(Letters to the Editor are welcomed. They may report new clinical or laboratory observations and new developments in medical care or may contain comments on recent contents of the Journal. They will be published, if found suitable, as space permits. Like other material submitted for publication, Letters must be typewritten…
ABSTRACTAll occupations are associated with stress, but certain occupations are significantly more stressful than others. Stress is not always harmful. It is the individual's reaction to stress that determines the outcome, ie, whether the individual will adapt or become maladaptive. Individuals who feel they can control events or are in…
ABSTRACTAnalysis of all published cases and Food and Drug Administration (FDA) reports of retinopathy attributed to hydroxychloroquine sulfate (Plaquenil) does not reveal any evidence of permanent visual field scotoma occurring when the daily dose is related to body weight and does not exceed 6.5 mg/kg for maintenance therapy. Risk factors…
ABSTRACTBarrett's esophagus is a premalignant condition that may often pass unrecognized in clinical practice. In adults, this condition is generally believed to be caused by chronic gastroesophageal reflux resulting in a metaplastic change in the epithelium of the esophagus. Diagnosis of Barrett's esophagus is established by careful biopsy of the…
ABSTRACTColorectal cancer is the second most common form of cancer in the United States, but controversy exists over the feasibility, benefits, and methods of screening. We conducted a large-scale, community-based screening program to determine the cost of screening for colorectal cancer. Based on detailed cost analysis, we arrived at a…
ABSTRACTGastroesophageal reflux and malnutrition are major determinants of perioperative morbidity and mortality in neurologically impaired children. The incidence of these risk factors can be reduced through careful preoperative evaluation and nutritional rehabilitation combined with the use of perioperative techniques intended to control the acid aspiration syndrome. In this article, we…
ABSTRACTHex death is one that follows a ritualized pronouncement of death by a powerful authority, a phenomenon not widely accepted by the Western medical community, despite scattered accounts witnessed by reputable observers. Case histories of two patients are presented. The first patient, a poorly educated man near death after a…
ABSTRACTIn patients with angina pectoris, ambulatory ST segment monitoring has documented that asymptomatic myocardial ischemic episodes occur with greater frequency than previously suspected. During such episodes, ischemia has been verified by nuclear, echocardiographic, and biochemical techniques. Painless ST segment depression is consistent with severe coronary artery disease when detected by…
ABSTRACTSixteen patients with spinal epidural compression by metastatic small-cell lung cancer were given radiotherapy for palliation. Lower limb motor deficit was the most prominent clinical manifestation. Neurologic dysfunction was commonly present for more than 48 hours before the diagnosis of compression. Median interval between diagnosis of lung cancer and epidural…
ABSTRACTThirty-nine postmenopausal women were randomized to treatment with either percutaneous estradiol or a placebo. Those taking the estradiol had an increase in serum estradiol to follicular phase levels and a concomitant fall in serum follicle-stimulating hormone (FSH) levels. Atrophic vaginal epithelium became well estrogenized, and the frequency and severity of…
ABSTRACTThis study was done to ascertain whether there was an increased incidence of acute rheumatic fever (ARF) in west Alabama, similar to that reported elsewhere within the United States. Hospital records for the previous 10 years were reviewed and 5-year intervals were compared (1980 through 1984 vs 1985 through 1989)….
ABSTRACTTo assess the usefulness of a continuous subcutaneous pump infusion of terbutaline for long-term tocolysis, we used this modality in 13 patients in whom other tocolytic regimens had failed. The mean ( $$ standard deviation) maternal age was 29.9 $$ 3.8 years. The study population included 10 singleton gestations, two…
The man who has on open mind can always learn something from discussion. In dealing with complicated subject matters such as that of the proper treatment of wounds, trustworthy conclusions are ereached only when we have been compelled to look at the facts from opposite points of view. And when…
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