Issue - Southern Medical Association

Case Report

Geriatric Acute Perforated Appendicitis Atypical Symptoms Lead to a Difficult Diagnosis

ABSTRACTA geriatric man was admitted to the hospital with left-sided chest pain and subsequently had a full cardiac evaluation by a cardiologist. The workup revealed no cardiac abnormalities, and the patient was discharged on the second hospital day. He returned within 48 hours for recurrence of the left-sided chest pain…

Case Report

Acute Femoral Artery Thrombosis Associated With Functional Protein C Deficiency as the Presenting Manifestation of Acute Monocytic Leukemia

ABSTRACTAcute leukemia may be linked to disturbances of the coagulation system, which are usually due to hyperviscosity because of disseminated intravascular coagulation or a high white cell count. We report a unique case of femoral artery thrombosis as the beginning symptom of acute monocytic leukemia (M5) associated with a low…

Primary Article

Risk Factors for Above‐Knee Amputations in Diabetes Mellitus

ABSTRACTBackground. Above-knee amputation (AKA) is a common complication in diabetics, mostly after one or more lower level amputations (LEAs) have been done. The aim of this study was to identify risk factors for AKAs among diabetics.Methods. We abstracted 1,800 medical records of hospitalizations for LEA. Kaplan's comorbidity classification was used…

Review Article

Cluster Headache Horton's Cephalalgia Revisited

ABSTRACTBackground. Cluster headache (CH), though not fully characterized until this century, is a relatively common primary headache disorder.Methods. We reviewed pertinent literature on CH and related cephalalgias.Results. We found that CH typically occurs in middle-aged men and has a characteristic cyclic temporal pattern. During the cluster cycle, CH paroxysms last…

Current Concepts

Low Anion Gap

ABSTRACTBackground. The purpose of this review is to provide a differential diagnosis for a low anion gap.Methods. We describe the anatomy of the anion gap. Also, we follow-up with a review of the English-language literature describing the causes of a low anion gap. During the past 15 years, the introduction…

Current Concepts

Tuberculosis of the Pleura

ABSTRACTBackground. Tuberculosis is a leading cause of mortality worldwide, with a growing death rate. Pleuritis remains the most common extrapulmonary site of involvement. Epidemiologic trends have altered the presentation of disease. The advent of molecular biology has allowed new insights into disease mechanisms. In this paper, I review the salient…

Primary Article

Decrease in Costs for Management of Lower Airway Disease in the Pediatric Intensive Care Unit

ABSTRACTBackground. We investigated whether a recently restructured pediatric intensive care unit (PICU) had a decrease in the cost of patient care over the years.Methods. We retrospectively studied 89 previously healthy patients admitted to the PICU of a community-based, university-affiliated teaching hospital over a 4-year period (1991 to 1994) for treatment…

Case Report

Intravascular Malignant Lymphomatosis With Neurologic Presentation Factors Facilitating Antemortem Diagnosis

ABSTRACTIntravascular malignant lymphomatosis (IML) is a rare disorder of small and medium size vessels that frequently goes undiagnosed until the time of autopsy. The clinical courses of two such patients were examined to determine factors that would facilitate antemortem diagnosis. Both patients had mental status changes, pyramidal tract signs, and…

Case Report

Electrocardiographic Changes With Right‐Sided Pneumothorax

ABSTRACTPneumothorax is a well-known complication of central line placement in the intensive care unit. Other causes include spontaneous pneumothorax, trauma, and infection. Most frequently, dyspnea or respiratory decompensation raises suspicion for pneumothorax, especially after central line placement. The diagnosis is confirmed by physical examination and chest radiography. We present five…

Primary Article

Euthanasia and Doctor‐Assisted Suicide Responses by Oncologists and Non‐oncologists

ABSTRACTPurpose. Public interest concerning euthanasia and doctor-assisted suicide is creating ethical dilemmas in the health care profession. We surveyed the views of oncologists and non-oncologists in Florida.Methods. Physicians responded to an attitudinal questionnaire. The data collected were compared with standard statistical methods.Results. Both oncologists and non-oncologists had similar opposition to…

Review Article

The Shadow Rule A simple Method for Sun Protection

ABSTRACTThe intensity of ultraviolet radiation (UVR) from the sun is directly related to the angle of the sun of altitude above he horizon. Solar alitude at any given clock time varies with season and latitude-longitude. The shadow rule indirectly determines the sun's altitue by observing the length of a person's…

Case Report

Transient Golden Appendicolith

ABSTRACTThis case report describes an accidental ingestion of a gold dental inlay prosthesis that became lodged in the appendix. A nonsurgical approach was pursued because this blunt foreign body posed a minimal perforation risk. A second opinion for an elective appendectomy was chosen by the patient until a preoperative abdominal…

Case Report

The Lung and Waldenström's Macroglobulinemia

ABSTRACTWe encountered a 47-year-old woman with Waldenström's macroglobulinemia (WM) manifested as lung involvement and endobronchial disease, without many of the other features common to the disease. In addition to the unusual aspects of this case, we review the clinical features of other reported cases of pulmonary involvement in WM.

Case Report

Peripheral Neuropathy and Lipid‐Lowering Therapy

ABSTRACTWe report a case of a peripheral neuropathy induced and exacerbated by several commonly used HMG-CoA reductase inhibitors including lovastatin, simvastatin, pravastatin, and atorvastatiin, and the vitamin niacin. A review of the literature shows similar cases with individual lipid-lowering drugs, but this case shows the cross-reactivity of the neuropathic process…

Case Report

Bilateral Vocal Cord Paralysis After Meningitis Due to Streptococcus pneumoniae

ABSTRACTWe report the clinical course of a 15-month-old boy who had fever, decreased activity, and weakness, with severe respiratory distress during transport to the hospital. Laboratory evaluation confirmed the diagnosis of meningitis due to Streptococcus pneumoniae. He was intubated on arrival and required 4 days of ventilatory support. Soon after…

News Potpourri

AIDS IN CHINA

Abstract

ALCOHOL AND BREAST CANCER Smith‐Warner SA, Spiegelman D, Yaun SS, et al Alcohol and breast cancer in women. a pooled analysis of cohort studies

Abstract

ALENDRONATE PREVENTS POSTMENOPAUSAL BONE LOSS McClung M, Clemmensen B, Daifotos A, et al Alendronate prevents postmenopausal bone loss in women without osteoporosis

Abstract

APOLIPOPROTEIN E AND THE DIAGNOSIS OF ALZHEIMER'S DISEASE Mayeux R, Saunders AM, Shea S, et al, for the Alzheimer's Disease Centers Consortium on Apolipoprotein E and Alzheimer's Disease Utility of the apolipoprotein E genotype in the diagnosis of Alzheimer's disease

Abstract

CALCIUM SUPPLEMENTS EFFECTIVE TO REDUCE BONE LOSS, BUT NOT TO TREAT OSTEOPOROSIS Riggs BL, O'Fallon WM, Muhs J, et al Long‐term effects of calcium supplementation on serum parathyroid hormone level, bone turnover, and bone loss in elderly women

News Potpourri

DIVERGENCE IN PREMATURE DEATH RATES BETWEEN BRITAIN AND FRANCE

Our Medical Heritage

Eichold‐Heustis Medical Museum of the South Mobile, Alabama

News Potpourri

ETHICAL DEBATE OVER HYMENORRHAPHY

Abstract

FINASTERIDE REDUCES THE NEED FOR SURGERY IN MEN WITH BENIGN PROSTATIC HYPERTROPHY McConnell JD, Bruskewitz R, Walsh P, et al The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia

Editorial

HEALTH CARE AT THE END OF LIFE SHOULD MEDICALLY ASSISTED DEATH BE AN ALTERNATIVE?

News Potpourri

HIGHER EDUCATION LEVELS ASSOCIATED WITH MORE TENSION HEADACHES

Correspondence

Insulin Resistance Syndrome

News Potpourri

IRELAND TO EXPAND ITS CARDIAC SERVICES

News Potpourri

LEGAL BLOOD ALCOHOL LEVEL IN DRIVERS MAY BE CUT BY HALF IN THE UNITED KINGDOM

News Potpourri

LEPROSY VACCINE APPROVED IN INDIA

Abstract

MORE EVIDENCE THAT ALENDRONATE IS EFFECTIVE FOR THE PREVENTION OF OSTEOPOROSIS Hosking D, Chilvers CED, Christiansen C, et al, for the Early Postmenopausal Intervention Cohort Study Group Prevention of bone loss with alendronate in postmenopausal women under 60 years of age

News Potpourri

NURSING SHORTAGE IN THE UNITED KINGDOM

Abstract

PARTAKING IN LEISURE PHYSICAL ACTIVITY REDUCES MORTALITY Kujala UM, Kaprio J, Sarna S, et al Relationship of leisure‐time physical activity and mortality. the Finnish twin cohort study

Abstract

PNEUMONIA IN CHILDHOOD REDUCES VENTILATORY FUNCTION IN ADULTHOOD Johnston IDA, Strachan DP, Anderson HR Effect of pneumonia and whooping cough in childhood on adult lung function

Correspondence

Reply

Editorial

SOME INSOUCIANT REFLECTIONS ON APPROACHING AGE 75

Expired CME Article

Southern Medical Association CME CREDIT

Correspondence

Streptococcal Bacteremia and Colorectal Cancer

News Potpourri

SWEDEN CUTS UNICEF FUNDING

Abstract

THE CARE OF PERSONS WITH RECENT SEXUAL EXPOSURE TO HIV Katz MH, Gerberding JL The care of persons with recent sexual exposure to HIV

News Potpourri

TRIAL OF INTERFERON‐B IN MULTIPLE SCLEROSIS ABORTED

Primary Article

Unreliability of the Infrared Tympanic Thermometer in Clinical Practice A Comparative Study With Oral Mercury and Oral Electronic Thermometers