Issue - Southern Medical Association

Case Report

Infection of a Knee Prosthesis With Tsukamurella Species

AbstractA 69-year-old woman with a history of multiple infections of a postoperative wound from a knee replacement was diagnosed with an infection with Tsukamurella sp. The infection was treated with a course of vancomycin and pipercillin/tazobactam, followed by a course of clarithromycin, ciprofloxacin, and ethambutol. The patient responded well. This…

Primary Article

Folk Remedy Use in the Inner City

AbstractBackground.Folk remedies (FRs) are common in some minority communicties within the United States. However, little information is available about the use of FRs in the inner city. The objectives fo this study were to identify the prevalence and types of FRs used in the inner city, to characterize the population…

Current Concepts

The Third Heart Sound

AbstractBackground.In the current era of cost-effective delivery of health care, it is particularly timely to carefully reevaluate the clinical utility of selected physical signs. The third heart sounds (S3) is one such sign that is the focus of the current review.Methods.I conducted a computerized MEDLINE search of articles related to…

Primary Article

Necrotizing Fasciitis and Malpractice Claims

AbstractBackground.Necrotizing fasciitis (NF) is an aggressive bacterial infection of the superficial fascia and subcutaneous tissues that is increasing in incidence. The high toll exacted by this illness provides a setting for malpractice claims.Method.We reviewed 180 consecutive malpractice claims submitted by attorney for medical expert review between 1987 and late 1997….

Primary Article

Clinical Presentation and Treatment of a Salmonella bredeney Epidemic in Shelby County, Alabama

AbstractBackground.Numerous residents of Shelby County, Alabama, were infected with Salmonella when a restaurant unknowingly served food tainted with the bacterium. Because of the similarity in symptoms caused by other gastrointestinal pathogens and the variability in time of presentation, and outbreak such as this could be confused with one of another…

Primary Article

Factors Influencing Morning Report Case Presentations

AbstractBackground.One of the most widely accepted didactic conferences among residency training programs is morning report. This study examines several factors that may influence the content of case presentations at morning report.Methods.This prospective survey is of cases presented over a 1-year period at two morning reports—a university hospital and its affiliated…

Primary Article

Graduate Surgical Trainee Attitudes Toward Postoperative Thromboprophylaxis

AbstractBackground.Postoperative deep vein thrombosis (DVT) results in significant morbidity and mortality. Appropriate patient risk assessment and proper use of prophylactic measures is crucial.Methods.We conducted a confidential survey of general surgery house staff. The survey addressed DVT risk factor recognition, proximal and distal DVT absolute risk estimation, DVT prophylaxis strategies, and…

Primary Article

Irritable Bowel Syndrome and Lactose Maldigestion in Recurrent Abdominal Pain in Childhood

AbstractBackground.The aim of this study was to evaluate the impact of irritable bowel syndrome (IBS) and lactose maldigestion in children with recurrent abdominal pain.Methods.Children who had abdominal pain association with defecation or change in bowel habit, disordered defecation, and distension were diagnosed with IBS, and lactose maldigestion was defined by…

Primary Article

Low Amniotic Fluid Volume is Poorly Identified in Singleton and Twin Pregnancies Using the 2 x 2 cm Pocket Technique of the Biophysical Profile

AbstractBackground.This study was done to determine the accuracy of the 2 x 2 cm pocket identifying low amniotic fluid (AF) volume in singleton and twin pregnancies.Methods.The AF volume was evaluated by ultrasonography for the presence of a 2 x 2 cm pocket before amniocentesis. The actual AF volume was then…

Primary Article

Quality of Care for Medicare Patients Hospitalized With Heart Failure in Rural Georgia

AbstractBackground:It is not known whether quality of care for congestive heart failure (CHF) at rural hospitals is similar to that in larger, urban hospitals.Methods.We reviewed hospital charts for 310 Medicare patients hospitalized with CHF at six hospitals in rural Georgia.Results.Of the 310 patients, 101 (33%) had left ventricular systolic dysfunction,…

Case Report

Always Remember Chylothorax

AbstractChylothorax is a rare cause of pleural effusion in association with cardiovascular surgery. A 68-year-old man had a coronary artery bypass graft; 10 days after surgery, he had progressive shortness of breath and a massive left pleural effusion. After chylothorax was diagnosed, it was successfully treated with a thoracostomy tube…

Case Report

Destructive Native Valve Endocarditis Caused by Staphylococcus lugdunensis

AbstractCoagulase-negative staphylococci are uncommon causes of native valve endocarditis, and the clinical course after valvular infection with these organisms is variable. In clinical practice, species identification is frequently not done, and possible differences in the pathogenicity of various species may be unrecognized. We report a case of Staphylococcus lugdunensis native…

Case Report

Transient Lumbosacral Polyradiculopathy After Prostatectomy Association With Spinal Stenosis

AbstractMononeuropathies are common after pelvic surgery. They are usually the result of unnatural positioning during surgery or faulty restraining devices. Polyneuropathy in the postoperative setting is rare. We report two cases of polyradiculopathy after radical prostatectomy using two different patient positions. Both patients complained of paresthesias and weakness in their…

Current Concepts

Epidemic Hysteria in Virginia The Case of the Phantom Gasser of 1933–1934

AbstractObjective.We studied an example of epidemic hysteria occurring outside a closed community and involving fear of being “gassed.” The description presented is that of a previously unrecorded case of epidemic hysteria in the state of Virginia during 1933–1934.Data Sources.data were gathered from contemporary newspaper accounts.Conclusion.The case of the Virginia “gasser”…

Case Report

Correlation of Pseudohypoxemia and Leukocytosis in Chronic Lymphocytic Leukemia

AbstractPseudohypoxemia has been reported in leukemic patients with extreme leukocytosis, and it is characterized by a low oxygen saturation on arterial blood gas analysis despite normal saturation on pulse oximetry. We report the case of a 51-year-old man with chronic lymphocytic leukemia and an elevated white blood cell (WBC) count…

Case Report

Thromboembolism in the Right Side of the Heart

AbstractRight-sided cardiac thromboemboli, or pulmonary emboli-in-transit, represent an unusual disease process with high morbidity and mortality. We present a detailed case report and a synopsis of our experience at the University of Mississippi Medical Center between 1990 and 1997 and review the current medical literature. These thrombi and emboli may…

Case Report

Rothia Endocarditis in a Child

AbstractRothia dentocariosa, an organism inhabiting the oral flora, has been reported to cause endocarditis in adults but not in children. Most patients reported with Rothia endocarditis have a history of poor dentition. We report a case of Rothia endocarditis in a child with congenital heart disease without other known risk…

Case Report

Sporadic Creutzfeldt‐Jakob Disease Presenting as Major Depression

ABSTRACTWe describe a 68-year-old white woman who initially had symptoms of major depression and was admitted to a psychiatric hospital where she had electroconvulsive therapy. With failure of psychiatric treatment and subsequent rapidly progressive dementia, she had left frontal brain biopsy. The biopsy. The biopsy revealed spongiform changes, the hallmark…

Case Report

Whipple's Disease Presenting as Sarcoidosis and Valvular Heart Disease

AbstractWhipple's disease is a rare systemic disorder that can present in a variety of ways and is often difficult to diagnose. It can involve almost any organ system and can mimic other diseases both in its symptoms and pathologic appearance. We present a case initially diagnosed as sarcoidosis that was…

Abstract

AGE, OBESITY, AND MORTALITY

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CALCIUM INTAKE FROM DRINKING WATER AND BONE MINERAL DENSITY

Expired CME Article

CME Article of the Month

Correspondence

Folate Deficiency

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FOLIC ACID, ALCOHOL, AND BREAST CANCER

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GASTROESOPHAGEAL REFLUX AND ESOPHAGEAL ADENOCARCINOMA

Correspondence

Hyponatremia Associated With Paroxetine Use

News Potpourri

News Potpourri

Correspondence

Obesity Management

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PERFORATED APPENDIX IN CHILDHOOD AND SUBSEQUENT FERTILITY IN ADULTHOOD

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POSTDISCHARGE CARE AND SUICIDE IN PATIENTS WITH MENTAL ILLNESS

Correspondence

Reply

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SLEEP APNEA INCREASES THE RISK OF ROAD TRAFFIC ACCIDENTS

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THYROID HORMONE AND BONE MASS

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VITAMIN B AND CHRONIC FATIGUE SYNDROME

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VITAMIN D DEFICIENCY AND HIP FRACTURES

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WHICH TEST FOR PATIENTS WITH ACUTE CHEST PAIN?