Issue - Southern Medical Association

Case Report

L-Carnitine as a Treatment for Rett Syndrome

ABSTRACT: A 17-year-old girl with Rett syndrome, who was taking no other medications, was treated with L-carnitine (50 mg/kg/day). Within 2 months of initiation of treatment, she became much more alert, developed good eye contact, started reaching for objects with both hands, and answered simple questions with one or two…

Primary Article

Chronic Gastritis Associated With Infection Due to Helicobacter pylori in Southern Appalachian Veterans With Dyspepsia

ABSTRACT: A prospective study of infection due to Helicobacter pylori in 104 Southern Appalachian veterans with upper gastrointestinal symptoms revealed a prevalence of 67%. There was no age difference observed between those with and without H pylori. The organism was shown to be present in 12 of 13 patients with…

Primary Article

Transportation of Children With Special Seating Needs

ABSTRACT: As of 1986, all 50 states had implemented mandatory child restraint laws. When used correctly, restraint systems have been proven to reduce the number of fatalities, hospitalizations, and injuries. To date, there is little information regarding compliance with restraint systems for disabled children. There are no data available on…

Primary Article

Frequency and Correlates of Bacteriuria Among Children With Neurogenic Bladder

ABSTRACT: Bacteriuria is a common clinical problem among children with neurogenic bladder due to meningomyelocele or traumatic spinal cord injury. To determine the frequency of bacteriuria among affected children at our institution, we obtained 257 urine specimens from 105 children being seen as outpatients for routine care over a 2-year…

Primary Article

Neonatal Fungemia and Amphotericin B

ABSTRACT: Disseminated candidemia is a common nosocomial infection in the neonatal intensive care unit, though only a few studies have reported the outcome of amphotericin B therapy in neonatal candidiasis. Our treatment regimen consisted of an initial daily amphotericin B dose of 0.5 mg/kg. (For infants weighing >1 kg, the…

Primary Article

Drug Abuse in an Obstetric Population of a Midsized City

ABSTRACT: Drug abuse during pregnancy has attracted national attention, but most studies are from large cities. This study is concerned with the indigent pregnant patients in a midsized city in the southeastern United States. In a 23-month study, 2,442 patients were delivered of neonates. Using specific criteria, 511 patients were…

Primary Article

Think Melanoma

ABSTRACT: Every physician’s office should be a melanoma detection station. Identification and surgical excision of early melanoma is today’s best answer to reducing the death rate from this treacherous disease. Public awareness of melanoma is gaining momentum. Melanoma education for physicians is vital if the battle against melanoma is to…

Primary Article

Necrotizing Surgical Infection and Necrotizing Fasciitis in Obstetric and Gynecologic Patients

ABSTRACT: Necrotizing fasciitis (NF) is a rapidly progressive disease characterized by extensive necrosis of the skin, fascia, and subcutaneous tissue, with sparing of the underlying muscle. Diabetes mellitus, Bartholin’s gland abscess, and recent surgical procedures (including episiotomy) are factors often found in obstetric and gynecologic patients. Mortality in this group…

Primary Article

Needs Assessment for Reducing Infant Mortality in Baltimore City: The Healthy Start Program

ABSTRACT: Needs assessments are essential for policy formulation and the appropriate design of intervention programs. Recent nationwide data show that among large metropolitan areas of the United States, Baltimore has one of the highest infant mortality rates and ranks in the worst top 10 for blacks and the top 5…

Primary Article

Overlapping Sphincteroplasty for Acquired Anal Incontinence

ABSTRACT: Overlapping sphincter repair is the operation of choice for incontinence due to obstetric injuries, trauma, or previous anorectal surgery. We present our experience from 1981 to 1990 using the overlapping sphincter repair for anal incontinence resulting from childbirth in 21 patients (58%), previous anorectal surgery in 7 (19%), trauma…

Primary Article

Outbreak of Gastroenteritis Due to Salmonella enteritidis From Locally Produced Grade A Eggs, South Carolina

ABSTRACT: Recent investigations of outbreaks of Salmonella enteritidis gastroenteritis among humans, especially in the northeastern United States, implicate grade A shell chicken eggs as the likely vehicle of transmission. In April 1991 we investigated an outbreak of S enteritidis infections after a wedding anniversary celebration in Beaufort, South Carolina. Sixty-eight…

Article

The German Health Care System: Model or Mirage?

ABSTRACT: Rising costs have spurred America’s leaders to look abroad for a model upon which to pattern reform of our health care system. On the surface, at least, Germany would appear to have an ideal system combining universal access, high quality, free choice of physicians, and cost control. Germany has…

Primary Article

Admission Serum Albumin Level as a Predictor of Outcome Among Geriatric Patients

ABSTRACT: This retrospective study consisted of 148 patients who were consecutively discharged during 1991 from a geriatric VA Hospital population. Seventy-six were 65 years of age or older, and all were male. Data included admission serum albumin level, age, length of stay, diagnosis, and disposition. Albumin level was negatively associated…

Primary Article

Effect of Citrate on Serum Aluminum Concentrations in Hemodialysis Patients: A Prospective Study

ABSTRACT: Twenty hemodialysis patients were prospectively evaluated to determine if concomitant citrate and aluminum administration enhances the absorption of aluminum, thereby increasing the possibility of toxicity. The four-phase study consisted of phase I, a washout phase; phase II, an aluminum treatment phase; phase III, a treatment phase combining aluminum and…

Primary Article

Stereotactic Brain Biopsy for Diagnosis of Progressive Multifocal Leukoencephalopathy

ABSTRACT: We describe three patients in whom the diagnosis of progressive multifocal leukoencephalopathy (PML) was made by stereotactic biopsy. All three patients had a rapidly progressive clinical course pathologically characterized by demyelination, Alzheimer I astrocytes, and basophilic intranuclear inclusions in oligodendrocytes. In each case, the diagnosis was confirmed with immunohistochemical…

Case Report

Achalasia Mistakenly Diagnosed as Eating Disorder and Prompting Prolonged Psychiatric Hospitalization

Acknowledgment

ACKNOWLEDGMENT

Case Report

Angiotropic Lymphoma Manifested by Fever and Painful Swollen Legs

Case Report

Apparent Culture-negative Endocarditis of the Prosthetic Valve Caused by Cardiobacterium hominis

Case Report

Autoimmune Hypothyroidism in a Patient With Generalized Resistance to Thyroid Hormone

Correspondence

Chemotherapy-Induced Alopecia

Case Report

Elevated Parathyroid Hormone-Related Protein and Hypercalcemia in a Patient With Cutaneous Squamous Cell Carcinoma Complicating Hidradenitis Suppurativa

Case Report

Hyperrenin-Hyperaldosterone-Dependent Malignant Hypertension in Polyarteritis Nodosa

Case Report

Inadvertent Puncture of the Urinary Bladder by a Peritoneal Dialysis Catheter

Case Report

Large Asymptomatic Carcinoid Tumor in an HIV-Infected Man

Editorial

MELANOMA MATTERS

Correspondence

Multicentric Granular Cell Tumors

Case Report

Multiple Beau’s Lines in a Patient With Fever of Unknown Origin

Case Report

NSAID Nephrotoxicity Revisited: Acute Renal Failure Due to Parenteral Ketorolac

Case Report

Renal Infarction Associated With Cocaine Use and Latent Protein C Deficiency

Case Report

Ribavirin and Intravenous Immune Globulin Therapy for Measles Pneumonia in HIV Infection

Case Report

Saccular Aortic Aneurysm Causing Complete Distal Esophageal Obstruction

Correspondence

Tentacle Elbow (To Replace Tennis Elbow)

Case Report

Toxic Shock Syndrome Mimicking Pelvic Inflammatory Disease Presumably Resulting From Tattoo

Case Report

Unusual Cutaneous Adverse Reaction to Warfarin Therapy