Case Histories

Airway Obstruction Due to Bilateral Giant Pulmonary Artery Aneurysms

&NA; Large pulmonary artery aneurysms are rare, but they are associated with significant morbidity and mortality. Significant airway obstruction due to extrinsic compression solely by a pulmonary artery aneurym is an extremely rare occurrence. We present a case of large bilateral pulmonary artery aneurysms causing extrinsic airway compression with collapse…

Case Histories

Diabetic Gustatory Sweating

&NA; Gustatory sweating is a potential manifestation of autonomic dysfunction in diabetes. This syndrome is seen in long‐standing diabetes and is associated with nephropathy, peripheral neuropathy, and other signs of dysautonomia. Symptoms of profuse head and neck diaphoresis with eating may suggest this clinical diagnosis. We present a patient who…

Case Histories

Syncope in an Adult With Uncontrolled Asthma

&NA; Cough syncope occurs primarily in middle‐aged male smokers with chronic obstructive pulmonary disease (COPD). It has also been described in children with asthma. I report the case of a 34‐year‐old nonsmoker who had syncope due to coughing, and who also related a 1‐year history of cough with wheezing. Chest…

Case Histories

Percutaneous Balloon Mitral Valvuloplasty During a Twin Gestation

&NA; Although percutaneous balloon mitral valvuloplasty is known to be a safe and effective procedure during a singleton pregnancy, its use during a twin gestation is limited to a single report with a poor obstetric outcome. In the case we are reporting, a 29‐year‐old nulliparous patient with a twin gestation…

Case Histories

Dermatofibrosarcoma Protuberans With Lung Metastasis in a Patient With Progressive Systemic Sclerosis

&NA; A female patient with progressive systemic sclerosis and pulmonary fibrosis had a dermatofibrosarcoma protuberans on the right thigh. After resection of the tumor, new lesions occurred in the scar, and wide excision was repeated. Two years later, a lung metastasis was discovered, and segmental resection was done. After 1…

Editorial

CIGARETTE SMOKING—A PARADOX

Expired CME Topic

Featured CME Topic Adverse Effects of Smoking

Expired CME Topic

Bronchoscopy Coverage and Reimbursement

Acknowledgment

Selected Annotated Bibliography

Original Article

Respiratory Syncytial Virus Infection and the Primary Care Physician

&NA; Respiratory syncytial virus (RSV) infection is a common viral illness affecting almost all children within their first few years of life. In most young children, RSV results in a mild respiratory infection. It is, however, the single most important cause of bronchiolitis and pneumonitis in infancy and contributes to…

Original Article

Accidental Injection of Epinephrine From an Autoinjector Invasive Treatment Not Always Required

Background. Individual case reports of accidental injection with epinephrine appear in the literature and seem to represent the worst case scenarios. We present a case series of 28 exposures to epinephrine via autoinjector.

Original Article

Legislators' Views on Tobacco Policy Are There Regional Differences in Kentucky?

Background. Tobacco‐growing states have few tobacco control laws, which are relatively weak compared with those in non‐tobacco‐growing states. Region of the country has been shown to be a predictor of legislators' intentions to vote for cigarette tax increases.

Original Article

Medium and Long‐Term Growth in Children Receiving Intranasal Beclomethasone Dipropionate A Clinical Experience

Background. A 12‐month controlled pediatric study of intranasal beclomethasone dipropionate (BDP) reported a 0.9 cm decrease in annual height growth velocity. Since children with allergic rhinitis may be treated for years, this report evaluates long‐term height growth effects.

Original Article

Determinants of Outcome for Patients Admitted to a Long‐Term Ventilator Unit

Background. This prospective cohort study was done to identify determinants of successful weaning from mechanical ventilation among patients admitted to the 10‐bed long‐term ventilator unit (LTVU) of a teaching hospital.

Original Article

Literary Psychiatric Observation and Diagnosis Through the Ages King Lear Revisited

&NA; Shakespeare's plays, and in particular King Lear, have been a favorite source of clinical observation and diagnosis for psychiatrists for the past two centuries. Most authors agree that the description of Lear's mental symptoms is remarkably consistent and close to life. This article summarizes previous attempts to diagnose the…

Original Article

Patients With Bipolar Illness Admitted to a General Medical Service

Background. This study was done to assess the size and characteristics of the patient population with bipolar illness treated on the general medical service of two divisions of the Charleston Area Medical Center, the largest hospital complex in West Virginia.

Original Article

Cardiac Surgery in Patients With Moderate Renal Impairment

Background. There is a paucity of information concerning the results of cardiac surgery in patients with moderate impairment of renal function. We reviewed our recent experience to determine the results of operation and the long‐term outcome.

Original Article

Ketorolac for Pain Management After Abdominal Surgical Procedures in Infants

Background. While the use of intravenous ketorolac in infants less than 6 months old has not been previously reported, ketorolac may reduce opioid use and prevent opioid‐associated side effects that are frequent in this age group. We reviewed our experience with ketorolac in infants to develop recommendations for using it…

Book Review

Blood Feud

Book Review

Systematic Reviews in Health Care: A Practical Guide

Case Histories

Syncope in an Adult With Uncontrolled Asthma

Cough syncope occurs primarily in middle-aged male smokers with chronic obstructive pulmonary disease (COPD). It has also been described in children with asthma. I report the case of a 34-year-old nonsmoker who had syncope due to coughing, and who also related a 1-year history of cough with wheezing. Chest examination…

Case Histories

Diabetic Gustatory Sweating

Gustatory sweating is a potential manifestation of autonomic dysfunction in diabetes. This syndrome is seen in long-standing diabetes and is associated with nephropathy, peripheral neuropathy, and other signs of dysautonomia. Symptoms of profuse head and neck diaphoresis with eating may suggest this clinical diagnosis. We present a patient who had…

Case Histories

Percutaneous Balloon Mitral Valvuloplasty During a Twin Gestation

Although percutaneous balloon mitral valvuloplasty is known to be a safe and effective procedure during a singleton pregnancy, its use during a twin gestation is limited to a single report with a poor obstetric outcome. In the case we are reporting, a 29-year-old nulliparous patient with a twin gestation was…

Case Histories

Airway Obstruction Due to Bilateral Giant Pulmonary Artery Aneurysms

Large pulmonary artery aneurysms are rare, but they are associated with significant morbidity and mortality. Significant airway obstruction due to extrinsic compression solely by a pulmonary artery aneurym is an extremely rare occurrence. We present a case of large bilateral pulmonary artery aneurysms causing extrinsic airway compression with collapse of…

Case Histories

Dermatofibrosarcoma Protuberans With Lung Metastasis in a Patient With Progressive Systemic Sclerosis

A female patient with progressive systemic sclerosis and pulmonary fibrosis had a dermatofibrosarcoma protuberans on the right thigh. After resection of the tumor, new lesions occurred in the scar, and wide excision was repeated. Two years later, a lung metastasis was discovered, and segmental resection was done. After 1 year…

Correspondence

Importance of Individualized Decision in the Management of Massive Pulmonary Embolism

Correspondence

A “Hospitalist” Rotation Increases Short-term Knowledge of Fourth-Year Medical Students

Editorial

CIGARETTE SMOKING—A PARADOX

Expired CME Topic

Selected Annotated Bibliography

Expired CME Topic

Bronchoscopy Coverage and Reimbursement

Expired CME Topic

Southern Medical Journal

Original Article

Respiratory Syncytial Virus Infection and the Primary Care Physician

Respiratory syncytial virus (RSV) infection is a common viral illness affecting almost all children within their first few years of life. In most young children, RSV results in a mild respiratory infection. It is, however, the single most important cause of bronchiolitis and pneumonitis in infancy and contributes to significant…

Original Article

Legislators' Views on Tobacco Policy Are There Regional Differences in Kentucky?

Background.Tobacco-growing states have few tobacco control laws, which are relatively weak compared with those in non–tobacco-growing states. Region of the country has been shown to be a predictor of legislators' intentions to vote for cigarette tax increases.

Original Article

Medium and Long-Term Growth in Children Receiving Intranasal Beclomethasone Dipropionate A Clinical Experience

Background.A 12-month controlled pediatric study of intranasal beclomethasone dipropionate (BDP) reported a 0.9 cm decrease in annual height growth velocity. Since children with allergic rhinitis may be treated for years, this report evaluates long-term height growth effects.

Original Article

Cardiac Surgery in Patients With Moderate Renal Impairment

Background.There is a paucity of information concerning the results of cardiac surgery in patients with moderate impairment of renal function. We reviewed our recent experience to determine the results of operation and the long-term outcome.

Original Article

Ketorolac for Pain Management After Abdominal Surgical Procedures in Infants

Background.While the use of intravenous ketorolac in infants less than 6 months old has not been previously reported, ketorolac may reduce opioid use and prevent opioid-associated side effects that are frequent in this age group. We reviewed our experience with ketorolac in infants to develop recommendations for using it after…

Original Article

Determinants of Outcome for Patients Admitted to a Long-Term Ventilator Unit

Background.This prospective cohort study was done to identify determinants of successful weaning from mechanical ventilation among patients admitted to the 10-bed long-term ventilator unit (LTVU) of a teaching hospital.

Original Article

Accidental Injection of Epinephrine From an Autoinjector Invasive Treatment Not Always Required

Background.Individual case reports of accidental injection with epinephrine appear in the literature and seem to represent the worst case scenarios. We present a case series of 28 exposures to epinephrine via autoinjector.

Original Article

Literary Psychiatric Observation and Diagnosis Through the Ages King Lear Revisited

Shakespeare's plays, and in particular King Lear, have been a favorite source of clinical observation and diagnosis for psychiatrists for the past two centuries. Most authors agree that the description of Lear's mental symptoms is remarkably consistent and close to life. This article summarizes previous attempts to diagnose the mental…

Original Article

Patients With Bipolar Illness Admitted to a General Medical Service

Background.This study was done to assess the size and characteristics of the patient population with bipolar illness treated on the general medical service of two divisions of the Charleston Area Medical Center, the largest hospital complex in West Virginia.

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