Primary Article

Use of Combined Oral Narcotic and Benzodiazepine for Control of Pain Associated With Bone Marrow Examination

ABSTRACT Backgroud.Bone marrow aspirate and biopsy is universally recognized as being painful. Few descriptions of effective analgesia or premedication for this procedure exist. In this study, we assessed an oral narcotic and benzodiazepine combination in controlling pain associated with bone marrow examination. Methods.Twenty-four consecutive ambulatory, adult patients referred for bone…

Primary Article

Use of Advance Directives by Health Care Workers and Their Families

ABSTRACT Background.Advance directives (ADs) are advocated for many but executed by few. To ascertain the importance of education in the decision to execute an AD, I did this study to determine the rate at which health care workers (a medically educated group) and their families execute ADs. Methods.All clinical staff…

Primary Article

Determinants of the Excessive Rates of Lung Cancer in Northeast Florida

ABSTRACT Background.Age-adjusted rates of lung cancer among whites, but not blacks, in Duval County (Jacksonville), Florida, have been among the highest of any metropolitan area of the United States for three decades. Methods.We conducted a case-control study, interviewing 507 patients with lung cancer diagnosed from 1993 to 1996 and 1,007…

Primary Article

Group A Streptococcal Pharyngitis in Adults 30 to 65 Years of Age

ABSTRACT Background.Although the frequency of group A streptococcal pharyngitis in adults is assumed to be low, there is little information on frequency other than in military populations. Methods.A prospective, observational study was done to determine the frequency of group A streptococcal pharyngitis in adults seen in the emergency department. Throat…

Expired CME Article

Diabetes in the Managed Care Setting: A Prospective Plan

ABSTRACT Background.As managed care organizations (MCOs) continue to expand into the care of the chronically ill, the concept of providing cost-effective care with a preventive approach is vital for primary care providers (PCPs) to embrace. Diabetes is an ideal disease to incorporate this concept. Methods.We reviewed the literature using MEDLINE….

Expired CME Article

Acute Respiratory Distress Syndrome: A Clinical Update

ABSTRACT Background.Because of recent advances in the treatment and improved outcome of acute respiratory distress syndrome (ARDS), we present an overview of ARDS to update general practitioners on the management of this condition. Methods and Results.We searched MEDLINE for original articles, editorials, and reviews on ARDS, acute lung injury, and…

Expired CME Article

Systemic Sclerosis From Autoimmunity to Alloimmunity

ABSTRACT Background.The biologic significance of microchimerism from pregnancy in systemic sclerosis and other autoimmune diseases is not fully characterized. Methods.We based this brief review on a systematic search of the MEDLINE database for all relevant articles published between 1980 and July 1998, indexing systemic sclerosis, microchimerism, and pregnancy as key…

Expired CME Article

Organization of Hospital-Based Acute Pain Management Programs

ABSTRACT Background.The management of acute pain is an aspect of hospital-based practice that has been neglected. Control of pain is important for ethical reasons, for compliance with new guidelines and standards, and for optimizing patient satisfaction and outcomes. Methods.We review the rationale for establishing priority to the control of acute…

Primary Article

Adverse Drug Reaction-Related Hospitalizations of Nursing Facility Patients A 4-Year Study

ABSTRACT Background.The purpose of this study was to document adverse drug reaction (ADR)- related hospitalizations from a nursing facility population. Methods.This 4-year prospective observational study used monthly repeated measures of 332 residents present for 30 or more days. The review included admission and monthly drug regimen review for each resident….

Case Report

Acute Respiratory Distress Syndrome in a Welder Exposed to Metal Fumes

ABSTRACT: A 43-year-old man began having malaise, chills, and fever 12 hours after cutting a galvanized steel grating with an acetylene torch at work. Over the next 72 hours, his symptoms persisted and became worse with progressive shortness of breath. He was admitted to the hospital and begun on antibiotics…

Case Report

What If Your Patient Prefers an Alternative Pain Control Method? Self-hypnosis in the Control of Pain

ABSTRACT: Despite the availability of specialized treatments for chronic pain, including biofeedback training, relaxation training, and hypnotic treatment, most physicians rely on the traditional approaches of surgery or pharmacotherapy. The patient in this case study had severe and chronic pain but found little relief from pain medications that also caused…

Case Report

Necrotizing Vasculitis of the Skin and Uterine Cervix Associated With Minocycline Therapy for Acne Vulgaris

ABSTRACT: In recent years, minocycline has become a commonly used agent for die treatment of acne vulgaris and rosacea. With this increased use have come reports of severe and in some cases life-threatening toxicity, often occurring in otherwise healthy young women after prolonged courses of minocycline. These adverse reactions include…

Case Report

Familial Inheritance of Mandibular Arch Malformations Affecting Three Individuals in One Family

ABSTRACT: Mandibular aplasia is defined as incomplete development of the mandibular process of the first brachial arch. Its prevalence is less than 1:70,000. It is usually associated with low-set ears, transposition of the viscera, congenital heart defects, and rib abnormalities, and is incompatible with life. In this case report, fetal…

Case Report

Mesenteric Lipodystrophy With Fever of Unknown Origin and Mesenteric Calcifications

ABSTRACT: Mesenteric lipodystrophy (ML) is a rare condition characterized by a nonspecific inflammatory process that involves the root of the mesentery in a lipoma-like lesion. Presenting features of ML include abdominal pain, weight loss, nausea, vomiting, diarrhea, and constipation. This case illustrates that ML should be included in the differential…

Case Report

Pigmented Schwannoma of the Ventral Spinal Cord

ABSTRACT: Pigmented schwannomas of the spinal canal are rare entities. We present a case of such in an unusual, ventral intradural, extramedullary location in a 27-year-old man. Imaging and histopathologic findings, including electron microscopy, showed an intradural, extramedullary pigmented schwannoma, densely adherent to the leptomeninges of the anterior median septum….

Case Report

Interaction Between Rifampin and Levothyroxine

ABSTRACT: Rifampin is a potent inducer of hepatic enzymes and is well documented to cause many clinically significant drug interactions. Studies in normal volunteers have shown its ability to decrease circulating levels of thyroid hormone, while having no effect on thyroidstimulating hormone (TSH). Reports of rifampin's effects on patients on…

Case Report

New Considerations in the Diagnosis and Therapy of Deep Vein Thrombosis

ABSTRACT: The cause of thrombosis is often unknown but is universally ascribed to part of Virchow's triad: stasis, hypercoagulability, and intimal injury. Venous thromboembolic disease is a common and costly medical problem, with iliofemoral deep vein thrombosis (IFDVT) being a less common but often underestimated presentation of this condition. Treatment…

Case Report

Fracture at Fenestration of Synthetic Tracheostomy Tube Resulting in a Tracheobronchial Airway Foreign Body

ABSTRACT: Tracheostomy tube fracture resulting in airway obstruction is a relatively rare but serious complication. We report the case of a 48-year-old man whose tracheostomy tube fractured and became lodged in the right primary bronchus. Recommendations are made for tracheostomy care to help prevent similar complications in patients with an…

Case Report

Asymptomatic Intussusception of the Appendix Due to Endometriosis

ABSTRACT: We present the case of a 29-year-old woman with an asymptomatic intussuscepted appendix found incidentally during surgical evaluation for a pelvic mass in a patient with endometriosis. This case represents the rare nature of this presentation and the need to fully evaluate the gastrointestinal tract in patients with endometriosis.

Abstract

ALCOHOL INTAKE AND GASTROINTESTINAL CANCER

Abstract

ASPIRIN AND THE RISK OF HEMORRHAGIC STROKE

Abstract

CHLAMYDIA INFECTION AMONG FEMALE MILITARY RECRUITS

Editorial

COMFORT CARE: WHY WAIT UNTIL THE END OF LIFE?

Abstract

GLYCEMIC CONTROL AND QUALITY OF LIFE ISSUES IN TYPE 2 DIABETES MELLITUS

Abstract

HIGH FOLIC ACID INTAKE REDUCES THE RISK OF COLON CANCER

Abstract

LONG-TERM EFFECTS OF INTENSIVE GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Abstract

METFORMIN AS A FIRST-LINE TREATMENT FOR TYPE 2 DIABETES MELLITUS

News Potpourri

News Potpourri

Abstract

RACIAL DIFFERENCES IN BONE TURNOVER AND STRUCTURE

Abstract

RISK FACTORS FOR INFANT HOMICIDE IDENTIFIED

Editorial

TO TREAT OR NOT TO TREAT PAIN

Abstract

U-SHAPED RELATIONSHIP BETWEEN WORKING HOURS AND MYOCARDIAL INFARCTION