Issue - Southern Medical Association


Is Tenure Irrelevant for Academic Clinicians?

ABSTRACTAcademic tenure is the guarantee that a faculty member cannot be arbitrarily dismissed. The tenure system developed to maintain academics free of external pressure and coercion, and in dramatic instances tenure has been used to defend academic freedom. With the development of the research-oriented medical school staffed by full-time faculty,…

Case Report

Systemic Lupus Erythematosus in a Child With Sickle Cell Disease

ABSTRACTAlthough sickle cell disease (SCD) and systemic lupus erythematosus (SLE) are two distinct chronic diseases, many clinical features are common to both conditions. We describe a young patient who had a mild clinical course of SCD until SLE developed when he was 15 years old. His initial manifestations of SLE…

Case Report

Treatment of a Pleural Effusion Due to Charcot’s Arthropathy

ABSTRACTCervical spinal cord injury compromises the ventilatory muscles and is associated with respiratory complications. Patients who are quadriplegics are also at increased risk of Charcot's arthropathy of the spine. The development of a large pleural effusion in quadriplegia further increases respiratory compromise. I present a case of Charcot's arthropathy of…

Primary Article

Two Biochemical Markers Effectively Used to Separate Smokeless Tobacco Users From Smokers and Nonusers

ABSTRACTData from asbestos workers were used to devise a cutpoint classifier to identify subjects as Nonuser (non-tobacco user), Smokeless (exclusive smokeless tobacco user), and Smoker (ignited tobacco user). In some clinical trials and smoking cessation programs, Smokeless should be separated from Smoker. One therefore needs a marker for smoke exposure,…

Current Concepts

Glove Safety Summary of Recent Findings and Recommendations From Health Care Regulators

ABSTRACTEvery health care worker should be aware of the quality and deficiencies of gloves in the health care setting. Since the introduction of the human immunodeficiency virus into the health care setting, the medical community's compliance with universal precautions and the standards mandated by the Food and Drug Administration have…

Case Report

Tumoral Fibrosis and Lack of Circumscription in Granular Cell Tumor of the Breast

ABSTRACTGranular cell tumors are benign neoplasms of putative Schwann cell origin that most commonly occur in the tongue. While granular cell tumors in the breast are uncommon, the occurrence of this tumor at this site warrants special consideration, since the mammographic, gross, and microscopic appearance can mimic carcinoma. We describe…

Case Report

Hepatobiliary Cystadenoma

ABSTRACTHepatobiliary cystadenomas are rare, truly benign cystic epithelial tumors with the potential to become cystadenocarcinoma. The initial symptom is vague, nonspecific abdominal pain, frequently in middle-aged women, but patients may be asymptomatic. Abdominal ultrasonography may be diagnostic. Intracystic fluid, obtained by sonographically guided fine-needle aspiration, may contain elevated levels of…

Clinical Review

Herpes Zoster and Internal Malignancy

ABSTRACTHerpes zoster (HZ) often occurs concomitantly with various internal malignancies, most commonly hematologic in origin. Authors in the past proposed that HZ was a marker for internal malignancy, since it is often found in association with a malignancy. A critical review of the literature revealed that when HZ and malignancy…

Case Report

Calcifying Amyloidoma of the Breast

ABSTRACTIn this case, a distinctive amyloid tumor of the breast clinically simulated carcinoma, although the patient related onset to trauma. Hepatosplenomegaly, elevated globulins, and anemia led to identification of large amounts of monoclonal IgG-κ production. The patient died of renal failure within several months despite chemotherapy. The matrix of the…

Case Report

Massive Edema of the Ovary Associated With Androgenic Manifestations

ABSTRACTMassive ovarian edema is a rare tumor-like condition of the ovary characterized by marked enlargement of one or both ovaries due to marked accumulation of edema fluid in the ovarian stroma. This paper reviews the literature on massive ovarian edema and presents a case associated with androgenic manifestations.

Primary Article

Delayed Development of Mid‐Ileal Conduit Stenosis The Importance of Life‐Long Urologic Follow‐Up

ABSTRACTMid-ileal conduit stenosis is an unusual yet morbid complication following ileal conduit urinary diversion. We report the cases of four patients who developed mid-ileal stenosis at an average interval of 19.5 years after urinary diversion, with the longest interval being 25 years. This series emphasizes the importance of life-long follow-up…

Primary Article

Discovery Method and Stage of Breast Cancer in Two Different Patient Populations

ABSTRACTOur purpose was to determine the discovery method and stage of newly discovered breast cancers at two different medical centers. To do this, we conducted a retrospective chart review at our urban and suburban teaching hospitals during 1991 through 1992 and 1992, respectively. Only 29 (26%) of 112 cancers at…

Primary Article

Thrombotic Tendencies and Correlation With Clinical Status in Patients Infected With HIV

ABSTRACTPrevious publications have described thrombotic events with unclear causes in individuals infected with the human immunodeficiency virus (HIV). We stratified the cases of 52 individuals infected with HIV by degree of immunosuppression and the presence of complicating illnesses. Plasma from these individuals was screened for abnormalities that might predispose to…

Case Report

Seabather’s Eruption

ABSTRACTSeabather's eruption is an unusual rash that develops in individuals who have been swimming in the ocean. We report the case of a 25-year-old woman who had the rash in a typical bathing suit distribution. Several species of cnidarian larvae have been implicated in causing the disease. Symptomatic treatment is…

Case Report

Leaking Gallbladder Remnant With Cholelithiasis Complicating Laparoscopic Cholecystectomy

ABSTRACTSince its introduction in 1989, laparoscopic cholecystectomy has rapidly become the preferred alternative to open cholecystectomy for symptomatic cholelithiasis. Although possible complications of laparoscopic cholecystectomy are essentially the same as for open cholecystectomy, we report a case of an inadvertent subtotal cholecystectomy, a complication that we believe has not been…

Case Report

Pulmonary Zygomycosis After Allogeneic Bone Marrow Transplantation

ABSTRACTThe Zygomycetes are uncommon human pathogens. They cause illness in some patients who are immunosuppressed and can present as any of several syndromes, including rhino cerebral, pulmonary, gastrointestinal, or cutaneous disease, or as disseminated infection. Pulmonary zygomycosis can occur in any of several patterns and can mimic more common pneumonic…

Primary Article

Evaluation of a Program to Remove Barriers to Public Health Care for Women With HIV Infection

ABSTRACTTo facilitate access to care for HIV-infected women, a maternal-child program was started at an HIV outpatient clinic in New Orleans. The program consisted of free child care and transportation, separate waiting and examination rooms, female care providers, merged visits for mother and child, and on-site colposcopy services. This study…

Case Report

Advanced Triploid Pregnancy and Preeclampsia

ABSTRACTTriploidy, though unusual in advanced gestations, may be associated with preeclampsia. The increase in paternal genetic material associated with the triploid diandric placenta may support the role of immunologic factors in the development of preeclampsia.

Primary Article

Equal Effectiveness of Very—Low‐Intensity Anticoagulation and Standard Low‐Intensity Anticoagulation A Pilot study

ABSTRACTWe compared the efficacy of very-low-intensity oral anticoagulation (OA) with that of the recommended standard low-intensity oral anticoagulation, using international normalized ratios (INRs). We enrolled 101 patients into a pilot study—51 patients in the very-low-intensity anticoagulation arm (INR 1.4 to 2.0) and 50 in the standard low-intensity anticoagulation arm (INR…

Case Report

Fatal Outcome of Jugular Vein Cannulation

ABSTRACTWe describe the case of a woman who had cannulation of the internal jugular vein for the placement of a hemodialysis catheter. The procedure was unsuccessful and resulted in a retropharyngeal hematoma, which in turn caused severe compression on a carotid artery that was already severely narrowed by atherosclerosis. This…

Case Report

Management of Disseminated Intra‐abdominal Lymphangiomatosis With Protein‐Losing Enteropathy and Intestinal Bleeding

ABSTRACTWe encountered an unusually severe case of intra-abdominal lymphangiomatosis associated with protein-losing enteropathy and intestinal bleeding. A low-fat diet effectively raised the patient's serum levels of hemoglobin and the total serum protein, perhaps by inducing a reduction in intestinal lymph flow and pressure.

Case Report

Basal Cell Carcinoma Due to Radiotherapy for Carcinoma of the Cervix

ABSTRACTWe report a case of basal cell carcinoma arising in a previously radiated field after treatment of cervical cancer. Our search of the literature yielded no other case of basal cell carcinoma due to irradiation for cervical carcinoma.

Case Report

Unilateral Polycystic (Dysgenetic) Disease of the Parotid Gland

ABSTRACTWe report a case of unilateral polycystic disease of the parotid gland. Only eight cases of this disease have previously been published in the English language literature, and seven of them were bilateral. Thus, we are reporting the second case of unilateral involvement. The disease is apparently limited to the…

Primary Article

Sequential Endoscopic/Laparoscopic Management of Sickle Hemoglobinopathy‐Associated Cholelithiasis and Suspected Choledocholithiasis

ABSTRACTWe reviewed the medical records of 17 patients with sickle hemoglobinopathy-associated cholelithiasis who were candidates for laparoscopic cholecystectomy (LG) between 1991 and 1994. Eight patients with suspected choledocholithiasis (CDL) were identified, all of whom had preoperative endoscopic retrograde cholangiopancreatography (ERCP), which revealed CDL in 3 patients (18%), all of whom…


Biliary Sludging in Trauma Patients


D‐Dimer Test for HELLP Syndrome


Hereditary Multiple Glomus Tumors (Glomangiomas)