Issue - Southern Medical Association

Case Report

Pulmonary Thromboembolism During Transurethral Resection of the Prostate

ABSTRACT: &NA; Although perioperative pulmonary thromboembolism (PTE) is a common complication of surgery, intraoperative pulmonary thromboembolism is unusual. We report the occurrence of PTE during transurethral resection of the prostate. We believe this to be the first report of such a case.

Case Report

Tick Paralysis Syndrome in a 5-Year-Old Girl

ABSTRACT: &NA; Tick paralysis syndrome (TPS) is an uncommon cause of ascending paralysis in children. Familiarity with its clinical features is important, since prompt diagnosis and removal of the tick is curative. We report the case of a 5‐year‐old girl with TPS manifested as lower extremity ataxia and paralysis and…

Case Report

Medical Complications Due to Mothball Abuse

ABSTRACT: &NA; Inhalant abuse is a major public health problem that has been associated with numerous acute and chronic medical problems. Inhalants are defined as volatile organic substances and are found in common household and commercial products that are easily accessible, inexpensive, and legally obtained. We discuss a rare case…

Case Report

Open Air Carbon Monoxide Poisoning in a Child Swimming Behind a Boat

ABSTRACT: &NA; Carbon monoxide (CO) poisoning is the most common fatal poisoning in the United States. The circumstances often involve an unsuspected increase of CO in an enclosed environment. Victims often are unaware that their activity or environment placed them at risk for CO poisoning. The possibility of open air…

Current Concepts

Radioguided Surgical Advancements for Head and Neck Oncology

ABSTRACT: &NA; Radioguided surgery is an innovative means by which a radionuclide is used to preoperatively image and intraoperatively visualize a structure of interest to the surgeon for excisional biopsy. This technology has allowed a cost‐effective, highly specific means by which to locate a structure (usually a lymph node) and…

Current Concepts

Persistence of Cerebral Blood Flow After Brain Death

ABSTRACT: &NA; Persistent cerebral blood flow occasionally confounds confirmatory tests for brain death and results in the anguish of delayed diagnosis, unnecessary use of expensive resources, and loss of transplant opportunities. We reviewed the literature to examine the reasons, frequency, and meaning of this problem. We found that this phenomenon…

Expired CME Article

Pediatric Iron Poisonings in the United States

Abstract Background. Iron overdose is considered a leading cause of poisoning‐related injury and death in young children. This report analyzes the nature, trend, and hazard patterns of unintentional pediatric iron overdoses in the United States from 1980 to 1996. Methods. Analyses include multiple regression and correlation analysis of national data…

Medical Education

Population‐Based Survey of Complementary and Alternative Medicine Usage, Patient Satisfaction, and Physician Involvement

Abstract Background. With an increasing proportion of Americans using complementary or alternative medicine (CAM), physicians need to know which patients are using CAM to effectively manage care. Methods. In this cross‐sectional study, telephone interviews were conducted with 1,584 South Carolina adults (ages 18 and older); 66% responded to the survey…

Primary Article

Income Inequality and All‐Cause Mortality in the 100 Counties of North Carolina

Abstract Background. This study evaluated the relationship between income inequality and all‐cause mortality in the 100 counties of North Carolina. Methods. Mortality data for 1985 to 1994 came from the National Center for Health Statistics and household income data from the 1990 Census. Associations between county‐level income inequality and age‐adjusted,…

Primary Article

Measuring Self‐Efficacy in Substance Abuse Intervention in Obstetric Practices

Abstract Background. This study presents findings on the effect of an office‐based obstetrics training program (given the acronym OBIWOM) on substance use assessment, management, and referral self‐efficacy among obstetricians and staff of private, community‐based obstetric practices. Methods. Participants were obstetricians and staff from 10 of 27 available community‐based, private obstetric…

Primary Article

Liver Transplantation in the Era of Cost Constraints

Abstract Background. The issue of containing cost has had a significant impact on organ transplantation. After our institution's 500th liver transplant, we critically examined the impact of the changing health care environment on liver transplantation. Methods. We retrospectively analyzed 500 consecutive liver transplants done in the period of 1989 to…

Primary Article

Clinical and Biopsy Specimen Features in Black and White Men With Clinically Localized Prostate Cancer

Abstract Background. The incidence of prostate cancer in black men is estimated to be 30% to 50% higher than among age‐matched white men, and black men have a twofold higher mortality rate. To determine whether racial differences exist in men with similarly staged disease, we compared clinical and pathologic features…

Primary Article

Blunt Trauma in Intoxicated Patients Is Computed Tomography of the Abdomen Always Necessary?

Abstract Background. Physical examination to detect abdominal injuries has been considered unreliable in alcohol‐intoxicated trauma patients. Computed tomography (CT) plays the primary role in these abdominal evaluations. Methods. We reviewed medical records of all blunt trauma patients admitted to our trauma service from January 1, 1992, to March 31, 1998….

Primary Article

Left Main Coronary Artery Rotational Atherectomy and Stenting

Abstract Background. Coronary artery bypass surgery is a difficult option in patients who are not candidates for bypass surgery and high‐risk patients with critical left main coronary artery (LMCA) disease. We report outcomes and short‐term follow‐up of patients who had LMCA rotational atherectomy and/or stenting, assess the role of these…

Primary Article

Limited Utility of Routine Drug Screening in Trauma Patients*

Abstract Background. Routine toxicology screening of seriously injured patients has become the standard of care in most trauma centers. However, the benefit of drug screening in acute trauma is unproven. We reviewed the impact of positive drug screening results on patient care within the first 3 days of treatment. Methods….

Primary Article

Frequency of Lipid‐Lowering Drug Therapy After Coronary and Carotid Operations for Atherosclerosis

Abstract Background. Coronary artery bypass grafting (CABG) and carotid endarterectomy (CE) are palliative operations for patients with severe atherosclerosis of the coronary or carotid arteries. Secondary preventive measures after these operations have received little attention. Methods. We conducted a retrospective observational study to determine the frequency of lipid‐lowering drug therapy…

Review Article

Hormesis and Health A Little of What You Fancy May Be Good for You

ABSTRACT: &NA; The term hormesis refers to beneficial effects from low doses of potentially harmful substances. Although there are many laboratory examples of this phenomenon, it remains controversial and has never become widely accepted by the health community. This review goes beyond the laboratory and describes many clinical and common…

Trauma Rounds

Blunt Pancreatic Trauma A Difficult Injury

ABSTRACT: &NA; The diagnosis and initial management of hemodynamically stable blunt pancreatic trauma should include a high index of suspicion when a patient has sustained a severe force vector in the anterior‐posterior direction of the abdominal cavity. Patients who are hemodynamically stable should have physical examination, computed tomography (CT) of…

Case Report

Open Air Carbon Monoxide Poisoning in a Child Swimming Behind a Boat

ABSTRACT:Carbon monoxide (CO) poisoning is the most common fatal poisoning in the United States. The circumstances often involve an unsuspected increase of CO in an enclosed environment. Victims often are unaware that their activity or environment placed them at risk for CO poisoning. The possibility of open air CO poisonings…

Case Report

Medical Complications Due to Mothball Abuse

ABSTRACT:Inhalant abuse is a major public health problem that has been associated with numerous acute and chronic medical problems. Inhalants are defined as volatile organic substances and are found in common household and commercial products that are easily accessible, inexpensive, and legally obtained. We discuss a rare case of mothball…

Case Report

Pulmonary Thromboembolism During Transurethral Resection of the Prostate

ABSTRACT:Although perioperative pulmonary thromboembolism (PTE) is a common complication of surgery, intraoperative pulmonary thromboembolism is unusual. We report the occurrence of PTE during transurethral resection of the prostate. We believe this to be the first report of such a case.

Case Report

Melanoma Vaccines as a Therapeutic Option

Case Report

Tick Paralysis Syndrome in a 5-Year-Old Girl

ABSTRACT:Tick paralysis syndrome (TPS) is an uncommon cause of ascending paralysis in children. Familiarity with its clinical features is important, since prompt diagnosis and removal of the tick is curative. We report the case of a 5-year-old girl with TPS manifested as lower extremity ataxia and paralysis and briefly discuss…

Case Report

Sinus Bradycardia Due to Mitoxantrone

Case Report

Reply

Case Report

Social Events and Scientific Innovations May Affect the Content of Delusions

Current Concepts

Pediatric Iron Poisonings in the United States

AbstractBackground.Iron overdose is considered a leading cause of poisoning-related injury and death in young children. This report analyzes the nature, trend, and hazard patterns of unintentional pediatric iron overdoses in the United States from 1980 to 1996. Methods.Analyses include multiple regression and correlation analysis of national data on pediatric iron…

Current Concepts

Persistence of Cerebral Blood Flow After Brain Death

ABSTRACT:Persistent cerebral blood flow occasionally confounds confirmatory tests for brain death and results in the anguish of delayed diagnosis, unnecessary use of expensive resources, and loss of transplant opportunities. We reviewed the literature to examine the reasons, frequency, and meaning of this problem. We found that this phenomenon occurs: (1)…

Current Concepts

Radioguided Surgical Advancements for Head and Neck Oncology

ABSTRACT:Radioguided surgery is an innovative means by which a radionuclide is used to preoperatively image and intraoperatively visualize a structure of interest to the surgeon for excisional biopsy. This technology has allowed a cost-effective, highly specific means by which to locate a structure (usually a lymph node) and access it…

Medical Education

Population-Based Survey of Complementary and Alternative Medicine Usage, Patient Satisfaction, and Physician Involvement

AbstractBackground.With an increasing proportion of Americans using complementary or alternative medicine (CAM), physicians need to know which patients are using CAM to effectively manage care. Methods.In this cross-sectional study, telephone interviews were conducted with 1,584 South Carolina adults (ages 18 and older); 66% responded to the survey of demographics, general…

Primary Article

Income Inequality and All-Cause Mortality in the 100 Counties of North Carolina

AbstractBackground.This study evaluated the relationship between income inequality and all-cause mortality in the 100 counties of North Carolina. Methods.Mortality data for 1985 to 1994 came from the National Center for Health Statistics and household income data from the 1990 Census. Associations between county-level income inequality and age-adjusted, all-cause mortality rates…

Primary Article

Limited Utility of Routine Drug Screening in Trauma Patients

AbstractBackground.Routine toxicology screening of seriously injured patients has become the standard of care in most trauma centers. However, the benefit of drug screening in acute trauma is unproven. We reviewed the impact of positive drug screening results on patient care within the first 3 days of treatment. Methods.We retrospectively reviewed…

Primary Article

Liver Transplantation in the Era of Cost Constraints

AbstractBackground.The issue of containing cost has had a significant impact on organ transplantation. After our institution's 500th liver transplant, we critically examined the impact of the changing health care environment on liver transplantation. Methods.We retrospectively analyzed 500 consecutive liver transplants done in the period of 1989 to 1998. Results.Comparing the…

Primary Article

Frequency of Lipid-Lowering Drug Therapy After Coronary and Carotid Operations for Atherosclerosis

AbstractBackground.Coronary artery bypass grafting (CABG) and carotid endarterectomy (CE) are palliative operations for patients with severe atherosclerosis of the coronary or carotid arteries. Secondary preventive measures after these operations have received little attention. Methods.We conducted a retrospective observational study to determine the frequency of lipid-lowering drug therapy before and after…

Primary Article

Measuring Self-Efficacy in Substance Abuse Intervention in Obstetric Practices

AbstractBackground.This study presents findings on the effect of an office-based obstetrics training program (given the acronym OBIWOM) on substance use assessment, management, and referral self-efficacy among obstetricians and staff of private, community-based obstetric practices. Methods.Participants were obstetricians and staff from 10 of 27 available community-based, private obstetric practices in the…

Primary Article

Blunt Trauma in Intoxicated Patients: Is Computed Tomography of the Abdomen Always Necessary?

AbstractBackground.Physical examination to detect abdominal injuries has been considered unreliable in alcohol-intoxicated trauma patients. Computed tomography (CT) plays the primary role in these abdominal evaluations. Methods.We reviewed medical records of all blunt trauma patients admitted to our trauma service from January 1, 1992, to March 31, 1998. Study patients had…

Primary Article

Clinical and Biopsy Specimen Features in Black and White Men With Clinically Localized Prostate Cancer

AbstractBackground.The incidence of prostate cancer in black men is estimated to be 30% to 50% higher than among age-matched white men, and black men have a twofold higher mortality rate. To determine whether racial differences exist in men with similarly staged disease, we compared clinical and pathologic features in black…

Primary Article

Left Main Coronary Artery Rotational Atherectomy and Stenting

AbstractBackground.Coronary artery bypass surgery is a difficult option in patients who are not candidates for bypass surgery and high-risk patients with critical left main coronary artery (LMCA) disease. We report outcomes and short-term follow-up of patients who had LMCA rotational atherectomy and/or stenting, assess the role of these interventions in…

Review Article

Hormesis and Health: A Little of What You Fancy May Be Good for You

ABSTRACT:The term hormesis refers to beneficial effects from low doses of potentially harmful substances. Although there are many laboratory examples of this phenomenon, it remains controversial and has never become widely accepted by the health community. This review goes beyond the laboratory and describes many clinical and common sense, real-world…

Trauma Rounds

Blunt Pancreatic Trauma: A Difficult Injury

ABSTRACT:The diagnosis and initial management of hemodynamically stable blunt pancreatic trauma should include a high index of suspicion when a patient has sustained a severe force vector in the anterior-posterior direction of the abdominal cavity. Patients who are hemodynamically stable should have physical examination, computed tomography (CT) of the abdomen,…