Issue - Southern Medical Association

Expired CME Article

Alcohol on Trial: The Evidence 1. Epidemiological Considerations of Alcohol Consumption

Alcohol consumption among eighth, tenth, and twelfth graders has decreased substantially since the 1970s. Consumption rates are still high among these age groups, with 12.4% of 8th and 28.6% of 12th graders reporting drinking five or more drinks in a row in the past 2 weeks. Alcohol consumption rates have…

Expired CME Article

Alcohol on Trial: The Evidence 5. Alcohol and Cancer

Editor’s Note: The wealth of animal research does not support the notion that alcohol is carcinogenic (ie, causes cancer); however, human epidemiological studies do support this idea. The link between alcohol and cancer is difficult to study in humans, because this link may be indirect, as appears to be the…

Expired CME Article

Alcohol on Trial: The Evidence 6. Alcohol and Pregnancy

Significant behavioral and cognitive deficiencies have been detected among children born to binge-drinking mothers. As this type of drinking pattern results in a high blood alcohol concentration (BAC) over a brief time, it is potentially more harmful to an unborn fetus than the consumption of larger quantities of alcohol over…

Expired CME Article

Alcohol on Trial: The Evidence 7. Behavior and Psychology

Men and women report differing opinions on the benefits of alcohol consumption, according to this cross-sectional survey of Finnish men and women aged 15 to 69. In this study, women frequently reported that alcohol helped them to cope with interpersonal conflicts and feel more enthusiastic about life. Men reported that…

Expired CME Article

Alcohol on Trial: The Evidence 8. Alcohol and Older Adults

High alcohol intake was not predictive of depression in older adults according to this cross-sectional analysis of data from the MRC trial cohort of 14,217 older adults (≥75 years of age). Several factors were predictive of depression, including no confiding relationship (OR, 3.4), smoking (OR, 1.6), and having two or…

Expired CME Article

Alcohol on Trial: The Evidence Alcohol CME Supplemental Materials

Understanding Alcohol Content Reporting in Research One standard drink is equal to: * 12 oz can or bottle of beer/wine cooler * 5 oz wine * 1.5 oz spirits * 0.5 oz pure alcohol * 12 grams pure alcohol

Expired CME Credit Submission and Evaluation Form

CME Credit—January 2005 Featured CME Topic: Alcohol

Expired CME Credit Submission and Evaluation Form – Alcohol

Review Article

Obesity and the African-American Adolescent in Mississippi: An Overview

Obesity is one of the most common conditions seen in medical practice, and is one of the most difficult to treat. This condition is often perceived as a cosmetic problem, but it is associated with a number of chronic medical conditions including, but not limited to, heart disease, hypertension, and…

Review Article

Preventing Warfarin-related Bleeding

Warfarin is one of the most common anticoagulants in current use. It maintains a narrow therapeutic index resulting in a significant amount of bleeding. Changes in concomitant medication use and acute illnesses are common causes of overanticoagulation. Monitoring regimens based on patient characteristics and the intensity and duration of anticoagulant…

Case Report

Surgical Management of Enoxaparin- and/or Warfarin-induced Massive Retroperitoneal Bleeding: Report of a Case and Review of the Literature

Abstract:A 70-year-old man on enoxaparin and warfarin sodium therapy due to pulmonary embolism was admitted for evaluation of a sudden, sharp pain in the left inguinal region. Physical examination revealed a 5 × 10 cm tender mass. Abdominal ultrasound showed a 9 × 9 × 10 cm left retroperitoneal hematoma….

Case Report

Miliary Tuberculosis in a Patient With Eosinophilic Fasciitis

The fibrosing disorders represent a diverse group of uncommon chronic diseases that include systemic sclerosis, eosinophilic fasciitis, eosinophilia-myalgia syndrome, toxic oil syndrome, and localized forms of fibrosis. A rare case of eosinophilic fasciitis is reported. The patient was a 61-year-old female who presented with generalized massive edema and eosinophilia. Signs…

Case Report

Brain Tuberculomas Due to Miliary Tuberculosis

Brain tuberculomas are a rare complication of tuberculosis arising through hematogenous spread from an extracranial source, most often of pulmonary origin. The clinical course is usually subacute or chronic, lasting weeks or months, and they typically occur in immunocompromised patients. Recognition and prompt diagnosis of this disorder is important because…

Case Report

Atypical Neuroleptic Malignant Syndrome Presenting as Fever of Unknown Origin in the Elderly

A 79-year-old nursing home resident who was taking olanzapine presented to multiple hospitals with fevers of unknown origin. After an extensive workup to rule out infection, the patient was diagnosed as having neuroleptic malignant syndrome (NMS). This patient’s presentation was atypical because of the lack of rigidity or tremor at…

Case Report

Successful Management of Central Nervous System Infection Due to Propionibacterium acnes with Vancomycin and Doxycycline

Propionibacterium acnes is an infrequent but increasingly recognized cause of neurosurgical infections. In this setting, it has been most commonly reported as complicating neurosurgical shunt procedures. The optimum therapy for central nervous system infections caused by P acnes has not been established. The authors report on a patient who had…

Case Report

A Case of Pseudoseizures

Pseudoseizures, historically described as hysterical seizures, closely resemble epileptic attacks. However, they lack the abnormal paroxysmal electrical discharges from the brain seen in epilepsy. Pseudoseizures may represent a dissociative coping mechanism in which anxiety is reduced by the appearance of the pseudoseizure. Psychotherapy is the mainstay of treatment for pseudoseizures….

Acknowledgment

The Patient’s Page

Did you know that college athletes consume more alcohol and binge drink more frequently than their nonathletic counterparts? Why is this? One explanation may be that athletes are more likely to exhibit the strong social ties which are often associated with binge drinking. Although many special educational programs do target…

Original Article

Public Perceptions of Alcohol Use by Physicians

Objectives: The objective of this study was to assess public perceptions of alcohol use by physicians on duty. Methods: A random telephone survey of 408 adults in one Tennessee county was used. Results: Only 1% of the respondents reported that they suspected that a physician with whom they were in…

Original Article

Substance Abuse and Symptoms of Mental Illness Among HIV-positive Persons in the Southeast

Objectives: Mental illness and substance abuse have been consistently associated with poor HIV-medication adherence and other negative health outcomes. Methods: A brief mental health and substance use screening instrument was administered to 1,362 HIV-infected individuals receiving care at two academic medical center Infectious Diseases Clinics in North Carolina. Results: Study…

Original Article

Tipping the Scales: The Effect of Literacy on Obese Patients’ Knowledge and Readiness to Lose Weight

Objectives: The purpose of this study was to determine the association between the literacy level of overweight/obese patients and their weight-loss knowledge, attitudes, and readiness. Methods: Structured patient interviews and a literacy screening instrument were administered in two primary care clinics at a university-based public hospital. Results: A convenience sample…

Original Article

Self-reported Physical Activity Among South Carolina Adults Trying to Maintain or Lose Weight

Objectives: The obesity epidemic is related to widespread physical inactivity in the United States. This study determined the proportion of South Carolinians trying to maintain or lose weight and within that subpopulation, the number who practiced a restricted diet and engaged in physical activity. Methods: Data from the 2002 South…

Original Article

The Clinical Properties of a Migrainous Population in Eastern Turkey-Erzurum

Objectives: The purpose of this study was to determine the clinical and demographic characteristics of patients with migraine headache, in the vicinity of Erzurum, Turkey. Methods: A uniform questionnaire was given to 185 patients diagnosed as having migraine according to the International Headache Society diagnostic criteria between August 2001 and…

Original Article

Relation Between Intraocular Pressure and Systemic Health Parameters in Taiwan

Objective: The aim of the study was to evaluate the association between intraocular pressure (IOP) and several systemic health parameters in Taiwan. Methods: We retrospectively reviewed the medical records from all participants who had been examined in China Medical University Hospital. A total of 1,271 subjects (mean age, 50.0 ±…

Expired CME Article

Alcohol

Expired CME Article – Alcohol

Editorial

Bereavement, Depression, and Our Growing Geriatric Population

The population of the United States is in great flux. In the 1970s and 1980s, as the baby boomer generation grew up, the majority of citizens were young, healthy, and often acted in the role of care provider to their loved ones. Today, as that generation ages, the populace is…

Editorial

Alcohol: The Good, the Bad, and the Ugly

Alcoholic beverages play an important role in modern Western society. In addition to their effects on health, they have profound socioeconomic implications. In 1999, approximately $116 billion was spent by consumers in the United States on alcoholic drinks.1 Absenteeism and decreased productivity due to hangovers cost businesses and employers $148…

Errata

Erratum

The title of Dr. Rizvi’s article was incorrect as published. The term “pathogenic” was substituted for “pathogenetic.” We regret the error.

Expired CME Article

Alcohol on Trial: The Evidence 2. Binge Drinking

College athletes consume alcohol more frequently than nonathlete students and also binge drink more frequently. This discrepancy exists between athletes and nonathletes despite frequent exposure to alcohol prevention attempts and highly motivating factors to discourage alcohol consumption by athletes. These findings were reported in a study of randomly chosen college…

Expired CME Article

Alcohol on Trial: The Evidence 3. Driving While Impaired

Asbridge M, Mann RE, Flam-Zalcman R, et al. The criminalization of impaired driving in Canada: assessing the deterrent impact of Canada’s first per se law. J Stud Alcohol 2004;65:450–459. Criminalization of drinking and driving corresponded with an 18% reduction in the number of drunk driving-related fatalities. Data from 1962 to…

Expired CME Article

Alcohol on Trial: The Evidence 9. Screening and Treatment for Alcohol Misuse

Healthcare professionals mentioned alcohol to only 1 in 6 patients (16%, 95% CI, 15.4–16.8) in this cross-sectional study of 23,349 adults. Even though white patients consume more alcohol than minorities (8.9 drinks/month vs 6.8 drinks/month, P < 0.005) and high income groups more than low-wage earners, physicians tend to discuss...

Expired CME Article

CME Questions: Alcohol

Expired CME Article Questions – Alcohol

Review Article

Depression as a Mediator Between Spousal Bereavement and Mortality from Cardiovascular Disease: Appreciating and Managing the Adverse Health Consequences of Depression in an Elderly Surviving Spouse

Bereavement in the elderly is becoming a more frequent phenomenon as a result of the aging of the population. The death of an elderly spouse increases psychologic morbidity, particularly depressive symptoms, as well as mortality. Depression increases the risk of death independent of age or bereavement, and can thus exacerbate…

Review Article

Stress Urinary Incontinence in Active Elderly Women

Urinary incontinence in the elderly is a significant health problem fraught with isolation, depression, and an increased risk of institutionalization and medical complications. Stress urinary incontinence (SUI), the complaint of involuntary loss of urine during effort or exertion or during sneezing or coughing, is the most common type of urinary…

Book Review

Case Studies in Biomedical Research Ethics

The human research subject protection enterprise has become extremely complex. Institutional review boards (IRBs) and researchers face increasing regulatory complexity. At the same time, an ever-growing number of technologies and therapies offer potentially great promise, but also present greater potential risk to research participants. At times the effort to adhere…

Letter to the Editor

Another Case of Testicle Duplication With Contralateral Agenesis

We read with interest the recent case report on the rare occurrence of unilateral testicular duplication with contralateral testicular agenesis or anorchism.1 In the introduction of this case, a sentence reads “We have found only one similar case reported in the literature.” In the conclusion, the last sentence reads “We…

Letter to the Editor

Further Reflections on Virchow’s Triad

Brotman et al1 discussed the relation between the original, classical, and “modern” versions of Virchow’s triad. The 1856 original summarized the effects of thrombosis, not its cause, and they recognize that the “modern” triad is “not what Virchow originally described,” but they conclude “After 150 years, it turns out that…

Letter to the Editor

Waist Circumference is a Better Predictor of Obesity-related Health Risk than Body Mass Index in the Chinese Including Children

Among the five anthropometric indices for diagnosing obesity—body mass index (BMI), percent body fat, waist circumference (WC), waist-to-hip ratio and waist-to-stature ratio—the most commonly used index around the world is BMI.1 Recently, Ng and Lai2 introduced another index, weight-length index, to be used together with BMI to define childhood obesity…

Letter to the Editor

Linear Basal Cell Nevus

We read with interest the article of Colvett et al1 describing a patient with numerous basal cell carcinomas on the lower extremity occurring in a linear distribution. The authors concluded from the patient’s presentation that this was a case of multiple metastases occurring in a linear distribution from a primary…

Letter to the Editor

Reply: Duplication of the Testis With Contralateral Anorchism

We would like to thank Dr. Summers and Dr. Kaminski for their interest in our article.1 Their comments are well taken.We did perform a MEDLINE/PUBMED search (1996 to December 2002), using the terms “testicle duplication” as well as “polyorchidism,” combined with “testicular agenesis,” “anorchism,” and “monorchism.” Unfortunately, the article by…

Letter to the Editor

Altitude and Atrial Fibrillation

A 56-year-old man described a 9-year history of intermittent palpitations. This was confirmed to be recurrent paroxysmal atrial fibrillation. The episodes would typically last for hours and were well tolerated, with heart rates up to the 120s. He described the episodes as not being related to any specific activity, food,…

Letter to the Editor

Musculoskeletal Manifestations as the Initial Presentation of Infective Endocarditis

Musculoskeletal manifestations of infective endocarditis may mimic rheumatologic disease.1,2 In infective endocarditis (IE), despite microbial infection of the endothelial surface of the heart, patients may not manifest valvular involvement and the diagnosis may be delayed.3 It is important to realize that the initial symptoms of IE may be musculoskeletal.

Letter to the Editor

Patient With Disseminated Mycobacterium Avium-Intracellulare Complex Involving the Bone Marrow, Causing Pancytopenia

We report the case of a 35-year-old female who presented to the emergency department with a recent diagnosis of acquired immunodeficiency syndrome (AIDS) 1 month prior while undergoing a workup for a 35-pound weight loss. She had a CD4 count of 25 and a high viral load. She reported nausea…

Letter to the Editor

Folic Acid and Neural Tube Defects

was particularly interested in the article by Hauser et al1 concerning folic acid and the prevention of neural tube defects. The history of our gradual understanding of the role of folic acid in helping to prevent neural tube defects is a fascinating one. These devastating defects—such as anencephaly, encephalocele, spina…

Letter to the Editor

Response: Further Reflections on Virchow’s Triad

I am pleased that our piece about Virchow and his eponymous triad generated such a detailed and thoughtful response. Dr. Malone agrees with our main point: Virchow did not identify stasis, hypercoagulability, and vessel wall injury as the three main precipitants of thrombosis. However, Dr. Malone is concerned that we…

Letter to the Editor

Response: Linear Basal Cell Nevus

We are pleased with the kind insight provided by Drs. Kimyai-Asadi and Jih. Their observation and expertise has been instructive for us and, we trust, for the Journal’s readership. That several of the subsequently biopsied lesions were interpreted as basal cell carcinomas, not basal cell nevus or fibroepithelioma of Pinkus,…

Medical Webwatch

Medical Webwatch

Established in 1993, this large, well-formatted web site is brimming with information. One of the main features of the site—heavily weighted in favor of healthcare professionals—is “Management Strategies in Herpes.” These are comprehensive summaries of the practical recommendations made in their more detailed series of “Monographs.” These are supported by…