Issue - Southern Medical Association

Original Article

Trends in Arkansas Motorcycle Trauma After Helmet Law Repeal

Objectives: This study aimed to assess the impact of the 1997 Arkansas helmet law repeal on motorcycle registrations, crash and fatality risks, and alcohol involvement in motorcycle crashes. Methods: Annual motorcycle registration data for the years 1990 through 2001 were obtained from the Arkansas Department of Finance and Administration. These…

Original Article

Extent and Determinants of Physician Participation in Expert Witness Testimony

Objectives: In the recent past, law firms have had difficulties in finding physicians to review malpractice cases and serve as expert witnesses. Over the last few years, however, many clinicians have had a decline in their income, causing some physicians to seek alternative sources of revenue such as the review…

Expired CME Credit Submission and Evaluation Form

CME Credit—April 2005: Health Risks of Online Communication

Expired CME Credit Submission and Evaluation Form – Health Risks of Online Communication

Review Article

Systematic Review of the Risk of Uterine Rupture with the Use of Amnioinfusion After Previous Cesarean Delivery

Objectives: Amnioinfusion is commonly used for the intrapartum treatment of women with pregnancy complicated by thick meconium or oligohydramnios with deep variable fetal heart rate decelerations. Its benefit in women with previous cesarean deliveries is less known. Theoretically, rapid increases in intrauterine volume would lead to a higher risk of…

Review Article

Lessons Learned in the Management of Thirteen Celiac Axis Injuries

Objectives: Celiac axis injuries are rare. The purposes of this study were to (1) review institutional experience, (2) determine additive effect on death of associated vessel injuries, and (3) correlate mortality rates with the American Association for the Surgery of Trauma–Organ Injury Scale (AAST-OIS) for abdominal vascular injury. Methods: This…

Case Report

Giant Cell Arteritis of the Female Genital Tract: Report of a Case and Review of the Literature

A 65-year-old female presented with constitutional symptoms of fever and weight loss with bilateral adnexal masses on physical examination. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed and subsequently revealed giant cell arteritis involving numerous small arteries in the ovaries, fallopian tubes, paraovarian and paratubal soft tissues, myometrium, and cervix….

Case Report

Cricopharyngeal Achalasia Responsive to Balloon Dilation in an Infant

This report describes an infant with vomiting and significant weight loss attributable to cricopharyngeal achalasia, a rare finding in children. The infant responded to balloon dilation of the upper esophageal sphincter, with resolution of symptoms and return to presymptomatic growth parameters. A brief description of the clinical features, diagnostic evaluation,…

Case Report

Wolf in Sheep’s Clothing: Advanced Kaposi Sarcoma Mimicking Vulvar Abscess

Kaposi sarcoma is a vascular neoplastic disorder that is associated with the acquired immunodeficiency syndrome (AIDS). The causative factor in Kaposi sarcoma is human herpes virus-8. This complication of AIDS has a predilection for homosexual males and is rarely associated with the female AIDS population. However, we present a case…

Case Report

Severe Thrombocytopenia Due to Hypersplenism Successfully Treated With Partial Splenic Embolization in Preoperative Management

Hypersplenism is a known complication of portal hypertension secondary to cirrhosis of the liver. Although thrombocytopenia secondary to hypersplenism does not cause clinically significant hemostatic defect, it may need to be addressed in selective circumstances, such as preoperative preparation for a surgery. This report describes a 30-year-old male with a…

Case Report

Pedunculated Localized Fibrous Tumor of the Pleura Presenting as a Moving Chest Mass

Localized fibrous tumor of the pleura is a rare primary pleural neoplasm. The tumors are usually discovered incidentally on routine chest radiography. A change in the lesion’s position with respiration and/or posture of the patient indicates a pedunculated pleural lesion. Computed tomography and magnetic resonance imaging reveal the relation of…

Case Report

Pseudotumor Presentation of Intracerebral Tuberculomas

Diagnosis of tuberculoma is difficult because of its tumorlike aspects. This report describes the case of a male who displayed a hemiplegia revealing an intracranial mass. Neuroimaging was consistent with a glioblastoma; however, the definite diagnosis was a tuberculoma. Clinical features of tuberculomas are nonspecific. Even though the neuroimaging features…

Case Report

Intracerebral Bleeding in a Patient With Neurosarcoidosis While on Corticosteroid Therapy

Neurosarcoidosis can have variable clinical manifestations. Intracerebral bleeding is very rare in the setting of neurosarcoidosis and has been reported only twice. In this report, we describe a patient with neurosarcoidosis who had intracerebral bleeding while on corticosteroid therapy, despite apparent clinical improvement. Key Points * Neurosarcoidosis can masquerade as…

Letter to the Editor

Diagnosis of Colon and Rectal Cancer in a Large VA Medical Center Practice: Does Fecal Occult Blood Screening Make a Difference?

Screening of average-risk patients for colorectal cancer by annual fecal occult blood testing (FOBT), sigmoidoscopy, or colonoscopy has demonstrated efficacy in both the prevention and earlier detection of this malignancy in adults 50 years or older.1,2 In 1998, the Albany VA Medical Center launched a systematic program of colorectal cancer…

Original Article

Female Patients’ Sex Preferences in Selection of Gynecologists and Surgeons

Objectives: In this study, the authors investigated sex preferences for gynecologists and surgeons among female patients, and explored potential contributing factors. Methods: One hundred forty-six female patients were surveyed in a private practice office concerning their sex preferences and past obstetric/gynecologic care. For data comparisons, χ2 or Fisher exact tests…

Original Article

Maternal Prepregnant Body Mass Index and Weight Gain Related to Low Birth Weight in South Carolina

Objectives: The primary purpose of this study was to describe the proportion of low birth weight that could be potentially prevented by programs focusing on maternal prepregnant body mass index (BMI) and/or weight gain during pregnancy. Methods: In this historic cohort design, study data consisted of birth certificates linked to…

Original Article

Postpartum Hemorrhage After Vaginal Birth: An Analysis of Risk Factors

Objective: To determine, in a single tertiary obstetric hospital, the incidence of and risk factors for postpartum hemorrhage (PPH) after a vaginal birth. Methods: PPH was defined as measured blood loss greater than 1,000 mL and/or need for a transfusion. Results: Over a 4-year period, 13,868 of 19,476 women delivered…

Original Article

Availability and Perceived Competence of Pediatricians to Serve as Child Protection Team Medical Consultants: A Survey of Practicing Pediatricians

Objectives: The effectiveness of multidisciplinary child protection teams has been demonstrated. This study is an attempt to assess the level of this commitment and the perceived competence of primary care pediatricians to provide this service. Methods: A questionnaire survey was mailed to primary care pediatricians practicing in the state of…

Original Article

Physical and Behavioral Health of Medicaid Children in Two Southern States

Objectives: As the primary insurer of children in the United States, Medicaid covers at least one in four US children. Information on the health and behavioral health needs of this group of children is critical to plan, deliver, and monitor services accordingly. Methods: Parent interview data from a representative sample…

Case Report

Recurrent Arthralgias in a Patient With Previous Mayaro Fever Infection

Mayaro fever is an acute, self-limited, febrile, mosquito-borne viral disease manifested by fever, chills, headache, myalgias, and arthralgias. The virus belongs to the family Togaviridae and the genus Alphavirus. Five other mosquito-borne viruses have been described as causing a similar dengue-like illness. The virus was first isolated in 1954, and…

Case Report

Worsening of Heart Failure in Becker Muscular Dystrophy After Nonsteroidal Anti-inflammatory Drugs

A 40-year-old male with Becker muscular dystrophy and cardiac involvement was stable in New York Heart Association class II for 7 years. He then had arthralgia caused by bilateral gonarthrosis. He received diclofenac 100 mg/d and 500 mg/d mephenamine acid. Six weeks later, he was hospitalized because of heart failure…

Expired CME Article

Implications of Cyberspace Communication: A Role for Physicians

Through the presentation of three clinical case reports and subsequent discussion, it is demonstrated that physicians must begin to familiarize themselves with the health-related implications of online communication, and must proactively address Internet use as it relates to health and well-being. Included case presentations highlight the following: the established association…

Expired CME Article

CME Questions: Implications of Cyberspace Communication: A Role for Physicians

Expired CME Questions – Implications of Cyberspace Communication: A Role for Physicians

Expired CME Article

CME Topic: Health Risks of Online Communication

Expired CME Article – Health Risks of Online Communication

Editorial

Patient Satisfaction After Laparoscopic Antireflux Surgery: Community Achievement

Gastroesophageal reflux disease (GERD) is a common problem, with up to 40% of the population having reflux symptoms during their lives. Fortunately for most, symptoms are either mild and infrequent or can be successfully managed with anti-acid medications such as histamine receptor-2 (H2) antagonists or proton pump inhibitors. However, some…

Editorial

Motorcycle Mayhem

Since the repeal of the Arkansas motorcycle helmet law in 1997, several studies1,2 from that state have been published, including one published in this issue of the Southern Medical Journal by Bledsoe and Li,3 documenting the adverse consequences of their misconceived blunder, heaping more fuel to the continual debate on…

Original Article

Depression Screening in the Pregnant Soldier Wellness Program

Objectives: The purpose of this study was to determine the prevalence of depression among active-duty low-risk pregnant women using the Edinburgh Postnatal Depression Scale. Rates for depression have been reported to be as high as 13% during pregnancy and 12 to 22% postpartum, with postpartum suicidal ideation at nearly 7%….

Original Article

Racial Bias in Patient Selection of an Obstetrician

Objective: The objective of this study was to determine racial bias in patient selection of an obstetrician. Methods: Obstetrical patients referred for genetic counseling at a community hospital were included. Self-reported patient race/ethnicity were compared with obstetrician’s race/ethnicity. Results: The patient population (n = 1,519) was 27.8% white, 25% Hispanic,…

Original Article

Laparoscopic Nissen Fundoplication in a Community Hospital: Patient Satisfaction Survey

Objectives: To assess the efficacy of laparoscopic Nissen fundoplication for esophageal reflux in a community hospital. Methods: One hundred nineteen patients (76%) of 157 patients having laparoscopic fundoplication for symptomatic reflux disease completed a questionnaire. All patients were evaluated with esophagoscopy, esophageal motility, and pH studies. Results: Mean follow-up was…

Review Article

Hypereosinophilic Syndrome: Two Case Reports of Contrasting Variants

Two cases of hypereosinophilic syndrome that illustrate different variants are reported. Recognition of the specific variant is important because the treatments differ. Patients with hypereosinophilic syndrome should be monitored for evidence of a myeloproliferative process because treatment with tyrosine kinase inhibitors in these patients is effective and may prevent significant…

Letter to the Editor

Improving Risk Factors in Diabetic Patients Participating in a Weight Management Program

Several studies have investigated the impact of weight loss in type 2 diabetic patients.1–3 Yet the role of different low-calorie diets and glucose control in obese diabetic patients has not been adequately studied.

Letter to the Editor

Unsedated Endoscopy

The editorial remark and article regarding “Unsedated Endoscopy” were interesting and well-written.1,2 It should be noted that the authors do not describe the diameter of the endoscope used. I would agree with the premise that unsedated standard endoscopy could be a problem. The recruiting methods may have shown some bias…

Medical Webwatch

Medical Webwatch

JointZone (http://www.iam.ecs.soton.ac.uk/users/mhn99r/learn/userlogin/index.jsp) is a comprehensive and structured overview of rheumatology. It can be accessed via “Free Browsing” or via “Personalized Learning,” where an up-to-date history of your reading as a percentage of the material available is offered. The web site is funded by Arthritis Research Campaign UK, and was developed…

Acknowledgment

The Patient’s Page

While the Internet has become an integral part of many people’s lives, it has also created new dangers, especially for young people.