Issue - Southern Medical Association

Primary Article

Establishing a Family Practice: A Model to Determine Economic Feasibility

ABSRACT: The availability of adequate health care is a major concern of urban and rural citizens. Community leaders and hospital administrators attempting to recruit family physicians and health care providers considering a specific community need a method by which they can evaluate a community's potential for supporting a first or…

Primary Article

Shigellosis in Kentucky, 1986 Through 1989

ABSTRACT: A marked increase in the number of cases of shigellosis was reported in Kentucky in 1988. To examine reasons for this increase, we reviewed the 389 cases of shigellosis reported from 1986 through 1989. Ninety-three percent (285/305) of cases due to known species were due to Shigella sonnei. Sixty-two…

Primary Article

Outpatient Liver Biopsy: One Man’s Experience

ABSTRACT: As an academically based gastroenterologist, I performed 94 outpatient liver biopsies over a 42-month period, using the standard suction technique. Differential blood count and vital signs were monitored, with no statistically significant postbiopsy changes noted in the group at large. One patient required admission to the hospital for bleeding,…

Primary Article

Breast Cancer Screening in a Biracial Community: The Charleston Tricounty Experience

ABSTRACT: Breast cancer remains a major cause of death among women in South Carolina. Mammography, breast self-examination, and clinical breast examination are effective methods for early detection and subsequent mortality reduction. The Tricounty Breast Cancer Screening Survey assessed knowledge of these methods and recommendations among 503 women in the Charleston…

Primary Article

Shotgun Injuries in Pediatric Patients

ABSTRACT: Firearms, particularly high-powered automatic weapons, injure progressively younger children in urban environments. At Arkansas Children's Hospital, 32 children have been admitted for gunshot wounds in 12 years. Air guns (3), handguns (19), and shotguns (10) caused the injuries. Shotgun wounds occurred during hunting accidents (2), flights from houses (3),…

Primary Article

Advantages of an Immunohistochemical Estrogen Receptor Assay

ABSTRACT: Immunohistochemical and biochemical assays for estrogen and progesterone receptors were done on 20 breast carcinomas, and results were correlated with various histologic features. The slide-based immunohistochemical technique demonstrated several distinct advantages relative to the tissue homogenization required by the traditional biochemical assay. With the use of frozen tissue sections,…

Primary Article

Spectrum of Invasive Pulmonary Aspergillosis in Immunocompetent Patients With Chronic Obstructive Pulmonary Disease

ABSTRACT: Invasive pulmonary aspergillosis is a well-recognized complication in immunocompromised patients, especially those with neutropenia. We report four cases of invasive pulmonary aspergillosis in patients whose main underlying disease was chronic obstructive pulmonary disease (COPD). Two patients had an acute fatal course, one had chronic necrotizing pulmonary aspergillosis ending in…

Primary Article

Invasive Aspergillosis in AIDS

ABSTRACT: Invasive pulmonary aspergillosis was diagnosed in two patients with HIV infection, one with prolonged neutropenia and another receiving corticosteroid therapy. We found 17 additional cases in the literature. A known predisposing risk factor for invasive aspergillosis, eg, neutropenia, corticosteroid use, or intravenous drug abuse, was present in 79% of…

Current Concepts

Cancers of the Maxillary Sinus

ABSTRACT: Maxillary sinus cancers are rare as compared with cancers of other sites. Because the onset is insidious, they are at an advanced stage at diagnosis and therefore present a therapeutic challenge for local control. Traditionally, treatment has been surgery or irradiation, or a combination of the two. Local control…

Primary Article

Flexible Sigmoidoscopy Screening for Asymptomatic Colorectal Disease in Patients With and Without Inguinal Hernia

ABSTRACT: Several studies have evaluated the diagnostic value of flexible sigmoidoscopy for screening asymptomatic patients before hernia repair. All have shown a 16% to 28% incidence of neoplastic (malignant or premalignant) lesions. None of these studies compared a similar group of asymptomatic patients without hernia to determine whether the incidence…

Review Article

Myocardial Calcifications in Neonates and Infants: A Unique Tissue Reaction

ABSTRACT: The deposit of calcium salts into myocardial cells represents the process of dystrophic calcification. Once it causes alterations in cellular calcium hemostasis, it can initiate deleterious events leading to ischemic myocardial injury and cell death. Myocardial calcifications in infants are markedly different from those in adults; calcifications are significantly…

Primary Article

Application of Estrogen Receptor Immunocytochemical Assay to Aspirates From Mammographically Guided Fine Needle Biopsy of Nonpalpable Breast Lesions

ABSTRACT: The importance of hormone receptors in the management and prognosis of breast cancer is well established, but difficult to apply to the growing numbers of very small breast cancers being detected. To assess the feasibility of applying estrogen receptor immunocytochemical assay (ER-ICA) to cytologic specimens, we prospectively studied 100…

Primary Article

Neutropenia-Wise and Pound-Foolish: Safe and Effective Chemotherapy in Massively Obese Patients

ABSTRACT: The massively obese patient has an increased risk of cancer and complications from therapy. Chemotherapy in massively obese patients may be complicated by difficulty in calculating body surface area. No guidelines exist for calculating doses by either actual or ideal weight, and the calculated doses may vary by as…

Primary Article

Epidemiologic Characteristics of Drug Use During Pregnancy: Experience in a Nashville Hospital

ABSTRACT: The nationwide incidence of drug abuse during pregnancy is increasing, but has not been described in our geographic area. Beginning August 1, 1989, all women admitted to the Obstetrical Service at the Metropolitan Nashville General Hospital were to have their urine tested for drugs. In the 11-month study period,…

Primary Article

Noncardiac Chest Pain in Patients With Heart Disease

ABSTRACT: This is a retrospective study of cardiac patients with noncardiac chest pain referred for evaluation of esophageal motility. Sixty-eight patients with heart disease were compared with 210 patients without heart disease according to findings from symptom questionnaires and a psychologic test (Brief Symptom Inventory). More than 70 % of…

Primary Article

Antibodies to Epstein-Barr Virus in Patients With Chronic Fatigue

ABSTRACT: To clarify the role of Epstein-Barr virus (EBV) infection and the value of EBV antibody testing in evaluating patients with chronic fatigue, we studied 200 consecutive patients with chronic fatigue (mean duration, 9 years). Complete EBV serologic panels were obtained for 154 patients, 35 (23%) of whom met serologic…

Primary Article

Does Patient Age or Intestinal Pathology Influence the Bacteria Found in Cases of Necrotizing Enterocolitis?

ABSTRACT: To evaluate the relationship between bacterial colonization in neonatal peritonitis and patient age or intestinal pathology, we retrospectively reviewed peritoneal culture results from 96 infants having surgery for necrotizing enterocolitis. Microorganisms recovered mirrored those usually found as fecal flora within the neonatal intensive care unit. These reflect, in turn,…

Primary Article

Diagnostic and Prognostic Importance of Comparing the Initial to the Previous Electrocardiogram in Patients Admitted for Suspected Acute Myocardial Infarction

ABSTRACT: Two hundred fifty-eight patients were admitted to the hospital for suspected acute myocardial infarction. Electrocardiograms recorded on admission (initial ECG) and the most recent available electrocardiogram recorded before admission (previous ECG) were compared to determine whether changes from the previous to initial ECG predicted acute myocardial infarction or complications…

Case Report

A Rare Cause of Parastomal Hernia: Stomach Herniation

Case Report

Accelerated Atherosclerosis in a Young Woman

Letter to the Editor

Corrigendum

Case Report

Dental Chair Apoplexy

Case Report

Hemorrhagic Cardioembolic Stroke: Is Anticoagulation Absolutely Contraindicated?

Evagations

HOW COMMON IS COMMON?

Letter to the Editor

Hypocholesterolemia in Substance Abusers

Letter to the Editor

Hypothyroidism and Autoimmunity

Case Report

Industrial Nail Gun Injuries

Case Report

Mediastinal Involvement by Alveolar Rhabdomyosarcoma: Evaluation With Computerized Tomography

Editorial

ON NOT TRACKING IT AROUND

Case Report

Perianal Ulcer in Disseminated Histoplasmosis

Case Report

Recurrent Abdominal Pain Due to Chronic Appendiceal Disease

Letter to the Editor

Request for Information

Case Report

Septic Arthritis Due to Nocardia asteroides

Case Report

Severe Hyperkalemia During Magnesium Sulfate Therapy in Two Pregnant Drug Abusers

Letter to the Editor

Sky Dreams

Case Report

Talc Granulomatosis Presenting as Spontaneous Pneumothorax

Case Report

The Paradox of ‘Chronic Unstable Angina’ Secondary to an Organizing Intracoronary Thrombus

Letter to the Editor

Treatment of Alcohol Withdrawal

Letter to the Editor

Treatment of Alcohol Withdrawal Reply