Issue - Southern Medical Association

Editorial

Behavioral Prescription Writing in Smoking Cessation Counseling A New Use for a Familiar Tool

AbstractTobacco use, a self-inflicted epidemic, causes more than 390,000 deaths in the United States each year. Smoking is a habit perpetuated by both physiologic and psychosocial mechanisms. Physician use of behavioral prescriptions is a practical, familiar, and efficient method for achieving smoking cessation. Physicians should ask patients if they want…

Article

Late Stage Lyme Borreliosis in Children

AbstractWe discuss the clinical presentation, diagnosis, and treatment of five children with late stage Lyme borreliosis who did not have antecedent tick bite or erythema chronicum migrans.

Article

Cresyl Violet A Rapid, Simple, Easily Interpretable Stain for Detecting Pneumocystis carinii in Sputum

AbstractOver a three-month period at the pathology laboratory of Jackson Memorial Hospital, 110 sputum samples from 62 hospitalized patients with suspected AIDS were examined for Pneumocystis carinii. Sputum specimens were either expectorated spontaneously (most patients) or expectorated after the inhalation of small amounts of nebulized normal saline. Each sputum sample…

Article

Efficacy of Prophylactic Antibiotics for the Prevention of Endomyometritis After Forceps Delivery

AbstractThe purpose of this prospective randomized controlled clinical trial was to determine whether prophylactic antibiotics reduce the incidence of endomyometritis after forceps delivery. Of the 393 patients studied, 192 received 2 gm of intravenous cefotetan after forceps delivery, and 201 patients received no antibiotics. There were seven cases of endomyometritis…

Article

Malignant Pleural Effusions Pleurodesis Using a Small-Bore Percutaneous Catheter

AbstractThis study describes our experience using a percutaneously placed small-bore catheter for drainage of malignant pleural effusions and subsequent instillation of a sclerosing agent to obliterate the pleural space. We treated 15 consecutive patients with known metastatic cancer and a symptomatic pleural effusion. Twelve patients survived for more than four…

Article

Incidence of Cardiac Arrhythmias Associated With Mild Hypokalemia Induced by Low-Dose Diuretic Therapy for Hypertension

AbstractNineteen men with mild to moderate hypertension and without a history of cardiac arrhythmias were randomized (double-blind) into groups to receive hydrochlorothiazide (HCTZ) at a dose of 25 mg/day, HCTZ at 50 mg/day, or HCTZ (25 mg) plus triamterene (50 mg) for a six-month period after a three-week (single-blind) placebo…

Article

Penetrating Thoracic Aortic Injuries Rare but Potentially Salvageable Sequelae of Urban Warfare

AbstractPenetrating injuries of the thoracic aorta are rare and often fatal. Victims of such wounds rarely survive to reach the emergency department. Those patients who do arrive will display one of two symptom complexes—either continuing hemorrhage or seeming hemodynamic stability with a widened mediastinum on chest roentgenography. As the results…

Article

Total Gastrectomy for Gastric Carcinoma

AbstractWe retrospectively analyzed experience with total gastrectomy (TG) for gastric carcinoma in 23 patients. The TNM stage was I in one patient, II in one patient, III in eight patients, and IV in 13. Linitis plastica was found in ten patients. The operation was considered curative in only eight patients…

Article

Ultrasonic Measurement of Lumbar Canal Diameter A Screening Tool for Low Back Disorders?

AbstractPreventive screening measures for low back pain are limited. Despite considerable evidence that anatomic narrowing of the lumbar spinal canal is a risk factor for specific back problems, difficulty in measuring the canal without unacceptable radiation exposure, cost, or discomfort has limited the assessment of its clinical significance. Using ultrasound…

Article

Neurologically Asymptomatic Patients With a Single Cerebral Lacuna

AbstractSixteen patients with CT evidence of a single cerebral lacuna had no clinical findings to indicate stroke syndromes. All patients had systemic arterial hypertension; 12 (75%) had cardiographic evidence of left ventricular hypertrophy, ten (63%) had radiologic evidence of cardiomegaly, and ten (63%) had clinical signs of hypertensive retinopathy. All…

Article

Isolated Limb Perfusion for Stage I Melanoma of the Extremity A Comparison of Melphalan and Dacarbazine (DTIC)

AbstractIsolated limb perfusion (ILP) for melanoma of the extremity was first used clinically more than 30 years ago. Although ILP with chemotherapeutic agents has become routine practice in many oncologic centers, few studies have evaluated the therapeutic efficacy of particular agents. Two consecutive groups of 100 patients with stage I…

Article

The Elderly Victim of Rape

AbstractA common misconception about sexual assault is that the rapist is motivated by a sexual desire stimulated by a victim seductive in her behavior or dress. A retrospective analysis of 740 reported sexual assaults revealed 21 cases involving a victim between the ages of 60 and 90 years of age….

Article

Assessment of Nutritional Status in Noninstitutionalized Elderly

AbstractAging may modify both the availability of and needs for certain nutrients. Our study was done to assess the contribution of age alone to micronutrient levels in older volunteers (aged 60 or more). One hundred two healthy elderly white subjects, 63 women and 39 men, carefully screened by history or…

Article

New Drug Approvals in 1988

Review Article

Psychiatric Aspects of HIV Disease

AbstractPsychiatric disorders associated with human immunodeficiency virus (HIV) infection are increasingly prevalent. The psychologic, sociocultural, and medicolegal dimensions of HIV disease further fragment and complicate the care of these individuals. This article reviews the psychiatric aspects of HIV disease and suggests practical approaches to management and patient care.

Current Concepts

Fluoxetine Prescribing Guidelines for the Newest Antidepressant

AbstractFluoxetine is an antidepressant drug with a unique chemical configuration which enhances serotoninergic transmission by inhibiting serotonin uptake. The chronic presence of serotonin in the synaptic cleft reduces postsynaptic receptors, a postulated explanation for its antidepressant efficacy. Comparative studies show that the therapeutic effectiveness of fluoxetine is equal to that…

Article

Spermatic Economy A 19th Century View of Male Impotence

It has always appeared strange to me that this affection should remain abandoned by the profession to a new solitary specialists, and for the benefit of the vile harpies who prey on this class of victims. Surgery, which has wrested so much from empiricism and ignorance, seems disposed to yield…