Issue - Southern Medical Association

Primary Article

Multicenter Randomized Trial of Ofloxacin Versus Cefoxitin and Doxycycline in Outpatient Treatment of Pelvic Inflammatory Disease

ABSTRACT: A multicenter randomized comparative trial was done to assess the safety and efficacy of oral ofloxacin (400 mg twice daily for 10 days) versus cefoxitin (2 g intramuscularly) followed by doxycycline (100 mg twice daily orally for 10 days) for the outpatient treatment of uncomplicated pelvic inflammatory disease (PID)….

Primary Article

Acute Upper Airway Obstruction Resulting From Systemic Diseases

ABSTRACT: Acute upper airway obstruction is usually associated with inflammatory processes such as epiglottitis, and with laryngeal trauma and laryngeal tumors. Not uncommonly, systemic diseases such as Wegener's granulomatosis and sarcoidosis may manifest initially as upper airway obstruction requiring intubation or tracheostomy. We describe our experience in the diagnosis and…

Primary Article

Omental Pedicle Graft to Improve Ischemic Anastomoses

ABSTRACT: An end-to-end anastomosis was done in the center of a 5-cm devascularized jejunal segment in 5 control laboratory rabbits and 14 experimental rabbits. A second group consisted of 5 control animals and 11 experimental animals having end-to-end jejunojejunostomy in the center of a 10-cm devascularized jejunal segment. In the…

Primary Article

Optimal Use of Beta Irradiation in the Treatment of Pterygia

ABSTRACT: Beta irradiation with strontium 90 has been associated with significant iatrogenic disease, causing such complications as ptosis, symblepharon, iridic and scleral atrophy, cataracts, and endophthalmitis. We studied 171 eyes in 140 patients treated and followed up during a 17-year period from 1973 to 1990. We sought to show that…

Primary Article

Bioimpedance Measurement of Body Water Correlates With Measured Volume Balance in Injured Patients

ABSTRACT: Bioimpedance technology is being used increasingly to determine drug volume of distribution, body water status, and nutrition repletion. Its accuracy in patients experiencing large volume flux is not established. To address this, we undertook this prospective study in 54 consecutive seriously injured adults who had emergency celiotomy soon after…

Primary Article

Home Exposures to Chlorine/Chloramine Gas: Review of 216 Cases

ABSTRACT: Chlorine and chloramine gas are frequently produced in the home when cleaning products are mixed. These gases are strong irritants with the potential for tissue damage. Numerous literature citations report industrial exposures to chlorine/amine gas, but there are few reports regarding home exposures. The purpose of this study was…

Primary Article

Epidemiologic and Clinical Aspects of Shigellosis in American Forces Deployed to Saudi Arabia

ABSTRACT: I describe nine cases of shigellosis seen at a large Navy field hospital in troops deployed to Saudi Arabia during the Gulf War. Eight cases were associated with consumption of food at civilian restaurants or civilian-contracted food services. Two adults had “pseudomeningitis” syndromes, illustrating that shigellosis in adults may…

Primary Article

Nontuberculous Mycobacterial Infection of the Central Nervous System in Patients With AIDS

ABSTRACT: Infections due to nontuberculous mycobacteria (NTM) are especially common in patients with AIDS. Meningitis due to NTM, however, is rare. A search for CSF cultures positive for NTM over the past 11 years at our hospital yielded 16 cases. Of these, 15 were caused by Mycobacterium avium-intracellulare (MAI), and…

Review Article

Surgical Treatment of Meckel’s Diverticulum

ABSTRACT: Meckel's diverticula are the result of incomplete degeneration of the vitelline duct. It is generally believed that less than 5% of them become symptomatic, the frequency decreasing with age. Meckel's diverticula are most commonly manifested in children by painless lower gastrointestinal bleeding and in adults, as an inflammatory process…

Current Concepts

Asphyxial Brain Damage in the Newborn: New Insights Into Pathophysiology and Possible Pharmacologic Interventions

ABSTRACT: New insights into the pathophysiology of the hypoxic-ischemic insult have opened the possibility of pharmacologic intervention in neonatal hypoxic-ischemic encephalopathy. It is now known that many neurons survive a hypoxic-ischemic insult but remain dysfunctional for hours, with profound alterations in cell function. A cascade of biochemical alterations occurs as…

Primary Article

Nonulcer Dyspepsia Associated With Psychiatric Disorder

ABSTRACT: Studies of dyspepsia show a 1% to 2% prevalence in adults, and 25% to 40% of these patients do not have a physical reason for their symptoms. These findings prompted us to do a retrospective follow-up study of 390 patients having motility studies for chest pain and gastrointestinal (GI)…

Our Medical Heritage

A Last Martyr of the Conquest of Yellow Fever

ABSTRACT: The last of six Rockefeller Foundation investigators to die studying yellow fever was Theodore B. Hayne, 31 years old and recently married. He had returned to hazardous duty in West Africa knowing of the deaths of four other investigators within the previous 3 years.

Primary Article

Chlamydial Cervical Infections in Rural and Urban Pregnant Women

ABSTRACT: The purpose of this investigation was to determine the incidence of cervicitis due to Chlamydia trachomatis in rural pregnant women, urban pregnant women, and urban nonpregnant women in Georgia. Evaluation of endocervical chlamydial cultures from 447 women showed prevalence rates for C trachomatis cervicitis of 12% in the urban…

Primary Article

Laparoscopic Management of Ectopic Pregnancy in a Resident Training Program

ABSTRACT: The range of procedures now routinely done through the laparoscope has continued to expand due to improved equipment for insufflation, hemostasis, and tissue manipulation, and to imaginative approaches to otherwise “routine” gynecologic problems traditionally treated by laparotomy. As with all new technologies, advocates predict that the methodology will prove…

Primary Article

Is a Hemoccult-Positive Rectal Examination Clinically Significant?

ABSTRACT: To determine the clinical significance of finding occult blood in a stool sample obtained during digital rectal examination of patients with no gastrointestinal complaints, we reviewed the records of patients who had colonoscopy for this indication. Of the 185 patients (average age, 59.4 years) who met study criteria, 48…

Primary Article

Predicting Severity of Trauma by Admission White Blood Cell Count, Serum Potassium Level, and Arterial pH

ABSTRACT: Traumatized patients frequently have leukocytosis, hypokalemia, and acidosis. The purpose of this study was to determine whether the admission serum potassium level (K+), white blood cell count (WBC), and arterial pH predicted the severity of injury in trauma patients. The injury severity score (ISS), total length of stay in…

Primary Article

Group A Streptococcal Bacteremia in a Mid-South Children’s Hospital

ABSTRACT: We reviewed microbiology and infection control records at a Memphis children's hospital from 1982 to 1990 to obtain epidemiologic, clinical, and microbiologic data on group A streptococcal (GAS) bacteremia. Varicella was the underlying condition in 8 of 37 (22%) patients identified and was often associated with severe GAS disease,…

Primary Article

Impact of Treating Involuntarily Admitted Schizophrenics on an Open Unit

ABSTRACT: When involuntary psychiatric patients are treated on unlocked units, problems may arise as to resource expenditure and the ability to provide optimal psychiatric care. This study investigates the problem and possible solutions.

Primary Article

Assessment of Medical Students’ Knowledge Regarding Human Immunodeficiency Virus Transmission: Comparisons by Gender, Residence, and Training Level

ABSTRACT:As the incidence of human immunodeficiency virus (HIV) infection increases, health care practitioners are being called upon to counsel and educate patients regarding the complications associated with HIV infection. In addition, the anxiety levels of health care workers reveal that similar educational efforts must be initiated early in the training…

Clinical Brief

Chronic Salicylate Intoxication

Case Report

Concurrent Verrucous Carcinomas of the Lip and Buccal Mucosa


Dizzy Medical Writing and Editing: A Decade of Non-Progress



Case Report

Perplexing Pericarditis Caused by Coccidioidomycosis

Case Report

Phrenic Nerve Palsy Accompanying Chiropractic Manipulation of the Neck

Case Report

Polycythemia as a Complication of Human Immunodeficiency Virus Infection

Case Report

Recurrence of Rectal Carcinoma in the Mediastinum


Squamous Cell Carcinoma of the Breast




Victims of Crime