Issue - Southern Medical Association

Expired CME Credit Submission and Evaluation Form

CME Topic: Statin Therapy in Rheumatoid Arthritis CME Credit—May 2005

Expired CME Credit Submission and Evaluation Form – Statin Therapy in Rheumatoid Arthritis CME Credit—May 2005

Review Article

Thyroid Disorders in Elderly Patients

Thyroid disorders are common in the elderly and are associated with significant morbidity if left untreated. Typical symptoms may be absent and may be erroneously attributed to normal aging or coexisting disease. Physical examination of the thyroid gland may not be helpful, as the gland is often shrunken and difficult…

Review Article

Abuse of Supraphysiologic Doses of Anabolic Steroids

The following article is a literature review of supraphysiologic doses of anabolic-androgenic steroids (AAS). This article contains a brief review of the history of AAS, the chemistry of the varying forms of AAS, and proposed mechanisms of action. The article then focuses on how AAS are used in an illicit…

Case Report

Removal of Vena Caval Filter at 224 Days

Patients at risk of pulmonary embolism usually receive anticoagulants, which are contraindicated in trauma victims. A woman with extensive deep venous thrombosis after a vehicle accident had a nitinol Recovery Filter inserted prophylactically. After her recovery, she requested filter removal because of her intention to become pregnant. The filter was…

Case Report

Determining Functional Significance of Subclavian Artery Stenosis Using Exercise Thallium-201 Stress Imaging

Subclavian artery stenosis (SAS) is a rare lesion accounting for nearly 2.5% of all extracranial arterial occlusions. Symptoms from SAS usually relate to subclavian steal, and include syncope, vertigo, ataxia, and, rarely, upper limb paralysis or hemipareses. Upper extremity ischemia may result in intermittent or constant arm pain. The majority…

Case Report

Ludwig’s Angina: An Uncommon Cause of Chest Pain

A 71-year-old male with coronary artery disease, hypertension, diabetes mellitus, tobacco and opioid dependence came to the emergency room complaining of one episode of retrosternal chest pain oppressive in nature of one day of evolution. He had acute respiratory distress and required mechanical ventilation. The initial impression was myocardial ischemia,…

Case Report

Foix-Alajouanine Syndrome: An Uncommon Cause of Myelopathy From an Anatomic Variant Circulation

Foix-Alajouanine syndrome is a rare cause of myelopathy caused by dural arteriovenous malformation of the spinal cord, mostly lower thoracic and lumbar. Patients are usually over 50 years of age and can present with acute lower extremity dysesthesias or intermittent sciatica. Progression to paraplegia may be slow. Spinal angiography is…

Case Report

Sweet Syndrome Associated with Furosemide

This case report describes a case of Sweet syndrome (SS) related to use of furosemide in a 46-year-old female who was admitted for treatment of congestive heart failure. Three days after administration of furosemide, the patient had a fever and a skin eruption appeared on her wrists, forearms, and legs….

Case Report

Isolated Intraperitoneal Bladder Rupture Following Minor Trauma After Alcohol Ingestion

The authors describe a case of intraperitoneal bladder rupture in a 41-year-old male caused by trauma from a fall after alcohol ingestion. The patient presented on the day following the fall with signs of acute urinary retention, and 500 mL of urine was drained after catheterization. Signs of peritonitis appeared…

Case Report

Cronkhite-Canada Syndrome With Hypothyroidism

Cronkhite-Canada syndrome is a rare, noninherited gastrointestinal polyposis syndrome associated with characteristic ectodermal abnormalities. This report describes a 60-year-old female who was diagnosed with Cronkhite-Canada syndrome with hypothyroidism after presenting with chronic diarrhea, alopecia, intermittent abdominal pain, generalized gastrointestinal polyposis, hyperpigmentation, and nail dystrophy. Endoscopic examination of the stomach and…

Original Article

Physical Function and Quality of Life in Older Adults: Sex Differences

Objectives: Age is associated with deterioration in physical function (PF) and health-related quality of life (HRQL). Methods: We examined sex differences in the association between PF and HRQL among older adults. One hundred eight adults (ages 60 to 98 years) completed the Continuous Scale-Physical Function Performance test (CS-PFP10), Functional Status…

Original Article

Ejection Fraction and QRS Width as Predictors of Event Rates in Patients with Implantable Cardioverter Defibrillators

Objectives: The Multicenter Automatic Defibrillator Implantation Trial II in 2002 recommended implantable cardioverter defibrillators (ICDs) prophylactically for all patients with a prior myocardial infarction and ejection fraction (EF) of 30% or less. In June of 2003, the Centers for Medicare and Medicaid Services approved reimbursement for ICD placement in patients…

Original Article

Distribution of Pleural Effusion in Congestive Heart Failure: What Is Atypical?

Objectives: This study was performed to determine the distribution of pleural effusion between the right and left hemithorax in patients with uncomplicated congestive heart failure, and to determine whether left-sided pleural effusion actually constitutes an atypical distribution in congestive heart failure. Methods: The study group consisted of 120 consecutive patients…

Original Article

Does the Use of Standardized History and Physical Forms Improve Billable Income and Resident Physician Awareness of Billing Codes?

Objectives: Resident physician knowledge of financial reimbursement guidelines for patient encounters is limited. We determined whether the use of standardized history and physical examination forms by residents for hospital admissions plus a brief lecture would increase the level of billing codes, increase billable income, and increase resident awareness of billing…

Original Article

Relation of Residency Selection Factors to Subsequent Orthopaedic In-training Examination Performance

Objectives: Orthopaedic surgery remains one of the most competitive specialties, with more than a 99% match fill rate in the past several years. An oversupply of qualified applicants leads to intense competition for these residency spots, allowing program directors to be more selective in choosing their future residents. Although many…

Case Report

Infliximab-induced Headache and Infliximab-induced Meningitis: Two Ends of the Same Spectrum?

This report describes a case of aseptic meningitis induced by the tumor necrosis factor-α inhibitor infliximab. The patient, a 51-year-old female, was being treated for Crohn’s disease. After an infliximab infusion, she had headache, fever, arthralgia, myalgia, and meningismus. Cerebrospinal fluid analysis was remarkable for a neutrophilic pleocytosis and elevated…

Case Report

Mastoiditis in an Immunocompetent Adult

A 20-year-old white male presented to the family practice department with a 1-month history of right ear pain and loss of hearing. During the month, he had been seen in emergency rooms twice and also by his dentist. He had been treated with pain medications, tooth extraction, and finally, antibiotics….

Expired CME Article

CME Questions: Rheumatoid Arthritis and Statins

Expired CME Article Questions – Rheumatoid Arthritis and Statins

Expired CME Article

Statin Therapy in Rheumatoid Arthritis

Rheumatoid arthritis, a chronic inflammatory polyarthritis that destroys synovial joints, is associated with systemic as well as local inflammation and with an increased risk of cardiovascular disease and death not fully explained by traditional cardiac risk factors. Statins (HMG-coA reductase inhibitors), medications originally designed to lower cholesterol, have been shown…

Editorial

Technology at the Crossroads with Care and Costs: The Implantation of the Automatic Internal Cardiac Defibrillator

The automatic internal cardiac defibrillator (AICD, ACD or ICD) represents one of the biggest challenges in medical practice in these days of reduced reimbursements, increased financial pressures, increasingly complex technology, and growing malpractice litigation. It has been proved most valuable in aborting sudden cardiac death (SCD), and has saved thousands…

Editorial

Vive la Difference!

Vive la difference! Sex differences in childhood prompt little boys to play with guns and little girls to play with dolls—admittedly a fading stereotype. As adults, men are from Mars and women are Venusian. Do seniors also reflect sex differences or does a socialization-of-aging process somehow eventually amalgamate and homogenize…

Errata

Errata

The CME Credit Submission and Evaluation Form on page 329 of the March 2005 issue ran with the heading “Featured CME Topic: Arthritis” in error. The heading should have read “Featured CME Topic: Complementary and Alternative Medicine.Barnes EV, Edwards NL. Treatment of osteoarthritis. South Med J 2005;98:205-9.The abstract that appeared…

Book Review

Hypertension: Hot Topics

Our understanding of the pathophysiology of hypertension has increased over the past few years. We are now in a much better position to help patients with this condition, not only by judiciously selecting medications to prescribe, but also by recommending changes in lifestyle. On the other hand, there is now…

Letter to the Editor

Memories From My Years in Public Practice

I am a retired allergist and have many good memories of my years in medical practice. One special remembrance was the year I made this unique offer: I told each of my staff they could pick a patient that they considered worthy and give them $100.00 off their medical treatment….

Letter to the Editor

Polymicrobial Peritonitis Including Pantoea agglomerans From Teething on a Catheter

A 24-month-old female with end-stage renal disease on chronic peritoneal dialysis presented with a 1-day history of cloudy peritoneal fluid without fever or abdominal pain. Her usual medicines included cotrimoxazole, iron, sodium citrate, erythropoietin, and growth hormone.

Letter to the Editor

Effect of Advanced Age in Subjective Surgical Outcome of Patients Undergoing Spine Surgery

Spine surgeons are often challenged by the treatment of elderly patients with degenerative spinal disease. We conducted a telephone survey of patients treated in our department to estimate the possible effect of age in surgical outcome.

Letter to the Editor

Sclerosing Hemangioma

We recently evaluated a 48-year-old, nonsmoking Filipino female with a 3-week history of cough and hemoptysis. Physical examination was unremarkable. Chest radiography and computed tomography scan of the chest showed a 6.0-cm mass in the right lower lobe. A purified protein derivative skin test was positive, and three sputum samples…

Medical Webwatch

Medical Webwatch

Immunotherapy in Allergic Asthma, www.audio-digest.org/cgi-bin/start/acaai/immunotherapy/main.html is a continuing medical education course from the American College of Allergy, Asthma & Immunology. In the format of slide and audio presentations it covers “Immunotherapy a Historical Perspective,” “Immunotherapy as a Treatment for Asthma – an Evaluation of Studies, Preventative Aspects, Safety and Economic…

Acknowledgment

The Patient’s Page

Nutritional Supplements in Cancer Care Lycopene— An antioxidant found most commonly in tomatoes, which has been shown to reduce the risk for developing prostate, lung or stomach cancers. Some studies also suggest that prostate cancer patients who took lycopene prior to surgery had a reduction in the size of the…