Issue - Southern Medical Association

Case Report

Diarrhea-Associated Hemolytic-Uremic Syndrome in a Child With Nail-Patella Syndrome

ABSTRACT: A 5-year-old girl with nail-patella syndrome had diarrhea-associated hemolyticuremic syndrome. Nail-patella syndrome is associated with a glomerulopathy characterized by the presence of fibrillar collagen within the glomerular basement membrane. Hemolyticuremic syndrome has also been reported in patients with collagen type III glomerulopathy, a disorder also characterized by the presence…

Case Report

Laser-Assisted Ablation of Renal Hemangioma

ABSTRACT: A symptomatic renal hemangioma was successfully ablated with a ureteropyeloscope and Nd:YAG laser.

Case Report

Chronic Hemoptysis: An Unusual Manifestation of Fungal Sinusitis

ABSTRACT: A woman with chronic hemoptysis as her only complaint had extensive testing and did not respond to antibiotic therapy. Radiologic examination of the sinuses identified a mass which, on surgical exploration, was found to be the result of a fungus, Pseudallescheria boydii. Although this fungus is known to be…

Case Report

Skin Necrosis Indicating Antiphospholipid Syndrome in Patient With AIDS

ABSTRACT: Although antiphospholipid antibodies have been detected in patients with human immunodeficiency virus (HIV) disease, the clinical manifestations of the antiphospholipid syndrome are extremely rare. We describe a woman with acquired immunodeficiency syndrome (AIDS) and elevated antiphospholipid antibodies who developed necrotic skin lesions and was subsequently shown to have antiphospholipid…

Primary Article

Radiation Therapy for Pancreatic Cancer A Retrospective Study of the University of Louisville Experience

ABSTRACT: Although multiple regimens and approaches have been used in attempts to treat pancreatic cancer, the 5-year disease-free survival is dismal. With an increase in incidence of pancreatic cancer over the past 35 years, researchers continue their efforts to find an effective treatment for this aggressive disease. Between January 1983…

Primary Article

Development and Validation of a Scaled Questionnaire for Evaluation of Residency Programs

ABSTRACT: As residency programs adapt to the need to promote primary care, the importance of quantitating qualitative issues increases. In this study, a questionnaire based on reported residency stressors was answered by 238 internal medicine residents. The Profile of Mood States (POMS) was also completed by 64. Factor analysis derived…

Case Report

Generalized Elastolysis (Cutis Laxa) Case Study Illustrating Associated Medical and Surgical Conditions

ABSTRACT: Cutis laxa is grouped with the other hyperelastic skin conditions, but it shows almost total lack of skin elasticity. Numerous other medical and surgical conditions may coexist with the skin problem, since it is a generalized affliction of the supporting connective tissues. Our patient had cutis laxa proved by…

Primary Article

Acute Myocardial Infarction in Oklahoma Are We Different?

ABSTRACT: Data regarding 787 patients admitted to Saint Francis Hospital in Tulsa, Oklahoma, with acute myocardial infarction (MI) were analyzed to determine circadian variation and to assess demographic and anatomic characteristics. The study population consisted of 634 men (81%) and 153 women (19%). This cohort displayed a circadian rhythm that…

Case Report

Hemolytic Jaundice Due to G6PD Deficiency Causing Kernicterus in a Female Newborn

ABSTRACT: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inherited deficiency of an enzyme necessary to protect the erythrocyte from oxidative stress and hemolysis. Without this enzyme, affected neonates are at risk for acute onset of hemolytic jaundice and severe sequelae, from hearing loss and mild retardation to kernicterus. In some populations,…

Case Report

Fever of Unknown Origin Following an Upper Gastrointestinal Series in a Patient With Polycystic Kidney Disease

ABSTRACT: Hematomas as a source of fever have been well recognized. We describe a patient with polycystic kidney disease (PCKD) who developed a fever of unknown origin following an upper gastrointestinal (UGI) series. Workup revealed a hemorrhagic cyst of a kidney at the level of the duodenum, where a paddle…

Case Report

Squamous Cell Carcinoma of the Lung With Metastasis to the Penis

ABSTRACT: Neoplasms metastatic to the penis are uncommon. Metastatic lesions from the lung to the penis are rare, with only eight case reports in the world literature. In this report we describe a patient with a single metastatic lesion to the penis and bilateral adrenal metastases from recurrent squamous cell…

Clinical Review

Diagnosing Depression After Stroke

ABSTRACT: Neurobehavioral sequelae of strokes can limit a patient's ability to describe or express emotion, can cause him to give “yes” answers to the clinician who expects them, or can directly cause apathy or crying spells. Also, anosognosia for depressive signs can cause the patient to deny depressive signs that…

Primary Article

A Comparison of Magnesium Sulfate and Indomethacin to Magnesium Sulfate Only for Tocolysis in Preterm Labor With Advanced Cervical Dilation

ABSTRACT: Preterm labor becomes more difficult to inhibit as the degree of cervical dilation increases. Indeed, some physicians do not even attempt tocolysis with advanced cervical dilation. We compared single-versus double-agent tocolytic therapy when the cervix was dilated 3 cm or greater. We conducted a retrospective study of 44 patients…

Case Report

Rectal Bleeding Due to Nonspecific Colitis in Premature Infants

ABSTRACT: Rectal bleeding is not uncommon in newborn infants. Anal fissures are regarded as the most common cause. We report two cases in which the presence of an anal fissure delayed the diagnosis of nonspecific colitis in premature infants. Rectosigmoidoscopic and biopsy findings are discussed with regard to the heterogeneous…

Article

Promotion of Sexual Abstinence Reducing Adolescent Sexual Activity and Pregnancies

ABSTRACT: The prevention of unplanned pregnancies has become a national public health priority. To assure that every newborn child in America is planned and wanted, three strategies are to be implemented: expansion of school-based sex education, expansion of free condom distribution, and expansion of the role of school-based health clinics….

Primary Article

Multiple Fire Ant Stings Indoors

ABSTRACT: The progressive spread and increasing colony density of imported fire ants throughout the southeastern United States will result in increasing numbers of individuals with untoward reactions to the stings of these insects. In order to alert physicians that imported fire ant colonies may exist within homes and other inhabited…

Primary Article

Does Smokeless Tobacco Cause Hypertension?

ABSTRACT: This article reviews the literature regarding the cardiovascular effects of smokeless tobacco use. Articles were identified using a MEDLINE search of the English-language literature from 1966 to 1992 and a manual search of bibliographies of identified articles. From 875 articles regarding smokeless tobacco, 12 pertinent articles were identified. Smokeless…

Primary Article

Survey of Clinical Breast Examinations and Use of Screening Mammography in Florida

ABSTRACT: This study examined data on usage of screening mammograms and clinical breast examination (CBE) by 1,339 Florida women interviewed during the 1991 Behavioral Risk Factor Surveillance Survey. Among women 20 to 40 years old, 87.3% reported a CBE within the past 3 years, exceeding the guidelines of the American…

Case Report

Caroli’s Disease Complicating Pregnancy

ABSTRACT: We describe two pregnancies in the same patient with Caroli's disease (congenital dilatation of the intrahepatic bile ducts). The first pregnancy was uneventful concerning the maternal Caroli's disease. The second pregnancy highlights the serious and potentially lethal complications of an acute episode to both the fetus and mother. The…

Case Report

Myonecrosis Due to Clostridium septicum in a Patient With Unexplained Neutropenia Successful Treatment With Granulocyte Colony-Stimulating Factor

ABSTRACT: We report a case of sepsis due to Clostridium septicum successfully treated with granulocyte colony-stimulating factor (GCSF). This case prompted our review of clostridial sepsis and considerations regarding the use of GCSF in cases of drug-induced neutropenia.

Primary Article

Unintentional Weight Loss in Long-term Care: Predictor of Mortality in the Elderly

ABSTRACT: We retrospectively reviewed the medical records of 153 long-term care residents. Of these, 24 had lost at least 5% of their body weight during a 1-month interval. An unmatched control group of 51 patients was randomly selected from the remaining patients. Subjects who lost at least 5% body weight…

Case Report

Zenker’s Bezoar

ABSTRACT: Zenker's diverticulum has been associated with a variety of symptoms such as dysphagia, regurgitation, aspiration, halitosis, and occasionally cough. In this case, a large Zenker's diverticulum containing a bezoar caused a persistent, debilitating cough presumably due to compression of adjacent neck structures.

Case Report

Recurrent Bilateral Spontaneous Pneumothoraces Associated With Pulmonary Angiocentric Immunoproliferative Lesion

ABSTRACT:A 28-year-old man had a left pneumothorax and diffuse reticulonodular infiltrates. He subsequently had a right pneumothorax and manifested bilateral recurrences after treatment of the initial pneumothoraces. Pulmonary angiocentric immunoproliferative lesion was diagnosed by open lung biopsy. Treatment with combination chemotherapy improved the infiltrates, but failed to prevent another pneumothorax….

Editorial

A CAUSE FOR COMMITMENT

Correspondence

Focal Nodular Hyperplasia of the Liver

Correspondence

Food Nodular Hyperplasia of the Liver Reply

Correspondence

Snake Bites

Correspondence

Two Enigmas in One Patient: TTP and SLE