Issue - Southern Medical Association

Article

‘The Falling Sickness’ in Literature

ABSTRACT &NA; Seizures have been described in literature since early times. Since classical literature reflects the attitudes of society, a review of “the falling sickness” in literature provides some insights into the profound affect of epilepsy. This article explores some great writings describing epilepsy and the changing view of an…

Article

CORRESPONDENCE

Case Report

Provocative Angiography in Obscure Gastrointestinal Bleeding

ABSTRACT &NA; Obscure gastrointestinal (GI) bleeding is relatively common but difficult to manage. By definition, diagnosis of a specific etiology is particularly challenging. We report the diagnostic use of provocative angiography in a patient with recurrent obscure GI bleeding. Although provocative angiography led to localization of bleeding and allowed specific…

Case Report

Androgen-Secreting Steroid Cell Tumor of the Ovary

ABSTRACT &NA; We present the case of a 93‐year‐old virilized woman with an androgen‐secreting ovarian tumor. This rare ovarian sex cord stromal tumor behaved in a malignant fashion. Various aspects of the presentation, diagnosis, and treatment of these tumors are discussed.

Case Report

Acute Quadriplegia in a 34-Year-Old Man

ABSTRACT &NA; A 34&hyphen;year&hyphen;old man of Native American descent had flaccid paralysis of the extremities 2 days after a camping trip. He had no respiratory difficulty, sensory deficit, or abnormal reflexes. He was subsequently found to have a serum potassium level of 1.6 mEq&sol;L, a thyrotropin level of <0.06 μIU&sol;L,…

Case Report

Marfanoid Habitus, Dysmorphic Features, and Web Neck

ABSTRACT &NA; Bilateral pneumothoraces and aortic dilatation developed in a 25&hyphen;year&hyphen;old white man with marfanoid habitus, dysmorphic features, web neck, and intellectual impairment. He had physical features suggestive of Shprintzen&hyphen;Goldberg syndrome. We review the common characteristics of Marfan and Shprintzen&hyphen;Goldberg syndromes and compare them with our case. Physicians should beware…

Case Report

Spontaneous Hemopneumothorax in Women

ABSTRACT &NA; Spontaneous hemopneumothorax is uncommon, especially among women. We report a case of spontaneous hemopneumothorax in a 19&hyphen;year&hyphen;old woman and review seven other cases of spontaneous hemopneumothorax in women that have been reported in the English language.

Case Report

Herpes Simplex Type 2 Causing Fulminant Hepatic Failure

ABSTRACT &NA; Although exceedingly rare, fulminant hepatic failure &lpar;FHF&rpar; in immunocompetent patients can develop with primary or recurrent infection due to herpes simplex virus &lpar;HSV&rpar;. The diagnosis is frequently obscured by the absence of mucocutaneous involvement. Elevated transaminase values with leukopenia and a relatively low bilirubin level may provide clues…

Case Report

Group C Streptococcal Infection in a Prosthetic Joint

ABSTRACT &NA; We present possibly the first reported case of prosthetic joint infection due to group C Streptococcus in a 53&hyphen;year&hyphen;old man. The patient was treated with surgical debridement along with extended intravenous antibiotics and long&hyphen;term oral penicillin therapy. He was able to retain the prosthesis and at 4&hyphen;year follow&hyphen;up…

Current Concepts

Penile Prosthetic Trends in the Era of Effective Oral Erectogenic Agents

ABSTRACT &NA; Before the introduction of sildenafil for the treatment of erectile dysfunction &lpar;ED&rpar;, penile implants were recognized as the most effective, though most invasive, therapy with a high satisfaction rate. We compared and evaluated trends in penile prosthesis procedures at a tertiary referral center before and after the introduction…

Current Concepts

Reemergence of Insulin Pump Therapy in the 1990s

ABSTRACT &NA; The publication of the landmark Diabetes Control and Complications Trial results in 1993 provided a strong impetus to achieve near&hyphen;normalization of blood glucose levels in type I diabetic patients using intensive insulin therapy programs. Recent studies show less hypoglycemia with this form of intensive therapy and equivalent or…

Current Concepts

Benign Transient Hyperphosphatasemia of Infancy and Childhood

ABSTRACT &NA; Six children, aged 11 to 25 months, were found to have elevated serum alkaline phosphatase &lpar;ALP&rpar; levels &lpar;1,077 to 9,271 U&sol;L&rpar; in the absence of disease. Benign transient hyperphosphatasemia &lpar;BTH&rpar; was diagnosed when the serum ALP levels returned to normal or decreased significantly within 3 months. Several theories…

Editorial

HEALTH SUPPLEMENT REGULATIONS AND CONSUMER PROTECTION RIGHTS

Evagations

MEDICAL PROGRESS PAST, PRESENT, AND FUTURE

Expired CME Article

Dietary Guidelines for Chronic Disease Prevention

ABSTRACT &NA; In developed nations, diet is related directly or indirectly to the most prevalent chronic diseases. Research has helped clarify diet&hyphen;disease relationships and enabled the promulgation of dietary recommendations for chronic disease prevention. We reviewed epidemiologic study results, clinical trial data, and general dietary recommendations from various agencies to…

Primary Article

Transurethral Resection of the Prostate Failure Patterns and Surgical Outcomes in Patients With Symptoms Refractory to &agr;&hyphen;Antagonists

Abstract Background &agr;&hyphen;Antagonists &lpar;AAs&rpar; are ineffective in some men with lower urinary tract symptoms &lpar;LUTS&rpar; due to benign prostatic hyperplasia &lpar;BPH&rpar;. Transurethral resection of the prostate &lpar;TURP&rpar; may be required. Reasons for AA failure and surgical outcomes in these patients have not been reported. Methods We retrospectively reviewed cases of…

Primary Article

Coronary Angioplasty in Black and White Patients Demographic Characteristics and Outcomes

Abstract Background Percutaneous transluminal coronary angioplasty &lpar;PTCA&rpar; is an effective means of revascularization, but differences may exist in application and outcomes for patient subgroups. Few data compare PTCA in black and white patients. Methods We compared patient characteristics and outcomes of PTCA in 3,447 white patients and 52 black patients….

Primary Article

Effects of Intercessory Prayer on Patients With Rheumatoid Arthritis

Abstract Background Many individuals pray during times of illness, but the clinical effects of prayer are not well&hyphen;understood. Methods We prospectively studied a cohort of 40 patients &lpar;mean age, 62 years&semi; 100&percnt; white&semi; 82&percnt; women&rpar; at a private rheumatology practice. All had class II or III rheumatoid arthritis and took…

Article

‘The Falling Sickness’ in Literature

ABSTRACT:Seizures have been described in literature since early times. Since classical literature reflects the attitudes of society, a review of “the falling sickness” in literature provides some insights into the profound affect of epilepsy. This article explores some great writings describing epilepsy and the changing view of an epileptic as…

Case Report

Acute Quadriplegia in a 34-Year-Old Man

ABSTRACT:A 34-year-old man of Native American descent had flaccid paralysis of the extremities 2 days after a camping trip. He had no respiratory difficulty, sensory deficit, or abnormal reflexes. He was subsequently found to have a serum potassium level of 1.6 mEq/L, a thyrotropin level of <0.06 μIU/L, and a…

Case Report

Group C Streptococcal Infection in a Prosthetic Joint

ABSTRACT:We present possibly the first reported case of prosthetic joint infection due to group C Streptococcus in a 53-year-old man. The patient was treated with surgical debridement along with extended intravenous antibiotics and long-term oral penicillin therapy. He was able to retain the prosthesis and at 4-year follow-up had no…

Case Report

Spontaneous Hemopneumothorax in Women

ABSTRACT:Spontaneous hemopneumothorax is uncommon, especially among women. We report a case of spontaneous hemopneumothorax in a 19-year-old woman and review seven other cases of spontaneous hemopneumothorax in women that have been reported in the English language.

Case Report

Androgen-Secreting Steroid Cell Tumor of the Ovary*

ABSTRACT:We present the case of a 93-year-old virilized woman with an androgen-secreting ovarian tumor. This rare ovarian sex cord stromal tumor behaved in a malignant fashion. Various aspects of the presentation, diagnosis, and treatment of these tumors are discussed.

Case Report

Herpes Simplex Type 2 Causing Fulminant Hepatic Failure

ABSTRACT:Although exceedingly rare, fulminant hepatic failure (FHF) in immunocompetent patients can develop with primary or recurrent infection due to herpes simplex virus (HSV). The diagnosis is frequently obscured by the absence of mucocutaneous involvement. Elevated transaminase values with leukopenia and a relatively low bilirubin level may provide clues to the…

Case Report

Provocative Angiography in Obscure Gastrointestinal Bleeding

ABSTRACT:Obscure gastrointestinal (GI) bleeding is relatively common but difficult to manage. By definition, diagnosis of a specific etiology is particularly challenging. We report the diagnostic use of provocative angiography in a patient with recurrent obscure GI bleeding. Although provocative angiography led to localization of bleeding and allowed specific treatment (placement…

Case Report

Marfanoid Habitus, Dysmorphic Features, and Web Neck

ABSTRACT:Bilateral pneumothoraces and aortic dilatation developed in a 25-year-old white man with marfanoid habitus, dysmorphic features, web neck, and intellectual impairment. He had physical features suggestive of Shprintzen-Goldberg syndrome. We review the common characteristics of Marfan and Shprintzen-Goldberg syndromes and compare them with our case. Physicians should beware of potential…

Correspondence

Recent Trends in Pediatric Iron Poisonings

Correspondence

Reply

Current Concepts

Reemergence of Insulin Pump Therapy in the 1990s

ABSTRACT:The publication of the landmark Diabetes Control and Complications Trial results in 1993 provided a strong impetus to achieve near-normalization of blood glucose levels in type I diabetic patients using intensive insulin therapy programs. Recent studies show less hypoglycemia with this form of intensive therapy and equivalent or improved glycemic…

Current Concepts

Penile Prosthetic Trends in the Era of Effective Oral Erectogenic Agents

ABSTRACT:Before the introduction of sildenafil for the treatment of erectile dysfunction (ED), penile implants were recognized as the most effective, though most invasive, therapy with a high satisfaction rate. We compared and evaluated trends in penile prosthesis procedures at a tertiary referral center before and after the introduction of sildenafil….

Current Concepts

Dietary Guidelines for Chronic Disease Prevention

ABSTRACT:In developed nations, diet is related directly or indirectly to the most prevalent chronic diseases. Research has helped clarify diet-disease relationships and enabled the promulgation of dietary recommendations for chronic disease prevention. We reviewed epidemiologic study results, clinical trial data, and general dietary recommendations from various agencies to develop a…

Current Concepts

Benign Transient Hyperphosphatasemia of Infancy and Childhood

ABSTRACT:Six children, aged 11 to 25 months, were found to have elevated serum alkaline phosphatase (ALP) levels (1,077 to 9,271 U/L) in the absence of disease. Benign transient hyperphosphatasemia (BTH) was diagnosed when the serum ALP levels returned to normal or decreased significantly within 3 months. Several theories have been…

Editorial

HEALTH SUPPLEMENT REGULATIONS AND CONSUMER PROTECTION RIGHTS

Evagations

MEDICAL PROGRESS PAST, PRESENT, AND FUTURE

Primary Article

Effects of Intercessory Prayer on Patients With Rheumatoid Arthritis

AbstractBackground.Many individuals pray during times of illness, but the clinical effects of prayer are not well-understood. Methods.We prospectively studied a cohort of 40 patients (mean age, 62 years; 100% white; 82% women) at a private rheumatology practice. All had class II or III rheumatoid arthritis and took stable doses of…

Primary Article

Coronary Angioplasty in Black and White Patients: Demographic Characteristics and Outcomes

AbstractBackground.Percutaneous transluminal coronary angioplasty (PTCA) is an effective means of revascularization, but differences may exist in application and outcomes for patient subgroups. Few data compare PTCA in black and white patients. Methods.We compared patient characteristics and outcomes of PTCA in 3,447 white patients and 52 black patients. Results.Comparing baseline characteristics,…

Primary Article

Transurethral Resection of the Prostate: Failure Patterns and Surgical Outcomes in Patients With Symptoms Refractory to α-Antagonists

AbstractBackground.&agr;-Antagonists (AAs) are ineffective in some men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Transurethral resection of the prostate (TURP) may be required. Reasons for AA failure and surgical outcomes in these patients have not been reported. Methods.We retrospectively reviewed cases of TURP for LUTS…

Trauma Rounds

Electrical Injuries

Electrical injuries may occur from high or low voltage contact. Low voltage injuries usually occur in the home, tetany may lead to sustained contact, and dangerous cardiac disturbances often result. High voltage injuries are usually work related and result from brief contact but may cause serious tissue destruction and secondary…