SMJ // April 1989, Volume 82 - Issue 4
Primary Article
Lack of Recognition of Internal Medicine as a Specialty: A Factor in Medical Student Career Choice?
ABSTRACT Interest among medical students in a career in internal medicine has recently declined. We propose that lack of recognition of general internal medicine as a specialty may be one factor in students decisions to enter other fields. A survey of 300 first-year and second-year medical students at the Medical…
Primary Article
Changes in the Internal Medicine Internship From 1967 to 1987: Explanations for Decreasing Interest in the Discipline?
ABSTRACT We compared the schedules and responsibilities of medical interns at an urban university hospital in 1967 with those in 1987. We analyzed admissions, length of stay, diagnostic problems, demographic data on interns, changes in diagnostic and therapeutic options, and number and type of consultations. The intern in 1987 spent…
Primary Article
Communication of Information About Therapeutic Alternatives: End-Stage Renal Disease Model
ABSTRACT We analyzed data from questionnaires obtained from 59 patients with end-stage renal disease and nine nephrologists and transplant surgeons to determine outcome of transplantation and dialysis (probability estimates) and the relative advantages of these two treatments (attitudinal responses). Data from national and local studies were available for comparison with…
Primary Article
Hypogammaglobulinemia in Infants Infected With Human Immunodeficiency Virus
ABSTRACT Two premature infants were infected with HIV via blood transfusions during the neonatal period. Although neither patient had serum antibody to HIV owing to severe hypogammaglobulinemia, HIV infection was confirmed by finding HIV antigen in the sera of both patients. These cases show that HIV infection can produce severe…
Primary Article
AIDS and Student Attitudes
ABSTRACT When recently polled, one half of 4,100 physicians believed they had the right not to treat patients with the acquired immunodeficiency syndrome (AIDS), and 15% said they would actually refuse to care for them. To assure medical care for the 365,000 AIDS patients projected for the US by 1992,…
Primary Article
Ticarcillin-Clavulanate Therapy for Infections With Ticarcillin-Resistant Microorganisms
ABSTRACT In a prospective study, 46 episodes of serious infection with ticarcillin-resistant microorganisms were treated with the combination ticarcillin disodium and clavulanate potassium (Timentin). Clinical cure was achieved in 35 of the 46 episodes (76%), and microbiologic eradication was achieved in 30 (65%). We found no development of resistance to…
Primary Article
Single-dose Piperacillin Versus Triple-dose Cefoxitin Prophylaxis at Vaginal and Abdominal Hysterectomy
ABSTRACT Two hundred fourteen women having vaginal or abdominal hysterectomy were entered into a prospective, randomized, blind clinical trial comparing a preoperative intravenous dose of piperacillin to three perioperative intravenous doses of cefoxitin given over an eight-hour period. Interregimen clinical, surgical, and outcome variables of the 207 evaluable subjects were…
Primary Article
Relationship Between Menarcheal Age and Adult Height
ABSTRACT Many factors contribute to the attainment of adult height, including genetic and environmental variables. To assess the relationship between menarcheal age and adult height, measured adult height and recalled menarcheal age were compared by regression analysis in 425 women. The overall regression equation, Height = 158.14 + .4321 (Age)…
Primary Article
Endocrinologic Evaluation of Impotence
ABSTRACT Among 600 impotent men who had endocrine evaluation for androgen deficiency, thyroid deficiency, and hyperprolactinemia, 192 (32%) were found to have an endocrine abnormality. Androgen deficiency was divided into primary testicular failure and “hypothalamic-pituitary dysfunction” by an androgen quotient derived using simultaneous gonadotropin and testosterone levels. This androgen quotient…
Primary Article
Cholecystectomy
ABSTRACT We retrospectively reviewed 360 consecutive cholecystectomies done by the four surgeons in our private group practice. No patient had dehiscence of the wound or evisceration. One patient had a seroma, which was opened in the office, but the fluid contained no white blood cells or bacteria on smear, and…
Primary Article
Continuous Infusion of Alfentanil for Maintenance of Anesthesia: Comparison With Halothane Anesthesia
ABSTRACT This study compares anesthetic maintenance, hemodynamic stability, and speed of recovery obtained with inhalational halothane versus intravenous alfentanil anesthesia administered continuously. In two groups of patients, anesthesia was induced with sodium thiopental, maintained with 70% nitrous oxide in 30% oxygen, and either halothane (n = 10) or a continuous…
Primary Article
Cardiac Complications of Aneurysm Repair
ABSTRACT To assess the early morbidity and mortality from coronary artery disease (CAD), we reviewed the charts of 49 patients who had elective resection of infrarenal abdominal aortic aneurysms between September 1978 and February 1986 at the VA and LSU medical centers in Shreveport. On the basis of history, physical…
Primary Article
Forensic Autopsy in the Elderly
ABSTRACT We analyzed deaths in a geriatric population investigated by the Mobile County (Alabama) Coroners Office during the three years of 1983 through 1985 inclusively. These subjects died both within and outside hospitals and thus provide broad representation of all types of deaths in the elderly. Of the total number…
Primary Article
STRETCH: A Rehabilitative Program for Patients With Breast Cancer
ABSTRACT Participants in an exercise-based rehabilitative program for women with breast cancer were evaluated for physical disability. Of 114 women who were evaluated initially, there was almost universal evidence of restriction of range of motion or abnormal posture. Of the 47 women who were available for evaluation after completion of…
Primary Article
Premalignant Lesions of the Anal Margin
ABSTRACT Premalignant lesions of the anal margin include Bowens disease (intraepithelial squamous cell carcinoma) and Pagets disease (intraepithelial adenocarcinoma). Our experience includes 11 patients with perianal Pagets disease and 37 patients with perianal Bowens disease treated from 1957 to 1986. The patients with perianal Pagets disease were older, had a…
Primary Article
Bronchioalveolar Carcinoma: Emphasis on Localized Lesions
ABSTRACT Although well defined pathologically, alveolar cell carcinoma can be difficult to diagnose because of its many clinical presentations. In a retrospective study of 45 cases, we reviewed the radiologic, pathologic, and clinical features of this neoplasm. Forty-one patients had a single peripheral mass that measured between 8 mm and…
Review Article
Granulomatous Vasculitides of the Lung A Clinicopathologic Approach to Diagnosis and Treatment
ABSTRACT The granulomatous vasculitides of the lung are uncommon. Overlap of their clinical and histopathologic features may create a confusing picture for the clinician and pathologist. This confusion is of concern because therapy differs depending on the exact diagnosis, with concomitant variations in associated drug toxicity. An integrated clinical and…
