Issue - Southern Medical Association

Primary Article

Treatment of Asymptomatic Myocardial Ischemia

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…

Current Concepts

Anxiety Disorders in Children and Adolescents

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…

Primary Article

Patient Characteristics Associated With Hospitalizations for Ambulatory Care Sensitive Conditions in South Carolina

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…

Primary Article

Equal Dependence of the High Prevalence of Health Problems on Age and Family Income in Rural Southern Areas

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…

Primary Article

Parental Knowledge About Common Respiratory Infections and Antibiotic Therapy in Children

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…

Primary Article

Fallopian Tube Prolapse After Hysterectomy

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…

Primary Article

Impact of Two Ambulatory Care Training Programs on Smoking-Cessation Activities

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…

Current Concepts

Physician Assistants as Partners in Physician-Directed Care

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…

Case Report

Neuroleptic Malignant Syndrome Due to Promethazine

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,…

Case Report

Laser Resurfacing Complication

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…

Case Report

Recurrent Juvenile-Onset Laryngotracheal Papillomatosis With Transformation to Squamous Cell Carcinoma of the Lung

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.

Case Report

Biatrial Myxoma Resembling an Interatrial Clot in Transit on Echocardiogram

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…

Case Report

Papillary Fibroelastoma of the Mitral Valve 12 Years After Mitral Valve Commissurotomy

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…

Case Report

Acrometastasis in Renal Cell Carcinoma

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…

Case Report

Pneumopericardium Mimicking Acute Myocardial Ischemia After Laparoscopic Cholecystectomy

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…

Case Report

Endoscopic Removal of a Knotted Nasogastric Tube Lodged in the Posterior Nasopharynx

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…

Correspondence

Acute Respiratory Distress Syndrome

Abstract

ALCOHOL CONSUMPTION AND MORTALITY

Abstract

AORTIC SCLEROSIS AND MORTALITY RATE

Editorial

BACHELOR OF ARTS VERSUS BACHELOR OF SCIENCE

Abstract

BEDRAILS AND FALLS

Abstract

CANCER IN PATIENTS WITH END-STAGE RENAL DISEASE

Abstract

COFFEE DECREASES THE RISK OF GALLSTONE DISEASE IN MEN

Article

Epidemiologic Adventure: The Broad Street Pump

Correspondence

Fatalities Attributed to GHB and Related Compounds

Abstract

HIP FRACTURES AND OCCULT VITAMIN D DEFICIENCY

Abstract

HORMONAL REPLACEMENT THERAPY AND RISK OF BREAST CANCER

Correspondence

Metabolic Spinal Disorders in the Elderly

News Potpourri

News Potpourri

Abstract

THE MANAGEMENT OF INSOMNIA

Correspondence

Treating Unrelated Disorders in Patients With Chronic Medical Diseases