November 2005, Volume 98 - Issue 11

CME Questions: Psychosomatic Pain: New Insights and Management Strategies


Abstract: Expired CME Questions - Psychosomatic Pain: New Insights and Management...

(pp 1111-1112)

Analysis of Diagnostic Error in Paid Malpractice Claims with Substandard Care in a Large Healthcare System

Thomas V. Holohan, MD, Janice Colestro, DNS, RN, John Grippi, MD, Jane Converse, JD, Michael Hughes, BMET

Abstract: Objective: Although claims databases are not representative of all care delivery, their predisposition toward serious unintended injury can complement resource-intensive chart reviews and guide patient safety initiatives. Materials and Methods: Non-Veterans Health...

(pp 1083-1087)

Late Stage (III and IV) Non-small Cell Cancer of the Lung: Results of Surgical Resection at Inova Fairfax Hospital

Paul D. Kiernan, MD, Michael J. Sheridan, SCD, James Lamberti, MD, Thomas LoRusso, MD, Vivian Hetrick, RN, Betty Vaughan, RN, Paula Graling, RN

Abstract: One hundred forty-two patients underwent surgery and related treatment for advanced stage (III, IV) non-small cell cancer of the lung. One hundred seventeen patients underwent up-front surgery, with a hospital mortality rate of 1.7% (2/117). Kaplan-Meier 5-year survival in...

(pp 1088-1094)

Effect of N-Acetyl Cysteine on Helicobacter pylori

Ahmet Kemal Gurbuz, MD, A Melih Ozel, MD, Ramazan Ozturk, MD, Sukru Yildirim, MD, Yusuf Yazgan, MD, Levent Demirturk, MD

Abstract: Background: Use of mucolytic agents that result in reduced mucous viscosity of the gastric mucous has been suggested to have an additive effect in curing Helicobacter pylori infection. Methods: Seventy H pylori–positive patients were given either eradication treatment...

(pp 1095-1097)

CME Credit—November 2005 CME Topic: Psychosomatic Pain: New Insights and Management Strategies


Abstract: Expired CME Credit Submission and Evaluation Form - Psychosomatic Pain: New Insights and Management...

(pp 1113)

PTH (1–34): A Novel Anabolic Drug for the Treatment of Osteoporosis

Michael F. Holick, MD, PHD

Abstract: The management of osteoporosis has in the past included providing patients with an adequate source of calcium and vitamin D and consideration of some type of antiresorption therapy such as hormone replacement, SERM therapy, or bisphosphonate therapy. However, patients who...

(pp 1114-1117)

Acetaminophen Overdose in Pregnancy

Jason M. Wilkes, MD, Larry E. Clark, MD, Jorge L. Herrera, MD

Abstract: Acetaminophen (APAP) is the most common drug overdose in pregnancy. Available data regarding APAP overdose in pregnancy is limited to case reports and a small prospective case series. APAP has been demonstrated to cross the placenta and in toxic doses may harm the fetal and...

(pp 1118-1122)

A Comprehensive Review of Disseminated Salmonella arizona Infection with an Illustrative Case Presentation

Jeffrey B. Hoag, MD, MS, Curtis N. Sessler, MD

Abstract: Salmonella arizona is known to cause infection in reptiles and other animals. Disseminated human infection is rare, except in the setting of a deficient immune system. The following is a unique account of disseminated infection including pericardial involvement. Unusual...

(pp 1123-1129)

Methicillin-resistant Staphylococcus aureus Empyema Necessitatis in an Eight-month-old Child

James Stallworth, MD, Elizabeth Mack, MD, Christopher Ozimek, MD

Abstract: Empyema necessitatis is a rare complication of empyema characterized by a spontaneous extension of pus from the pleural space into adjacent soft tissues. It is uncommon in the pediatric population and is usually caused by Mycobacterium tuberculosis. This report describes...

(pp 1130-1131)

Klippel-Feil Syndrome Associated With Pneumatocyst of the Right Cervical Rib

Alpay Haktanir, MD, Bumin Değirmenci, MD, Ramazan Albayrak, MD, Murat Acar, MD, Aylin Yucel, MD

Abstract: A patient with Klippel-Feil syndrome reported with a pneumatocyst of the proximal epiphysis of a right cervical rib. There was no additional skeletal abnormality except for fusion of the C3 and C4 vertebral bodies. To the best of our knowledge, this is the first reported...

(pp 1132-1134)

Unusual Case of Pyopneumothorax in Tennessee

Souad S. Youssef, MD, Vijay Ramu, MD, Felix A. Sarubbi, MD

Abstract: Rupture of a coccidioidal pulmonary cavity with subsequent pyopneumothorax is a rare clinical event, even in areas endemic for coccidioidomycosis. Our encounter with a patient diagnosed with this condition in northeast Tennessee serves notice to clinicians that...

(pp 1139-1141)

Disseminated Cat Scratch Disease With Vertebral Osteomyelitis and Epidural Abscess

Nahed Abdel-Haq, MD, Walid Abuhammour, MD, Hossam Al-Tatari, MD, Basim Asmar, MD

Abstract: A 5-year-old boy with cat scratch disease presented with fever of unknown origin and osteomyelitis of the thoracic spine and epidural abscess. He did not have localizing signs or symptoms. Computed tomography of the abdomen, which was initially negative, showed...

(pp 1142-1145)

Isolated Acetabular Osteoporosis in TOH in Pregnancy: A Case Report

U K. Debnath, FRCS, R Kishore, MRCS, R J. Black, FRCS

Abstract: Transient osteoporosis of the hip (TOH) is a rare, self-limiting syndrome characterized by hip pain in the 2nd or 3rd trimester of pregnancy. Conventional radiography shows demineralization of the femoral head. Diagnosis is confirmed by MRI scan. Over the course of a few...

(pp 1146-1148)

Acute Progressive Bilateral Carpal Tunnel Syndrome After Upper Respiratory Tract Infection

Ihab I. El Hajj, MD, Mohamad I. Harb, MD, Raja A. Sawaya, MD

Abstract: This report describes the case of a 32-year-old male presenting with acute progressive bilateral carpal tunnel syndrome after a benign upper respiratory tract infection. Serial nerve conduction studies confirmed progressive entrapment of the median nerves in the carpal...

(pp 1149-1151)

Patient’s Page

Jennifer McKinney, MA

Abstract: Acetaminophen is the most widely prescribed analgesic for use during pregnancy. Although this medication is approved for use in pregnant women, excessive amounts are known to cause liver failure, in both the mother and the fetus. It is therefore imperative that expectant...

(pp 1156)

Widespread Emergence of Methicillin Resistance in Community-acquired Staphylococcus aureus Infections in Denver

Megan J. Clancy, MD, Amy Graepler, MT, Peter E. Breese, MSPH, Connie S. Price, MD, William J. Burman, MD

Abstract: Background: Increasing rates of methicillin resistance among outpatient Staphylococcus aureus infections led us to assess the epidemiology and outcome of a local outbreak. Methods: A retrospective cohort study of outpatient skin and soft tissue infections due to S aureus in...

(pp 1069-1075)

Population-based Study of the Geographic Variation in Colon Cancer Incidence in Alabama: Relationship to Socioeconomic Status Indicators and Physician Density

Michèle P. L. Shipp, MD, DRPH, Renee Desmond, PHD, Neil Accortt, PHD, Reda J. Wilson, MPH, Mona Fouad, MD, MPH, Mohamad A. Eloubeid, MD, MHS

Abstract: Objectives: The objective of this population-based study was to examine the relationship between race, socioeconomic characteristics (socioeconomic status, SES), physician density, and colon cancer incidence in Alabama. Methods: Data for 5,788 colon cancer cases from 1996...

(pp 1076-1082)

A Case of Allergic Bronchopulmonary Aspergillosis Leading to Pneumonia with Unusual Organisms

Brown James McCallum, MD, David Amrol, MD, Joseph Horvath, MD, Nadeem Inayat, MD, Rohit Talwani, MD

Abstract: We describe the case of a 50-year-old male with a history of asthma and seizure disorder who presented with a 5-month history of dyspnea. The patient had been treated with multiple courses of antibiotics for presumed community-acquired pneumonia before being determined to...

(pp 1135-1138)

Psychosomatic Pain: New Insights and Management Strategies


Abstract: Expired CME Article - Psychosomatic Pain: New Insights and Management...

(pp 1098)

Psychosomatic Reasons for Chronic Pains

Søren Ventegodt, MD, Joav Merrick, MD

Abstract: In this issue of the Southern Medical Journal, the review by J. Rubin on psychosomatic pain1 quoted a study2 in which it was found that “college students with chronic pain yielded a history of abuse (physical and/or sexual) in 43.5% of the females (275 subjects) and 23.8%...

(pp 1063)

Salmonella Infections in the Setting of AIDS: A Serpentine Course

J Michael Kilby, MD

Abstract: Infectious complications of the acquired immunodeficiency syndrome (AIDS) tend to be caused by organisms that fall into two broad categories: 1) opportunistic pathogens prevalent in the natural environment but rarely causing serious disease in normal hosts (Pneumocystis,...

(pp 1066-1067)

Methicillin-resistant Staphylococcus aureus Pneumonia in Children: A Call for Increased Vigilance

Ekopimo Ibia, MD, MPH

Abstract: During the past two decades in the United States, Staphylococcus aureus pneumonia has been infrequently encountered in healthy children. However, that trend may be changing, given the emerging reports from several parts of the country.1–3 These reports suggest that the...

(pp 1059-1060)

Treatment of Late Stage Non-small Cell Lung Cancer: We Have More Work to Do

Coty Ho, MD

Abstract: The successful treatment of non-small cell lung cancer (NSCLC), like most solid tumors, still relies on complete surgical resection. However, a meaningful disease-free interval with surgery alone has been typically restricted to early stages I and II. Over the years, we...

(pp 1064)

Community-acquired MRSA: A Notable Adversary

John S. Francis, MD, PHD, Karen Carroll, MD

Abstract: In this issue, Clancy et al1 describe their findings from a retrospective cohort study conducted in 2003 on 193 patients evaluating the epidemiology, outcomes, and molecular characterization of community-acquired Staphylococcus aureus (CA-SA) infections from an integrated...

(pp 1061-1062)

Helicobacter pylori Treatment

Murali Krishna, MD, Judy Lalmuanpuii, MD

Abstract: Helicobacter pylori is a Gram negative bacterium that was isolated in 1983 and has since been shown to be associated with peptic ulcer disease as well as gastric adenocarcinoma and gastric lymphoma. It has a worldwide prevalence. The rate of infection varies among different...

(pp 1068)

Malpractice Claims: Finding the Silver Lining

Eric J. Thomas, MD

Abstract: In this issue of SMJ, Holohan and colleagues present findings from their review of 1,949 paid malpractice claims in the Veterans Health Administration from 1998 to 2003. The article nicely highlights that diagnostic errors are an important quality problem in the US...

(pp 1065)

Medical Webwatch

Jim Young

Abstract: PDQ (Physician Data Query) from the National Cancer Institute is a comprehensive database containing peer-reviewed summaries on cancer treatment, screening, prevention, genetics, supportive care, complementary, and...

(pp 1155)

Does Olanzapine-Fluoxetine Combination Increase the Risk of Mania in Poorly Compliant Bipolar Depressed Patients?

Roy R. Reeves, DO, PhD, Mark E. Ladner, MD

Abstract: Fluoxetine is useful for the treatment of depression and olanzapine for the treatment of schizophrenia and acute bipolar mania. In 2001, olanzapine-fluoxetine combination was found to be effective in a small sample of patients with nonbipolar depression.1 Subsequently, a...

(pp 1152-1153)

Percutaneous Intervention of Left Main Coronary Artery Disease: A Fresh Look at a Class III Recommendation

Matthew J. Diamond, DO, Jaspal Gujral, MBBS, FACP, Deepak Kapoor, MD

Abstract: Percutaneous intervention of left main coronary artery (LMCA) disease is a class III recommendation per the latest guidelines published by the American Heart Association/American College of Cardiology.1 As techniques, technologies, research, and pharmaceuticals advance,...

(pp 1153-1154)