Issue - Southern Medical Association

Article

Flavobacterium meningosepticum Sepsis in an Infant With a Diarrheal Prodrome

ABSTRACTA full term, previously normal 2 1/2-month-old black boy was transferred to our hospital from an outlying facility on hospital day 5 for failure to thrive. Three weeks before transfer, the infant was hospitalized for a diarrheal illness with fever. The baby received 3 days of ceftriaxone empirically and was…

Article

Roles of Physicians, Attorneys, and Illness Experience in Advance Directives

ABSTRACTBackgroundAge, illness severity, functional status, and education are associated with advance directive completion. We examined these patient characteristics and discussions with attorneys and physicians in a predictive model for advance directive completion.MethodsWe did a cross-sectional survey of 255 randomly selected patients in a VA outpatient clinic.ResultsPatients were predominantly men (95.2%),…

Article

Chalk Eating in Middle Georgia A Culture‐Bound Syndrome of Pica?

ABSTRACTBackgroundAlthough geophagia (earth eating) has been observed and documented in many areas of the world, the specific preference for consuming kaolin is less well known. The ingestion of kaolin, also known as white dirt, chalk, or white clay, is a relatively common type of pica found in the central Georgia…

Article

Usefulness of Acute Phase Reactants in the Diagnosis of Acute Infections in HIV‐Infected Children

ABSTRACTBackgroundChildren infected with the human immunodeficiency virus (HIV) often have hypergammaglobulinemia, causing elevation of the erythrocyte sedimentation rate (ESR). This study was done to determine whether C-reactive protein (CRP) is a better indicator of acute infection than ESR in HIV-infected children.MethodsErythrocyte sedimentation rate, CRP, and immunoglobulin G (IgG) levels were…

Current Concepts

Appalachian Perspective on Modifiable Risk Factors in Coronary Artery Disease How Well Are We Doing?

ABSTRACTBackgroundDespite recognition of modifiable risk factors and available and effective life-style and pharmacologic therapies, many individuals have unrecognized or untreated risk factors for coronary artery disease.MethodsUsing MEDLINE, we searched for relevant review articles and clinical trials related to hypertension, hyperlipidemia, diabetes mellitus, smoking, physical activity, obesity, and psychologic risk factors…

Article

Sledding Injuries in the Southeastern United States

ABSTRACTBackgroundHeavy ice and snow accumulation combined with record low temperatures in Chattanooga, Tennessee, from February 2–6, 1996, contributed to many sledding injuries.MethodsWe retrospectively reviewed medical records of emergency visits to seven area hospitals from February 2–6, 1996. We further reviewed sledding injury records. Sledding was defined as sliding on snow…

Article

Detection of Sentinel Lymph Nodes With Lymphazurin in Cervical, Uterine, and Vulvar Malignancies

ABSTRACTBackgroundIdentification of sentinel lymph nodes may allow prediction of metastatic disease in cancer patients. We did a prospective study to determine whether lymphazurin dye could identify sentinel lymph nodes in patients with cervical, uterine, and vulvar cancer.MethodsIn 33 patients having surgery for either uterine, cervical, or vulvar carcinoma, lymphazurin dye…

Current Concepts

Assessment of Orthostatic Blood Pressure Measurement Technique and Clinical Applications

ABSTRACTBackgroundOrthostatic hypotension, a decline in erect blood pressure, is the result of an impaired hemodynamic response to an upright posture or a depletion intravascular volume. The measurement of orthostatic blood pressure can be done at the bedside and therefore is easily applied to several clinical disorders. Despite its usefulness, the…

Article

Comparison of the Use and Accuracy of Methods for Determining Pleural Fluid pH

ABSTRACTBackgroundThe blood gas analyzer (BGA) has been considered the “gold standard” for pleural fluid pH determination.MethodsWe report the various methods used to measure pleural fluid pH by 277 acute care institutions who responded to a mailed questionnaire. The techniques used included the BGA (32%), dip stick or pH indicator paper…

Case Report

The Diagnosis of Cor Triatriatum Sinistrum in Children A Continuing Dilemma

ABSTRACTCor triatriatum (CT) is a rare congenital cardiac anomaly. The salient clinical, roentgenographic, electrocardiographic, echocardiographic, and hemodynamic findings are presented in two asymptomatic children and one with nonspecific dyspnea on exertion. Two male children had a classical form of cor triatriatum with normal physical and inconsequential roentgenographic and electrocardiographic findings….

Article

Striking Cholestatic Liver Disease A Distinct Manifestation of Advanced Primary Amyloidosis

ABSTRACTIn patients with systemic amyloidosis, amyloid fibrils are typically deposited in numerous organs, including the kidneys, heart, and liver. Although amyloid deposition in the liver is common in patients with systemic amyloidosis, clinical liver disease is relatively rare. The patient described here had cholestatic liver disease as the primary manifestation…

Article

Lead Toxicity From Gunshot Wound

ABSTRACTLead toxicity from gunshot wound is a rare complication. It occurs when body fluids, especially synovial cavity fluids, dissolve lead from the bullets, resulting in absorption and toxicity. Metabolic stress, infection, or alcoholism can also enhance absorption. Combination of chelation and surgical removal can result in favorable prognosis. Awareness of…

Article

Treating Elder Neglect Collaboration Between a Geriatrics Assessment Team and Adult Protective Services

ABSTRACTNeglect is the most common type of elder maltreatment in the United States. Currently, the only formal intervention available is provided by each state's adult protective service agency (APS). Elder neglect involves a complicated relationship among an individual's medical problems, social situation, and ability to function in the environment. Geriatric…

Article

Acetazolamide Relieves Concurrent Episodic Movement Disorders Encountered in Southern States

ABSTRACTPatients with episodic or paroxysmal movements or postures often are thought to have hysteric or psychosomatic illnesses. Kinesigenic (movement-induced) posturing similarly is usually misinterpreted. This case is notable because of the presence of symptoms of two distinct diseases with similar symptoms and changes from one dystonic posture to another during…

Article

Cirrhotic Ascites, Ovarian Carcinoma, and CA‐125

ABSTRACTWe describe two postmenopausal women with ascites and elevated CA-125 level, a serologic marker used to detect ovarian cancer. Both patients had unrecognized liver disease but underwent surgical exploration for suspected ovarian disease, which subsequently revealed benign pelvic organs. Elevated serum CA-125 levels have been reported in many patients with…

Article

Hantavirus Pulmonary Syndrome

ABSTRACTWe present the first case of Hantavirus pulmonary syndrome in the Dallas/Fort Worth area. The patient was a 50-year-old previously healthy white man, who had adult respiratory distress syndrome (ARDS) and hypotensive shock after 1 week of nonspecific “viral” symptoms. Despite supportive care, the patient died within several hours of…

Article

Pulmonary Bone Marrow Embolism in Sickle Cell Disease

ABSTRACTWe report an unusual lethal complication of sickle cell anemia. The patient was admitted with a diagnosis of acute chest syndrome and died shortly after that of respiratory failure. Autopsy revealed numerous deposits of bone marrow hematopoietic tissue occluding the microvascular circulation of the lung. Many causes of acute chest…

Abstract

A NEW DISEASE ENTITY FLOCK WORKER'S LUNG

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AN OBJECTIVE LOOK AT VITAMIN SUPPLEMENTATION

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BETA‐BLOCKERS AFTER MYOCARDIAL INFARCTION

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BETA‐BLOCKERS IN OLDER PATIENTS AFTER MYOCARDIAL INFARCTION

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CAN SUDDEN DEATH AMONG ATHLETES BE PREVENTED?

Article

CME Article of the Month Southern Medical Association CME CREDIT Date of Original Release

Article

Corrections

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ESTROGEN AND PROGESTIN FOR THE SECONDARY PREVENTION OF CORONARY HEART DISEASE IN POSTMENOPAUSAL WOMEN

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EUTHANASIA IN THE USA

Article

News Potpourri

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ORAL CONTRACEPTIVES AND THE RISK OF OVARIAN CANCER

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RECOMMENDATIONS FOR REQUESTS FOR PHYSICIAN‐ASSISTED SUICIDE

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SHOULD A COLONOSCOPY BE DONE WHEN SMALL ADENOMAS ARE FOUND BY SCREENING FLEXIBLE SIGMOIDOSCOPY?

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