Issue - Southern Medical Association

Primary Article

Epiglottitis: A 9-Year Case Review

ABSTRACT: A retrospective chart review of all cases of suspected epiglottitis from 1985 to 1993 at Arkansas Children's Hospital identified 29 patients treated for epiglottitis during this 9-year period. Review of the immunization status of these patients showed 72% without Hib vaccination, 11% who had initiated the Hib series, and…

Primary Article

Significance of Chest Trauma in Children

ABSTRACT: Chest trauma in children is a marker of injury severity and is associated with a high mortality rate. This retrospective study of 1,356 trauma patients from a private pediatric hospital over a 2.5-year period identified 82 patients with chest injuries and a mortality rate of 22%. Results of Injury…

Case Report

Sudden Cardiac Death Due to Primary Coronary Sinus Thrombosis

ABSTRACT: Coronary sinus thrombosis has been reported only as a complication of cardiac transplantation and right heart catheterization in noninfected patients. We report a case of acute coronary sinus thrombosis occurring in the absence of these procedures and resulting in sudden cardiac death.

Case Report

False Aneurysm of the Thyrocervical Trunk

ABSTRACT: False aneurysm of the thyrocervical trunk as a complication of central venous catheterization is rare. We report a case of this complication in a 63-year-old white man and review the history, diagnosis, pathophysiology, and treatment of these aneurysms.

Case Report

Secondary Arterial Hypertension Linked to Freon Exposure

ABSTRACT: Freons are generally considered to be minimally toxic. There are no reports in the literature of Freons causing secondary arterial hypertension. We report two cases of acute, massive Freon exposure that preceded secondary arterial hypertension. We hypothesize that the arterial hypertension was precipitated by renal proximal tubular damage, although…

Clinical Review

Medical Complications of Glue Sniffing

ABSTRACT: Glue sniffing refers to the deliberate inhalation of volatile solvents, commonly found in adhesives, for the purpose of intoxication. The increasing prevalence of inhalant use suggests that many physicians will encounter a glue-sniffing patient at some time during their practice. Knowledge of the epidemiology, toxicology, and medical complications associated…

Case Report

Mycobacterium avium-intracellulare Complex Pneumonia in a Non–HIV-Infected Individual: An Increasingly Recognized Disease

ABSTRACT: In the past, Mycobacterium avium omplex (MAC) was considered a colonizing microbe in the immunocompetent host. Today it should be considered a potential pathogen. We present a case of MAC necrotizing pneumonia in a 27-year-old man who tested negatively for the human immunodeficiency virus, had no typical granulomas, and…

Case Report

Verapamil Therapy for Persistent Antral Spasms in a Child

ABSTRACT: Little is known about the use of calcium channel blockers in children with gastric motility disorders. We report the case of an 11-year-old child who was hospitalized after 3 weeks of persistent vomiting, abdominal pain, and a 12-lb weight loss. When his symptoms failed to improve with traditional treatment,…

Case Report

Malignant Mesenchymoma of the Pleura

ABSTRACT: Malignant mesenchymomas are uncommon tumors of soft tissues. Three such tumors involving the pleura have been reported in the literature. We report a case of malignant mesenchymoma of the pleura that had liposarcomatous, rhabdomyosarcomatous, chondrosarcomatous, and osteosarcomatous elements.

Primary Article

Prevalence of Lead Intoxication in Urban, Adult Medical Inpatients

ABSTRACT: Medical inpatients in inner-city hospitals have both potentially lead-related disorders and potential lead exposure. To see whether there is substantial unexpected lead intoxication in this population, we did a cross-sectional study of 117 consecutively admitted patients to a general medical ward of an inner-city university hospital. The mean (SD)…

Primary Article

The Air Gun: Toy or Weapon?

ABSTRACT: Originally used in warfare, air guns are commonly used in target shooting, as toys, and as "beginner" guns for children. The projectile force of these weapons can rival that of many conventional handguns. Pneumatic weapons pose a serious threat to the pediatric population, and their potential for serious injury…

Case Report

Paclitaxel: Severe Mucocutaneous Toxicity in a Patient With Hyperbilirubinemia

ABSTRACT: Paclitaxel is a novel anticancer drug that is being increasingly used to treat cancer of the breast and other organs. We describe a patient with metastatic breast cancer and liver dysfunction who had severe mucocutaneous toxicity after administration of a standard dose of paclitaxel. Another interesting finding in this…

Case Report

Gastric Intramural Pseudocyst With Associated Gastric Outlet Obstruction: Recognition and Management

ABSTRACT: Pancreatic pseudocyst is a well-recognized complication of pancreatitis. Most pseudocysts either resolve spontaneously or are amenable to internal drainage. Occasionally, the pseudocyst extends to distant areas within the abdominal cavity or may invade a nearby anatomic structure. Direct extension into the stomach is infrequently noted both radiographically and clinically….

Clinical Review

Diabetic Eye Disease: A Primary Care Perspective

ABSTRACT: Patients with diabetes are at risk for multiple visual complications, most notably diabetic retinopathy, but also glaucoma, cataracts, optic nerve disease, and strabismus. Diabetic retinopathy is the leading cause of blindness for the majority of Americans. Microvascular damage from diabetes leads to microaneurysms, hemorrhage, exudates, and cotton-wool spots. Further…

Case Report

Double-Lumen Esophagus: Formation of a New Lumen or Septation of the Existing One?

ABSTRACT: Presented here are two cases in which two esophageal lumens were identified at endoscopy. One patient had a history of antireflux surgery and both patients had received esophageal dilations. Both patients have done poorly with standard esophageal dilation and are not considered likely to gain from surgery. The mechanism…

Case Report

Primary Squamous Cell Carcinoma of the Breast

ABSTRACT: Primary squamous cell carcinoma of the breast is a rare cancer. Published reports of prognosis are variable, and most studies are case reports of one or a few patients. We report an additional case of squamous cell carcinoma of the breast occurring in a 53-year-old black woman. In reviewing…

Primary Article

Systemic Inflammatory Response Syndrome Caused by Chronic Salicylate Intoxication

ABSTRACT: Systemic inflammatory response syndrome (SIRS) is characterized by body temperature abnormalities, tachypnea or hyperventilation, tachycardia, and leukocytosis or leukopenia. Although it is typically associated with a serious infection and referred to as sepsis, SIRS can stem from noninfectious causes, as well. We report the cases of four patients with…

Primary Article

Physician Reporting of and Referral for Patient Complaints About Sleep Disorders

ABSTRACT: The first goal of this Nebraska-based study was to determine physician reporting of patient complaints about sleep. The second goal was to determine the patterns of referral to sleep disorders laboratories by geographic location and specialty practice. A total of 299 Nebraska physicians (177 in urban areas and 122…

Primary Article

Microbiologic Assessment of the Transabdominal Ultrasound Transducer Head

ABSTRACT: The objectives of this study were to determine (1) the rate of bacterial isolation from the abdomen of women having obstetric ultrasonography, (2) the rate of bacterial transmission to the transducer head, and (3) the eradication rate after routine wiping of the transducer head. A total of 191 obstetric…

Primary Article

Visceral Leishmaniasis in Pakistani Children

ABSTRACT: Visceral leishmaniasis is endemic in Pakistan. No studies of visceral leishmaniasis in childhood have been reported from Pakistan. We prospectively studied clinical and laboratory features in 58 Pakistani children with visceral leishmaniasis. Mean age of the children was 2.9 years. Fever, pallor, and abdominal distention were the most common…

Primary Article

Pulmonary Fibrosis and Lung Cancer in the United States: Analysis of the Multiple Cause of Death Mortality Data, 1979 Through 1991

ABSTRACT: We determined the relationship between pulmonary fibrosis and lung cancer in the United States from 1979 through 1991 by analyzing death certificate reports compiled by the National Center for Health Statistics. Of the 26,866,600 people who died during the study period, 107,312 died with pulmonary fibrosis, 1,739,725 died with…

Case Report

Placenta Increta Occurring in a Blighted Ovum

ABSTRACT: We present a rare case of placenta increta, confirmed postoperatively by pathologic analysis, occurring before 20 weeks' gestation in a blighted ovum. Hysterectomy was necessary for control of hemorrhage.

Primary Article

Abdominal Wall Reconstruction After Temporary Abdominal Wall Closure in Trauma Patients

ABSTRACT: We retrospectively analyzed 36 patients requiring temporary abdominal wall closure on admission to a level I trauma center from 1988 to 1992. There were 10 deaths (28%) in the study population. Of the 26 survivors, 8 patients (31%) had primary fascial closure at initial hospitalization, whereas 18 patients (69%)…

Editorial

CHANGING CLINICAL PERSPECTIVES TOWARD GASTROESOPHAGEAL REFLUX