Issue - Southern Medical Association

Primary Article

Acquired Immunodeficiency Syndrome in Alabama: Special Concerns for Black Women

ABSTRACT BackgroundAmong AIDS case reports from rural and small town areas of the United States, rates are higher in the South than in any other part of the country. MethodsFor this study, we analyzed AIDS surveillance statistics from the state of Alabama for trends, distributions, and populations affected. We aggregated…

Case Report

Synchronous Pulmonary Cryptococcosis and Histoplasmosis

ABSTRACT: A chronically immunosuppressed patient receiving oral steroid therapy had a cavitary lesion; both Histoplasma capsulatum and Cryptococcus neoformans were found in samples of respiratory secretions. C neoformans was also found in specimens taken from skin lesions and blood. This is the first reported instance of synchronous infection by these…

Case Report

Cellulitis and Myositis Caused by Agrobacterium radiobacter and Haemophilus parainfluenzae After Influenza Virus Vaccination

ABSTRACT: Agrobacterium radiobacter is a gram-negative aerobic bacillus that has been reported as a cause of disease only 36 times in the literature. More than half of the patients (25) have had bacteremia. Peritonitis, urinary tract infection, endocarditis, and one case of cellulitis associated with bacteremia have also been reported….

Current Concepts

Intracranial Saccular (Berry) Aneurysm A Brief Overview

ABSTRACT: An incidental saccular intracranial (berry) aneurysm is not an uncommon finding at autopsy. Rupture of such an aneurysm can produce severe neurologic deterioration and death, often without warning. Morbidity and mortality can be reduced in some patients with early surgical intervention. Familial aggregation of cerebral aneurysms occurs frequently enough…

Case Report

Cardiac Rupture Due to Blunt Trauma

ABSTRACT: Cardiac rupture due to blunt trauma has been recognized with increasing frequency over the past two decades. The mortality rate is high and the majority of patients die before they arrive at the emergency department. A high index of suspicion and prompt surgical intervention are crucial for survival. We…

Primary Article

Physician Education in Hyperlipidemia Management: The Impact on Collaboration

ABSTRACT: Collaboration of health care professionals is likely beneficial in modifying patient behavior in the treatment of hyperlipidemia. The purpose of this study was to determine whether limited instruction and demonstration of collaborative management of hyperlipidemia in a continuing medical education (CME) would change physicians' office practices, as determined 1…

Case Report

En Bloc Pancreaticoduodenectomy and Colectomy for Duodenal Neoplasms

ABSTRACT: Duodenal malignancy is rare and generally considered to have both a low resectability rate and a poor prognosis. Historically, the involvement of the colon or its mesentery has been considered a criterion for unresectability by many surgeons because of the overall magnitude of surgery involved with an en bloc…

Review Article

The Addition of Antibiotics to Fibrin Glue

ABSTRACT: Fibrin glue is composed of two separate solutions of fibrinogen and thrombin. When mixed together, these two solutions mimic the final stages of the clotting cascade to form a fibrin clot. Because the resulting fibrin patch is a good medium for microbial growth, the addition of antibiotics to one…

Primary Article

Unexpected Second Trimester Pregnancy Loss Due to Maternal Parvovirus B19 Infection

ABSTRACT: Five unexplained second trimester fetal deaths occurring in a 3-month interval were evaluated to determine whether the fetal demise was associated with maternal infection due to parvovirus B19. One fetus was markedly hydropic, a classic finding of fetal infection; no gross anomalies were present in the other four. Liver…

Primary Article

Ender Nails: An Alternative for Intramedullary Fixation of Femoral Shaft Fractures in Children and Adolescents

ABSTRACT: Fixation of femur fractures in children and adolescents is becoming widely accepted because of the lower chance of iatrogenic infection and prohibitive cost of inhospital traction and spica cast care. Interlocking nails, which have dramatically improved adult femur fracture care, have posed problems, such as injury to the greater…

Primary Article

Sertindole Hydrochloride: A Novel Antipsychotic Medication With a Favorable Side Effect Profile

ABSTRACT: Forty percent of all long-term care hospitalization days are accounted for by patients with schizophrenia. New approaches to managing this disorder are needed, including improved efficacy and better tolerability to enhance compliance with treatment. Sertindole hydrochloride is a novel antipsychotic medication soon to be available in the United States…

Case Report

Intravascular Tumor: A Previously Unreported Finding of Glucagonoma

ABSTRACT: Glucagonoma is a relatively rare pancreatic islet cell tumor. Historically, these tumors present a typical constellation of symptoms including diabetes, weight loss, anemia, necrolytic migratory erythematous rash, and propensity for thrombosis. This clinical presentation is described as the glucagonoma syndrome. The syndrome can be confirmed with the use of…

Current Concepts

Blood Glucose Determination: Point of Care Testing

ABSTRACT: Mechanisms for point of care glucose determinations have changed significantly since first introduced approximately 20 years ago. Such tests are now commonly done in acute and chronic care hospitals, as well as in physicians' offices and patients' homes. Although basically reliable, there are a number of potential problems with…

Current Concepts

Hazards Associated With Metalworking by Artists

ABSTRACT: Metalworking is the constructive sculptural application of various technologic processes for producing art from ferrous and nonferrous metals. Self-employed artists and their workplaces are not protected by governmental agencies. We describe the techniques involved in metalworking processes and discuss the physical trauma and medical syndromes associated with each process,…

Primary Article

Diagnosis of Alzheimer's Disease in a Community Hospital-Based Brain Bank Program

ABSTRACT: Several studies in recent years have addressed the accuracy of the clinical diagnosis of Alzheimer's disease (AD). However, most large studies have been done in university centers specializing in dementia. The purpose of this study was to assess the diagnostic accuracy of dementia in a community-based brain bank program,…

Case Report

Stevens-Johnson Syndrome and Respiratory Failure in a 9-Year-Old Boy

ABSTRACT: The etiology of respiratory failure associated with Stevens-Johnson syndrome may be multifactorial, including upper airway involvement, pneumothorax/pneumomediastinum, and direct involvement of the respiratory mucosa. Respiratory failure from direct involvement of the respiratory mucosa is relatively uncommon. We describe a 9-year-old boy who had respiratory failure associated with Mycoplasma pneumoniae-induced…

Case Report

Hemangioma of the Temporal Bone in a Patient Presumed to Have Ménière's Syndrome

ABSTRACT: This case report describes a patient with a facial nerve hemangioma of 8 years' duration that initially caused most of the symptoms of Ménière's syndrome: fullness, sensorineural hearing loss, dizziness, tinnitus, and disruption of balance. The hearing loss was in the high-frequency range (≥3,000 Hz); typically, the initial hearing…

Case Report

Primary Subclavian Vein Thrombosis and Pulmonary Embolism

ABSTRACT: Thrombotic veno-occlusion of the upper extremity is infrequent in the absence of external trauma or in the presence of an indwelling catheter. Inadvertent injury to the underlying venous circulation can occur when the upper extremity is subjected to an unaccustomed repetitive action. The resultant intimal damage may become a…

Case Report

Presentation and Management of a Thyroglossal Duct Cyst With a Papillary Carcinoma

ABSTRACT: Thyroglossal duct carcinoma is rare, and its presentation is similar to that of a thyroglossal duct cyst: a nontender, palpable mass in the midline location. Rapid increase in growth may be a sign of malignancy, but the diagnosis is based on the pathology of the cyst. Initial treatment of…

Primary Article

Peer Discussion on Training Physicians to Be Competent Communicators: Support for a Multiple Discourse Approach

ABSTRACT: To consider medical educators' views about training physicians to be competent communicators, a focus group was conducted at a large southeastern medical college with faculty responsible for training interns and residents to be competent communicators. The medical school was undergoing a curriculum review and instructional development process, including an…

Primary Article

Surgical Treatment of Gastrointestinal B-Cell Mucosa-Associated Lymphoid Tissue Lymphomas

ABSTRACT: We retrospectively evaluated clinicopathologic features of 35 patients treated for primary gastrointestinal lymphomas of MALT type (mucosa-associated lymphoid tissue) between 1970 and 1993. Fourteen patients (40%) were treated for acute abdominal conditions (bowel obstruction in 8, perforation in 2, and gastrointestinal bleeding in 4), and the rest had exploratory…

Primary Article

Endoscopic Retrograde Cholangiopancreatography in the Treatment of Bile Leaks and Bile Duct Strictures After Laparoscopic Cholecystectomy

ABSTRACT: We reviewed our experience over 3 years with 11 patients who had bile leaks (Group 1) and 8 patients who had bile duct strictures after laparoscopic cholecystectomy (LC) and were treated with endoscopic retrograde cholangiopancreatography (ERCP) (Group 2). In Group 1, bile leaks were at the level of the…

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Acknowledgment

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Editorial

GERIATRIC MEDICINE AS A CHALLENGE TO INTERNISTS