Issue - Southern Medical Association

Case Report

Tethered Cord Syndrome in Adults

ABSTRACTAdult onset of tethered cord syndrome is a rare pathologic entity. Its treatable nature makes early diagnosis and timely surgical intervention important goals. Because of present referral patterns, adult patients with tethered cord syndrome may present initially to their primary care physician. We present a recent representative case of adult-onset…

Case Report

Pneumococcal Abscess Manifesting as an Anterior Mediastinal Mass and Fatal Hemoptysis

ABSTRACTAn elderly man had several weeks of night sweats, weight loss, and an anterior mediastinal mass on chest radiography. Computed tomographic-guided needle aspiration was nondiagnostic. Shortly after the patient's admission, three sets of blood cultures yielded Streptococcus pneumoniae. Despite systemic antimicrobials, the patient had an episode of acute hemoptysis and…

Case Report

Nail‐Patella Syndrome An Incidental Finding From Abdominal Discomfort

ABSTRACTAn otherwise healthy 18-year-old woman had abdominal discomfort. Physical examination and laboratory studies were unremarkable, with the exception of nail dystrophy of the ulnar digits. An abdominal plain film revealed bilateral posterior iliac horns, pathognomonic of nail-patella syndrome. Additional radiographs showed hypoplastic patellas bilaterally. While glomerulonephritis occurs in 30% of…

Original Article

Surgical Management of Endometrial Adenocarcinoma Using Laparoscopically Assisted Staging and Treatment

ABSTRACTBackgroundBecause of inaccuracies in clinical staging, endometrial adenocarcinoma is now a surgically staged disease. This study was done to determine the safety and efficacy of a laparoscopically assisted approach in the treatment and staging of this disease.MethodsUsing a retrospective chart review, we identified demographic characteristics, mean blood loss, operative findings,…

Original Article

Effect of Erythromycin on Myocardial Repolarization in Patients With Community‐Acquired Pneumonia

ABSTRACTBackgroundErythromycin has been associated with prolongation of myocardial repolarization and torsades de pointes (TdP).MethodsTo determine the frequency, dose-response, and risk factors for erythromycin-associated prolongation of myocardial repolarization, we observed data of patients admitted to our hospital with pneumonia who were treated with erythromycin.ResultsIn 35 women and 28 men enrolled in…

Original Article

Ionized Serum Magnesium in Type 2 Diabetes Mellitus Its Correlation With Total Serum Magnesium and Hemoglobin A1c Levels

ABSTRACTBackgroundHypomagnesemia has been described in diabetes mellitus. We sought to compare serum total and ionized magnesium (Mg) levels in patients with type 2 diabetes with control subjects and to determine the relationship between diabetes control, as assessed by hemoglobin A1c (Hb A1c) and Mg (total and ionized).MethodsSerum ionized Mg was…

Original Article

Asymptomatic Patients at High Risk for Deep Venous Thrombosis Who Receive Inadequate Prophylaxis Should Be Screened

ABSTRACTBackgroundPatients after stroke and major orthopedic surgery have increased factors for developing deep vein thrombosis. We sought to determine the implications of screening high-risk patients to detect proximal deep vein thrombosis.MethodsWe used decision analysis to determine the implications of screening vs not screening asymptomatic high risk patients with duplex ultrasonography…

Original Article

Screening for Cerebral Aneurysm in Patients With Polycystic Liver Disease

ABSTRACTBackgroundPolycystic liver disease (PCLD) is an autosomal dominant disease characterized by multiple macrocystic lesions throughout the liver. The association between PCLD and cerebral aneurysm is well documented, and approximately 20% of patients with PCLD have demonstrable cerebral aneurysms at autopsy. The prevalence reported from autopsy series, however, may not reflect…

Original Article

Factors Influencing Enrollment in Clinical Trials for Cancer Treatment

ABSTRACTBackgroundRecruitment of cancer patients to clinical trials is an ongoing challenge. In this study, we assess factors that may influence enrollment in clinical trials for cancer treatment.MethodsBetween June 1997 and January 1998, data were collected on all adult cancer patients evaluated for enrollment in National Cancer Institute-sponsored clinical trials at…

Original Article

Ketorolac Versus Acetaminophen for Treatment of Acute Fever in the Emergency Department

ABSTRACTBackgroundThe purpose of this preliminary study was to compare acetaminophen to ketorolac for treating patients with fever in the emergency department (ED).MethodsIn this prospective, randomized, double-blind pilot study, patients were enrolled as a convenience sample during a 6-month study period. All subjects 18 years or older with a temperature of…

Original Article

Zinc Protoporphyrin and Percentage of Hypochromic Erythrocytes as Markers of Functional Iron Deficiency During Therapy With Erythropoietin in Patients With Advanced Acquired Immunodeficiency Syndrome

ABSTRACTBackgroundWe assessed zinc protoporphyrin (ZPP) and the percentage of hypochromic erythrocytes in patients with advanced acquired immunodeficiency syndrome (AIDS) treated with recombinant erythropoietin (rhEPO).MethodsPatients received 150 IU rhEPO subcutaneously every second day for 10 days, and 150 IU rhEPO plus 62.5 mg of intravenous iron every second day for an…

Original Article

Survey of the Stocking of Poison Antidotes in Alabama Hospitals

ABSTRACTBackgroundWe wanted to estimate the current antidote supply in Alabama hospitals, establish if certain antidotes were stocked more than others, and identify certain parameters (eg, treatment level of care, licensed bed size, or county population) as predictors for the current antidote supply.MethodsWe faxed surveys to treatment level I/II hospitals and…

Case Report

Localized Bullous Pemphigoid in a Patient With B‐Cell Lymphoma

ABSTRACTBullous pemphigoid (BP) is an immunobullous disease characterized by circulating IgG antibodies directed towards cutaneous basement zone antigens. We report the case of a patient who had BP localized to a stoma site. At initial examination, a nodule was noted on the temple, which proved to be a large cell…

Case Report

Pathologic Fracture of the Humerus Due to Metastatic Cholangiocarcinoma

ABSTRACTCholangiocarcinoma is a rare tumor of the bile duct system known to frequently metastasize to the axial skeleton, lungs, adrenal glands, brain, and lymphatic system. Spread to the long bones has not previously been reported in the literature partly because of the short life expectancies of patients with this disease….

Case Report

Surgical Management of a Pulmonary Artery Missile Embolism After an Air Rifle Wound to the Liver

ABSTRACTMissile embolism to the pulmonary artery is rare, and controversy persists about whether to remove the missile. We describe a case of a pellet-embolism from the liver (via hepatic vein) to the left pulmonary artery. In this case, the pellet was removed surgically.

Case Report

Solitary Spinal Intramedullary Abscess Caused by Nocardia asteroides

ABSTRACTNocardial spinal cord abscesses are extremely rare. Only three have been reported, one each from Austria, Thailand, and the United States. All three patients also had extraneurologic nocardiosis. We present the first case of an intramedullary abscess caused by Nocardia asteroides and without concomitant extraneurologic nocardiosis. It is also the…

Original Article

Breast‐Feeding Initiation Predictors, Attitudes, and Practices Among Blacks and Whites in Rural Mississippi

ABSTRACTObjectivesWe attempted to determine the incidence, predictors, attitudes, and practices of breast-feeding initiation among women in a low-income rural Mississippi community.MethodsWe interviewed 420 new mothers regarding breast-feeding.ResultsNinety-six women (24&percnt;) initiated breast-feeding. More whites (44&percnt;) than blacks (20&percnt;) initiated breast-feeding. Of those 96, 59&percnt; planned to breast-feed for <6 months and…

Case Report

Partial Failure of Sternal Fusion in an Adolescent

ABSTRACTWe describe the case of an adolescent girl who had an isolated cranial sternal cleft without any associated abnormalities; the cleft had been well tolerated since her birth. A review of the literature shows that such cases are uncommon. In such cases, surgery is only for cosmetic reasons.

Case Report

Septic Shock From the Administration of a Bacterially Contaminated Platelet Transfusion

ABSTRACTWe report the case of a 6-year-old boy who began to have fever and hypotension during the administration of a platelet transfusion. Subsequent investigation revealed the etiology to be bacterial contamination of the platelet product. Serratia marcescens was cultured from both the patient's blood and the platelet product. When fever…

Abstract

ALCOHOL CONSUMPTION&comma; MORTALITY&comma; AND MORBIDITY IN YOUNG MEN

Abstract

BONE MASS AND CONGITIVE FUNCTION IN WOMEN

Abstract

BREAST FEEDING REDUCES THE RISK OF ASTHMA

Evagations

CAN A GOOD AND ETHICAL PHYSICIAN A MANAGED CARE GATEKEEPER BE&quest;

Original Article

CME Article of the Month Southern Medical Association CME CREDIT

Abstract

FACTORS AFFECTING COGNITIVE FUNCTION IN WOMEN

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FRUIT AND VEGETABLE INTAKE AND RISK OF STROKE

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INFLUENZA VACCINATION IN HIV&hyphen;INFECTED PERSONS

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OUTCOMES OF TREATING DEPRESSION IN PREGNANCY

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RISEDRONATE IS EFFECTIVE IN THE TREATMENT OF OSTEOPOROSIS

Abstract

SHOULD H PYLORI BE ERADICATED IN PATIENTS WITH NONULCER DYSPEPSIA&quest;

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USE OF COMPLEMENTARY THERAPIES FOR ARTHRITIS