score on Skills Analysis—Reading on the Medical College Admissions Test). In the past a number of well known dyslexics have…
Our Medical Heritage
The Caduceus as a Medical Emblem Heritage or Heresy?
Evagations
DONT JUST DO SOMETHING—STAND THERE
Case Report
Gallium 67 Uptake in Thymic Rebound
Case Report
Melanotic Neuroectodermal Tumor of Infancy
Case Report
SPECIAL PROGRAMS
Case Report
Thrombosis of the Aorta Caused by Mucormycosis
Case Report
Thymoma and Aregenerative Anemia
Case Report
Repeated Systemic Mercury Embolization
Case Report
Ovarian Cancer Manifested as Exertional Hypotension Due to Obstruction of the Inferior Vena Cava
SUMMARYWe have reported a case of inferior vena cava obstruction caused by recurrent ovarian carcinoma. This case is noteworthy first because it shows that physical findings in inferior vena cava obstruction may be minimal. Secondly, we believe ours is the first reported case of exertional hypotension caused by obstruction of…
