Issue - Southern Medical Association

Case Report

Hepatic Iron Overload Associated With Self-Medication

ABSTRACT: A patient with the incidental finding of an elevated serum ferritin level was found to have hepatic iron overload associated with iron injections. Liver disease is an example of one of the potential complications of folk remedies or patient self-medication that physicians may encounter, especially along the US-Mexican border.

Case Report

Training Room Evaluation of Chest Pain in the Adolescent Athlete

ABSTRACT: A physician or athletic trainer will often be faced with an athlete complaining of chest pain during or after an event. Chest pain in children and adolescents is usually of a noncardiac origin; only 5% of cases are due to cardiac problems. With a properly documented history and physical…

Case Report

Myelolipoma of the Adrenal Gland: A Case Report

ABSTRACT: Adrenal myelolipomas are rare benign neoplasms composed of mature fat and bone marrow elements. Most are asymptomatic tumors found incidentally at postmortem examinations. We report the natural history of an adrenal myelolipoma in a middle-aged man over a 6-year interval.

Case Report

Disseminated Histoplasmosis in a Patient From a Nonendemic Area Who Has Acquired Immunodeficiency Syndrome

ABSTRACT: Disseminated histoplasmosis is a serious opportunistic infection in patients with the acquired immunodeficiency syndrome (AIDS), often seen as the first manifestation of the syndrome. However, cases are reported almost exclusively from patients who live in or have traveled to endemic areas. We describe a case of disseminated histoplasmosis in…

Case Report

Multiple Symmetrical Lipomatosis: Computed Tomographic Appearance

ABSTRACT: In a case of localized multiple symmetrical lipomatosis (Madelung's disease), we examined the cervical fat accumulation by computed tomography. We describe the radiographic features of this process and briefly review the pathophysiology of this rare disorder.

Primary Article

Epilepsy Surgery: Removing the Thorn From the Lion’s Paw

ABSTRACT: In the United States, 10,000 to 20,000 patients have epilepsy uncontrolled by medication. The addition of a second-line drug to the primary regimen has a 2% to 11% chance of controlling the seizures. We present a series of 35 patients with intractable epilepsy who had surgical resection of their…

Case Report

Perforation of a Meckel’s Diverticulum During Laparoscopic Cholecystectomy

ABSTRACT: Laparoscopic procedures incur risks and complications that differ from their “open” counterparts. Although rare, injury to asymptomatic umbilical remnants (eg, Meckel's diverticulum) is one of these unique complications.

Article

Understanding Federal Medical Device Statutes and Their Application to Various Penile Prostheses

ABSTRACT: Medical devices have become an important component of our professional armamentarium. This paper exposes the practitioner to the Food and Drug Administration and its control over medical devices. Specifically, the 1976 amendment to the Food and Drug Administration Acts is described, along with the subsequent federal laws. Because of…

Case Report

Microangiopathic Hemolytic Anemia as an Initial Presentation of Metastatic Cancer of Unknown Primary Origin

ABSTRACT: Microangiopathic hemolytic anemia (MAHA) is a well-documented but rare complication of disseminated cancer; it usually occurs in the late or terminal stage of cancer. We describe a case of metastatic carcinoma of unknown origin in which MAHA was the initial presentation. A 36-year-old woman came to our hospital with…

Case Report

Extra-Adrenal Myelolipoma: Report of Two Cases

ABSTRACT: Myelolipomas are benign tumors composed of an admixture of mature adipose tissue and normal hematopoietic cells. The vast majority occur within the adrenal glands, but several extra-adrenal myelolipomas (EAMLs) have been reported. The typical EAML is a solitary, well-defined mass within the abdomen, most commonly in the retroperitoneal presacral…

Case Report

Primary Lymphoma of the Liver Mimicking Metastatic Liver Disease

ABSTRACT: Primary lymphoma of the liver is rare. In the 50 previously reported cases in the literature, computed tomography usually showed a solitary, bulky hypodense area in the liver. We report a case of primary lymphoma of the liver presenting multiple lesions in the liver and clinical and biochemical evidence…

Case Report

Progressive Pulmonary Cryptococcosis in a Patient Who Is Immunocompetent

ABSTRACT: Pulmonary cryptococcal disease can have variable clinical and roentgenographic presentations. Symptoms and radiographic abnormalities can resolve prior to therapy, even in a patient who is immunocompromised. Antifungal therapy is generally not recommended for a patient who is immunocompetent with nonprogressive, nondisseminated pulmonary cryptococcosis. We present a case of pulmonary…

Case Report

Association of Systemic Lupus Erythematosus and Gluten Enteropathy

ABSTRACT: Systemic lupus erythematosus presents various clinical manifestations. The coexistence of systemic lupus erythematosus and celiac sprue has been rarely reported. We present a patient who had systemic lupus erythematosus with malabsorption demonstrating characteristic clinical and pathologic findings of celiac sprue (gluten enteropathy).

Primary Article

Alfentanil for Conscious Sedation During Colonoscopy

ABSTRACT: This investigation was designed to determine whether the narcotic alfentanil, a relatively new fentanyl derivative with rapid onset of action and offset of activity, alone or in combination with midazolam has advantages over the traditional meperidine and midazolam regimen for conscious sedation. Thirty-five subjects were randomized to receive an…

Primary Article

Hurricane Andrew-Related Injuries and Illnesses, Louisiana, 1992

ABSTRACT: To determine the extent and types of injuries and illnesses in Louisiana associated with or related to Hurricane Andrew, we gathered data from hospital emergency departments and coroner's offices on demographic variables, institution, nature and cause of the injury or illness, body part affected, location, and date and time…

Primary Article

Significance of Solitary and Multiple Esophageal Ulcers in Patients With AIDS

ABSTRACT: We endoscopically evaluated odynophagia and/or dysphagia in 23 patients with acquired immunodeficiency syndrome (AIDS). Eleven patients (48%) were found to have esophageal ulcers. Seven of them had deep, sharply demarcated, well-circumscribed ulcer craters with raised edges; in two the ulcer extended to the muscularis propria. Ulcers were single in…

Case Report

Tracheoesophageal Fistula as the Initial Presentation of Hodgkin’s Disease

ABSTRACT: We present a rare example of a tracheoesophageal fistula as the initial manifestation of Hodgkin's disease.

Case Report

Torsion, Necrosis, and Inflammation of an Epiploic Appendix of the Large Bowel A Diagnostic and Therapeutic Dilemma

ABSTRACT: We present the case of a young patient with abdominal pain of 3 weeks' duration and a preoperative presumptive diagnosis of acute appendicitis, diverticulitis, colon perforation, or possibly neoplasm. Even after resection of a large mass involving the right colon, the diagnosis was not confirmed until surgical pathology identified…

Case Report

Gold Pulmonary Toxicity in a Patient With a Normal Chest Radiograph

ABSTRACT: We report a case of gold pulmonary toxicity in a patient with adult-onset Still's disease with dyspnea on exertion and a normal chest radiograph. Withdrawal of gold therapy resulted in complete resolution of pulmonary toxicity in our patient without the need for additional steroid therapy.

Case Report

Intramural Gastric Actinomycosis

ABSTRACT: We report a case of intramural gastric actinomycosis and review the features of the additional 16 cases of this uncommon infection reported in the literature. The patient had gastrointestinal symptoms, weight loss, and fever after gastric operation. At laparotomy, an infiltrating gastric tumor-like lesion was found. Histology revealed actinomycosis,…

Article

Lessons Learned From Hurricane Andrew Recommendations for Care of the Elderly in Long-Term Care Facilities

ABSTRACT: We report on the experience of a 500-bed, long-term care facility in Miami, Fla, which provides housing and nursing care units for patients—ranging from those who are independendy ambulatory to those who are acutely ill and feeble—in preparing for, during, and in the immediate aftermath of Hurricane Andrew, which…

Correspondence

Altered Responses to Medications Exposed to Excessive Temperatures During Shipping

Correspondence

Fingerstick Glucose Determination and CPR

Correspondence

Fingerstick Glucose Determination and CPR Reply

Editorial

HEALTH SYSTEM REFORM: WHITHER THE ACADEMIC MEDICAL CENTER?

Editorial

OVERHEATING OF DRUGS DURING SHIPPING AND STORAGE

Editorial

TO CARE FOR HEALTH

Correspondence

Tuberculous Mastitis

Correspondence

Tuberculous Mastitis Reply