Issue - Southern Medical Association

Case Report

Atrophy of Hand Muscles Associated With Gastric Cancer: Coincidence or Paraneoplastic Manifestation?

ABSTRACT: A case of a stage IB gastric cancer associated with spontaneous muscle atrophy of both hands is reported. The cause of this atrophy was not apparent with current neurologic diagnostic modalities. Although the association of gastric cancer with muscle atrophy may be coincidental, it may be part of a…

Primary Article

Surgery for Obstructive Sleep Apnea Effects on Sleep, Breathing, and Oxygenation

ABSTRACT: Advances in the treatment of obstructive sleep apnea have evolved rapidly over the past two decades. Nasal continuous positive airway pressure (CPAP) devices are effective, but are neither curative nor universally well tolerated. Uvulopalatopharyngoplasty (UPPP) has been reported to have widely varying success rates; many studies of this procedure…

Primary Article

Physicians’ Perceptions Regarding Body Temperature in Health and Disease

ABSTRACT: Although body temperature has been monitored for more than a century as a means of distinguishing health from disease, physicians' perceptions of concepts of clinical thermometry are largely unknown. To characterize such perceptions, we did a descriptive analysis of responses to a survey questionnaire dealing with body temperature. Seventy-five…

Case Report

Fatal Bacillus cereus Meningoencephalitis in an Adult With Acute Myelogenous Leukemia

ABSTRACT: Bacillus cereus, a ubiquitous, endospore-forming, aerobic gram-positive bacillus, is primarily associated with toxin-mediated food poisoning. Frequently, isolates of Bacillus species from clinical specimens are dismissed as contaminants. We report a rapidly fatal case of disseminated infection due to B cereus in a patient receiving induction chemotherapy for MO acute…

Case Report

Bronchiolitis Obliterans Organizing Pneumonia Cured by Standard Dose Inhaled Triamckiolone: The First Documented Case

ABSTRACT: Bronchiolitis obliterans organizing pneumonia (BOOP) is characterized clinically by progressive cough, fever, and dyspnea and pathologically by plugging of the bronchiolar and alveolar lumen with buds of loose connective tissue containing fibroblasts and inflammatory cells. The radiographic appearance of the disease varies. Definitive diagnosis requires the histologic identification of…

Primary Article

Computed Tomographic Findings in Pseudomembranous Colitis: An important Clue to the Diagnosis

ABSTRACT: Computed tomography (CT) is increasingly used to evaluate abdominal diseases, including those of the colon. Recent CT studies have documented colonic abnormalities in patients with pseudomembranous colitis; however, these, findings are not widely appreciated by primary care physicians. Over a 25-month period, we prospectively identified 13 patients who had…

Case Report

Treatment of Idiopathic Pulmonary Hemosiderosis With Inhaled Flunisolide

ABSTRACT: Idiopathic pulmonary hemosiderosis (IPH), a rare clinical entity, is characterized by bleeding into the alveoli and progressive pulmonary fibrosis. It is usually treated with systemic corticosteroids during acute bleeding episodes and with prolonged courses of oral corticosteroids and/or other immunosuppressant drugs for maintenance therapy. Because prolonged treatment with these…

Primary Article

Eosinophilia-Myalgia Syndrome: A Long-term Follow-up Study

ABSTRACT: In this case-series analysis, of 34 patients originally identified with eosinophiliamyalgia syndrome (EMS), 31 survivors were followed-up by yearly telephone interviews. We ascertained type, duration, and severity of symptoms and whether certain patient characteristics were associated with illness improvement. At a median of 3.6 years after onset, 3 patients…

Primary Article

Corticosteroid-Induced Asthma A Manifestation of Limited Hyperinfection Syndrome Due to Strongyloides stercoralis

ABSTRACT: Inadequate therapeutic response to parenteral corticosteroids in patients with acute bronchial asthma is infrequent. We report four patients whose bronchial asthma symptoms worsened after treatment with parenteral corticosteroids. All had larvae of Strongyloides stercoralis in the stool. The new attack or the exacerbation of asthma appeared to be precipitated…

Clinical Review

Severe Obesity: Expensive to Society, Frustrating to Treat, But Important to Confront

ABSTRACT: Obesity is a major contributor to chronic and costly diseases and disabilities. More than 30% of American adults are obese, and the percentage has been rising for 20 years. A recent estimate placed the direct economic costs of obesity at more than $39.3 billion, or 5.5% of all medical…

Primary Article

Predictive Value of Postmyelographic Computed Tomography for Patients With Severe Postmyelographic Headache

ABSTRACT: Our goal was to determine if evidence of cerebrospinal fluid (CSF) leakage on routine postmyelogram computed tomography (CT) of the lumbar spine was useful in predicting subsequent development of moderate or severe headaches in patients having outpatient myelography. We reviewed postmyelogram CT studies of the lower lumbar region of…

Primary Article

Herbs and HIV: The Health Food Industry’s Answer

ABSTRACT: Patients with tragic diseases such as AIDS (acquired immunodeficiency syndrome) may be at risk for using herbal remedies and other alternative medical therapies. To ascertain what products may be available for use among AIDS patients in our community, we surveyed 20 local health food stores. Store employees were asked…

Case Report

Perineurioma

ABSTRACT: Perineurioma is a rare, probably benign peripheral nerve sheath neoplasm. Perineurial cell origin is most efficiently demonstrated immunohis to chemically by positivity for epithelial membrane antigen and negativity for S-100 protein and Leu 7.

Case Report

Unsuspected Subdural Hematoma as a Differential Diagnosis in Elderly Patients

ABSTRACT: Subdural hematomas are among the most common forms of intracranial hemorrhage encountered in clinical practice and are a surgically remediable cause of dementia. When the symptom presentation is subtle or diffuse, a subdural hematoma can be overlooked. This is especially true among elderly people who may exhibit unrelated, preexisting…

Primary Article

Relative Value of Femoral and Lumbar Bone Mineral Density Assessments in Patients With Ankylosing Spondylitis

ABSTRACT: The objective of this study was to examine the relative sensitivity of femoral and lumbar bone mineral density (BMD) measurements in patients with ankylosing spondylitis (AS) and to identify the most appropriate test site for detection of osteopenia in these patients. Fourteen patients with ankylosing spondylitis had femoral and…

Primary Article

Impact of a Personal Emergency Response System on Hospital Utilization by Community- Residing Elders

ABSTRACT: The purpose of this study was to determine whether use of a 24-hour personal emergency response system (PERS) might be associated with selected hospital utilization rates among community-residing users. Utilization rates of 106 patients were reviewed for 1 year before and 1 year after enrollment in the PERS. Self-paired…

Clinical Review

Ectopic Breast Tissue, Supernumerary Breasts, and Supernumerary Nipples

ABSTRACT: This article will review the embryology, clinical presentation, diagnosis, treatment, and clinical significance of ectopic breast tissue, supernumerary breasts, and supernumerary nipples. These structures most commonly develop along the embryonic “milk line.” Supernumerary nipples can be identified at birth, whereas ectopic breast tissue becomes noticeable only after hormonal stimulation,…

Primary Article

Combined Laparoscopy and Minilaparotomy for Outpatient Reversal of Tubal Sterilization

ABSTRACT: This retrospective study determines risks, outcomes, and cost savings in microscopic tubal sterilization reversal done by minilaparotomy. From January 1992 to December 1993, 40 women, as outpatients, had combined laparoscopy and minilaparotomy for tubal anastomosis. The mean operating time was 1.7 hours, mean blood loss was 20 mL, and…

Primary Article

Recanalization Characteristics of Intracoronary Streptokinase Compared to Intravenous Tissue Plasminogen Activator Following Acute Myocardial Infarction A Community Hospital Experience

ABSTRACT: This study compares the recanalization characteristics of intracoronary streptokinase (IC-SK) with those of intravenous tissue plasminogen activator (t-PA) in patients with acute myocardial infarction (AMI) treated in the first 6 hours after onset of symptoms. We studied 263 patients with AMI. Among these, 160 were treated with IC-SK; in…

Case Report

Single Daily Dose of Methimazole Compared to Every 8 Hours Propylthiouracil in the Treatment of Hyperthyroidism

ABSTRACT: This study to compare single-dose and multiple-dose antithyroid therapy was prompted by a perceived lack of compliance in our University Medical Clinics by those patients using multidose regimens. Twenty-two hyperthyroid patients were randomly assigned to two therapy groups. Twelve received methimazole (Tapazole) 30 mg once daily in the morning;…

Case Report

Iliac Vein Compression Syndrome From Urinary Bladder Distension Due to Prostatism

ABSTRACT: Urinary bladder distention is a rarely reported cause of iliac vein compression. We report a case of bilateral lower extremity and scrotal edema resulting from marked bladder distention. The bladder was readily palpable and a 4,100 cm3 postvoid residual urine volume was found. No other cause of lower extremity…

Case Report

Pregnancy Complicated by Guillain-Barré Syndrome

ABSTRACT: We report a case of a pregnant patient with Guillain-Barré syndrome. Her symptoms, including weakness, vague numbness, urinary incontinence, and unsteady gait, were initially mild and mimicked many of the changes seen in pregnancy. Her progressive weakness was not preceded by any known illness. Evaluation of symptoms revealed an…

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