Issue - Southern Medical Association

Case Report

Hemoptysis and Hematemesis Due to a Broncholith: Granulomatous Mediastinitis

ABSTRACT: A 40-year-old man had new onset of hemoptysis and hematemesis. Bronchoscopy revealed red, inflamed mucosa with apparent rich blood supply in the left primary bronchus. Computed tomography revealed calcified subcarinal lymph nodes with a small extension into the left primary bronchus. Shortly after admission, the patient had an episode…

Case Report

Methotrexate and Angiographic Embolization for Conservative Treatment of Cervical Pregnancy

ABSTRACT: Cervical pregnancy has traditionally been treated by hysterectomy. Recent reports of the use of methotrexate have been encouraging as a potential conservative approach. We present a case of a cervical pregnancy diagnosed at 8 weeks' gestation in a woman who greatly desired fertility. She was treated successfully with a…

Primary Article

Combined Tracheal and Esophageal Trauma From Gunshot Wounds

ABSTRACT: During a 5-year period between 1988 and 1993, nine patients with combined tracheal and esophageal injuries were treated at our institution. All injuries resulted from gunshot wounds and all were repaired. All patients survived, but complications included one tracheoesophageal fistula. Combined injuries of the trachea and esophagus should be…

Primary Article

Eosinophilic Gastroenteritis

ABSTRACT: Eosinophilic gastroenteritis is a rare condition of unknown etiology characterized by peripheral eosinophilia, eosinophilic infiltration of the gastrointestinal tract, and gastrointestinal symptomatology. Eosinophilic gastroenteritis is generally classified according to the layer of gastrointestinal tract involved. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea, weight loss, anemia, protein-losing…

Case Report

Dysphagia From Thoracostomy Tube Compression of the Esophagus After Single Lung Transplantation

ABSTRACT: Esophageal compression by a thoracostomy tube is an unusual complication. Signs and symptoms related to this complication may begin several days after placement of the thoracostomy tube. We report the case of a single long transplant recipient who had severe dysphagia from esophageal compression by a thoracostomy tube more…

Primary Article

Aspiration of Fetal Pleural Effusions or Ascites May Improve Neonatal Resuscitation

ABSTRACT: In cases complicated by massive pleural effusions and/or fetal ascites, marked neonatal respiratory embarrassment may occur. Fetal centesis done just before delivery is useful in improving resuscitative efforts. Four cases in which the fetus had massive pleural effusions and/or ascites were managed by fetal centesis before delivery. All babies…

Primary Article

Dysphonia in the Elderly: Diagnosis and Management of Age-Related Voice Changes

ABSTRACT: In our laryngology practice, we have noted an increasing number of elderly patients referred to us for problematic dysphonia. We present our findings of the most common disorder affecting this age group. A sample of 47 consecutive patients over age 60 with dysphonia revealed presbylaryngis, ie, age-related anatomic and…

Primary Article

Tracheobronchial Foreign Body Aspiration in Children

ABSTRACT: In this retrospective study, we reviewed the demographic and radiographic findings of 155 children with bronchoscopy-proven tracheobronchial foreign body aspiration (FBA). Two thirds of the patients were male, and most were children between 1 and 2 years of age. An aspirated peanut accounted for one third of all cases….

Current Concepts

Analyzing Signs and Symptoms of Metabolic Diseases

ABSTRACT: Inborn metabolic errors, while not common, may have significant implications for patients. Those patients with such errors who have acute life-threatening symptoms must be treated immediately, and specimens for analysis should best be obtained during the critical stage. Many infants and children seen with acute symptoms are the ones…

Primary Article

Multidrug-Resistant Salmonella typhi in Pakistani Children: Clinical Features and Treatment

ABSTRACT: Multidrug-resistant Salmonella typhi has become a major public health problem. In this study, typhoid fever was diagnosed by isolation of Salmonella typhi from blood or by a positive Widal's reaction in 170 Pakistani children. There were 111 boys (65%) and 59 girls (35%). The average age was 6.2 years;…

Case Report

Schwannoma of the Breast

ABSTRACT: Schwannoma arising within breast parenchyma is rare. We report such a case in a 50-year-old woman. The tumor, which measured 7 mm, is the smallest and the only mammographically detected schwannoma of the breast thus far reported. Clinicians should be aware that this benign tumor of breast may simulate…

Primary Article

Screening for Fever in an Adult Emergency Department: Oral vs Tympanic Thermometry

ABSTRACT: The accuracy of tympanic thermometers in clinical practice continues to be questioned. We evaluated the Genius tympanic thermometer in our adult emergency department. All patients had both tympanic and oral temperature measurements. Patients with an oral or tympanic temperature ≥100.0°F had a rectal temperature taken. Oral and rectal measurements…

Review Article

Medical Care of Women Deployed During Desert Storm

ABSTRACT: The Desert Shield/Desert Storm troop deployment included record numbers of women and highlighted the vacuum of planning and information regarding medical care for women deployed to a theater of war. I review the retrievable literature from that conflict and discuss the data regarding resource management and clinical significance. The…

Current Concepts

Neonatal Circumcision: An End to the Controversy?

ABSTRACT: The incidence of urinary tract infections is 10 times higher in the uncircumcised male than in those circumcised. An extensive review of bacterial adherence, the initiating factor in urinary tract infections, is presented to show that bacterial adherence to the prepuce is necessary for pyelonephritis to occur. Colonization with…

Primary Article

Maternal Serum Amylase and Lipase Profiles in Pregnancy: Determinations in Both Once-Sampled and Multisampled Patient Cohorts

ABSTRACT: The objective of this study was to determine the effect(s) of pregnancy and of advancing gestation on maternal serum amylase and lipase levels. Thus, serum amylase and lipase concentrations were quantitated in three groups of women. Groups included (1) 118 pregnant women whose serum amylase and lipase levels were…

Primary Article

Eye Patch Treatment for the Pain of Corneal Abrasion

ABSTRACT: The traditional use of patching and topical antibiotics in the treatment of corneal abrasion has recently been challenged, particularly after foreign body removal. In a prospective, controlled, randomized study of 33 patients treated in the emergency department for eye pain and corneal abrasion, we attempted to determine whether eye…

Primary Article

Diagnosis of Thoracic Outlet Syndrome in the Emergency Department

ABSTRACT: The use of the emergency department (ED) as a source for primary care has increased the number of patients seen in this setting with even chronic symptoms such as pain, paresthesias, and weakness in the upper extremity. This group may include individuals with thoracic outlet syndrome (TOS). We were…

Primary Article

Prevention of Pediatric Mortality From Trauma: Are Current Measures Adequate?

ABSTRACT: Trauma accounts for nearly half of pediatric deaths in the United States. We reviewed all pediatric trauma-related deaths that occurred over a 5-year period at two Georgia trauma centers to determine the number of trauma deaths in children, mechanism of injury, cause of death, and compliance with safety standards….

Primary Article

Treatment Of Mania: Relationship Between Response to Verapamil and Changes in Plasma Calcium and Magnesium Levels

ABSTRACT: Twelve patients meeting DSM-IIIR criteria for mania received verapamil over a 2-week period, with dosing up to 360 mg/day. Severity of mania was measured at baseline and weekly by use of the Young Mania Scale. Plasma calcium and magnesium determinations and an ECG were obtained at baseline and after…

Primary Article

Human Adjuvant Disease: Presentation as a Multiple Sclerosis–like Syndrome

ABSTRACT: Twenty-six women had a systemic disease with central nervous system (CNS) involvement at a mean age of 39.2 years (range, 23 to 64 years) after receiving silicone breast implants (n=25) or silicone fluid injections into breasts (n=1). The median latency period between breast surgery and onset of symptoms was…

Case Report

Carcinoid Tumor and the Nephrotic Syndrome: A Novel Association Between Neoplasia and Glomerular Disease

ABSTRACT: Various malignancies are associated with the paraneoplastic evolution of the nephrotic syndrome. Renal biopsy in these instances frequently shows membranous glomerulonephritis. We describe a patient who had metastatic bronchial carcinoid tumor with development of microscopic hematuria and subsequent nephrotic syndrome in conjunction with another paraneoplastic process, a malignancy-related neuropathy….

Primary Article

Bacteremia Due to Providencia stuartii: Review of 49 Episodes

ABSTRACT: We reviewed cases of Providencia stuartii bacteremia at a large community teaching hospital during a 12-year period (1981 to 1992). None of the infections were hospital-acquired. Of the 49 patients, 47 (96%) came from a nursing home, and 45 (92%) had a long-term indwelling Foley catheter. The urinary tract…

Editorial

IS SILICONE SAFE? LET SCIENCE DECIDE

Editorial

MANAGED MEDICINE: BOON OR BOONDOGGLE?

Correspondence

Vestibular Vertigo and Lovastatin Therapy

Correspondence

What Is “Normalization“ of Blood Glucose?

Correspondence

What Is “Normalization” of Blood Glucose?