Issue - Southern Medical Association

Primary Article

Nephrotoxicity Associated With Concomitant ACE Inhibitor and NSAID Therapy

ABSTRACT: Angiotensin-I converting enzyme (ACE) inhibitors and nonsteroidal anti-inflammatory drugs (NSAIDs) can be nephrotoxic and may synergistically compromise renal function. A computer-assisted study was done to assess the prevalence of compromised renal function and the clinical importance of this drug interaction. A search of the records of all patients seen…

Review Article

Dementia: What to Do

ABSTRACT: Dementia is a syndrome of acquired intellectual deterioration that interferes with personal or social functioning. Diagnosis requires historical information from the family and the mental status evaluation of orientation, recent memory, comprehension, calculation, and abstraction. Most dementias create permanent, even progressive cognitive deterioration, yet there are some presentations for…

Primary Article

Acute Promyelocytic Leukemia: Impact of Hemorrhagic Complications on Response to Induction Chemotherapy and Survival

ABSTRACT: From 1976 to 1989, 21 adult patients with previously untreated acute promyelocytic leukemia were seen at the University of Virginia Hospital. We reviewed their cases retrospectively to determine the impact of hemorrhagic complications and other factors on treatment outcome. We observed a complete remission rate of 35%; the median…

Primary Article

Surgical Management of Palmar Hyperhidrosis

ABSTRACT: Hyperhidrosis is an idiopathic pathologic condition characterized by excessive sweating beyond that required to cool the body. Disturbance of the central nervous system, endocrine system, or obesity has been associated with this condition. Patients have a history of several years of occupational or social embarrassment. Individuals of Japanese ancestry…

Primary Article

Assessing the Risk of Occupational Acquisition of the Human Immunodeficiency Virus: Implications for Hospital Policy

ABSTRACT: In determining infection control policy, it is essential to quantitatively assess the risk of transmission of human immunodeficiency virus (HIV) to health care workers and their families. The risk should be placed in perspective by comparing it with other occupational hazards. The risk of seroconversion from a needlestick injury…

Primary Article

Comparison of Cefuroxime Axetil, Cefaclor, and Amoxicillin—Clavulanate Potassium Suspensions in Acute Otitis Media in Infants and Children

ABSTRACT: In this randomized, blinded, multicenter comparison study, 377 infants and children with acute otitis media (AOM) received a 10-day course of an oral suspension of one of the following: cefuroxime axetil (CAE), 30 mg/kg/day; cefaclor (CEC), 40 mg/kg/day; or amoxicillin-clavulanate potassium (AMX-CL), 40 mg/kg/day. Clinical efficacy was determined by…

Primary Article

Medicinal Leeches: Once Again at the Forefront of Medicine

ABSTRACT: Medical grade leeches have recently been used in the management of acute problems relative to venous congestion in patients with traumatic injuries and surgical problems. Specific cases, especially in the realm of reconstructive microsurgery, have demonstrated the effectiveness and application of leech therapy. Specific contraindications include arterial insufficiency from…

Primary Article

Anxiety Levels and Cancer Fear in Patients Admitted for Elective Operations

ABSTRACT: Patients who are to have elective operations project varying degrees of anxiety, and many spontaneously express fear (without basis) that their operation involves a diagnosis of malignancy. To measure total, covert, and overt anxiety objectively, we gave the Institute for Personality and Ability Testing anxiety test to 125 consecutive…

Primary Article

A Modification of the Supraclavicular Approach to the Central Circulation

ABSTRACT: Traditional anterior or posterior triangle approaches to the central circulation may be at times unsuccessful in the patient whose anatomy makes cannulation difficult. We used a supraclavicular approach to cannulation of the central circulation in 100 patients for intraoperative monitoring or insertion of renal dialysis catheters. We have had…

Primary Article

The Absence of Nephrotoxicity and Differential Nephrotoxicity Between Tobramycin and Gentamicin

ABSTRACT: We conducted a prospective, double-blind, randomized trial of gentamicin and tobramycin to evaluate differences in nephrotoxicity. We evaluated levels of creatinine, creatinine clearance, β2-microglobulin, and N-acetyl-beta-D-glucosaminidase (NAG) as indicators of nephrotoxicity, and attempted to correlate them. Forty patients met the criteria for evaluation; 14 were given tobramycin and the…

Primary Article

Synergistic Effects of Psyllium in the Dietary Treatment of Hypercholesterolemia

ABSTRACT: We investigated psyllium fiber supplementation as a means of enhancing the cholesterol-lowering effect of the phase I American Heart Association diet. Fifty-nine subjects with total serum cholesterol (TC) levels ranging from 5.56 to 10.24 mmol/L (215 to 396 mg/dL) were given a 2-month dietary lead-in followed by 3 months…

Primary Article

Comparative Study of Plasma Epinephrine and Norepinephrine Concentrations During Hemodialysis: Measurement by High-Performance Liquid Chromatography Versus Radioenzymatic Assay

ABSTRACT: We measured epinephrine and norepinephrine levels simultaneously using two methods of detection of catecholamines in plasma—radioenzymatic assay and high-performance liquid chromatography with electrochemical detection. Measurements were made in 15 stable patients during hemodialysis. No statistical differences in intradialysis plasma concentrations were found for epinephrine or norepinephrine, and no statistical…

Primary Article

Carcinoma of the Male Breast: A Review of 41 Cases

ABSTRACT: We reviewed the cases of 41 consecutive men treated for breast carcinoma from 1950 through 1987 at Vanderbilt University Affiliated Hospitals to examine controversies in and methods of therapy for this disease. Twenty-two patients (52%) had stage I or II lesions potentially curable by operative therapy. The overall 5-year…

Article

A Personal History of the Ectopic Brain

Letter to the Editor

Allergic Reaction to Yellow Dye No. 5

Article

Carl Moyer (1908-1970): Surgical Teacher of the Mid-20th Century

Case Report

Cytomegalovirus-Induced Osteomyelitis in a Patient With the Acquired Immunodeficiency Syndrome

Case Report

Disseminated Strongyloidiasis in AIDS and Non-AIDS Immunocompromised Hosts: Diagnosis by Sputum and Bronchoalveolar Lavage

Case Report

Duplex Doppler Examination of a Perinephric Abscess in a Renal Transplant

Announcement

Educational Opportunities

Letter to the Editor

Fiberoptic Bronchoscopy for Investigating Adenocarcinoma of Unknown Primary Site

Letter to the Editor

Football

Case Report

Hematoma of the Optic Nerve Sheath After Penetrating Trauma

Case Report

Intra-abdominal Palpation of a Nasogastric Tube in the Stomach Does Not Assure Appropriate Placement

Announcement

Jim C. Barnett, MD—Incoming President of SMA

Letter to the Editor

Lyme Borreliosis and the Heart

Case Report

Malignant Melanoma and Pigmented Lesions: A Diagnostic and Management Dilemma

Announcement

Officers—1989-1990

Editorial

ON LENDING A HE’PING HAND

Editorial

ON WRITING FOR READING

Letter to the Editor

Prevalence of HIV Infection Among Intravenous Drug Users: A View From New Orleans

Grand Rounds

Sarcoidosis… or Something Like It

Case Report

Simultaneous Pneumococcal and Pneumocystis Pneumonia in Patients With the Acquired Immunodeficiency Syndrome

Announcement

STATE MEDICAL ASSOCIATIONS IN THE SOUTHERN REGION ANNUAL MEETINGS

Article

The Scope of Scopes

Letter to the Editor

Thimerosal Sensitivity

Announcement

We Are Pleased to Welcome Our New SMA Members