Abstract Background.A Food and Drug Administration pre-market approval study evaluated the safety and effectiveness of the Storz Modulith SL 20 lithotriptor. Methods.Protocol was a maximum of 2,000 shock waves per treatment and no more than three treatments per patient. Safety and effectiveness parameters were defined and followed. Results.The overall success…
Abstract Background.Child fatality review (CFR) by interagency teams can contribute to the prevention of childhood deaths. We investigated the potential usefulness of Georgia's CFR, legislated in 1990 primarily to prevent death from child maltreatment, for identifying preventable deaths from injury and sudden infant death syndrome (SIDS). Methods.Using CFR report data…
Abstract Background.Eight patients with 11 instances of wrist-level ulnar nerve entrapment, a fairly uncommon compression syndrome, were identified in a hand surgery practice from 1992 through 1996. Methods.Presentations, causes, and surgical outcomes were examined, and the pertinent literature was reviewed. Results.All eight patients had extrinsic, nonidiopathic compression of the ulnar…
Abstract Background.Pregnancy-related adult respiratory distress syndrome (ARDS) can lead to maternal mortality and morbidity. Methods.Records of all pregnant patients diagnosed with ARDS over a 14-year period were reviewed and the cases were stratified into survivors and nonsurvivors. Results.Forty-one cases were identified and 31 survived (maternal mortality rate of 24.4%). Adult…
Abstract Background.The hyperadrenergic syndrome, delirium tremens, as contrasted with the milder alcohol withdrawal syndromes, is a medical emergency. The clinical features of delirium tremens were carefully described almost 200 years ago. Since then, many therapies have been suggested as superior to preceding therapeutic approaches. Unfortunately, morbidity and mortality remain relatively…
Abstract Background.The nursing home clinician may encounter euthyroid residents with low total serum thyroxine (T4)values associated with certain medications or nonthyroidal illness (NTI). Hypothyroidism may be incorrectly diagnosed and thyroid hormone prescribed. Methods.We reviewed all T4 determinations and individuals with low T4 and normal thyroid-stimulating hormone (TSH) levels were identified….
Abstract Background.The purpose of this paper was to determine whether Medicare reimbursement for hip fracture reaches cost in geriatric patients. Methods.We conducted a retrospective review using the hospital trauma registry. Demographics, operations, length of stay, clinical outcome, discharge disposition, hospital charges, and hospital costs were reviewed and compared with diagnosis-related…
Abstract Background.This study was done to define the seasonality of respiratory syncytial virus (RSV) epidemics in the southeastern United States. Methods.We tested 5,092 fresh nasal aspirates or washings, using the Kallestad Pathfinder enzyme immunoassay (EIA) or the Directigen RSV membrane EIA according to manufacturers' directions. Results.A total of 1,419 (27.9%)…
ABSTRACT: A 28-year-old man needed urgent decompression because of development of cauda equina syndrome 36 hours after an operation for disk degeneration and spinal stenosis. At reexploration, swollen blood-soaked Surgicel (a hemostatic agent) was found to be the only cause of compression. Six months after the operation, the patient was…
ABSTRACT: Adverse drug reactions can vary from a simple rash to anaphylactic shock. While certain medications including the penicillins are well known to cause such reactions, other drugs are not as commonly recognized. Azathioprine hypersensitivity reactions tend to be benign and self-limiting with cessation of drug ingestion. We report a…
ABSTRACT: Chromobacterium violaceum infection is confined to the tropical and subtropical areas, with almost all reported cases occurring in the Southeast. The most common feature of this infection is sepsis, followed by cutaneous involvement and liver abscesses. Treatment consists of surgical drainage of purulent collections and appropriate antimicrobial therapy, such…
ABSTRACT: Cosmetic liposuction is considered to be safe and effective in properly selected patients and is widely done as an outpatient or office procedure. When major complications occur, office-based practitioners may refer patients to a hospital emergency department, where medical personnel unfamiliar with this procedure may underestimate the risk of…
ABSTRACT: Increasing violations of prescription drug regulations should alert physicians, trainers, and physiotherapists at collegiate and professional levels. Failure to adhere to state and federal requirements can have severe consequences for both physician and nonphysician practitioners. Training manuals that include a chapter on drug management will not allow disciplinary powers…
ABSTRACT: Pasteurella multocida has been implicated as the cause of a variety of respiratory conditions (eg, bronchitis, pneumonia, lung abscess, empyema), but hemoptysis has been noted only in conjunction with other lung conditions. We report a case in which hemoptysis was the sole manifestation of Pasteurella infection. The patient was…
ABSTRACT: Primary hyperparathyroidism is unusual in children. It is most commonly due to a solitary sporadic parathyroid adenoma, though parathyroid hyperplasia and related familial syndromes should be considered. In the case presented here, an 11-year-old boy with primary hyperparathyroidism had preoperative imaging studies that localized to the inferior aspect of…
ABSTRACT: Solid tumors rarely present with fever. Among those that do, carcinoma of the colon has been infrequently reported as a primary cause of fever. This patient had carcinoma of the right colon with prolonged fever, but no evidence of infection or gastrointestinal symptoms. At surgical resection, a caecal adenocarcinoma…
ABSTRACT: Systemic sclerosis is uncommonly associated with hematologic malignancies. We report the case of a patient who had chronic myelogenous leukemia 3 years after the CREST variant of systemic sclerosis was diagnosed. She also later had porphyria cutanea tarda. The majority of patients who had hematologic malignancies after the diagnosis…
ABSTRACT: Two cases of acute tumor lysis syndrome occurring in patients with hepatocellular carcinoma are reported. Both patients were treated with transcatheter chemoembolization. Tumor lysis syndrome was not anticipated in the first case and was diagnosed late. However, the second patient's syndrome was detected early and treated appropriately. Subtle changes…
ABSTRACT: We present the case of a 59-year-old woman with an International Federation of Gynecology and Obstetrics stage IIIB serous psammocarcinoma. Only 12 cases of this rare ovarian neoplasm have been reported previously. These tumors act like borderline tumors and, therefore, do not usually require chemotherapy or radiation therapy after…
ABSTRACT: Wire mesh repair of abdominal wall hernias was abandoned almost four decades ago. Recently, a woman who had a wire mesh repair of an incisional hernia in 1964 came to the emergency room with a complete small bowel obstruction. The obstruction was caused by a segment of wire mesh…
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