Issue - Southern Medical Association

Case Report

Suppression of Cell‐Mediated Immunity in Hypothyroidism

ABSTRACTA 71-year-old man had severe hypothroidism, chronic autoimmune thyroiditis, and bacteremia due to Edwardsiella tards. Review of the literature identified the hypothesis the E tarda infections may occur more frequently in immunocompromised patients. Previous animal studies have shown decrease in lymphocyte function during hypothyroidism, with return of normal lymphocyte function…

Acknowledgment

Long‐term Survival After Autologous Bone Marrow Transplantation for Metastatic Breast Carcinoma

ABSTRACTA phase II study of doxorubicin (Adriamycin)-based induction chemotherapy followed by cyclophosphamide/BCNU (CyBCNU) intensification and autologous bone marrow transplantation (ABMT) was conducted in 20 consecutive women with hormone-resistant metastatic breast cancer referred to our center. Of these 20 women, aged 24 to 56 (median age, 41), 9 had complete remission…

Clinical Review

Brain Imaging in AIDS

ABSTRACTAlthough central nervous system (CNS) involvement is common in the population with acquired immunodeficiency sysdrome, the presenting neurologic signs, and symptoms are often vague and nonfocal. This reresents a significant diagonostic cahllenge for the primary care physician. Cross-sectional imaging now plays an important role in the diagnosis of pathologic processes…

Primary Article

Frequency of Uncommon Abbreviations in Medical Journals

ABSTRACTAlthough the use of abbreviations not understood by the average reader is discouraged by journal editors, I nevertheless found that 43% of 147 articles published during June 1993 in eight general and surgical journals contained uncommon abbreviations. In 26 (18%) of the 147 articles, all the abbreviations and their explanatory…

Case Report

Vaginal Evisceration

ABSTRACTAn 89-year-old woman had small intestinal prolapse through the vagina while straining at stool. She had had a vaginal hysterectomy 24 years earlier. Resuscitation, reduction, and repair resulted in survival.

Primary Article

Bilateral Synchronous Testicular Germ Cell Cancer

ABSTRACTBilateral synchronous testicular cancer is a rare occurrence usually associated with similar histologic findings in each testicle. We describe eight patients with bilateral synchronous testicular germ cell cancer, of whom four had dissimilar histologic findings. Contralateral disease in three patients was identified only by testicular ultrasonography or intraoperative exploration of…

Review Article

Cefprozil, a New Cephalosporin Its Use in Various Clinical Trials

ABSTRACTCefprozil is a new oral cephalosporin with a broad spectrum of activity against a wide range of aerobic gram-positive and gram-negative organisms, as well as certain anaerobic bacteria. Cefprozil has demonstrated good stability in the presence of β;-lactamase-producing organisms, a common cause of bacterial resistance with many older β;-lactam antibiotics….

Article

Human Immunodeficiency Virus Transmission and Surgeons Update

ABSTRACTConcerns of patients and health care providers regarding disease transmission in the health care setting are not unique to the current human immunodeficiency virus (HIV) epidemic. The data show that the risk to health care workers (HCWs) from patients is far greater than the risk to patients from HCWs. Despite…

Primary Article

Blood Specimens From Patients Referred for Cytogenetic Analysis Vanderbilt University Experience From 1985 to 1992

ABSTRACTCytogenetic records were examined from consecutive nononcology blood specimens from 2,821 patients referred for cytogenetic services to Vanderbilt University Medical Center, Nashville, Tenn, from January 1985 to December 1992. We grouped the records according to reasons for referral and diagnoses. The most common reasons for referral were history of multiple…

Case Report

Group B Streptococcal Vertebral Osteomyelitis With Bacteremia

ABSTRACTGroup B streptococcal vertebral osteomyelitis is rare in adults. Osteomyelitis due to this organism is in general related to contiguous infections, recent surgery, or peripheral vascular disease. All reported cases of group B streptococcal vertebral osteomyelitis, however, have had no association with these predisposing factors and have usually been presumed…

Medical Education

The Impact of Rheumatology in the Primary Care Setting One Rheumatologist’s Odyssey

ABSTRACTI report my experience during one 6-month period as the sole rheumatologist running a weekly clinic at a small community hospital. The report illustrates the impact of rheumatologic expertise in an environment well-served by generalists and other medical subspecialists. This experience identifies important gaps in the education of generalists in…

Primary Article

Esophagopleural Fistula A Complication of Photodynamic Therapy

ABSTRACTMesotlielioma of the pleura remains an incurable disease for which novel treatments are being investigated. One of these is intraoperative photodynamic therapy (PDT), using the principle of cell cytotoxicity produced by light-activated sensitization. We report a complication of this therapy that defined the maximal tolerated dose of PDT, ie, esophagopleural…

Article

Psychiatry and the Practice of Medicine The Need to Integrate Psychiatry Into Comprehensive Medical Care

ABSTRACTPsychiatric problems are common in general medical practice and strongly influence medical utilization. A number of studies have shown the positive effects of psychiatric interventions for both medical inpatients and outpatients. Unfortunately, historic and economic forces have tended to keep the medical and mental health components of care separated. This…

Case Report

Bilateral Endobronchial Non‐Hodgkin’s Lymphoma

ABSTRACTPulmonary involvement with non-Hodgkin's lymphoma, while well recognized, is less common than with Hodgkin's lymphoma. Endobronchial non-Hodgkin's lymphoma is even rarer and usually occurs in the presence of disseminated disease. We present a case of bilateral endobronchial non-Hodgkin's lymphoma.

Primary Article

Hospital‐Based Alcohol and Drug Specialty Consultation Service Does it Work?

ABSTRACTThe goals of this report are to describe the development of an inpatient-based alcohol and drug abuse consultation service in a university hospital. At the University of Wisconsin Hospital, we collected data on baseline diagnosis, health services, and costs for inpatients who received such a consultation in 1992–1993 (n =…

Primary Article

Impact of Unfunded Research in Medicine, Pathology, and Surgery

ABSTRACTThe impact of unfunded medical research (ie, research conducted with no visible means of support) has received scant attention. In this study, we counted research contributions from the 10 most-cited journals in the fields of internal medicine, pathology, and surgery. Ten consecutive articles, excluding case reports and review articles, for…

Article

Social Security Disability Guidelines for Medical Practitioners

ABSTRACTThe purpose of this paper is to introduce medical practitioners to the concepts and function of the Social Security Administration's process of awarding disability benefits. Better understanding of this massive and important program will enable physicians to focus on and present appropriate information. This will facilitate processing of applications to…

Primary Article

Are Postoperative Complications Related to Resident Sleep Deprivation?

ABSTRACTThis real-world study compares the outcome of surgery and the sleep-deprivation status of the resident surgeon. Residents who operated the day after a 24-hour on-call period were considered sleep deprived; all other resident surgeons were considered non-sleep-deprived. We retrospectively reviewed data on 6,371 surgical cases and identified 351 postoperative complications….

Primary Article

Cold Pressor Test as a Predictor of the Severity of Hypertension

ABSTRACTThis report examines the cold pressor test (CPT) as it relates to the severity of hypertension. A total of 123 hypertensive patients were studied by physical examination, retinal funduscopy, chest roentgenogram, electrocardiogram, blood urea nitrogen measurement, and urinalysis. Casual and valid basal resting blood pressure determinations were made, followed by…

Case Report

Tuberculous Otitis Media

ABSTRACTTuberculous otitis media (TOM) is a rare cause of chronic suppurative infection of the middle ear and mastoid. The increasing incidence of tuberculosis in the United States may be associated with more cases of TOM than recognized previously. Patients typically have a chronic tympanic membrane perforation and ear drainage associated…

Case Report

Prolonged Survival in Carcinomatous Meningitis Associated With Breast Cancer

ABSTRACTWe describe a patient who survived for more than 7 years after the diagnosis of meningeal carcinomatosis associated with breast cancer. Meningeal carcinomatosis occurs in 1% to 5% of patients with breast cancer. The median survival ranges from 3 to 7 months, but most reports include a small number of…

Primary Article

Pentobarbital Sedation for Patients in the Pediatric Intensive Care Unit

ABSTRACTWe present our experience with pentobarbital for sedation during mechanical ventilation in six infants when fentanyl and midazolam failed. The patients ranged in age from 2 to 17 months and in weight from 3.0 to 11.4 kg. Before the switch to pentobarbital, the maximum doses of fentanyl ranged from 7…

Case Report

Cocaine‐Induced Ischemic Cerebral Infarction Mistaken for a Psychiatric Syndrome

ABSTRACTWe present the case of a 39-year-old woman who developed an ischemic cerebral infarction after using cocaine. Initially the patient was thought to suffer from a psychiatric disorder, and a computed tomography (GT) scan at the time of admission was entirely normal. Further evaluation of the patient by staff on…

Acknowledgment

Teohnetium Tc 99m Sestamibi Scan for Localizing Abnormal Parathyroid Glands After Previous Neck Operations Preliminary Experience in Reoperative Cases

ABSTRACTWe used technetium Tc 99m sestamibi for successful preoperative localization of abnormal parathyroid glands in nine patients with hyperparathyroidism and a history of neck surgery. The intraoperative and pathologic findings were correlated with the preoperative technetium-sestamibi scan results. These nine patients had had 13 previous neck operations, two for thyroid…

Acknowledgment

BOOKS RECEIVED

Editorial

DOES NORMALIZATION OF BLOOD GLUCOSE REDUCE THE COMPLICATIONS OF DIABETES?

Correspondence

Malingered Pregnancy

Correspondence

Pseudothrombophlebitis in Neuropathic Arthropathy of the Shoulder

Correspondence

Sclerotherapy for Malignant Pleural Effusions Alternatives to Tetracycline

Correspondence

Unilateral Adrenal Hyperplasia

Editorial

WITH ALL DUE RESPECT