SMJ // December 1989, Volume 82 - Issue 12
Editorial
SISYPHUS TANTALIZED A CORRIGENDUM
Primary Article
Ingestion of Prescription Drugs by Children An Epidemiologic Study
ABSTRACTAlthough the Poison Prevention Packaging Act of 1970 has resulted in a 65% decline in ingestion of products packaged in child-resistant containers, ingestion of prescription drugs by children has declined by only 36%. Since ingestion of solid prescription drugs remains an important cause of ingestion-related morbidity in children, this descriptive…
Primary Article
Thyroid Nodules in Children Current Profile of a Changing Disease
ABSTRACTPediatric thyroid disease has changed since the decline of widespread cervical irradiation. Our analysis of 32 recently resected childhood thyroid nodules showed that the incidence of malignancy (22%) is decreasing, though the incidence of nodules is stable. Risk factors for development of thyroid disease include female sex, age around puberty,…
Primary Article
Aerobic and Anaerobic Microbiology of Intra-abdominal Abscesses in Children
ABSTRACTIn this study of the aerobic and anaerobic microbiology of 23 intra-abdominal abscesses, aerobic bacteria alone were present in one specimen, anaerobic bacteria only in four, and mixed aerobic and anaerobic flora in 18. Ninety bacterial isolates (3.9 isolates per specimen), 63 anaerobic (2.7 per specimen), and 27 aerobic and…
Primary Article
Downs Syndrome Current Screening Techniques
ABSTRACTAntenatal screening for Downs syndrome traditionally relied upon performing amniocentesis for karyotype on pregnant women aged 35 years and older. This method detects approximately 20% of all Downs syndrome pregnancies, with a false-positive rate of 4.3%. By incorporating maternal serum alpha-fetoprotein values as an additional screening parameter to maternal age,…
Primary Article
Pleural Effusion Comparison of Clinical Judgment and Lights Criteria in Determining the Cause
ABSTRACTPleural fluid analysis is often the initial diagnostic test used to determine the cause of a pleural effusion. We prospectively studied 33 consecutive patients with pleural effusions to determine whether the fluid arose from a transudative or an exudative process. Clinical judgment by an internist before thoracentesis and both serum…
Primary Article
Abdominoperineal Resection for Rectal Carcinoma Perioperative Risk Factors
ABSTRACTThis retrospective review of 37 cases of abdominoperineal resection for adenocarcinoma sought to correlate preoperative clinical characteristics and intraoperative events with the likelihood of subsequent development of specific complications in the postoperative period. Mortality was 3% (1/37), and the complication rate was 76% (28/37), with urologic (49% [18/37]) and pulmonary…
Primary Article
Nosocomial Diarrhea Beware the Medicinal Elixir
ABSTRACTAn unusual case of osmotic diarrhea that persisted despite fasting led to the discovery of an unexpected source of hospital-acquired diarrhea. Numerous patients were subsequently found to have onset of diarrhea shortly after the initiation of treatment with theophylline elixir. Although theophylline can promote gastrointestinal secretion and motility, this effect…
Primary Article
Carcinoid Tumors of the Gastrointestinal Tract A 44-Year Experience
ABSTRACTWe retrospectively studied 112 patients treated for gastrointestinal carcinoid tumors between 1942 and 1986. The three most common sites were jejunum-ileum (27%), rectum (27%), and appendix (21%), followed by colon (12%), duodenum (9%), and stomach (4%). Seventy-five percent of patients had localized disease, primarily in the rectum and appendix. Colon…
Primary Article
Relationship Between Mammographic Features and Hormone Receptor Content in Patients With Breast Cancer
ABSTRACTRecurrences of breast cancer are more responsive to hormone therapy if the tumors are positive for estrogen receptors or progesterone receptors. To assess the relationship between hormone receptor content, mammographic tumor morphology, and breast parenchymal patterns, we reviewed charts and mammograms of 210 patients with primary unilateral breast cancer. Mammograms…
Primary Article
Comparison of the Need for Bypass Shunt After Stroke or Transient Ischemic Attack in 97 Patients
ABSTRACTUsing local anesthesia, we did 97 carotid endarterectomies—48 of them for acute completed stroke, stroke in evolution, or stroke associated with unstable neurologic status, and 49 for transient cerebral ischemic attack. The neurologic status of the awake patients was monitored continuously. Neurologic deterioration resulting from clamping of carotid circulation, and…
Primary Article
Imported Fire Ant as a Health Hazard
ABSTRACTMembers of the American Medical Association in 13 southern states were surveyed to assess the magnitude of medical problems caused by stings of the imported fire ant (IFA). Of the 29,205 physicians surveyed, 2,022 (7%) reported treating approximately 20,755 patients annually for reactions to IFA stings. Most patients were treated…
Review Article
Allergy to Imported Fire Ants
Article
Preservation Surgery for Malignant Disease Why It Works
ABSTRACTLocal recurrence has been considered a grave prognostic sign after radical surgery for breast cancer. Controlled trials have recently discovered local recurrence to be an innocent event after limited surgery. Nine years ago I proposed a hypothesis to resolve this dilemma. The discovery of natural killer (NK) cells has added…
Article
Physician Advertising Some Reasons for Caution
ABSTRACTPhysician advertising is a growing trend which, proponents contend, will bring needed reforms to health care. Among these reforms are better informed patients, reduction in the price of health care, improvement in the quality of care, and reduction in the incidence of malpractice litigation and the cost of malpractice insurance….
Medical Education
Context of Social Awareness Prelude to Social Service
ABSTRACTA required period of social service has recently been suggested as an addition to the medical school curriculum. The intent of this action is to improve the social sensitivity of physicians. If such a requirement is not placed within the appropriate context it may fail to achieve its objectives. Attention…
