Case Report

Granulocyte Colony Stimulating Factor in the Treatment of Alcohol Abuse, Leukopenia, and Pneumococcal Sepsis

ABSTRACTA 32-year-old woman was admitted with alcoholism, leukopenia, and pneumococcal sepsis (ALPS). Standard treatment consists of antibiotics, vitamin replacement, and intensive care unit support. Even with this treatment, the mortality rate is exceedingly high. In addition to standard therapy, this patient received subcutaneously 300 μg granulocyte colony stimulating factor (G-CSF)…

Case Report

Asymptomatic Extralobar Sequestration in a 43‐Year‐Qld Woman

ABSTRACTA 43-year-old white woman had an asymptomatic left lower lobe density on a chest roentgenogram. She had a past history of biopsy-proven sarcoidosis in 1984 that resolved without corticosteroids. A midsystolic click was heard on cardiac examination. Computed tomography (CT) revealed an extralobar pulmonary sequestration in the left base. Rapid…

Case Report

Metastatic Breast Carcinoma to the Os Calcis Presenting as Heel Pain

ABSTRACTA 47-year-old woman who had been treated for breast carcinoma 11 years previously developed significant heel pain of unclear etiology, which ultimately proved to be metastatic adenocarcinoma. A low index of suspicion and falsely negative plain radiographs contributed to a delay in diagnosis. No other osseous metastases besides those to…

Case Report

Primary Pulmonary Non‐Hodgkin’s Lymphoma

ABSTRACTA 48-year-old woman with an asymptomatic lung mass on a routine chest roentgenogram was found to have a primary non-Hodgkin's lymphoma involving the lung. Extensive evaluation revealed no evidence of lymphoma at any other site. She required an open lung biopsy for definitive diagnosis and was found to have unresectable…

Case Report

Epidural Corticosteroid Injections for Acute Radiculopathy in a 95‐Year‐Old Woman

ABSTRACTA previously independent 95-year-old woman had acute, disabling left lumbosacral radiculopathy diagnosed by clinical findings and imaging studies. Significant side effects of oral nonsteroidal and narcotic medications led to treatment with epidural steroids (triamcinolone acetonide). These injections provided pain relief, allowing a short course of inpatient rehabilitation that improved the…

Case Report

Decompression Sickness in a Private Pilot

ABSTRACTAlthough safe, civil aviation can result in some unique medical problems. Most physicians are not familiar with aviation-related medical problems. One such problem, decompression sickness, is not mentioned in most medical texts, and is not included in most medical school instruction. If not promptly recognized and treated, decompression sickness can…

Case Report

Hiccups Due to Gastroesophageal Reflux

ABSTRACTHiccups (singultus) are most often a transient phenomenon that resolves without medical therapy. Intractable hiccups can be an indication of a serious underlying disease process and should be investigated. To demonstrate the evaluation of intractable singultus, we describe a patient who had unsuccessful outpatient therapy for persistent hiccups and who…

Review Article

Hiccups

ABSTRACTHiccups result from a variety of causes and serve no known physiologic function. Although most episodes are time-limited, hiccups may become protracted, with serious consequences. Assessment of hiccups entails a focused history and physical examination coupled with selected laboratory tests. If a correctable malady is discovered, treatment should address the…

Primary Article

Epidemiology of Salmonellosis in Arkansas

ABSTRACTHuman salmonellosis continues to be a major public health issue. Our epidemiologic review of cases from 1989 to 1992 was done to define the current reported rate of infection due to Salmonella species for the state of Arkansas, which might be expected to have higher rates of infection because it…

Current Concepts

Nutrition Concepts for the Primary Care/Generalist Physician

ABSTRACTImportant nutrition concepts will aid primary care/generalist physicians to implement practical aspects of health promotion and disease prevention in their practice, and improve the overall health of their patients. In today's society, chronic diseases that are related variably to overnutrition and dietary excesses or imbalances (obesity, diabetes mellitus, hypertension and…

Case Report

Angiotropic Large Cell Lymphoma

ABSTRACTLymphomas are malignant neoplasms of cells native to lymphoid tissue that can arise anywhere in the body. Angiotropic large cell lymphoma (ALCL) is characterized by a proliferation of neoplastic mononuclear cells within the lumina of small blood vessels. The clinical manifestations are usually neurologic, including progressive dementia and nonlocalizing deficits,…

Primary Article

Prader‐Willi Syndrome Effect of Group Home Placement on Obese Patients With Diabetes

ABSTRACTMorbid obesity and type II diabetes, common complications of Prader-Willi syndrome (PWS), are difficult to manage in the home setting. We assessed the effect of specialized group home placement on these complications in eight individuals with PWS, all of whom were obese and four of whom had type II diabetes….

Primary Article

Physician Understanding of the National Practitioner Data Bank

ABSTRACTNational Practitioner Data Bank (NPDB) reports are part of the process for acquiring staff privileges, professional credentials, and licenses throughout a physician's entire career. We surveyed our hospital's 66 residents to assess their understanding of NPDB. Only 9 residents had heard about NPDB. A follow-up survey of the 10 medical…

Case Report

Bilateral Breast Carcinoma After Radiation Therapy for Hodgkin’s Disease

ABSTRACTThe success of modern cancer therapy is resulting in an increasing number of long-term cures. The price of success, however, is the incidence of treatment-related morbidity and mortality. The physician should be aware of the potential sequelae of cancer therapy. A case of bilateral breast cancer occurring 13 years after…

Clinical Review

Pathogenesis, Recognition, and Management of Common Cardiac Arrhythmias. Part II Supraventricular Premature Beats and Tachyarrhythmias

ABSTRACTThis review of supraventricular premature beats and tachyarrhythmias includes discussions of atrial and atrioventricular junctional premature beats, the reentry supraventricular tachycardias, the automatic supraventricular tachycardias, atrial fibrillation, and atrial flutter.

Primary Article

Predictive Validity of Medical Student Choices of Practice Location

ABSTRACTWe compared University of Alabama medical students' 1980–1981 practice location and specialty preferences with actual practice locations and specialties in 1991 with the following results. (1) Primary care physicians were located mostly in small or large communities, whereas larger than expected numbers of subspecialists practiced in smaller cities. (2) Actual…

Case Report

Parainfluenza Virus Type 2 Meningitis and Parotitis in an 11‐Year‐Old Child

ABSTRACTWe describe the case of an 11-year-old Bolivian boy with parotitis and aseptic meningitis to demonstrate that parainfluenza virus type 2 can cause disseminated infection in a normal child. Parainfluenza virus type 2 was isolated from nasopharyngeal and CSF specimens from the patient and was confirmed to be parainfluenza virus…

Primary Article

Laparoscopic Plication of Perforated Ulcer Results of a Selective Approach

ABSTRACTWe reviewed our experience with laparoscopy for perforated ulcer from April 1, 1992, to March 31, 1993. All patients admitted to the gastrointestinal surgery service with a diagnosis of perforated viscus had evaluation for possible laparoscopic Graham plication (LGP). Of eight patients considered, five had successful diagnostic laparoscopy. Two patients…

Correspondence

Choosing Lithium, Anticonvulsant, or Electroconvulsant Therapy for Mood Disorders

Editorial

FORECASTING WEATHER AND MAKING DIAGNOSES

Correspondence

Rocky Mountain Spotted Fever Versus Lyme Disease

Editorial

SCHOLARSHIP PROGRAM TO RECOGNIZE MEDICAL EXCELLENCE

Correspondence

To the Editor

Correspondence

Transverse Incisions for Biopsies