Issue - Southern Medical Association

Editorial

GROWING UP TOGETHER

Primary Article

Reporting of Child Abuse: Influence of Characteristics of Physician, Practice, and Community

ABSTRACT: This survey of 120 Alabama pediatricians, family physicians, and general practitioners investigated the relationship between physician, practice, and community characteristics and the factors that impede reporting of detected child abuse. Solo practitioners and rural physicians were most concerned about the effect of reporting on their relationship with their patients….

Primary Article

Large Pericardial Effusion After Cardiac Surgery: Role of Echocardiography in Diagnosis and Management

ABSTRACT: We performed M-mode and two-dimensional (2-D) echocardiograms prospectively in 140 patients an average of eight days after open heart surgery. Large pericardial effusions occurred in 13 patients; three had complete circumcardiac pericardial effusion, four had local anterior adhesions, five had extensive anterior adhesions (posterior loculated effusion), and one had…

Primary Article

Preoperative Cardiac Consultations in a Teaching Hospital

ABSTRACT: Perioperative consultations may play a major role in the care of surgical patients in an era of prospective payments. Since insurance reimbursement policy favors limitations in the number of consultants on a case, general medicine (“holistic”) consultation services may become preferred perioperative consultants in the future. To focus curriculum…

Primary Article

Hypertension: Variations in Prevalence in the Black Population

ABSTRACT: Prevalence trends in hypertension in black men and women show an inversion at about ages 45 to 54 years. Incidence, mortality, and treatment of hypertension after age 35 can probably be related to this inversion. Incidence data are inconsistent and scanty. Morbidity data are incomplete and mostly unreliable. Mortality…

Primary Article

Hospital Costs, Use of Resources, and Dynamics of Death Associated With Diabetes Mellitus

ABSTRACT: The federal Medicare DRG (diagnosis-related group) system is entering its sixth year. The hospital industry contends that DRGs are under-reimbursing for the hospital care provided. Our analysis by outcome (ie, survival vs death) of 3,329 patients with insulin-dependent or non-insulin-dependent diabetes mellitus showed that the 242 diabetes-related deaths were…

Primary Article

Surgical Management of Colonic Inertia

ABSTRACT: Fourteen patients with chronic constipation due to colonic inertia were treated with total abdominal colectomy and ileorectal anastomosis at the Cleveland Clinic Foundation from 1981 to 1986. All patients were white women ranging in age from 28 to 64 years (mean 41 years). The duration of symptoms averaged 21…

Primary Article

Incarceration of the Retroverted Gravid Uterus: Report of Four Patients Managed With Uterine Reduction

ABSTRACT: Incarceration of the retroverted gravid uterus may have an adverse effect on pregnancy. To evaluate these effects, we reviewed obstetric records to identify parturients with the diagnosis of incarceration of the retroverted uterus during the years 1977 to 1987. Four such patients were identified by this retrospective review, for…

Announcement

CALL FOR ABSTRACTS

Primary Article

Abdominal Leiomyosarcoma: Aggressive Management

ABSTRACT: We retrospectively reviewed 34 cases of intra-abdominal leiomyosarcoma treated between 1967 and 1986. Thirty-three patients had operation, and the primary tumor was removed in all but one. Fifteen patients had peritoneal implants at initial surgical exploration; 14 had tumor recurrence and had at least one reoperation. Five-year survival was…

Primary Article

Biochemical Testing in Patients With Alcoholic Liver Disease

ABSTRACT: We evaluated physicians laboratory utilization patterns for hospitalized patients with alcoholic liver disease and examined the relationship between the frequency of test ordering and certain variables in clinical outcome. During the study, 185 patients with alcoholic liver disease were hospitalized 378 times at the VA Medical Center, Long Beach,…

Primary Article

Lupus Nephritis: Efficacy of Monthly Pulse Therapy With Intravenous Methylprednisolone

ABSTRACT: Fourteen patients with severe systemic lupus erythematosus and nephritis were treated with high-dose intravenous methylprednisolone (IVMP) pulse therapy. Six patients (group 1) received one or two courses of 1 gm of IVMP when they were acutely ill with rapidly progressive renal failure or with multisystemic disease. All patients had…

Primary Article

Digital Subtraction Angiography of the Foot in Atherosclerotic Occlusive Disease

ABSTRACT: Digital subtraction angiography (DSA) provides additional information regarding patency or occlusion of vessels that is not always detected by conventional angiography. Patency of distal vessels is a positive prognostic factor in predicting salvage of the foot in patients having various treatment procedures for occlusive atherosclerotic disease. I evaluated the…

Primary Article

Carcinoma of the Prostate: Changing Incidence Associated With Annual Urologic Screening

ABSTRACT: The Urology Service at Brooke Army Medical Center has conducted routine screening rectal examinations for early diagnosis of carcinoma of the prostate since 1979. A review of the incidence of carcinoma of the prostate reveals that routine screening has yielded a significant increase in disease incidence. This incidence appears…

Primary Article

Tracheoesophageal Compression Syndromes Related to Vascular Ring

ABSTRACT: Seventeen cases of vascular ring have been encountered at Ochsner Clinic over the past 22 years. Anatomic configurations consisted of double aortic arch in 11 cases, right aortic arch with left ligamentum arteriosum in five cases, and aberrant right subclavian artery in one case. In four cases chest x-ray…

Primary Article

Nurse-Initiated Health Promotion Prompting System in an Internal Medicine Residents Clinic

ABSTRACT: Although cure of many diseases depends on early detection, screening schemes have been difficult to implement in busy clinic environments. We describe the testing of a nurse-initiated prompting system for six health promotion and disease prevention procedures in an internal medicine residents clinic at a university-affiliated community program. Maneuvers…

Review Article

Physical Treatments in Psychiatry: Current and Historical Use in the Southern United States

ABSTRACT: Several surveys during the 1970s showed a decline in the use of electroconvulsive therapy (ECT). Psychosurgery, insulin coma, and continuous sleep treatment are widely assumed to be in total disuse. This is the first comprehensive survey on the use of physical treatments in psychiatry in the southern United States….

Current Concepts

Psychiatric Manifestations of AIDS Spectrum Disorders

ABSTRACT: This paper reviews the proposed etiology and epidemiology of the acquired immunodeficiency syndrome (AIDS). It summarizes the psychiatric symptoms associated with members of high-risk groups, patients who have AIDS-related complex (ARC) or AIDS, and patients who are seropositive yet asymptomatic. It differentiates between psychiatric manifestations predating and following prodromal…

Current Concepts

Intraoperative Radiation Therapy for Locally Advanced Cancers

Medical Education

Why Perform a Routine History and Physical Examination?

ABSTRACT: Science uses two types of data—one for generating hypotheses and a second for testing hypotheses. In clinical medicine the history and physical examination generate the data used for making hypotheses about what could possibly be wrong with the patient; but the various laboratory and imaging procedures are used for…

Case Report

Double Duodenal Webs in an Adult

Case Report

Euthyroid Hyperthyroxinemia Due to Familial Excess of Thyroxine-Binding Globulin

Case Report

Methemoglobinemia and Hemolytic Anemia After Phenazopyridine Hydrochloride (Pyridium) Administration in End-Stage Renal Disease

Case Report

Polyglandular Autoimmune Syndrome, Type 2

Case Report

Acute Bilateral Diffuse Pulmonary Shadowing After Evacuation of Hydatid Mole

Case Report

Neurogenic Pulmonary Edema: New Concepts of an Old Disorder

Case Report

Secondary Adrenal Insufficiency Manifested as an Acute Febrile Illness

Case Report

Unusual Chronic Maculopapular Rash Associated With Human Immunodeficiency Virus Infection

Case Report

Aneurysm of the Internal Iliac Vein as a Rare Source of Pulmonary Thromboembolism

Breif Report

Primary Aortoduodenal Fistula: Successful Diagnosis and Treatment

Breif Report

Cryptococcal Meningoencephalitis Presenting Transient Focal Cerebral Symptoms

Breif Report

Gallbladder Hydrops in Mucocutaneous Lymph Node Syndrome

Breif Report

Yersinia enterocolitica Causing Spinal Osteomyelitis and Empyema in a Nonimmunocompromised Host

Breif Report

Acute Inguinal Lymphadenitis Associated With Yersinia enterocolitica

Breif Report

Depression Associated With Enalapril

Letter to the Editor

Natural Resource

Letter to the Editor

Acute Renal Failure in an Alcoholic

Letter to the Editor

Hypertensive Left Ventricular Hypertrophy

Abstract

Hypertensive Left Ventricular Hypertrophy reply