Issue - Southern Medical Association

Primary Article

Osteomyelitis of the Jaw in Patients Infected With the Human Immunodeficiency Virus

ABSTRACTEight patients with osteomyelitis of the jaw were identified at two county hospitals over a 4-year period. Three patients (37.5%) were found to be HIV-seropositive, including two patients not previously known to be HIV-seropositive. Signs and symptoms of infection were similar in both groups of patients, and commonly included fever,…

Primary Article

Efficacy of Radiographic Evaluation of the Cervical Spine in Emergency Situations

ABSTRACTEvaluation of trauma to the cervical spine usually includes predominantly normal x-ray studies that prevent expeditious workup and treatment and increase cost. In a retrospective review of the cases of 1,686 consecutive trauma patients who had routine radiographs for possible injury to the cervical spine, injuries were detected in 32…

Primary Article

Elective Combined Abdominal‐Vaginal Cesarean Hysterectomy for Cervical Neoplasia

ABSTRACTFrom January 31, 1990 to November 15, 1991, I treated three patients by cesarean hysterectomy with cervical conization for cervical neoplasia. All three hysterectomies were facilitated by the use of a combined abdominal-vaginal technique, which is described in this report.

Primary Article

Gram’s Stain and Culture of Sputum in the Routine Management of Pulmonary Infection

ABSTRACTGrain's stain (GS) and culture of sputum are used routinely for diagnosis of lung infection. We prospectively studied physicians' use of sputum GS and culture for management of lung infection, the correlation between GS and culture in 224 adequate sputum specimens from patients admitted to our hospital over a 15-month…

Current Concepts

Human Herpesvirus 6

ABSTRACTHuman herpesvirus 6 (HHV-6) is a relatively recently discovered virus. Although systematic studies on the spread of this virus are lacking, considerable data have been collected regarding the prevalence of HHV-6 infection. A number of laboratory methods are available for the diagnosis of HHV-6 infection, but currently these tests are…

Primary Article

Staging Ovarian Cancer Diagnosed During Laparoscopy Accuracy Rather Than Immediacy

ABSTRACTImmediate staging and debulking of an unsuspected ovarian malignancy detected at the time of diagnostic laparoscopy is appropriate when personnel knowledgeable in these procedures are available. However, when assistance is unavailable, termination of the diagnostic laparoscopy and timely referral is acceptable. This report reviews techniques to preoperatively distinguish a benign…

Primary Article

Analgesic Rebound Headache Experience in a Community Hospital

ABSTRACTIn the past, chronic daily headaches have been attributed to many possible causes, including “tension,” excessive contraction of pericranial muscles, and depression. A careful history reveals that many patients start out with fairly typical intermittent migraine attacks that evolve over the years into a pattern of daily or almost daily…

Primary Article

Chemotherapy for Patients With Pulmonary Kaposi’s Sarcoma Benefit of Filgrastim (G‐CSF) in Supporting Dose Administration

ABSTRACTKaposi's sarcoma (KS) is common in individuals infected with the human immunodeficiency virus (HIV-1). Although KS is frequently indolent, it can also be aggressive and life-threatening, especially in patients with pulmonary involvement (PKS), who have poor survival rates when untreated. In an effort to develop treatment regimens for PKS that…

Primary Article

Incidence and Simple Management of Priapism Following Dynamic Infusion Cavernosometry‐Cavernosography

ABSTRACTOf 239 patients with erectile dysfunction (aged 36 to 70 years) who were evaluated with dynamic infusion cavernosometry-cavernosography, 32 (13.4%) developed priapism after the procedure and were successfully managed with immediate intracorporal injection of phenylephrine. No single risk factor for the development of priapism was identified in this group. Early…

Primary Article

Sensitivity and Positive Predictive Value of Clinical Signs of Hypogonadism in Elderly Men

ABSTRACTOne hundred three ambulatory elderly men had serum free testosterone (FT) assessed as part of a study of bone loss. The FT was analyzed using radioimmunoassay. Each participant was questioned regarding the presence of erections adequate for sexual activity and the presence of sexual desire. Each was examined for decreased…

Primary Article

Pseudoseizures Etiologic and Psychotherapeutic Considerations

ABSTRACTPseudoseizures are a somatic form of communication involving dissociative mechanisms. This paper outlines basic strategies for psychotherapeutic management with a case example.

Primary Article

Interhospital Transfers, the COBRA Law (1985), and the Use of a Public Assistance Health Plan

ABSTRACTPublic outcry regarding unsafe interhospital patient transfers led to the passage of the COBRA Law of 1985. Since its implementation in 1986, the law has been sharply criticized for its sporadic enforcement, narrow focus, and lack of care provisions for the poor. We reviewed retrospectively the charts of all emergency…

Primary Article

Eustachian Tube Dysfunction and Its Sequelae in Patients With Cleft Palate

ABSTRACTThe incidence of middle ear disorders in patients with cleft palate deformities was determined in a retrospective review of 110 children with palate or palate and lip involvement. Ages ranged from 2 months to 18 years and included patients with associated abnormalities such as Pierre Robin syndrome and Treacher Collins…

Primary Article

Evaluation of Flumazenil for Reversing the Effects of Midazolam‐Induced Conscious Sedation or General Anesthesia

ABSTRACTTo evaluate the effectiveness of flumazenil in reversing midazolam-induced conscious sedation and general anesthesia, we gave either flumazenil or placebo to 55 patients in a double-blind manner after surgery. Whether surgery was done under conscious sedation (CS group) or general anesthesia (GA group) depended on the procedure. Recovery was assessed…

Primary Article

Pyogenic Hepatic Abscess

ABSTRACTWe reviewed the clinical courses of 37 patients treated for pyogenic liver abscesses. These abscesses were cryptogenic in 38% of the patients, associated with biliary tract or intra-abdominal disease processes in 48%, and hematogenous in 11%. Computed tomography was more accurate (96%) in diagnosing a hepatic abscess than ultrasonography (82%)….

Primary Article

End‐Stage Renal Disease With Venous Occlusion in Both Upper Extremities

ABSTRACTWe studied 27 patients with venographically documented bilateral subclavian vein occlusion thrombosis after the use of dual lumen hemodialysis catheters. Immediate venous access was severely limited because all patients had previously had multiple access failures. The rate of venous pressure rise between hemodialysis treatments is inconsistent in suggesting imminent thrombosis…

Primary Article

Compensation Status as a Predictor of Outcome in Nonsurgically Treated Low Back Injury

ABSTRACTWhether the compensation status of patients injured in occupational accidents influences treatment outcome remains a controversial issue. This article describes the treatment outcome status of compensated versus noncompensated patients who received comprehensive functional restoration treatment of low back pain in a hospital-based, interdisciplinary, occupational rehabilitation and pain management program. Results…

Case Report

Cystic Pheochromocytoma Radiologic Diagnosis

SUMMARYCystic pheochromocytomas are unusual variants of adrenal pheochromocytomas. Computed tomography and pathologic findings in the two cases reported here illustrate three cardinal principles in the diagnosis of cystic pheochromocytomas: (1). A suprarenal cystic tumor discovered on CT may be the result of hemorrhage and necrosis of an adrenal pheochromocytoma. (2)…

Case Report

Neuroimaging of Arachnoiditis Induced by Spinal Anesthesia

SUMMARYDespite the simplicity, effectiveness, and safety of spinal anesthesia, arachnoiditis can occur as a complication. The cause of this is often unknown, especially since disposable spinal kits are now normally used. It is postulated that an untoward reaction to the anesthesia or chemical contamination was the cause of arachnoiditis in…

Case Report

Hypoglycemia Due to a Pharmacy Dispensing Error

SUMMARYDrug dispensing error should be considered as a cause of hypoglycemia when the usual initial workup is unrevealing, as in the case described.

Case Report

Systemic Lupus Erythematosus With Retroperitoneal Fibrosis and Thrombosis of the Inferior Vena Cava

SUMMARYI have described a 17-year-old adolescent in whom retroperitoneal fibrosis was the initial manifestation of systemic lupus erythematosus. She had thrombosis of the inferior vena cava during the course of her illness. Standard treatment with corticosteroids resulted in apparent resolution of this complication.

Case Report

Magnetic Resonance Imaging of Nalbuphine‐Induced Myocutaneous Sclerosis

SUMMARYMyocutaneous sclerosis is a known complication of intramuscular and subcutaneous injection of narcotics. We have described the MRI findings of this entity with superimposed infection in a patient addicted to intramuscular and subcutaneously administered nalbuphine. The clinical and imaging features of this disorder are sufficiently characteristic to allow confident diagnosis….

Case Report

Cutaneous Larva Migrans

SUMMARYThe case of cutaneous larva migrans presented here is typical for its mechanism and geographic location of infection, evolution of lesions, and prompt response to treatment. Except for pin-worms, helminth infections are rarely thought of in emergency departments away from the areas where the parasites are especially prevalent. The several-day…

Case Report

Serious Adverse Effects Induced by Simultaneous Administration of Two Nonsteroidal Anti‐inflammatory Drugs

SUMMARYWe have described the case of a 58-year-old woman in whom acute hemolytic anemia, renal failure, and granulocytopenia developed after intake of mefenamic acid and diclofenac. Results of direct and indirect Coombs' tests were negative, but the lymphocyte transformation test was positive for these two nonsteroidal anti-inflammatory drugs (NSAIDs). We…

Case Report

Primary Bronchopulmonary Fibrosarcoma of the Trachea in a Child

SUMMARYWe have reported the unusual case of a 7-year-old boy who was admitted with respiratory symptoms of several months' duration. He was found to have a tumor of the trachea, which proved to be a low-grade fibrosarcoma with smooth muscle differentiation.

Case Report

Delayed Recurrences in Primary Fallopian Tube Carcinoma

Case Report

Internal Closure of an Aspergilloma Cavity Report of a New Technique and Review of the Literature

Case Report

Life‐Threatening Hyperkalemia Associated With Captopril Administration

Case Report

Metastatic Choriocarcinoma Correlation of MRI, CT, and Angiography

Case Report

Oropharyngeal Impalement on a Wrought Iron Fence

Case Report

Pure Red Cell Aplasia and Hepatitis A

Case Report

Rhabdomyolysis‐Induced Delayed Hypocalcemia After Parathyroidectomy

Correspondence

Simultaneous Nocardial Empyema and Pneumocystis carinii Pneumonia as an Initial Manifestation of HIV Infection

Editorial

THE WINDS OF CHANGE IN MEDICINE

Case Report

Use of Thioridazine in Post‐Traumatic Stress Disorder