Issue - Southern Medical Association

Review Article

Ambulatory Blood Pressure Monitoring

Noninvasive, 24-hour ambulatory blood pressure monitoring (ABPM) has evolved over the past 25 years from a novel research tool of limited clinical use into an important and useful modality for stratifying cardiovascular risk and guiding therapeutic decisions. Early clinical uses of ABPM were mostly focused on identifying patients with white-coat…

Expired CME Topic

Generalized Anxiety Disorder

Anxiety is a part of daily life. While mild levels of anxiety can be positive, moderate to severe levels can cause intense distress. When anxiety interferes with a person's ability to function, it warrants treatment. Generalized anxiety disorder (GAD) is a chronic disabling condition characterized by at least 6 months…

Expired CME Credit Submission and Evaluation Form

CME Credit—June 2003 Featured CME Topic: Generalized Anxiety Disorder

To receive a CME certificate for 1 hour in category 1 credit toward the AMA Physician's Recognition Award, complete all sections of this form and mail it with a check (payable to SMA) for $15 ($30 for nonmembers) to: Publications Department, SMA, PO Box 190088, Birmingham, AL 35219-0088. The completed…

Case Report

Bee Envenomation: A Rare Cause of Thrombotic Thrombocytopenic Purpura

Thrombotic thrombocytopenic purpura (TTP) is characterized by the pentad of microangiopathic hemolytic anemia, thrombocytopenia, neurologic symptoms, renal insufficiency, and fever. Although many underlying diseases and conditions are associated with TTP, there has been only one previously documented case of bee-sting-associated TTP. In this article, we describe the case of a…

Case Report

Pulmonary Aspergillosis and Central Nervous System Hemorrhage as Complications of Autoimmune Hemolytic Anemia Treated with Corticosteroids

Warm, active antibody adult autoimmune hemolytic anemia is the most common form of hemolytic anemia not related to drug therapy. Mortality in adult autoimmune hemolytic anemia is related to the inability to successfully treat patients’ underlying disease, or the infectious complications of splenectomy and prolonged steroid therapy. Predisposing factors for…

Case Report

Mycobacterium xenopi Pneumonia in the Southeastern United States

Mycobacterium xenopi (M. xenopi) is a slow-growing, nontuberculous mycobacterium (NTM). This organism is found in fresh water and has been isolated in water samples collected from water systems in homes and hospitals. Before the acquired immunodeficiency syndrome epidemic, M. xenopi infection was infrequent and occurred in clusters; however, M. xenopi…

Case Report

Painful Diabetic Peripheral Neuropathy Relieved with Use of Oral Topiramate

Diabetic peripheral neuropathy affects 5 to 50% of people with diabetes in the United States. It is a progressive disorder that results in a gradual decrease in peripheral sensation and eventually complete loss of sensation. Patients with diabetic peripheral neuropathy are challenging to treat because of intolerable adverse medication effects…

Case Report

Reversible Cortical Blindness after Lung Transplantation

Cyclosporine (CYA) is a calcineurin inhibitor widely used in immunosuppressive regimens after organ transplantation. Several neurologic side effects are frequently associated with CYA use; however, reversible cortical blindness is a rare manifestation of CYA toxicity traditionally seen after liver and bone marrow transplantation. This report presents a case of reversible…

Case Report

Epidermodysplasia Verruciformis

Epidermodysplasia verruciformis is an uncommon cutaneous entity characterized by persistent human papillomavirus infection. A defect in cell-mediated immunity is the suggested causative factor. Numerous specific human papillomavirus types have been detected in this disease. Multiple nonmelanoma skin cancers are commonly seen in such patients; thus, early diagnosis is beneficial.

Case Report

A Sewing Needle in the Liver

An 85-year-old woman with Alzheimer’s dementia was hospitalized because of prolonged fever, breathlessness, and generalized pain. Blood analysis showed an elevated erythrocyte sedimentation rate, and temporal artery biopsy showed giant cell arteritis. Prednisone therapy was instituted, and the patient’s condition partially improved. Incidentally, abdominal radiographs revealed a sewing needle in…

Case Report

Pemphigus Vulgaris: An Acquired Blistering Disease

Pemphigus vulgaris is one of a group of autoimmune disorders that are caused by autoantibodies against the desmoglein adhesion molecules of squamous epithelial cells. It is a rare form of immune dysfunction that can prove vexing to the patient and physician, but it has distinct clinical and histologic findings. We…

Case Report

Pulmonic Valve Endocarditis

Pulmonic valve endocarditis is an extremely rare infection that shares epidemiologic, clinical, radiologic, microbiologic, and prognostic features with tricuspid valve endocarditis. We report a case of pulmonic valve infection on a structurally normal heart and review the English-language literature on this subject.

Case Report

Improvement in Hypertrophic Cardiomyopathy after Significant Weight Loss: Case Report

A 17-year-old obese boy found to have familial apical hypertrophic cardiomyopathy on routine screening was enrolled in a weight loss program on the basis of the hypothesis that significant weight loss would improve his cardiac status. He was followed with serial dual-energy x-ray absorptiometry, electrocardiography, echocardiography, and blood pressure and…

Original Article

Physical Activity Levels Among Overweight and Obese Adults in South Carolina

Background: Obesity in the United States has reached epidemic proportions and is a major cause of morbidity and mortality.

Original Article

Aromatase Inhibition for the Treatment of Idiopathic Hypogonadotropic Hypogonadism in Men with Premature Ejaculation

Background: Idiopathic hypogonadotropic hypogonadism (IHH) has been observed to occur in men with premature ejaculation (PE). Common IHH therapies include testosterone replacement, which increases testosterone levels but suppresses gonadotropin release; and gonadotropin-releasing hormone supplementation, which restores gonadotropin levels but is impractical for chronic use. Hormonal imbalances associated with IHH/PE are…

Original Article

Effect of Stress on Pregnancy Outcome among Women Undergoing Assisted Reproduction Procedures

Background: This study was performed to examine the effect of stress on pregnancy outcome in women who underwent assisted reproductive technology (ART) procedures.

Original Article

Effect of Obesity on Health-Related Quality of Life among Appalachian Elderly

Background: There is a paucity of research on health behaviors, health status, and overall health-related quality of life among Appalachian elderly. Identifying factors among older adults that place them at risk for low health-related quality of life is important for targeting unmet health needs and guiding community efforts to help…

Original Article

Prevalence of Overweight, Obesity, and Associated Diseases among Outpatients in a Public Hospital

Background: The prevalence of obesity is increasing and may be particularly high among indigent public hospital patients. The purpose of this study was to determine the prevalence of obesity and its associated chronic medical conditions among outpatients at Louisiana State University Health Sciences Center–Shreveport, an urban tertiary health center that…

Case Report

West Nile Virus Infection Presenting as Cerebellar Ataxia and Fever: Case Report

Evidence of West Nile encephalitis virus infection has been documented in most states of the continental United States within a short period of its first introduction in 1999. Health care providers are mostly aware of the usual presentations of this disease, eg, aseptic meningitis, encephalitis and Guillain-Barré syndrome. We present…

Case Report

Gastrointestinal Metastases from Breast Cancer: A Case Report

Breast cancer is the most frequently encountered cancer in women and the second leading cause of cancer death. Distant metastases are present in about 60% of the patients at the time of diagnosis. 1 The lymph nodes, lung, bone, liver, peritoneal cavity, and brain are the usual sites for metastases…

Editorial

Obesity and the Heart: An Ever-growing Problem

Recent evidence indicates that the prevalence of overweight and obesity in the United States has been increasing at epidemic proportions over the past two decades, and that the impact of obesity and cardiovascular diseases is being appropriately and increasingly recognized. 1,2 There is now no question that obesity exerts a…

Editorial

Obesity: An Epidemic

More than half of the adults in the United States today are either overweight or obese, compared with about 25% in the 1960s. 1,2 The prevalence of obesity increased by 5.6% between 2000 and 2001 alone. Obesity is associated with increased mortality risk, and statistics show the potential reduced life…

Editorial

Management and Treatment of Obesity

Although there is no longer any doubt that obesity poses a health risk for individuals and is a tremendous public health problem in the United States, little research has been conducted to study the effect of obesity on the use of health services. In this issue of Southern Medical Journal,…

Editorial

Stress and Infertility

I’m under a great deal of stress at work. Will this affect my upcoming IVF cycle?” Patients commonly ask this question in my practice, and Lovely et al 1 address the subject in this issue of Southern Medical Journal. In their study, Lovely et al measured cortisol and 6-sulfatoxy-melatonin during…

Letter to the Editor

Extraintestinal Hodgkin's Disease in a Patient with Crohn's Disease

To the Editor: The relationship between Crohn’s colitis and non-Hodgkin’s lymphoma is well established. 1,2 Only a few publications that associate Crohn’s disease (CD) with Hodgkin’s disease (HD) have been reported, however. We report an unusual case of a patient who developed HD without intestinal involvement 2 years after underlying…

Letter to the Editor

A Different Therapeutic Approach in Patients with Severe Ulcerative Colitis: Hyperbaric Oxygen Treatment

To the Editor: Hyperbaric oxygen treatment (HBOT) has been used in patients with some diseases of the gastrointestinal system, such as radiation enterocolitis, CD, and experimental colitis; however, the experience with HBOT in patients with ulcerative colitis (UC) is limited. 1,2 We present a case of clinical remission after HBOT...

Letter to the Editor

Arsenic and Heavy Metal Poisons

To the Editor: In April 1997, shortly after opening an antique automobile restoration business, I gradually began to experience several debilitating illnesses. My symptoms included severe burning sensations in my hands and feet, which ultimately resulted in what is known as peripheral neuropathy, or numbness in the extremities. In addition,…

Review Article

Can Angiotensin-converting Enzyme Inhibitors Reverse Atherosclerosis?

Angiotensin II, a potent vasoconstrictor, is mainly present in the vascular endothelium. Multiple studies have confirmed that angiotensin-converting enzyme (ACE) inhibitors, which block the formation of angiotensin II, lower blood pressure and also improve heart failure. These agents not only have beneficial hemodynamic effects but also bestow additional benefits on…