Issue - Southern Medical Association

Expired CME Article

Inflammation: Nutritional, Botanical, and Mind-body Influences

Chronic inflammation is becoming an important risk factor to identify in regard to inhibiting disease onset and its progression. Nutritional science attempted to improve health by manipulating fats so that we could consume “healthy” nonsaturated fats while simultaneously allowing foods to have a longer shelf-life. However, despite our good intentions,…

Expired CME Article

Use of Echinacea in Upper Respiratory Tract Infection

Abstract:The significant burden of upper respiratory tract infection in adults and children, coupled with a lack of specific treatment options, invites the use of alternative therapies. Echinacea is an herb widely used for the prevention or treatment of upper respiratory tract infection. This review article examines the mechanism of action,…

Expired CME Article

Integrative Therapies for Menopause

Menopause is a transitional time for women. This gives practitioners an opportunity to focus on recommending healthy lifestyle changes. Hormone replacement therapy (HRT) has been the mainstay of therapy for menopausal symptoms. With recent research findings, women and their physicians are seeking alternatives that do not carry the risks associated…

Expired CME Credit Submission and Evaluation Form

CME Credit—March 2005 Featured CME Topic: Complementary and Alternative Medicine

Expired CME Credit Submission and Evaluation Form – Complementary and Alternative Medicine

Review Article

Acupuncture: A Clinical Review

This article summarizes the research base, probable mechanism of actions, and clinical applications of acupuncture. It offers the clinician a deeper understanding of appropriate conditions for which acupuncture may be useful, outlines how to integrate acupuncture into a clinical practice, and describes referral and training issues. Key Points * Basic…

Review Article

Neoadjuvant Therapy: An Emerging Concept in Oncology

Neoadjuvant therapy, an adjunctive therapy given before the main therapy, has become an integral part of modern multidisciplinary cancer management. Organized by the primary organ involved by cancer, this review summarizes the outcomes of neoadjuvant therapy for common malignant solid tumors, based on large, randomized, controlled trials. In locally advanced…

Review Article

Extrapulmonary Small Cell Carcinoma

This article reviews the recent literature on extrapulmonary small cell carcinomas. Until now, only four cases have been published in the English literature, two of those in the Southern Medical Journal. Sharing the information on diagnosis and treatment of these cases is important for better understanding and treatment of these…

Case Report

Pulmonary Sarcoidosis Presenting with Acute Respiratory Failure

This is a case report of pulmonary sarcoidosis presenting with acute respiratory failure. A 33-year-old black man presented with 4 days of headache and fever. He had subsequent development of respiratory failure on the seventh hospital day. Workup showed high serum angiotensin-converting enzyme and increased pulmonary parenchymal uptake of gallium….

Case Report

Acupuncture Therapy Rapidly Terminates Intractable Hiccups Complicating Acute Myocardial Infarction

Acupuncture is a well-known alternative therapy in practice worldwide. Its dramatic effect on hiccups has been rarely reported. We describe a 77-year-old male who had hiccups after an acute myocardial infarction. Despite aggressive treatment including breath-holding to interrupt the respiratory rhythm, continuous positive airway pressure, and medication with metoclopramine, prochlorperazine,…

Case Report

Primary Non-Hodgkin Lymphoma of the Larynx

A rare case of primary large B-cell non-Hodgkin lymphoma of the larynx is reported. The patient was an 80-year-old female who presented with pharyngeal discomfort and dysphagia. Radiotherapy was instituted with complete remission of the tumor. Nine months afterward, she presented with aspiration pneumonia and dysphagia. Indirect laryngoscopy disclosed laryngeal…

Case Report

Acute Epstein-Barr Virus Infection Causing Bilateral Conjunctival Hemorrhages

The systemic and ocular manifestations of acute Epstein-Barr virus infection are protean. Conjunctival hemorrhage has been described once. This report describes a young male who had bilateral conjunctival hemorrhages in the setting of acute Epstein-Barr virus infection. Key Points * The manifestations of acute Epstein-Barr virus infection are variable. *…

Case Report

Thrombotic Thrombocytopenic Purpura Without Schistocytes on the Peripheral Blood Smear

A hallmark of the clinical syndrome of thrombotic thrombocytopenic purpura (TTP) is evidence of microangiopathic hemolytic anemia. The presence of schistocytes on the peripheral blood smear, elevated plasma lactic dehydrogenase, and decreased haptoglobin concentration are used as evidence of microangiopathic hemolytic anemia to make a diagnosis of TTP. This report…

Original Article

Peak Expiratory Flow Rate as Predictor of Inpatient Death in Patients with Chronic Obstructive Pulmonary Disease

Objectives: Few studies analyze hospital deaths and related factors in patients with acute exacerbation of chronic obstructive pulmonary disease who require hospitalization. Methods: A cross-sectional study was done with 284 patients who had been admitted consecutively to the Short Stay Medical Unit at the Juan Canalejo Hospital in A Coruña….

Original Article

Enteral Nutrition by a Forward Surgical Team in Afghanistan

Objectives: The modern practice of trauma surgery is a global physiologic approach to caring for the injured patient. Included in that approach is consideration of the traumatized patient’s nutritional needs and implementing early enteral feeding. This is routine practice in the United States but logistically impractical when using commercial enteral…

Expired CME Article

Approach to Communicating with Patients About the Use of Nutritional Supplements in Cancer Care

In recent years, complementary and alternative medicine has become popular among the general population in the Western world. Cancer patients have joined this global trend, often seeking supplements to conventional oncologic care, usually without their physicians’ knowledge. Among the most common forms of complementary and alternative medicine used by cancer…

Expired CME Article

Pain Management in Children: Developmental Considerations and Mind-body Therapies

One of the most challenging roles of medical providers serving children is to appropriately assess and treat their pain. Pain is one of the most misunderstood, underdiagnosed, and undertreated/untreated medical problems, particularly in children. New JCAHO regulations regard pain as “the fifth vital sign” and require caregivers to regularly assess…

Editorial

In-hospital Death in Patients With Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is escalating in importance in the United States. With an aging population and the continued effects of cigarette smoking, the number of patients with COPD is growing. COPD is the fourth leading cause of death in the United States.1 In COPD, the obstructive defect is…

Editorial

Sarcoidosis Presenting as Acute Respiratory Failure

Sarcoidosis is a multisystem disease of unknown cause with a myriad of potential clinical manifestations. A vast majority of patients with sarcoidosis present with lymph node and lung involvement. In the acute stage, sarcoidosis can present clinically as one of the well-defined classic syndromes (Lofgren or Heerfordt syndrome); however, sarcoidosis…

Expired CME Article

Complementary and Alternative Medicine

Expired CME Article – Complementary and Alternative Medicine

Expired CME Article

Music as Therapy

Music is widely used to enhance well-being, reduce stress, and distract patients from unpleasant symptoms. Although there are wide variations in individual preferences, music appears to exert direct physiologic effects through the autonomic nervous system. It also has indirect effects by modifying caregiver behavior. Music effectively reduces anxiety and improves…

Expired CME Article

Introduction

The fields of complementary and alternative medicine (CAM) and its evolving progeny, integrative medicine (IM), have become highly visible areas in clinical care as well as education and research. Although patient use of alternative therapies has been very high in multiple surveys, physician knowledge in these areas has sometimes lagged….

Expired CME Article

CME Questions: Complementary and Alternative Medicine

Expired CME Article Questions – Complementary and Alternative Medicine

Review Article

Substance Abuse: Medical And Slang Terminology

Substance abuse is among one of the major problems plaguing our society. It has come to the attention of several health-care professionals that a communication gap exists between themselves and substance abusers. Most of the time the substance abusers are only familiar with the slang terms of abused substances, a…

Letter to the Editor

The Unseen Aesthetics of Double-decker Televisions: A Southernism

With certainty, it can be said that the television set is not a recognizable, or even desirable, Southern cultural phenomenon. But, like it or not, televisions have become ubiquitous in the Southern home. These virtual carpetbaggers have contributed mightily in homogenizing the uniqueness of our rural identity…sullying our accents, making…

Letter to the Editor

On Omeprazole and Iron Replacement

I read with great interest the article1 entitled “Effect of Omeprazole on Oral Iron Replacement in Patients With Iron Deficiency Anemia.” The authors declared that the patients presented here are the first of their kind to be reported. However, this relation has been well known for a long time and…

Letter to the Editor

March Madness-associated Deep Vein Thrombosis

We describe a case of March madness-associated deep vein thrombosis in a spectator. Review of the literature revealed one previously reported case of pulmonary embolism related to prolonged television viewing.1

Medical Webwatch

Medical Webwatch

Medical Rounds (www.medicalrounds.com) is a web-based educational project developed by Kenneth F. Cunningham, MD, FRCPC, Department of Medicine, St. Paul’s Hospital, University of British Columbia. It presents multimedia online education utilizing recordings of webcasts, presentations, and conferences. In addition to the presentations that are developed in-house, they also offer an…

Acknowledgment

The Patient’s Page

Breathing techniques can be a very effective form of pain relief. Children in pain will often hold their breath or take very shallow breaths. Breathing deeply can help your child relax. Use of a rhythmic, deep-chest breathing technique, or patterned, shallow breathing can reduce pain, stress, anxiety, and even panic…