August 2002, Volume 95 - Issue 8

Thoracoscopic Management of Pleural Effusions in Kaposi's Sarcoma A Rapid and Effective Alternative for Diagnosis and Treatment

EDMUNDO R. RUBIO MD, EDUARDO E. CHANG MD, KEVIN L. KOVITZ MD

Abstract: &NA; Kaposi's sarcoma (KS) is one of the most common causes of pleural effusion in patients with acquired immunodeficiency syndrome (AIDS). Pleural effusions due to KS carry a high morbidity and mortality. Their treatment is...

(pp 919‐921)

Herniated Nucleus Pulposus With Radiculopathy in an Adolescent Successful Nonoperative Treatment

RAMONA HOOD‐WHITE, DEVON J. LOWDON MD

Abstract: &NA; The following report describes a 17‐year old girl with a central herniated nucleus pulposus (HNP) at L4‐5. The diagnosis of lumbar disk herniation was based on findings from magnetic resonance imaging (MRI)....

(pp 932‐933)

Primary Splenic Lymphoma Complicated by Hematemesis and Gastric Erosion

MARK A. BIRD MD, DARIUS AMJADI MD, KEVIN E. BEHRNS MD

Abstract: &NA; Gastrosplenic fistula resulting from erosion of a primary splenic lymphoma is a rare cause of massive upper gastrointestinal hemorrhage associated with benign peptic ulcer disease, gastric Crohn's disease, gastric adenocarcinoma, and primary gastric and...

(pp 941‐942)

Metastatic Breast Cancer Manifested as Refractory Anemia and Gastric Polyps

TARA B. KARAMLOU MD, JOHN T. VETTO MD, CHRISTOPHER CORLESS MD, THOMAS DELOUGHERY MD, DOUGLAS FAIGEL MD, CHARLES BLANKE MD

Abstract: &NA; Gastric metastasis from breast cancer is uncommon and typically occurs in patients with disseminated disease. The vast majority of patients with gastric lesions have a known preexisting diagnosis of breast cancer. In contrast, we describe a case in which a minimal...

(pp 922‐925)

HELLP Syndrome Leading to a Diagnosis of Pregnancy

SATHEESH K. KATHULA MD, SRIDHAR R. BOLLA MD, EVERETT F. MAGANN MD

Abstract: &NA; HELLP syndrome (an acronym for hemolysis, elevated liver enzymes, and low platelets) is a life‐threatening complication of pregnancy seen in association with either preeclampsia or eclampsia. HELLP syndrome is rarely diagnosed before 24...

(pp 934‐935)

Klüver‐Bucy Syndrome as a Result of Minor Head Trauma

ALI SALIM MD, ANTHONY K. KIM MD, BRIAN J. KIMBRELL MD, PATRIZIO PETRONE MD, GUSTAVO ROLDÁN, JUAN A. ASENSIO MD

Abstract: &NA; Klüver‐Bucy syndrome (KBS) has been described as a disconnection of the temporal lobes from the remainder of the brain. Its presence in minor head trauma has not been previously reported. We therefore report what we believe to be...

(pp 929‐931)

Long‐Term Survival of a Patient With Human Immunodeficiency Virus Infection and Hodgkin's Lymphoma

HAFEEZ A. DIWAN MD, PhD, JAY UMBREIT MD, BEVERLY P. NELSON MD

Abstract: &NA; When patients infected with human immunodeficiency virus (HIV) are found to have Hodgkin's lymphoma (HL), it is generally advanced, with involvement of extranodal sites including bone marrow, spleen, and liver, and prognosis...

(pp 943‐944)

Coexisting Gilbert's Syndrome and Sickle Cell Disease

ANUPAMA BORKER MD, JOHN UDALL MD, RAJ WARRIER MD

Abstract: &NA; We report the coexistence of Gilbert's syndrome and homozygous sickle cell disease in a child with persistent unconjugated...

(pp 939‐940)

Hemothorax and Retroperitoneal Hematoma After Anticoagulation With Enoxaparin

MICHAL MRUG MD, PRASHANT V. MISHRA MD, HENRY C. LUSANE MD, MARTIN J. CUNNINGHAM MD, MARTIN A. ALPERT MD

Abstract: &NA; A 58‐year‐old woman with chronic obstructive pulmonary disease had spontaneous bilateral hemothorax and a retroperitoneal hematoma after 4 days of anticoagulation therapy with enoxaparin (1 mg/kg subcutaneously every 12...

(pp 936‐938)

Self‐Medication With &ggr;‐Hydroxybutyrate to Reduce Alcohol Intake

JAMES K. GLISSON PharmD, JOHN NORTON MD

Abstract: &NA; We describe a 52‐year‐old man who self‐medicated with &ggr;‐hydroxybutyrate (GHB), a widely available illicit substance, to obtain a decrease in ethanol consumption. He successfully reduced his...

(pp 926‐928)

KLÜVER‐BUCY SYNDROME AFTER MINOR BRAIN INJURY

NA

Abstract: ...

(pp 794‐795)

NHLBI STOPS TRIAL OF ESTROGEN PLUS PROGESTIN DUE TO INCREASED BREAST CANCER RISK AND LACK OF OVERALL BENEFIT

NA

Abstract: ...

(pp 795‐797)

HEAT STROKE

NA

Abstract: ...

(pp 791‐792)

&ggr;‐HYDROXYBUTYRIC ACID A MEDICINE OR A DRUG OF ABUSE?

NA

Abstract: ...

(pp 793‐794)

Featured CME Topic Drug‐Associated Heat Stroke

NA

Abstract: ...

(pp 798)

Drug‐Associated Heat Stroke

MAURICIO MARTINEZ MD, LISA DEVENPORT MD, JULLETTE SAUSSY MD, JORGE MARTINEZ MD

Abstract: &NA; During the June 1998 heat wave in New Orleans, 8 patients came to the emergency department of a large public hospital over a 14‐day period. They were subsequently admitted to the intensive care unit with a diagnosis of heat stroke. On each of these days,...

(pp 799‐802)

Limb Amputation and Limb Deficiency Epidemiology and Recent Trends in the United States

TIMOTHY R. DILLINGHAM MD, LILIANA E. PEZZIN PhD, ELLEN J. MacKENZIE PhD

Abstract: Background. The purpose of this study was to provide a comprehensive perspective on the epidemiology and time trends in the incidence of limb amputations and limb deficiency in the United...

(pp 875‐883)

Simultaneous Bilateral Rupture of Quadriceps Tendons Analysis of Risk Factors and Associations

MRUGESHKUMAR K. SHAH MD, MPH, MS

Abstract: Background. Simultaneous bilateral quadriceps tendon rupture is an uncommon injury that is frequently misdiagnosed. It has been associated with multiple medical conditions including renal disease, rheumatologic disorders, and endocrine...

(pp 860‐866)

Deaths Associated With Pregnancy Outcome A Record Linkage Study of Low Income Women*

DAVID C. REARDON PhD, PHILIP G. NEY MD, FRITZ SCHEUREN PhD, JESSE COUGLE MSc, PRISCILLA K. COLEMAN PhD, THOMAS W. STRAHAN JD

Abstract: Background. A national study in Finland showed significantly higher death rates associated with abortion than with childbirth. Our objective was to examine this association using an American population over a longer...

(pp 834‐841)

Displaced Plaque in Retroperitoneal Adenopathy

RIYADH N. AL‐OKAILI MD, STEPHEN I. SCHABLE MD, TROY J. MARLOW MD

Abstract: Background. This study was designed to determine when to consider incidental retroperitoneal masses on the basis of a displaced calcified atheromatous abdominal aorta on lateral...

(pp 857‐859)

Injuries to Tobacco Farmers in Kentucky

TIM W. STRUTTMANN MSPH, DONNA K. REED BS

Abstract: &NA; Like all types of farming, raising tobacco has many hazards that may lead to injury, disability, or death. Burley tobacco farming is a multistep process that is not highly mechanized. An 8‐year emergency department surveillance system in Kentucky...

(pp 850‐856)

Noninvasive Carbon Dioxide Monitoring During Neurosurgical Procedures in Adults End‐Tidal Versus Transcutaneous Techniques

SCOTT D. McBRIDE JR. MD, JOEL O. JOHNSON MD, PhD, JOSEPH D. TOBIAS MD

Abstract: Background. We prospectively compared transcutaneous (TC) versus end‐tidal (ET) carbon dioxide monitoring during neurosurgical procedures in...

(pp 870‐874)

Comparison of Rectal and Tympanic Thermometry During Exercise

KATHERINE R. NEWSHAM MA, ATC, JAN E. SAUNDERS DO, ERIC S. NORDIN DO

Abstract: Background. Heat‐related deaths are among the most preventable injuries in athletics. We sought to examine two methods of monitoring body temperature during exercise as a means of preventing heat‐related...

(pp 804‐810)

Urinary Tract Infection as a Possible Marker for Teenage Sex

HANH NGUYEN MD, MICHAEL WEIR MD

Abstract: Background. Pediatric urinary tract infections (UTIs) are markers for genitourinary reflux or obstruction. Adult UTIs are treated by telephone triage without microbiologic study. The contrast between pediatric and adult UTIs prompted our retrospective...

(pp 867‐869)

Emergency Department Overcrowding in Florida, New York, and Texas

ROBERT W. DERLET MD, JOHN R. RICHARDS MD

Abstract: Background. This study was done to determine the incidence, causes, and effects of overcrowding in emergency departments (EDs) in Florida, New York, and...

(pp 846‐849)

Breastfeeding Rates at an Urban Medical University After Initiation of an Educational Program

CAROL L. WAGNER MD, THOMAS C. HULSEY PhD, MICHAEL W. SOUTHGATE MD, DAVID J. ANNIBALE MD

Abstract: Background. Our objective was to improve breastfeeding initiation rates at an urban medical...

(pp 909‐913)

Incidental Granulomatous Inflammation of the Uterus

ELISE HOFF MD, RICHARD A. PRAYSON MD

Abstract: Background. Granulomas of the uterine corpus have been reported in a variety of pathologic conditions but are relatively rare findings in routine histopathologic...

(pp 884‐888)

Effect of Helicobacter pylori Eradication in the Glycemia of Children With Type 1 Diabetes A Preliminary Study

RODOLFO E. BÉGUÉ MD, RICARDO GÓMEZ MD, TERRY COMPTON RN, ALFONSO VARGAS MD

Abstract: Background. We previously reported that children with diabetes and Helicobacter pylori infection had higher levels of glycated hemoglobin (HbA1c) than uninfected peers. We sought to determine whether eradication of the infection could decrease their HbA1c...

(pp 842‐845)

Hepatitis A Epidemic in the Elderly

GERI R. BROWN MD, KIM PERSLEY MD

Abstract: Background. The purpose of this study was to characterize acute hepatitis A in patients more than 40 years...

(pp 826‐833)

Access to Care and Stage at Diagnosis for Patients With Lung Cancer and Esophageal Cancer Analysis of the Savannah River Region Information System Cancer Registry Data

MARC D. SILVERSTEIN MD, PAUL J. NIETERT PhD, XIAOBU YE MS, DANIEL T. LACKLAND DrPH

Abstract: Background. Disparities have been observed in both the incidences of lung and esophageal cancers and the survival of those patients. Our goals were to determine if race was associated with stage of cancer at diagnosis, and to identify predictors of advanced‐stage...

(pp 900‐908)

Aspergillosis in Liver Transplant Recipients Successful Treatment and Improved Survival Using a Multistep Approach

ANDREA DUCHINI MD, DAVID C. REDFIELD MD, JOHN G. McHUTCHISON MD, MATHEW E. BRUNSON MD, PAUL J. POCKROS MD

Abstract: Background. Invasive aspergillosis is a life‐threatening complication in liver transplant recipients, with a reported mortality rate of more than 90%. Treatment is difficult, and no single agent is uniformly effective in treating this patient...

(pp 897‐899)

Squamous Cell Carcinoma of the Penis A Retrospective Review of Forty‐Five Patients in Northwest Louisiana

BRETT S. CARVER MD, JOHN A. MATA MD, DENNIS D. VENABLE MD, JAMES A. EASTHAM MD

Abstract: Background. Squamous cell carcinoma of the penis is a rare malignancy in the United States, accounting for only 0.4% of all cancers in...

(pp 822‐825)

Impact of Medicaid Managed Care on Utilization of Obstetric Care Evidence From TennCare's Early Years

FRANK A. SLOAN PhD, CHRISTOPHER J. CONOVER PhD, MAY LING MAH BS, PETER J. RANKIN PhD

Abstract: Background. TennCare expanded Medicaid coverage, substituting managed care for fee‐for‐service reimbursement in...

(pp 811‐821)

Anemia of Cancer in Intermediate‐Grade Non‐Hodgkin's Lymphoma

THOMAS J. MORROW MD, SALVATORE VOLPE MD, SANJAY GUPTA PhD, MBA, RIMA E. TANNOUS PharmD, MS, MOSHE FRIDMAN PhD

Abstract: Background. Current literature suggests that anemia at baseline is an important adverse prognostic factor for lymphoma‐related outcomes. We evaluated the prevalence, risk factors, and prognostic value of anemia in patients with intermediate‐grade...

(pp 889‐896)

Emerging Technology in Diabetes Mellitus Glucose Monitoring and New Insulins

RAYMOND L. REYNOLDS MD, DENNIS G. KAROUNOS MD

Abstract: &NA; Modern diabetes management requires intensive self‐monitoring of blood glucose levels, often coupled with a multicomponent insulin program. Recent advances include alternate site blood glucose testing devices, which facilitate more frequent sampling by...

(pp 914‐918)

Metastatic Breast Cancer Manifested as Refractory Anemia and Gastric Polyps

TARA B. KARAMLOU, MD, JOHN T. VETTO, MD, CHRISTOPHER CORLESS, MD, THOMAS DELOUGHERY, MD, DOUGLAS FAIGEL, MD, CHARLES BLANKE, MD

Abstract: Gastric metastasis from breast cancer is uncommon and typically occurs in patients with disseminated disease. The vast majority of patients with gastric lesions have a known preexisting diagnosis of breast cancer. In contrast, we describe a case in which a minimal breast...

(pp 922-925)

Klüver-Bucy Syndrome as a Result of Minor Head Trauma

ALI SALIM, MD, K. ANTHONY KIM, MD, BRIAN J. KIMBRELL, MD, PATRIZIO PETRONE, MD, GUSTAVO ROLDAN, JUAN A. ASENSIO, MD

Abstract: Klüver-Bucy syndrome (KBS) has been described as a disconnection of the temporal lobes from the remainder of the brain. Its presence in minor head trauma has not been previously reported. We therefore report what we believe to be the first case of KBS due to mild head...

(pp 929-931)

Herniated Nucleus Pulposus With Radiculopathy in an Adolescent: Successful Nonoperative Treatment

RAMONA HOOD-WHITE, J. DEVON LOWDON, MD

Abstract: The following report describes a 17-year old girl with a central herniated nucleus pulposus (HNP) at L4-5. The diagnosis of lumbar disk herniation was based on findings from magnetic resonance imaging (MRI). A decision to use conservative treatment was unanimously agreed...

(pp 932-933)

Long-Term Survival of a Patient With Human Immunodeficiency Virus Infection and Hodgkin’s Lymphoma

A. HAFEEZ DIWAN. MD, PhD, JAY UMBREIT, MD, BEVERLY P. NELSON, MD

Abstract: When patients infected with human immunodeficiency virus (HIV) are found to have Hodgkin's lymphoma (HL), it is generally advanced, with involvement of extranodal sites including bone marrow, spleen, and liver, and prognosis tends to be unfavorable. We present the case...

(pp 943-944)

Coexisting Gilbert’s Syndrome and Sickle Cell Disease

ANUPAMA BORKER, MD, JOHN UDALL, MD, RAJ WARRIER, MD

Abstract: We report the coexistence of Gilbert's syndrome and homozygous sickle cell disease in a child with persistent unconjugated...

(pp 939-940)

Thoracoscopic Management of Pleural Effusions in Kaposi’s Sarcoma: A Rapid and Effective Alternative for Diagnosis and Treatment

EDMUNDO R. RUBIO, MD, EDUARDO E. CHANG, MD, KEVIN L. KOVITZ, MD

Abstract: Kaposi's sarcoma (KS) is one of the most common causes of pleural effusion in patients with acquired immunodeficiency syndrome (AIDS). Pleural effusions due to KS carry a high morbidity and mortality. Their treatment is difficult, and they respond poorly to chemical...

(pp 919-921)

HELLP Syndrome Leading to a Diagnosis of Pregnancy

SATHEESH K. KATHULA, MD, SRIDHAR R. BOLLA, MD, EVERETT F. MAGANN, MD

Abstract: HELLP syndrome (an acronym for hemolysis, elevated liver enzymes, and low platelets) is a life-threatening complication of pregnancy seen in association with either preeclampsia or eclampsia. HELLP syndrome is rarely diagnosed before 24 weeks of gestation. This atypical...

(pp 934-935)

Hemothorax and Retroperitoneal Hematoma After Anticoagulation With Enoxaparin

MICHAL MRUG, MD, PRASHANT V. MISHRA, MD, HENRY C. LUSANE, MD, J. MARTIN CUNNINGHAM, MD, MARTIN A. ALPERT MD

Abstract: A 58-year-old woman with chronic obstructive pulmonary disease had spontaneous bilateral hemothorax and a retroperitoneal hematoma after 4 days of anticoagulation therapy with enoxaparin (1 mg/kg subcutaneously every 12 hours) for suspected pulmonary thromboembolism. The...

(pp 936-938)

Primary Splenic Lymphoma Complicated by Hematemesis and Gastric Erosion

MARK A. BIRD, MD, DARIUS AMJADI, MD, KEVIN E. BEHRNS, MD

Abstract: Gastrosplenic fistula resulting from erosion of a primary splenic lymphoma is a rare cause of massive upper gastrointestinal hemorrhage associated with benign peptic ulcer disease, gastric Crohn's disease, gastric adenocarcinoma, and primary gastric and splenic...

(pp 941-942)

Self-Medication With γ-Hydroxybutyrate to Reduce Alcohol Intake

JAMES K. GLISSON PharmD, JOHN NORTON MD

Abstract: We describe a 52-year-old man who self-medicated with &ggr;-hydroxybutyrate (GHB), a widely available illicit substance, to obtain a decrease in ethanol consumption. He successfully reduced his ethanol intake over a 3-month period, but he was unable to sustain...

(pp 926-928)

Treatment of Retroperitoneal Fibrosis With Tamoxifen

Jameela Al-Salman, MD, A Rashid Makhdomi, MD

Abstract: ...

(pp 947)

Relapsing Group B Streptococcal Bacteremia

Michael T. Flannery, MD, Lara Winters, BS

Abstract: ...

(pp 949-950)

Informed Consent for Circumcision

George Hill, BA

Abstract: ...

(pp 946)

Successful Treatment of Cryptococcal Osteomyelitis and Paraspinous Abscess

Lloyd I. Maliner, MD

Abstract: ...

(pp 945)

Fatal Granulomatous Bronchopneumonia Complicated by Acute Renal Failure

Macaulay Onuigbo, MD, MSc, Michael Hise, MD, Emilio Ramos, MD, Nelson Traong, MD, Pamela Amelung, MD, Cinthia Drachenberg, MD

Abstract: ...

(pp 947-949)

Medicine and the Sin Tax

Marshall Millman, MD, PhD

Abstract: ...

(pp 945-946)

HEAT STROKE

Ronald C. Hamdy, MD, FRCP, FACP

Abstract: ...

(pp 791-792)

NHLBI STOPS TRIAL OF ESTROGEN PLUS PROGESTIN DUE TO INCREASED BREAST CANCER RISK AND LACK OF OVERALL BENEFIT

NA

Abstract: ...

(pp 795-797)

γ-HYDROXYBUTYRIC ACID: A MEDICINE OR A DRUG OF ABUSE?

Luigi Gallimberti, MD

Abstract: ...

(pp 793)

KLÜVER-BUCY SYNDROME AFTER MINOR BRAIN INJURY

Leon A. Weisberg, MD

Abstract: ...

(pp 794-795)

Drug-Associated Heat Stroke

MAURICIO MARTINEZ, MD, LISA DEVENPORT, MD, JULLETTE SAUSSY, MD, JORGE MARTINEZ, MD

Abstract: During the June 1998 heat wave in New Orleans, 8 patients came to the emergency department of a large public hospital over a 14-day period. They were subsequently admitted to the intensive care unit with a diagnosis of heat stroke. On each of these days, the ambient...

(pp 799-803)

Simultaneous Bilateral Rupture of Quadriceps Tendons: Analysis of Risk Factors and Associations

MRUGESHKUMAR K. SHAH, MD, MPH, MS

Abstract: Background.Simultaneous bilateral quadriceps tendon rupture is an uncommon injury that is frequently misdiagnosed. It has been associated with multiple medical conditions including renal disease, rheumatologic disorders, and endocrine...

(pp 860-866)

Deaths Associated With Pregnancy Outcome: A Record Linkage Study of Low Income Women

DAVID C. REARDON, PhD, PHILIP G. NEY, MD, FRITZ SCHEUREN, PhD, JESSE COUGLE, MSc, PRISCILLA K. COLEMAN, PhD, THOMAS W. STRAHAN, JD

Abstract: Background.A national study in Finland showed significantly higher death rates associated with abortion than with childbirth. Our objective was to examine this association using an American population over a longer...

(pp 834-841)

Hepatitis A Epidemic in the Elderly

GERI R. BROWN, MD, KIM PERSLEY, MD

Abstract: Background.The purpose of this study was to characterize acute hepatitis A in patients more than 40 years...

(pp 826-833)

Comparison of Rectal and Tympanic Thermometry During Exercise

KATHERINE R. NEWSHAM, MA, ATC, JAN E. SAUNDERS, DO, ERIC S. NORDIN, DO

Abstract: Background.Heat-related deaths are among the most preventable injuries in athletics. We sought to examine two methods of monitoring body temperature during exercise as a means of preventing heat-related...

(pp 804-810)

Impact of Medicaid Managed Care on Utilization of Obstetric Care: Evidence From TennCare’s Early Years

FRANK A. SLOAN, PhD, CHRISTOPHER J. CONOVER, PhD, MAY LING MAH, BS, PETER J. RANKIN, PhD

Abstract: Background.TennCare expanded Medicaid coverage, substituting managed care for fee-for- service reimbursement in...

(pp 811-821)

Breastfeeding Rates at an Urban Medical University After Initiation of an Educational Program

CAROL L. WAGNER, MD, THOMAS C. HULSEY, PhD, W. MICHAEL SOUTHGATE, MD, DAVID J. ANNIBALE, MD

Abstract: Background.Our objective was to improve breastfeeding initiation rates at an urban medical...

(pp 909-913)

Displaced Plaque in Retroperitoneal Adenopathy

RIYADH N. AL-OKAILI, MD, STEPHEN I. SCHABLE, MD, TROY J. MARLOW, MD

Abstract: Background.This study was designed to determine when to consider incidental retroperitoneal masses on the basis of a displaced calcified atheromatous abdominal aorta on lateral...

(pp 857-859)

Noninvasive Carbon Dioxide Monitoring During Neurosurgical Procedures in Adults: End-Tidal Versus Transcutaneous Techniques

D. SCOTT MCBRIDE, JR., MD, JOEL O. JOHNSON, MD, PhD, JOSEPH D. TOBIAS, MD

Abstract: Background.We prospectively compared transcutaneous (TC) versus end-tidal (ET) carbon dioxide monitoring during neurosurgical procedures in...

(pp 870-874)

Emergency Department Overcrowding in Florida, New York, and Texas

ROBERT W. DERLET, MD, JOHN R. RICHARDS, MD

Abstract: Background.This study was done to determine the incidence, causes, and effects of overcrowding in emergency departments (EDs) in Florida, New York, and...

(pp 846-849)

Effect of Helicobacter pylori Eradication in the Glycemia of Children With Type 1 Diabetes: A Preliminary Study

RODOLFO E. BEGUE, MD, RICARDO GOMEZ, MD, TERRY COMPTON, RN, ALFONSO VARGAS, MD

Abstract: Background.We previously reported that children with diabetes and Helicobacter pylori infection had higher levels of glycated hemoglobin (HbA1c) than uninfected peers. We sought to determine whether eradication of the infection could decrease their HbA1c...

(pp 842-845)

Aspergillosis in Liver Transplant Recipients: Successful Treatment and Improved Survival Using a Multistep Approach

ANDREA DUCHINI, MD, DAVID C. REDFIELD, MD, JOHN G. MCHUTCHISON, MD, MATHEW E. BRUNSON, MD, PAUL J. POCKROS, MD

Abstract: Background.Invasive aspergillosis is a life-threatening complication in liver transplant recipients, with a reported mortality rate of more than 90%. Treatment is difficult, and no single agent is uniformly effective in treating this patient...

(pp 897-899)

Injuries to Tobacco Farmers in Kentucky

TIM W. STRUTTMANN, MSPH, DONNA K. REED, BS

Abstract: Like all types of farming, raising tobacco has many hazards that may lead to injury, disability, or death. Burley tobacco farming is a multistep process that is not highly mechanized. An 8-year emergency department surveillance system in Kentucky identified 674 injury cases...

(pp 850-856)

Access to Care and Stage at Diagnosis for Patients With Lung Cancer and Esophageal Cancer: Analysis of the Savannah River Region Information System Cancer Registry Data

MARC D. SILVERSTEIN, MD, PAUL J. NIETERT, PhD, Y E XIAOBU, MS, DANIEL T. LACKLAND, DrPH

Abstract: Background.Disparities have been observed in both the incidences of lung and esophageal cancers and the survival of those patients. Our goals were to determine if race was associated with stage of cancer at diagnosis, and to identify predictors of advanced-stage lung and...

(pp 900-908)

Urinary Tract Infection as a Possible Marker for Teenage Sex

HANH NGUYEN, MD, MICHAEL WEIR, MD

Abstract: Background.Pediatric urinary tract infections (UTIs) are markers for genitourinary reflux or obstruction. Adult UTIs are treated by telephone triage without microbiologic study. The contrast between pediatric and adult UTIs prompted our retrospective review of adolescent...

(pp 867-869)

Squamous Cell Carcinoma of the Penis: A Retrospective Review of Forty-Five Patients in Northwest Louisiana

BRETT S. CARVER, MD, JOHN A. MATA, MD, DENNIS D. VENABLE, MD, JAMES A. EASTHAM, MD

Abstract: Background.Squamous cell carcinoma of the penis is a rare malignancy in the United States, accounting for only 0.4% of all cancers in...

(pp 822-825)

Limb Amputation and Limb Deficiency: Epidemiology and Recent Trends in the United States

TIMOTHY R. DILLINGHAM, MD, LILIANA E. PEZZIN, PhD, ELLEN J. MACKENZIE, PhD

Abstract: Background.The purpose of this study was to provide a comprehensive perspective on the epidemiology and time trends in the incidence of limb amputations and limb deficiency in the United...

(pp 875-883)

Incidental Granulomatous Inflammation of the Uterus

ELISE HOFF, MD, RICHARD A. PRAYSON, MD

Abstract: Background.Granulomas of the uterine corpus have been reported in a variety of pathologic conditions but are relatively rare findings in routine histopathologic...

(pp 884-888)

Anemia of Cancer in Intermediate-Grade Non-Hodgkin’s Lymphoma

THOMAS J. MORROW, MD, SALVATORE VOLPE, MD, SANJAY GUPTA, PhD, MBA, RIMA E. TANNOUS, PharmD, MS, MOSHE FRIDMAN, PhD

Abstract: Background.Current literature suggests that anemia at baseline is an important adverse prognostic factor for lymphoma-related outcomes. We evaluated the prevalence, risk factors, and prognostic value of anemia in patients with intermediate-grade non-Hodgkin's lymphoma...

(pp 889-896)

Emerging Technology in Diabetes Mellitus: Glucose Monitoring and New Insulins

L RAYMOND REYNOLDS, MD, DENNIS G. KAROUNOS, MD

Abstract: Modern diabetes management requires intensive self-monitoring of blood glucose levels, often coupled with a multicomponent insulin program. Recent advances include alternate site blood glucose testing devices, which facilitate more frequent sampling by individuals with...

(pp 914-918)