Case Report

Unilateral Adrenal Hyperplasia

ABSTRACT: A case of unilateral primary adrenal hyperplasia, without concomitant hypokalemia, is presented. After surgical removal of the gland, a complete remission occurred. This rare condition may, in fact, be more frequent than thought as it can coexist with normokalemia. We postulate that it is probably a new phase of…

Review Article

Mediastinal Lung Cancer: Answers and Questions

ABSTRACT: A literature review was done to define the relative roles of radiation and surgery in the treatment of mediastinal stage III, non-small-cell lung cancer with no distant metastasis. No two reports are comparable. Little information is available on the clinical, preoperative stage as it relates to surgical findings and…

Primary Article

Tobacco Use Among American Adolescents: Geographic and Demographic Variations

ABSTRACT: A previous national study indicated that the South dominated other regions of the United States in tobacco use. Using the results of the Teenage Attitudes and Practices Survey conducted by the National Center for Health Statistics, we examined the geographic and demographic differences of tobacco use among US adolescents….

Primary Article

Medicine Residents’ Practices in Cancer Screening in a Hispanic Population

ABSTRACT: Cancer screening is a valuable intervention to reduce breast cancer mortality and the incidence of invasive cervical carcinoma. We conducted a retrospective survey to determine the residents' compliance with use of mammography and Pap smear in Hispanic women. A total of 280 charts that met the inclusion criteria were…

Case Report

Cementifying Fibroma: Resection of Recurrent Mandibular Lesion With Microsurgical Preservation of Inferior Alveolar Nerve and Immediate Reconstruction

ABSTRACT: Cementifying fibroma is a benign fibro-osseous lesion that may occur in either the mandible or the maxilla, with a predilection for the mandible. In the patient described, a recurrent mandibular cementifying fibroma was successfully resected, with microsurgical preservation of the inferior alveolar nerve and immediate reconstruction via an autogenous…

Primary Article

Incidence of Cervical Spine Injury in Patients With Gunshot Wounds to the Head

ABSTRACT: Cervical spine immobilization is standard during the early stages of prehospital and hospital care of patients with blunt head injury. However, the need for cervical spine immobilization in patients with gunshot wounds to the head has not been addressed. To determine the incidence and types of cervical spine injury…

Case Report

Pernicious Anemia Manifesting as Angina Pectoris

ABSTRACT: Here we describe a case of angina pectoris in a patient for whom an extensive cardiovascular workup was done, with negative results. Eventually, the cause of his symptoms was found to be pernicious anemia. Although angina is an uncommon manifestation of pernicious anemia, a review of the literature suggests…

Case Report

Group G Streptococcal Bacteremia Caused by an Asymptomatic Esophageal Carcinoma in an Elderly Man

ABSTRACT: I describe the case of a 70-year-old man with group G streptococcal bacteremia, anemia, and stools positive for occult blood in whom no clear source of infection was found until an asymptomatic esophageal carcinoma was diagnosed. Group G bacteremia has been associated with neoplastic sources. Although this patient was…

Primary Article

Fluoroscopic Evaluation of the Ureters During Intravenous Urography

ABSTRACT: In a prospective study, we assessed the usefulness of fluoroscopy in visualizing the ureters during intravenous urography. The percentage of ureter visualized was compared on radiographs acquired with and without fluoroscopic guidance. The length of ureter shown was significantly greater with fluoroscopic spot filming than with traditional urography. We…

Primary Article

Sarcoidosis and ELISA for Borrelia burgdorferi

ABSTRACT: Lyme disease can be confirmed by detection of IgM and IgG antibodies against the causative pathogen Borrelia burgdorferi. Enzyme-linked immunosorbent assay (ELISA) can be confirmatory within weeks of symptom onset. Sarcoidosis has not previously been reported as one of the disease processes associated with a false-positive ELISA for Lyme…

Current Concepts

Preconception Evaluation and Intervention

ABSTRACT: Many pregnancies are predisposed to complications by events that occur in the first weeks of gestation. In fact, these complications may occur prior to the time that a woman knows she has become pregnant. Preconception care offers patients the opportunity to address these conditions before conception; the potential for…

Case Report

Massive Upper Gastrointestinal Bleeding Due to Candida Esophagitis

ABSTRACT: Significant hemorrhage from esophageal candidiasis in patients without a major bleeding diathesis is extremely uncommon. A case of recurrent, severe upper gastrointestinal bleeding due to hemorrhagic candidal esophagitis in a man with renal failure is described. Dysphagia, odynophagia, and retrosternal chest discomfort were all absent. Oral thrush was present…

Article

Snake Venom Poisoning in the United States: A Review of Therapeutic Practice

ABSTRACT: Snake venom poisoning constitutes a medical emergency. It is a complex type of poisoning that not only affects the local bite site but may involve multiple organ systems as well. In the United States, poisonous snakes account for approximately 8,000 bites annually, resulting in about 9 to 15 fatalities….

Primary Article

CT Findings of Hypoxic Basal Ganglia Damage

ABSTRACT: The outcome of hypoxic ischemic injury ranges from complete recovery to a persistent vegetative state or death, depending on the length of time the patient remains unconscious and the degree of associated cardiac failure. We describe three patients who were comatose from a hypoxic and/or ischemic injury and whose…

Primary Article

Laparoscopic Appendectomy, Is It Worth It?

ABSTRACT: The recent experience with open appendectomy was compared to our initial experience with laparoscopic appendectomy. Thirty-eight patients had open appendectomy for acute appendicitis. Two major and four minor complications occurred. Concurrently, 39 patients had laparoscopic appendectomy. There was one major and one minor complication. Of the laparoscopic patients, 69%…

Primary Article

Characteristics of Severe Hypoglycemia in the Patient With Insulin-Dependent Diabetes

ABSTRACT: To avoid, delay, or ameliorate the microvascular complications of diabetes, intensive insulin therapy with the goal of normoglycemia is required. In most patients with insulin-dependent diabetes mellitus (IDDM), this cannot be achieved because of severe hypoglycemia, which is one of the major causes of morbidity in diabetic patients. To…

Primary Article

Desmopressin Acetate in Cardiac Surgery: A Double-Blind, Randomized Study

ABSTRACT: Use of desmopressin acetate (DDAVP) for patients having cardiac surgery is controversial. We did a double-blind, randomized study of 83 patients having cardiac operations at Georgetown University Hospital. The effect of DDAVP on bleeding as compared to placebo was evaluated by blood loss, replacement volume, and laboratory tests. There…

Primary Article

Noncompliance of High-Risk Pregnant Women in Keeping Appointments at an Obstetric Complications Clinic

ABSTRACT: We conducted this survey to determine reasons for missed appointments and the relationship between missed appointments, knowledge of diagnosis, and perception of the impact of this diagnosis on pregnancy outcome. We attempted to interview, by telephone, 506 women within 24 hours of their missing an appointment at a high-risk…

Case Report

Toxoplasma gondii Pneumonia in Patients With the Acquired Immunodeficiency Syndrome: Diagnosis by Bronchoalveolar Lavage

ABSTRACT: We describe the cases of two individuals with advanced AIDS who sought treatment for rapidly progressive respiratory failure due to T gondii pneumonia. The first patient responded to specific therapy after an early diagnosis but died 2 months later of bacterial sepsis. In the second case, the diagnosis was…

Primary Article

The Geography of AIDS: Patterns of Urban and Rural Migration

ABSTRACT: We sought to describe the migration patterns of patients infected with the human immunodeficiency virus (HIV) who seek health services in North Carolina. Of 390 consecutive adult patients with HIV seen at one tertiary care medical center in the southeastern United States in the summer of 1990, 340 (87%)…

Correspondence

Childhood Sexual Abuse

Correspondence

Don’t Overlook Small Intestinal Endoscopy for Evaluating Gastrointestinal Bleeding of Obscure Origin

Correspondence

Don’t Overlook Small Intestinal Endoscopy for Evaluating Gastrointestinal Bleeding of Obscure Origin Replay

Correspondence

Recognizing Delirium in Patients With Psychiatric Symptoms

Correspondence

Recognizing Delirium in Patients With Psychiatric Symptoms Replay

Editorial

Snake Bites

SMA Menu