Issue - Southern Medical Association

Primary Article

Aminoglycoside Dosing: A Randomized Prospective Study

ABSTRACTAlthough clinical benefits for aminoglycoside dosing services have been suggested, this has not been clearly documented in a prospective fashion. Therefore, we randomly assigned patients to be dosed (1) by their physician (Physician dosing method), (2) by predicting an initial dosage (Predictive dosing method), or (3) by calculating an initial…

Review Article

Amiodarone Pulmonary Toxicity: A Multidisciplinary Review of Current Status

ABSTRACTAmiodarone, a benzofuran derivative, has proven useful in the control of serious cardiac arrhythmias. We reviewed the English language medical literature to characterize clinical, radiographic, scintigraphic, pathologic, diagnostic, and prognostic data concerning amiodarone pulmonary toxicity. Our review showed that features consistent with amiodarone pulmonary toxicity include exertional dyspnea, fever, and…


Words—10 Years Later

ABSTRACTCertain phrases in the medical language have lost their meaning and in some cases now suggest the exact opposite of the facts. These are “anemia of chronic disease,” “liver function tests,” “the prevalence,” “S1 was present,” “S1 is normal,” “neurologic syncope,” “orthostatic hypotension,” “the neck veins were distended,” “hospital-acquired pneumonia,”…

Primary Article

Colorectal Cancer: Metastatic Patterns and Prognosis

ABSTRACTFrom 1979 to 1982, 163 patients with colorectal cancer were found to have distant metastases. Of these, 112 (69%) had metastatic disease at the time of initial diagnosis (synchronous metastases [SM]); in the remaining 51 (31%) metastases developed during the course of the disease (metachronous metastases [MM]). The liver was…

Primary Article

Indigenous Human Cutaneous Anthrax in Texas

ABSTRACTIn December 1988 an indigenous case of cutaneous anthrax was identified in Texas. The patient, a 63-year-old male Hispanic from southwest Texas, was a sheep shearer and had a recent history of dissecting sheep that had died suddenly. He experienced an illness characterized by left arm pain and edema. A…

Primary Article

Midline Disk Herniations of the Lumbar Spine

ABSTRACTMost lumbar disk displacements occur through the lateral fibers of the posterior longitudinal ligament, whereas only a small percentage occur through the strong midline fibers. The midline disk herniation is identified as a focal midline dural sac compression and is better seen on the lateral myelogram and computed tomography scan….

Primary Article

Two-Way Medicine: Strategies for Improving Doctor-Patient Relationships

ABSTRACTPatients are unhappy with the way physicians treat them, not so much medically, as personally. If public opinion is correct, recent medical graduates are less able to win the favor of their patients than previous ones. This article outlines a series of practical strategies for improving doctor-patient relationships. Sooner or…

Primary Article

Recent Advances in Surgery of the Temporal Bone and Skull Base

ABSTRACTRemarkable advances have been made in the field of neuro-otologic and skull base surgery within the past decade. Each component of the “disease model”—prevention, diagnosis, therapy, and rehabilitation—is undergoing rapid progress. The purpose of this paper is to highlight only a few of these achievements. Each topic chosen has witnessed…

Current Concepts

Hand Infections

ABSTRACTThe hand is a commonly injured part of the body that frequently becomes infected. Improperly treated hand infections can lead to severe disability including stiffness, contracture, and amputation. This article describes the current concepts of diagnosis and treatment of common hand infections.

Primary Article

Endoscopic Transnasal Antrochoanal Polypectomy: An Alternative to the Transantral Approach

ABSTRACTThe use of functional endoscopic sinus surgery has been limited typically to management of chronic sinusitis, nasal polyposis, and recurrent acute sinusitis. Antrochoanal polyps (ACPs) traditionally have been resected using a Caldwell-Luc sinusotomy. We used the endoscopic approach, however, in the treatment of five cases of ACP. There was recurrence…

Primary Article

Doppler Ultrasonography of the Umbilical Cord in Normal Pregnancy

ABSTRACTUsing continuous wave Doppler ultrasonography to measure umbilical artery-flow velocity waveforms (FVWs) is a safe, noninvasive means of quantifying placental resistance to blood flow. Detection of abnormally elevated resistance to umbilical perfusion may identify pregnancies complicated by uteroplacental insufficiency. Use of this technique to identify high-risk pregnancies requires ready access…

Primary Article

Genetic Conditions Among Patients Receiving Genetic Services in Middle Tennessee

ABSTRACTWe reviewed genetics charts of 2235 patients seen from 1985 to 1990 at Vanderbilt University Medical Center, Nashville, Tennessee, and summarized the 20 most common reasons for referral (occurring in 1138 of the patients) and the diagnoses or conditions among patients receiving genetic services in one of four clinical settings…

Primary Article

Carbamazepine Therapy in Neuropsychiatric Patients

ABSTRACTWe reviewed the charts of 106 patients treated with carbamazepine. Age, sex, race, seizure type, seizure focus, age at onset, duration of epileptic illness, reasons for discontinuing treatment, other medications, and response to treatment of seizures, psychiatric symptoms, and behavioral symptoms were recorded. Statistical analysis was done to determine clinical…

Primary Article

Guidelines for Regional Anesthesia in Obstetrics: Potential Impact on Obstetric Anesthesia Services in Rural Alabama

ABSTRACTWhen the American Society of Anesthesiologists published its Guidelines for Regional Anesthesia in Obstetrics, I did a survey to determine what impact a broadly implemented strict interpretation of those guidelines might have on obstetric anesthesia care in small rural Alabama hospitals. Thirty-six rural Alabama hospitals with fewer than 200 beds…

Author Index


Case Report

Azathioprine in the Treatment of Chronic Refractory Steroid-Dependent Asthma

Our Medical Heritage

History of Pediatrics Part II



Case Report

Symptomatic Rubella Reinfection in an Immune Contact of a Rubella Vaccine Recipient