Abstract Background. Asymptomatic myocardial ischemia is commonly observed in patients with coronary artery disease. Numerous studies have shown that patients with asymptomatic ischemia are at higher risk for adverse outcome than those without ischemia. Several recent studies have investigated the therapeutic options available in the management of patients with asymptomatic…
Abstract Background. Children and adolescents frequently have symptoms of anxiety. In addition, anxiety disorders are some of the most frequent psychiatric disorders in this age group. Methods. We used computerized literature searches (MEDLINE and PSYCHLIT) to identify clinical, research, and review articles on this subject. Various journals and textbooks from…
Abstract Background. Data for this study came from South Carolina 1995 Hospital Inpatient Encounter Data Base. The population figures were 1995 South Carolina population estimates. Methods. We examined patient sociodemographic characteristics and costs associated with adult and pediatric ambulatory care sensitive condition (ACSC) hospitalization in South Carolina. Bivariate statistical comparisons…
Abstract Background. People who have periods of low family income are at risk for increased health problems in the future, even if they present a similar clinical picture before the reduction in family income. The association between low income and health status was studied in residents of an area with…
Abstract Background. Widespread antibiotic use has fostered the emergence of antibiotic-resistant bacteria. Parental expectations have been cited as one reason for physicians to overprescribe antibiotics. The objective of this study was to determine parental knowledge about antibiotics and their use for common respiratory tract infections. Methods. A survey was administered…
Abstract Background.Fallopian tube prolapse is reported to most commonly occur after vaginal hysterectomy. Both diagnosis and management have varied, resulting in differing efficacies of treatment. Methods. We reviewed the presentation, diagnosis, management, and outcomes of 18 cases of tubal prolapse in 17 women. Results. Most cases (65%) occurred after abdominal…
Abstract Background.Tobacco use causes significant morbidity and mortality. Resident physicians at the George Washington University Medical Center are trained to counsel patients to stop smoking. Methods. I retrospectively reviewed charts of 300 patients treated by resident physicians in the Department of Medicine (200) and the Department of Health Care Sciences…
ABSTRACT: 1998 marked the acceptance of Physician Assistants (PAs) as members in the Southern Medical Association. We review the history of the PA profession and, more importantly, the physician/PA relationship. We also provide an overview of PA education and certification requirements. Variations in state law regarding PA utilization, including the…
ABSTRACT: A 42-year-old man came to our emergency room hyperthermic (oral temperature, 42.4°C), diaphoretic, and delirious. Other findings included labile blood pressure, sinus tachycardia (heart rate, 138/min), tachypnea (respiratory rate 34/min), muscle rigidity, and incontinence. Two days earlier, he had gone to a local clinic with complaints of abdominal pain,…
ABSTRACT: A 43-year-old woman had full facial laser resurfacing for treatment of multiple actinic keratoses and aging skin. Healing was uneventful on most of the areas treated except the forehead, where a progressive nonhealing wound developed. After seeking numerous consultations around the Southeast, the patient came to our facility, 6…
ABSTRACT: A 47-year-old female patient with recurrent juvenile-onset laryngotracheal papillomatosis for 27 years had multiple bilateral pulmonary lesions, the largest of which was a well-differentiated squamous cell carcinoma. This case is unique because the malignant transformation occurred in a nonirradiated, nonsmoking patient.
ABSTRACT: A 47-year-old man had an embolic stroke. Transesophageal echocardiography showed biatrial, elongated, mobile masses that appeared interconnected via a patent foramen ovale. Echocardiography did not distinguish between an interatrial clot in transit and an atypical biatrial myxoma. Surgical resection and subsequent histopathologic examination identified the mass as a biatrial…
ABSTRACT: A 63-year-old woman who had had mitral valve commissurotomy 12 years earlier was seen because of rheumatic mitral stenosis and left brachial paresis due to cerebral embolism. On clinical evaluation, a diastolic rumble was heard over the mitral area, and the echocardiogram revealed a mass attached to the mitral…
ABSTRACT: Acrometastasis is rare and may occur as the primary manifestation of an occult malignant tumor. Clinically, it may mimic benign osteoarthritic diseases, thus resulting in misdiagnosis and improper treatment. We describe a patient with renal cell carcinoma that presented itself as a case of chronic osteomyelitis after trauma to…
ABSTRACT: Pneumopericardium occurred after laparoscopic cholecystectomy in a 57-yearold woman. The patient had chest pain accompanied by T-wave inversion on electrocardiogram, with signs and symptoms suggestive of acute myocardial ischemia. Evaluation for myocardial infarction, however, was negative and clinical findings resolved spontaneously. Although pneumopericardium after laparoscopic procedures has been previously…
ABSTRACT: The complication of knotting nasogastric (NG) tubes on removal occurs infrequently with small diameter feeding tubes. Knotting of large caliber NG tubes is even more uncommon. We describe our experience in one such case, which was further complicated by the inability to visualize the NG tube in the posterior…
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