Issue - Southern Medical Association

Case Report

Malignant Teratoma of the Testicle Diagnosis Suggested by Preoperative Ultrasonography

ABSTRACTA 22-year-old white man was found to have malignant teratoma of the testicle (nonseminomatous germ cell testicular tumor), which had been suggested by ultrasonography. Modified template retroperitoneal lymphadenectomy with nerve sparing showed no microscopic metastatic tumor.

Case Report

Diaphragmatic Myoclonus Diagnosis by Fluoroscopy and Electromyography With Response to Phenytoin

ABSTRACTA 40-year-old woman presented a 6-week history of “fluttering” in her chest. A diagnosis of bilateral diaphragmatic myoclonus was made by fluoroscopy and electromyography of both hemidiaphragms. No central or peripheral cause was identified, but treatment with intravenous phenytoin had an immediate effect. With therapy, she has been symptom free…

Case Report

Diagnosis of Probable Cocaine‐Induced Cerebral Vasculitis by Magnetic Resonance Angiography

ABSTRACTCocaine-induced cerebral vasculitis is a serious but uncommon clinical entity. We present a case of probable cocaine-induced cerebral vasculitis that was unusual in that it was suggested by magnetic resonance angiography. The patient was a 42-year-old woman, who used cocaine both intravenously and intranasally, who was admitted with the acute…

Current Concepts

The Digital Toolbox for Teaching

ABSTRACTContinued improvements in computer technology have led to significant enhancement of clinical teaching. We describe a “digital toolbox” consisting of personally accessible hardware and software products to assist in clinical teaching. The areas covered are computer-assisted diagnosis, digitization and display of clinical materials, archiving of digitized clinical materials, and decision…

Case Report

Desmoplastic Fibroma A Role for Radiotherapy?

ABSTRACTDesmoplastic fibroma is a rare, locally aggressive, benign tumor that is considered the skeletal counterpart of the desmoid tumor of soft tissues. Although the treatment of choice of desmoplastic fibroma is surgical excision, radiation therapy should be considered when surgery is not a viable option.

Current Concepts

Vascular and Other Serious Infections With Mycobacterium bovis After Bacillus of Calmette‐Guérin Therapy for Bladder Cancer

ABSTRACTIntravesical application of bacillus of Calmette-Guérin (BCG) has proved to be an effective form of treatment for some stages of bladder cancer. Infrequent, serious complications of this treatment have become apparent as its use has become more widespread. We report a case of Mycobacterium bovis mycotic abdominal aortic aneurysm and…

Current Concepts

Late Generalized Tuberculosis Unusual Features of an Often Overlooked Disease

ABSTRACTLate generalized tuberculosis—ie, disseminated tuberculosis occurring long after the primary infection—is an often unrecognized cause of severe illness in patients with relative immunocompromise, such as the elderly, alcoholics, or those with chronic illnesses. It has become increasingly recognized in the elderly as a cause of a gradual debilitating illness, often…

Current Concepts

Detection of Specific Antibodies in Human Blastomycosis by Enzyme Immunoassay

ABSTRACTSerologic tests for the diagnosis of blastomycosis have had inadequate sensitivity, but results are improved with enzyme immunoassay (EIA) with A-antigen of Blastomyces dermatitidis. The Premier Blastomyces EIA kit (Meridian Diagnostics Inc, Cincinnati, Ohio) detected antibody against the B dermatitidis A-antigen in sera from 104 of 125 patients (83%) with…

Current Concepts

An Evaluation of the Safety and Efficacy of Fluconazole in the Treatment of Onychomycosis

ABSTRACTSixteen subjects were enrolled in this open-label noncomparative study to evaluate the safety and efficacy of fluconazole as a single daily dose for a period of 6 months. Liver function enzymes were monitored to assess safety. An adverse reaction questionnaire was used on a monthly basis to assess patient tolerance….

Case Report

Splenic Lymphoma With Villous Lymphocytes Diagnosis by Flow Cytometry and Immunocytochemistry

ABSTRACTSplenic lymphoma with villous lymphocytes (SLVL) is a recently described low-grade non-Hodgkin's lymphoma diat may be confused with chronic lymphocytic leukemia and hairy cell leukemia. Herein we report a case of SLVL and show how clinical features, cellular morphology, and flow cytometric analysis are used to distinguish among these three…

Current Concepts

Pica in a Rural Obstetric Population

ABSTRACTThe incidence of pica during pregnancy has been reported to range from 0% to 68% depending on the patient population. This study was designed to define characteristics and factors influencing the practice of pica in a rural obstetric population. Our study group was 125 consecutive pregnant women who were interviewed…

Clinical Review

Pseudohypertension

ABSTRACTThe purpose of this review is to integrate information available regarding pseudohypertension. A MEDLINE search (1966 to December 1993) was conducted using the key words pseudohypertetision and Osler's maneuver. All articles containing reference to pseudohypertension were selected and reviewed. Additional articles were obtained from the citations included within these articles….

Current Concepts

Physician Religious Beliefs and the Physician‐Patient Relationship A Study of Devout Physicians

ABSTRACTThe purpose of this study was to determine the type and frequency of religious interactions that occur between devout physicians and their patients. Physicians identified by their peers as having religious or spiritual beliefs that were an important part of their lives were surveyed. Forty physicians responded (response rate 77%)….

Current Concepts

Ectopic Pregnancy Ultrasonographic Diagnosis and Interpretive Pitfalls

ABSTRACTThe ultrasonographic evaluation of ectopic pregnancy is fraught with potential pitfalls in image interpretation. Though recent advances in sonographic techniques have improved the precision and scope of the study, considerable expertise is still needed to perform and interpret the sonogram for a suspected ectopic gestation. In this article, we review…

Current Concepts

Herpetic Geometric Glossitis A Distinctive Pattern of Lingual Herpes Simplex Virus Infection

ABSTRACTTwo immunocompromised patients with herpetic geometric glossitis, a clinically distinctive form of lingual herpes simplex virus (HSV) type 1 infection, are described. The significant features of herpetic geometric glossitis are summarized, the clinical differential diagnosis of this form of HSV infection is reviewed, and the possible pathogenesis of these lingual…

Current Concepts

Malpractice Litigation Fear and Risk Management Beliefs Among Teaching Hospital Physicians

ABSTRACTWe address four major issues related to physicians' fear of litigation: What are physicians' attitudes and beliefs toward malpractice? To whom or what do they attribute the “malpractice crisis”? Is fear of litigation associated with demographic and practice variables? What measures do physicians take to reduce risk? Hospital physicians in…

Current Concepts

Evaluation of the Psychosocial Impact of the MiniMed Variable‐Rate Implantable Insulin Pump

ABSTRACTWe examined the psychosocial impact of treatment with an implantable insulin pump among persons with insulin-dependent diabetes mellitus (IDDM). Of specific interest was whether use of the MiniMed implantable insulin pump (MIP) resulted in changes in functional status, performance of diabetes self-care behavior, psychologic symptoms, and perceived level of stress….

Current Concepts

Are Learning Objectives Useful in Evaluating Medical School Course and Instructor Performance?

ABSTRACTWe tested the hypothesis that learning objectives could be used to evaluate course and instructor effectiveness. Ninety-seven third-year medical students who had their surgical clerkship or their medical clerkship as their first clinical rotation were compared. The surgery clerks received 171 urologic learning objectives. Students taking the surgical clerkship had…

Editorial

AN ESSAY ON THE EDITORIAL

Correspondence

Rationing Health Care

Correspondence

Raynaud’s Phenomenon and Anorexia Nervosa

Correspondence

Rectal Examinations and Appendicitis Malpractice Claims