SMJ // September 2004, Volume 97 - Issue 9

Original Article

Compassionate-use Oxaliplatin with Bolus 5-Fluorouracil/Leucovorin in Heavily Pretreated Patients with Advanced Colorectal Cancer

Objectives: The efficacy of a concomitant oxaliplatin/bolus 5-fluorouracil/leucovorin regimen in 123 heavily pretreated patients with advanced colorectal cancer was evaluated. Patients with an Eastern Cooperative Oncology Group performance status of 0 to 2 and radiographically progressive cancer which failed to respond to between two and five prior treatment modalities were…

Expired CME Article

Concussion in Athletes

Annotation: Treatment of the “ding” or “bellring” complaint continues to involve tough decision-making. Combined multispecialty research-based guidelines have now evolved to permit better handling of return to contact during practice and formal competition. Dr. Terrell brings first-hand experience and current evidence-based criteria and discussion to the reader.

Expired CME Article

Management of the Critically Injured Athlete: Packaging of Head and Cervical Spine Injuries

Annotation: Initially all sports medicine providers will encounter potential or real injury in collision and/or individual sports. Proper training and equipment must be available, and all involved must be ready to package and transport effectively when that injury occurs. Head and neck injuries can be catastrophic. This article points to…

Expired CME Article

Low Back Pain in Running-based Sports

Annotation: Low back pain is ubiquitous in all strenuous sports efforts at all levels and ages. Pars fractures (often stress fractures) require careful management and usually referral. Most complaints can be handled by the trainer and therapy methods.

Expired CME Article

Exercise-induced Asthma

Annotation: Exercise-induced asthma (EIA) is one of the issues in athletes that can and should be controlled. That control can negate EIA from factoring into ability to perform as well as the level of performance.

Expired CME Article

Sudden Cardiac Death in Athletes

Annotation: Any death of a young person is tragic; however, the sudden death of a young athlete is a particularly devastating event within a community. Emotions raised by these incidents include sorrow for the young person’s death, fear of our own mortality, incredulity at the loss of a seemingly healthy…

Expired CME Article

Current Issues in Sports Nutrition in Athletes

Annotation: The benefits of sports nutrition evaluation and counseling are important to both elite athletes and active men and women of all ages who want to optimize health and performance. Proper nutrition is essential to staying metabolically healthy during a run, a draining practice, or as a year-round philosophy to…

Expired CME Article

Foot Orthoses in Sports Medicine

Annotation: In today’s age of sports medicine, there is real focus on biomechanics, proprioception, and kinesthetic awareness. This facilitates prevention and treatment of foot and ankle as well as more proximal injuries, and has led to an increase in the use of foot orthoses. Competitive and recreational leg-based sports frequently…

Expired CME Credit Submission and Evaluation Form

CME Credit—September 2004 CME Topic: Sports Medicine

Expired CME Credit Submission and Evaluation Form – Sports Medicine

Case Report

Effect of Omeprazole on Oral Iron Replacement in Patients with Iron Deficiency Anemia

Hypochlorhydric states such as atrophic gastritis and partial gastrectomy have long been known to cause iron deficiency anemia. However, studies to date have failed to show a similar association with omeprazole, a proton pump inhibitor that also produces achlorhydria. These studies, however, have primarily involved nonanemic, iron-replete individuals. The effect…

Case Report

Desquamative Interstitial Pneumonia and Hepatitis C Virus Infection: A Rare Association

Extrahepatic manifestations of hepatitis C virus (HCV) infection are common. The authors report the unusual occurrence of desquamative interstitial pneumonia (DIP) in a patient with HCV. An immunologic response to HCV infection may have a role in the pathogenesis of DIP in patients with chronic HCV. Since DIP is treatable,…

Case Report

Myonecrosis in Sickle Cell Anemia Case Report and Review of the Literature

Vascular occlusion is responsible for most of the severe complications of sickle cell anemia (SCA). The involvement of muscle and fascia is uncommon in SCA, but myonecrosis may occur in SCA crisis. The data accumulated in the literature is limited to only a few reports describing mainly adult patients presenting…

Case Report

Mucinous Cystic Neoplasms of the Pancreas

Mucinous cystic neoplasms of the pancreas (MCNP) are rare tumors with presentation and findings that differ in most cases from pancreatic pseudocysts. A simple pancreatic cystic lesion in a younger-aged patient with a history of pancreatitis and endoscopic retrograde cholangiopancreatography (ERCP) demonstration of ductal communication with the cyst strongly suggests…

Case Report

Fibrosing Colonopathy in an Adult Cystic Fibrosis Patient After Discontinuing Pancreatic Enzyme Therapy

Fibrosing colonopathy, a complication of cystic fibrosis, has generally been reported in young children with exposure to high doses of pancreatic enzymes. The authors report the case of a 25-year-old male with cystic fibrosis who presented with gradually progressive symptoms of bowel obstruction. Pathologic examination of the right colon revealed…

Case Report

Successful Ivermectin Treatment of Hepatic Strongyloidiasis Presenting with Severe Eosinophilia

A 49-year-old, previously healthy nurse presented with hepatic lesions and severe peripheral eosinophilia due to strongyloidiasis. Imaging studies of the abdomen showed predominantly peripheral, confluent hepatic lesions. The hepatic lesions and eosinophilia did not show any improvement with albendazole, but completely resolved with ivermectin treatment. Our findings suggest that Strongyloides…

Case Report

Microscopic Polyangiitis Presenting with Liver Dysfunction Preceding Rapidly Progressive Necrotizing Glomerulonephritis

The authors describe a 52-year-old woman diagnosed with microscopic polyangiitis. She presented with abnormal liver function tests accompanied by fever, headache, and fatigue. Two months later, rapidly progressive necrotizing glomerulonephritis developed together with seropositivity for perinuclear antineutrophil cytoplasmic antibody. Although liver dysfunction from microscopic polyangiitis is very rare, especially at…

Original Article

Who Is Willing to Undergo Endoscopy Without Sedation: Patients, Nurses, or the Physicians?

Objectives: Some studies suggest that the majority of the United States population is now willing to undergo unsedated endoscopy. We studied the willingness of patients, nurses, and physicians to undergo endoscopy without sedation. Methods: Adult patients presenting to us for outpatient endoscopy at two large tertiary care level 1 trauma…

Original Article

Physical Activity Trends in South Carolina, 1994–2000

Objectives: During the 1990s, physical activity recommendations and surveillance methods were developed in an attempt to increase and monitor, respectively, regular physical activity prevalence rates. For this article, Behavioral Risk Factor Surveillance System data were analyzed to determine whether regular physical activity proportions in South Carolina adults changed from 1994…

Original Article

Pancreatic Tumors in Patients with Lung Malignancies: A Spectrum of Clinicopathologic Considerations

Objectives: Lung cancer and pancreatic cancer are the most lethal tobacco-associated malignancies. To elucidate possible clinical interrelationships, the authors reviewed the clinicopathologic characteristics of patients treated for both pulmonary and pancreatic neoplasms. Methods: Patients presenting with a potentially resectable pancreatic mass and a diagnosis of metachronous malignant neoplasm of the…

Original Article

Long-distance Fixed-wing Transport of Obstetrical Patients

Objectives: Aeromedical obstetrical transports are mostly performed utilizing helicopters. The program here reviewed performs mostly fixed-wing transports. The purpose of the current study is to review our fixed-wing transfers and identify the complications encountered. Methods: A retrospective review was conducted of the fixed-wing obstetrical air transports performed by the StatCare…

Original Article

A Novel Specific Prophylaxis for Menstrual-associated Migraine

Objectives: Few migraine prophylactic therapies have demonstrated a 50% reduction in headaches. Even when successful, the economic burden of prophylaxis can discourage widespread usage. This article presents a pilot study of a novel, effective, specific, and inexpensive prophylactic strategy for menstrual-associated migraine. Materials and Methods: Eleven women with menstrual-associated migraine…

Original Article

Adult Outcome of Child and Adolescent Attention Deficit Hyperactivity Disorder in a Primary Care Setting

Objectives: To determine the adult status of children and adolescents previously diagnosed with attention deficit hyperactivity disorder (ADHD). Methods: From a consecutive sample, a case series from a primary care, private physician, office-based practice was evaluated. Seventy-seven adults were eligible, having been diagnosed with ADHD as children and adolescents by…

Original Article

Photodynamic Therapy and Endoscopic Mucosal Resection for Barrett’s Dysplasia and Early Esophageal Adenocarcinoma

Background:Endoscopic mucosal resection (EMR) and endoscopic ablation with porfimer sodium photodynamic therapy (PDT) have recently been combined to improve the accuracy of histologic staging and remove superficial carcinomas. Materials and Methods:All patients with Barrett’s esophagus and high-grade dysplasia were evaluated with computed tomography and endosonography. Patients with nodular or irregular…

Case Report

Eosinophilic Gastroenteritis, Ascites, and Pancreatitis: A Case Report and Review of the Literature

Eosinophilic gastroenteritis is an inflammatory disorder of the gastrointestinal tract in which eosinophilic infiltration occurs in the gut layers. A case of subserosal eosinophilic gastroenteritis was diagnosed in a patient with abdominal pain, eosinophilic ascites, and pancreatitis. To our knowledge, this is the first case report of eosinophilic gastroenteritis associated…

Editorial

Proton Pump Inhibitors and Iron Deficiency: Is the Connection Real?

Iron therapy has been used for centuries, perhaps dating back to 1500 BCE, even though recognition of iron deficiency has been more recent.1 The main causes of iron deficiency remain blood loss from the gastrointestinal and genitourinary tracts and, in poorer countries, lack of dietary iron. Gastrointestinal malabsorption of iron…

Editorial

Unsedated Endoscopy: You Don’t Get a Medal For It!

When my older brother’s wife was preparing to deliver her first child, she announced at a family gathering her intention to deliver “naturally,” without anesthetic of any kind. “After all, ” we were told, “women in poor countries do it all the time.”“That may be,” my brother said. “But why…

Expired CME Article

Sports Medicine

Expired CME Article – Sports Medicine

Expired CME Article

Supplements and Athletes

Annotation: No sports medicine-related subject has received more global press than dietary supplements in athletes. From the male and female high school sports, to the Olympic field and professional baseball diamond, our athletes have a problem. Long a recognized national authority on the subject of dietary supplements, Dr. Lombardo capsules…

Expired CME Article

Sports Medicine in Youth Athletes

Annotation: These capsuled thoughts from Richard Gross, MD, a long-standing devotee of and writer about youth sports and youth sports injuries, points up the increasing attention to and the importance of the physical and psychosocial problems of the youth athlete.

Expired CME Article

Exercise Physiology and Its Role in Clinical Sports Medicine

Annotation: Increasingly, the greater sports medicine world has been able to turn to exercise physiology for information that targets the capabilities of our recreational and competitive athletes. Functional physiologic deficits can be quantitated. Erasure of those deficits can be documented. Sports-specific physiologic qualities can help direct coaches in their training…

Expired CME Article

Sports Medicine: The Primary Care Perspective

Annotation: Dr. Jim Puffer has impeccable credentials to discuss the evolution of sports medicine as a primary care specialty. A founding member of the Primary Care Sports Medicine Fellowships and head USA Team Physician for the 24th Olympiad, Dr. Puffer’s leadership in Sports Medicine is legend. As the aggregate musculoskeletal…

Expired CME Article

The Preparticipation Athletic Exam Process

Annotation: The resources related to surveying of athletes, the triage and the decision-making related to athletic participation remains varied and confusing. At secondary school levels, there is disagreement and local variation, especially in the efforts to screen for cardiovascular disorders and potential problems. Dr. Reed offers his thoughts as a…

Expired CME Article

Coding and Reimbursement in Sports Medicine

Annotation: Dr. Filler has been in orthopaedic leadership positions for over 30 years, and in the national forefront of nomenclature and coding for over 20 years. He currently sits on the prestigious American Medical Association Current Procedural Terminology Editorial Panel. His summary thoughts and current insights are described here.

Expired CME Article

The Female Athlete

Annotation: The female athlete remains less well understood and less well studied compared with male athletes, especially in the areas of performance factors, repetitive stress, and acute injuries. Logical reasons for this include: (a) a limited two-generation span of the high-profile elite female; (b) fewer females involved in coaching, research,…

Article

The Patient’s Page

Do you suffer from low iron? Are you taking iron replacement therapy? Is it working? Or do you continue to have low iron in spite of iron supplementation? It could be drug related. Patients who take medications called “proton pump inhibitors,” such as Prevacid, Protonix and Prilosec may actually be…

Letter to the Editor

Septic Discitis as a Cause of Intractable Back Pain: Déjà Vu.

I read with interest the article by Patel et al1 which describes an elderly immunocompromised man who developed intractable back pain following cytotoxic curative chemotherapy for non-Hodgkin lymphoma. I agree with the authors that septic discitis is an important, although often overlooked, differential diagnosis of back pain in immunocompromised individuals…

Letter to the Editor

Pneumonia Presenting as Singultus

Singultus (“hiccups”) is a common complaint in the emergency department (ED). The causes are extensive, but most cases of singultus are caused by conditions that are not of clinical significance.1–4 However, we present a case of community-acquired pneumonia presenting as singultus.

Letter to the Editor

Reducing Patient Aggression and Hostility in Primary Care with Urine Drug Testing

We wish to report a reduction in work place aggression and violence in our clinic after the implementation of regular urine drug testing in high-risk populations. Our primary care clinic is home to about 4,000 patients. We average 10 narcotic renewals a day for patients with chronic nonmalignant pain. Since…

Letter to the Editor

Virchow’s Triad?

Your journal recently published an interesting letter offering a unique perspective on the intent of Virchow’s triad.1 Brotman et al successfully demonstrated that Rudolf Virchow postulated a triad as an explanation for the adverse consequences observed in the pulmonary vasculature following pulmonary embolism, and more specifically, as it pertained to…

Letter to the Editor

Erroneous Claims of Priority in Publication

We read with interest the recent case report regarding septic arthritis caused by Chryseobacterium meningosepticum.1 The authors claim in the abstract, introduction, and key points that their patient is the first reported case of septic arthritis due to this pathogen. However, Gunnarsson et al2 reported septic arthritis caused by C…

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