Issue - Southern Medical Association

Case Report

Retroperitoneal Reticulum Cell Sarcoma: A Cause of Paraneoplastic Pemphigus

ABSTRACTA 67-year-old man had mucosal ulcerations and bullous and lichenoid skin lesions resembling those of several other patients with underlying neoplasms. Computed tomography revealed an occult retroperitoneal sarcoma. Autoantibodies pathogenic to epithelia induce this syndrome, which has been termed “paraneoplastic pemphigus.” Imaging for an occult neoplasm should be considered in…

Article

Advance Directives on Hospital Admission: A Survey of Patient Attitudes

ABSTRACTA survey of 200 outpatients using an anonymous, self-administered questionnaire revealed that 18% had already completed an advance directive. Only 5% had received information concerning advance directives from their physicians. Eighty-seven percent stated they would not be offended if, on admission to the hospital, they were to be asked whether…

Article

Cutaneous Melanoma in African-Americans

ABSTRACTAlthough cutaneous melanoma is rare in African-Americans, it continues to have a poor prognosis. We reviewed our experience with 13 African-American patients who had cutaneous melanoma diagnosed between 1969 and 1990. Eight of these 13 lesions were on the foot. These lesions were seen at a late stage, and 50%…

Current Concepts

Chronic Pancreatitis

ABSTRACTChronic pancreatitis is caused most often by chronic excessive alcohol consumption. The disease can be diagnosed by investigations that measure function or assess morphology of the pancreas, thereby permitting a tailored management approach. In many patients, abdominal pain and steatorrhea can be managed effectively by enzyme supplementation, provided such supplements…

Article

Selection of Oral Controlled-Release Drugs: A Critical Decision for the Physician

ABSTRACTControlled-oral release dosage formulations of medications have become relatively prevalent in medicine today because of their ability to reduce noncompliance and, perhaps, to increase efficacy. However, there are many patient- and drug-related factors that may present special problems in product selection. For example, interchange of controlled-release brands that may have…

Article

Mesenteric, Omental, and Retroperitoneal Cysts in Children: A Clinical Study of 22 Cases

ABSTRACTCystic lesions of the mesentery, omentum, and retroperitoneum are rare; from 1956 to 1990, 22 patients had operative treatment for such lesions at our institution. They ranged in age from 1 month to 14 years; 75% were younger than 5 years. All had either an acute abdomen or, more commonly,…

Article

Endodermal Sinus Tumor of the Ovary: Review of 10 Cases

ABSTRACTEndodermal sinus tumors are rare but highly malignant neoplasms of children and young adults. In all, only about 200 cases have been reported in the literature. Ten patients with endodermal sinus tumor of the ovary who were treated at Jackson Memorial Hospital from 1977 to 1989 were retrospectively reviewed. The…

Article

Resolution of Hypertensive Retinopathy Despite Persistent High Diastolic Pressure

ABSTRACTFour patients with exudative retinopathy due to hypertension were observed for periods ranging from 12 to 35 months. Despite multiple drug therapy in high dosage and some clinic attendance, blood pressure was not controlled and remained severely elevated. Even though severe hypertension persisted, however, exudative phenomena disappeared and renal function…

Article

Familial Acalculous Gallbladder Disease

ABSTRACTFour patients, all sisters, presented a long-standing history of pain in the gallbladder region and no calculi. All were first thoroughly investigated and then relieved of their symptoms by cholecystectomy. This prompted an investigation of their family over three generations, which revealed a surprisingly large number of relatives, mostly female,…

Article

Feeding Gastrostomy: A Critical Review of Its Indications and Mortality Rate

ABSTRACTGastrostomy can be a valuable adjunct to patient care, and percutaneous endoscopic gastrostomy is often considered the method of choice for gastrostomy placement. As with all surgical procedures, however, patient selection is important no matter how the gastrostomy is placed. In a retrospective review of 125 randomly selected patients having…

Article

Effect of Insurance Status on Pain Medication Prescriptions in a Hematology/Oncology Practice

ABSTRACTTo determine whether insurance status (payer class) affects the amount and type of pain medication prescribed, and whether patients in those groups without prescription drug coverage received lower-cost medications, a case-control study with retrospective chart review was initiated in a university-based hematology/oncology practice in northwest Louisiana. Charts of 710 active…

Article

Mammographic Patterns and Breast Cancer Risk Factors Among Women Having Elective Screening

ABSTRACTWe assessed the association between Wolfe mammographic patterns and breast cancer risk factors among 239 women who attended the Breast Evaluation Unit screening program of the Comprehensive Cancer Center of Alabama, University of Alabama at Birmingham, from November 1984 through April 1986. Evaluation consisted of a breast cancer risk assessment…

Article

Prevention of Preterm Birth: Early Detection and Aggressive Treatment With Terbutaline

ABSTRACTWe evaluated a program for prevention of preterm birth involving early detection and aggressive intervention with subcutaneous terbutaline pump therapy in a high-risk, private patient population. Risk factor screening, frequent cervical examinations, and intensive patient education were used to detect preterm labor before it progressed to an advanced stage. Home…

Case Report

Thoracic Actinomycosis: An Unusual Childhood Infection

I have reported a rare case of thoracic actinomycosis in a child with a chest wall mass and pneumonic infiltrate. This case emphasizes the possibility of actinomycosis occurring in a well child with no previous dental problems, chronic lung disease, loss of consciousness, or immunocompromised status. The findings on thoracic…

Case Report

Pseudohyponatremia in Multiple Myeloma

Severe hyponatremia in any asymptomatic patient should alert the clinician to the possibility that pseudohyponatremia may be attendant with chylomicronemia or paraproteinemia. In cases of chylomicronemia, the serum is creamy, and in paraproteinemia the serum has increased viscosity. In such cases, the calculated serum osmolality will be decreased but the…

Case Report

Small Cell Carcinoma of the Ovary With Hypercalcemia Responsive to Sequencing Chemotherapy

Small cell carcinoma of the ovary with hypercalcemia is a rare neoplasm that has been exceedingly difficult to treat. It tends to occur in young women, and we have found no reports of survivors when this neoplasm has spread beyond the ovary. We have described a patient who has had…

Case Report

Transnasal Endoscopic Closure of Anterior Fossa Cerebrospinal Fluid Fistula

The anterior skull base can be approached intranasally, and the development of endoscopes and accompanying endoscopic instruments in recent years makes possible extremely precise and defined work along the ethmoid and sphenoid sinus roof. Since these areas are the most frequent locations of anterior skull base CSF rhinorrhea, it follows…

Case Report

Disseminated Intravascular Coagulopathy Due to Salmonellosis Precipitated by Blunt Trauma

We have reported an unusual cause of disseminated intravascular coagulopathy (DIC) in a patient with multiple injuries from blunt trauma. The source of continued hemorrhage remained elusive despite laparotomy and thoracotomy. Bleeding appeared to resolve only after discovery and treatment of infection due to Salmonella enteritidis, which the patient had…

Case Report

Anorexia and Weight Loss as the Solitary Symptoms of Choledocholithiasis

Review Article

Apoproteins, Lipoprotein Subtractions, and the Risk of Coronary Artery Disease

Case Report

Common Bile Duct Calculus: MRI Findings

Case Report

Cushing’s Disease Caused by Ectopic Pituitary Adenoma Within the Pituitary Stalk

Case Report

Cushing’s Disease With a Unilateral Adrenal Macronodule: Evolutive Transition or Incidental Finding?

Letter to the Editor

Directory of Pharmaceutical Indigent Programs

Case Report

Isolated Cardiac Metastasis From Cervical Carcinoma: Presentation as Acute Anteroseptal Myocardial Infarction

Letter to the Editor

‘It Only Takes a Moment’

Case Report

Osteomyelitis Due to Pseudallescheria boydii

Letter to the Editor

Patient-Controlled Analgesia for Management of Pain Associated With Acute Sickle Cell Crisis

Case Report

Recurrent Nocardiosis in a Renal Transplant Recipient

Letter to the Editor

Reply

Letter to the Editor

Response to Editorial on Obstetric Anesthesia

Case Report

Rhodococcus equi Causing Bacteremia in an Adult With Acute Leukemia