Issue - Southern Medical Association

Original Article

Breast Cancer Incidence and Exposure to Environmental Chemicals in 82 Counties in Mississippi

Objective: Breast cancer is a major public health problem in the United States and in most industrialized countries. Environmental exposure to several chemicals has been implicated in the cause of breast cancer. However, data are not consistent about the role of the environment in breast cancer incidence. To assess environmental…

Original Article

Breast and Cervical Cancer Mortality in the Mississippi Delta, 1979–1998

Background: Historically, the Mississippi Delta region has been medically underserved. This may lead to lower cancer prevention efforts and higher breast or cervical cancer mortality rates. Methods: Death rates for 1979 through 1998 were calculated for Mississippi Delta women and for women living elsewhere in the US. Results: Breast cancer…

Original Article

Association between Epstein-Barr Virus and Classic Hodgkin Lymphoma in Jordan: A Comparative Study with Epstein-Barr Virus-associated Hodgkin Lymphoma in North America

An association between Epstein-Barr virus and Hodgkin lymphoma has been shown in several parts of the world. The reported incidence of Epstein-Barr virus in Hodgkin lymphoma varies significantly from one country to another and ranges from

Expired CME Article

Epidural Intracranial Abscess as a Complication of Frontal Sinusitis: Case Report and Review of the Literature

Two cases of epidural abscess as a complication of frontal sinusitis are presented. The diagnoses were suspected on the basis of history and were confirmed by magnetic resonance imaging and computed tomography. Both patients were treated successfully by means of surgery and intravenous antibiotics. One patient developed meningitis in the…

Expired CME Credit Submission and Evaluation Form

CME Credit—March 2004 CME Topic: Epidural Intracranial Abscess

Expired CME Credit Submission and Evaluation Form – Epidural Intracranial Abscess

Case Report

Jaundice Secondary to Isolated Porta Hepatis Metastasis in Colorectal Cancer: Case Report and Review of the Literature

Colorectal cancer occurs mainly after the age of 50. The liver is the most frequent site of metastases, although isolated metastases to the porta hepatis are rarely reported in the literature. From 1924 to 1993, only 16 cases of periportal lymph nodes metastases were reported. We report a case of…

Case Report

Chylothorax as a Result of Chronic Lymphocytic Leukemia: Case Report and Review of the Literature

Chylothorax occurs when a disruption in the thoracic duct allows chyle to escape into the pleural space. The most commonly reported cause is malignancy, especially lymphoma. However, chylothorax caused by chronic lymphocytic leukemia is rarely reported in the literature. We describe a patient who developed chylothorax secondary to chronic lymphocytic…

Case Report

Pernicious Anemia: Presentations Mimicking Acute Leukemia

Vitamin B12 deficiency can cause profound alterations in the bone marrow. These alterations can mimic the more serious diagnosis of acute leukemia. The two patients described in this report were originally suspected of having acute leukemia or myelodysplasia on the basis of the bone marrow smear, and induction chemotherapy was…

Case Report

Isolated Splenic Metastasi from Primary Lung Adenocarcinoma

Metastatic disease involving the spleen is uncommon, and isolated metastasis to the spleen is extremely rare. Most patients with splenic metastases have widely disseminated metastatic disease. A current literature review shows the incidence of isolated splenic metastasis ranges from 0 to 26% of all patients with splenic metastases. The reported…

Case Report

Solitary Recurrent Metastasis of Squamous Cell Carcinoma of the Uterine Cervix in the Spleen: Case Report

In cervical squamous cell carcinoma, solitary metastasis to and recurrence in the parenchyma of the spleen are uncommon in the absence of apparent disease in other sites. A case of a 50-year-old patient with a Stage IIa carcinoma of the cervix treated with radical hysterectomy and pelvic lymphadenectomy followed by…

Case Report

Atypical Presentation of Metastatic Basal Cell Carcinoma

Basal cell carcinoma is an indolent, slow-growing tumor that rarely metastasizes. Approximately 70% of tumors occur in the head and neck regions. If a basal cell tumor metastasizes, it usually spreads to the regional lymph nodes first, followed by the lungs. We describe a patient with basal cell carcinoma of…

Case Report

Anorectal Melanoma: Report of Three Cases with Extended Follow-up

Primary anorectal melanoma is rare. There is controversy regarding the best surgical treatment because of its poor prognosis. Three cases with extended follow-up are reported in this article. A 53-year-old woman with rectal bleeding was diagnosed with a melanoma of the rectum and underwent an abdominoperineal resection. The patient died…

Case Report

Endobronchial Myofibroblastic Sarcoma Presenting with Hemoptysis In a Patient with a Normal Chest X-ray

Hemoptysis is an important symptom in clinical practice. The diagnosis of the underlying cause is often difficult, particularly in patients presenting with a normal chest x-ray. We report a case of hemoptysis with a normal chest x-ray due to a rare endobronchial neoplasm: myofibroblastic sarcoma.

Case Report

Renal Actinomycosis Mimicking Renal Tumor: Case Report

A 68-year-old man was admitted after fever and general fatigue with severe inflammatory signs and anemia. T1- and T2-weighted magnetic resonance imaging showed low- to isointensity and low-intensity tumor in the right kidney, respectively, suggesting renal actinomycosis. However, the right kidney was explored transabdominally because the possibility of renal malignant…

Case Report

Anticonvulsant Hypersensitivity Syndrome: Treatment with Corticosteroids and Intravenous Immunoglobulin

We describe the case of a patient in whom anticonvulsant hypersensitivity syndrome developed during treatment with phenytoin and progressed when therapy was changed to phenobarbital. Although therapeutic options remain controversial, corticosteroids and IV immunoglobulin were used in our patient. The patient had a complete recovery, suggesting the potential benefit of…

Case Report

Nicotine Replacement Therapy-associated Syndrome of Inappropriate Antidiuretic Hormone

Nicotine has been documented to regulate the release of plasma arginine vasopressin (AVP). The literature is inconclusive about the effects of nicotine replacement therapy on AVP release, although cigarette smoking has been shown to increase the release of AVP. No clinical case reports have documented the possible association between nicotine…

Original Article

Patterns of Colorectal Cancer Incidence, Risk Factors, and Screening in Kentucky

Background: Colorectal cancer incidence rates are higher in Kentucky than in the United States in general, and there are regional variations within the state. Methods: This study investigates these variations in relation to lifestyle and health behaviors, combining data from the Kentucky Behavioral Risk Factor Surveillance System (BRFSS), and from…

Original Article

Screening Preferences for Colorectal Cancer: A Patient Demographic Study

Background: Colorectal cancer is a leading cause of cancer-related death. Screening for colorectal cancer is a rational and cost-effective strategy for reducing the incidence of colorectal cancer and related mortality. Despite endorsement by academic and health care organizations, patient awareness and compliance with screening is low, partly because of patient-related…

Original Article

Colorectal Carcinoma in Young Females

Background: We sought to study the clinicopathologic characteristics of colorectal cancer in young female patients. We also wanted to determine the association of colorectal cancer with anemia in these female patients and, finally, to determine the effect of gender on prognosis in young patients with colorectal cancer. Methods: We performed…

Original Article

Absolute CD4 and CD8 Counts and CD4-to-CD8 Ratios in Eight Patients with Indolent B-cell Chronic Lymphocytic Leukemia

Background: There are some patients with B-cell chronic lymphocytic leukemia who exhibit an extraordinary natural resistance to this malignancy, which lasts for many years. In this study, we report the T-cell subset values and ratios in eight such patients. Methods: Impath (New York, NY) evaluated immunophenotyping by performing flow cytometry….

Original Article

Chronic Lymphocytic Leukemia in Turkey: Experience of a Single Center in Istanbul

Background: In this study, the clinical characteristics, survival, and prognostic factors of 200 patients diagnosed as having chronic lymphocytic leukemia (CLL) were analyzed. Methods: The medical charts of 200 CLL patients registered to our center between 1984 and 2000 were retrospectively evaluated. Results: Of all patients, 129 were men and…

Original Article

Metastatic Spine Tumors

Cancer is the second leading cause of death in the United States, and vertebral body metastases often occur in systemic malignancy. Metastatic spinal tumors may present with pain or neurologic deficit, or may be detected during screening examinations in patients with known malignancy. Management of spinal metastases remains controversial. The…

Original Article

Management Strategies for Patients with Brain Metastases: Has Radiosurgery Made a Difference?

Background: Brain metastases develop in up to 50% of all patients with cancer. The purpose of this retrospective study was to compare the outcomes for brain metastases patients treated with adjuvant whole-brain radiotherapy (WBRT) or stereotactic radiosurgery (SRS). Methods: Between 1990 and 1995, 86 patients with brain metastases received external…

Case Report

Bilateral Synchronous Carcinoma of the Male Breast in a Patient Receiving Estrogen Therapy for Carcinoma of the Prostate: Cause or Coincidence?

An unusual case of bilateral, synchronous breast cancer in a male patient who had a history of long-term estrogen therapy for prostate cancer is presented. The possible role of estrogen in the development of male breast cancer is revisited.

Expired CME Article

Epidural Intracranial Abscess

Expired CME Article – Epidural Intracranial Abscess


Detecting and Preventing Colorectal Cancer in Specific Communities

The prevention of cancer and cancer mortality, when possible, are now the duties of all physicians. To help them do so effectively, data from national studies should be supplemented by information concerning cancer incidence, availability and utilization of screening, and risk and protective factors within specific communities. The detailed and…



Waites K, Brown S. Antimicrobial resistance among isolates of respiratory tract infection pathogens from the southern United States: Data from the PROTEKT US surveillance program 2000/2001. Southern Med J 2003; 96 ( ): 974–985.The correct data in Table 2 for the state of Nevada under Fluoroquinolone susceptibility are: 100% (susceptible),…

Review Article

Utilization Review and Managed Health Care Liability

This article explores the development of jurisprudence interpreting application of the Employee Retirement Income Security Act of 1974 to patient care denials by managed care. It identifies quality-of-care protections for patient care under present federal law. If an insurance company utilization review denies care based on patient-specific reasoning, then the…