Issue - Southern Medical Association

Expired CME Credit Submission and Evaluation Form

CME Credit—June 2005 CME Topic: Antiphospholipid Syndrome

Expired CME Credit Submission and Evaluation Form – Antiphospholipid Syndrome

Review Article

Mycobacterium avium Complex Pulmonary Disease in Immunocompetent Patients

Mycobacterium avium complex is becoming increasingly recognized as one of the most common mycobacterial pathogens in humans. It is rapidly becoming a significant cause of pulmonary disease even in those with an intact immunity. In 1997, the American Thoracic Society published recommendations for the diagnosis and treatment of nontuberculous mycobacteria….

Case Report

Mycobacterium abscessus and Other Nontuberculous Mycobacteria: Evolving Respiratory Pathogens in Cystic Fibrosis: A Case Report and Review

Cystic fibrosis (CF) is a risk factor for the development of nontuberculous mycobacteria (NTM) infection. Prevalence of these organisms varies from center to center with the predominance of affected patients being in the adult population. The difficulty in diagnosing NTM infection in CF involves the overlap between signs and symptoms…

Case Report

Actinomycosis Esophagitis in a Patient with Persistent Dysphagia

Many causes of esophagitis exist in immunocompromised patients. Uncommon pathogens must be considered to facilitate timely and appropriate therapy. A limited number of cases of esophageal actinomycosis have been reported. This report describes an unusual case of esophageal actinomycosis in a patient with persistent dysphagia. The broad differential may have…

Case Report

Unusual Cause of Dysphagia: Inflammatory Pseudotumor of the Lung

Inflammatory pseudotumor (IPT) is a rare disease that usually occurs in the lung. Patients with IPT are usually asymptomatic, with a solitary pulmonary nodule or mass detected on routine chest roentgenogram. IPT can behave as a malignant tumor both clinically and radiologically. Cough, fever, dyspnea, and hemoptysis are the usual…

Case Report

Lymphangiomatosis: A Case Report

Lymphangiomatosis is a rare congenital malformation that can involve visceral organs, soft tissue, and bone. This report describes a 5-year-old female with this disorder who presented with respiratory distress and subsequently died. Clinical, diagnostic, and treatment aspects of this entity are discussed.

Letter to the Editor

Influence of Places of Birth, Medical Education, and Residency Training on the Eventual Practice Locations of Family Physicians: Recent Experience in Virginia

Several earlier studies have demonstrated that the state where generalist physicians complete their residency training is an important predictor of eventual practice location.1,2 The purpose of this study was to analyze the relative contributions of the locations of birth, medical education, and residency training in determining a family physician’s eventual…

Original Article

Evaluation of the Efficacy and Safety of Outpatient Parenteral Antimicrobial Therapy for Infections With Methicillin-sensitive Staphylococcus aureus

Objectives: As increasing numbers of patients are being treated with outpatient parenteral antimicrobial therapy (OPAT), it becomes ever more important to ascertain the risks and benefits of such treatment for patients. Methods: We conducted a retrospective analysis of 1,515 patients with methicillin-sensitive Staphylococcus aureus infections who were treated with outpatient…

Original Article

Cutaneous Community-acquired Methicillin-resistant Staphylococcus aureus Infection in Participants of Athletic Activities

Objectives: Cutaneous community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA) has been identified in otherwise healthy individuals either with or without methicillin-resistant S. aureus (MRSA)-associated risk factors who participate in athletic activities. The purpose of this study was to describe the clinical features of CAMRSA skin infection that occurred in university student athletes,…

Original Article

Clinical Description and Follow-up Investigation of Human West Nile Virus Cases

Objectives: The objective of this study was to investigate long-term outcomes after West Nile virus infection. Methods: We reviewed the medical records of persons reported with West Nile virus in Tennessee in 2002 and interviewed cases 1 year after acute illness. Results: In 2002, 56 cases of West Nile virus…

Original Article

Hospitalists and Improved Cost Savings in Patients With Bacterial Pneumonia at a State Level

Objectives: In the hospitalist literature, most studies have focused on outcomes related to cost savings for individual hospital systems. This study sought to determine if hospitalists could improve cost savings at a state level. Methods: This is a retrospective analysis of a statewide database for inpatients in 2002 with bacterial…

Original Article

Surgical Management of Intracranial Cavernous Malformations: The Louisiana State University Health Sciences Center, Shreveport Experience

Intracranial cavernous malformations are vascular anomalies consisting of endothelium-lined caverns filled with blood at various stages of thrombosis and organized and separated by a collagenous stroma devoid of mature vessel wall elements. They represent a clinical challenge both in diagnosis and management due to the variety of presenting symptoms and…

Expired CME Article

Antiphospholipid Syndrome: Review

Antiphospholipid syndrome spans many medical disciplines. Classic criteria include the presence of anticardiolipin antibody or lupus anticoagulant with typical complications of thrombosis or pregnancy loss. Other common associated manifestations include livedo reticularis, thrombocytopenia, valvular heart disease, and nephropathy with renal insufficiency, hypertension, and proteinuria. Treatment of serious complications with anticoagulation…

Case Report

Rare Case of Fatal Yellow Fever Vaccine-associated Viscerotropic Disease

This report describes a case of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) that occurred after vaccination in a 22-year-old female. Our patient presented with a clinical syndrome of fever, headache, nausea, and vomiting, which quickly progressed to multiorgan failure and ultimately death on hospital day 4. YEL-AVD is an extremely…

Self-Assessment Examination (Historical)

CME Questions: Antiphospholipid Syndrome

Expired CME Article Questions – Antiphospholipid Syndrome

Editorial

Outpatient Parenteral Antibiotic Therapy: Not So Crazy After All These Years

Outpatient parenteral antibiotic therapy, or OPAT, has emerged as an essential component of our health care delivery system in the United States. The idea evolved from the initial use of an indwelling Silastic catheter for the successful delivery of home total parenteral nutrition for a patient with massive mesenteric thrombosis…

Editorial

Alzheimer Disease

Only a few years ago, the diagnosis of Alzheimer disease (AD) was often avoided by busy clinicians and met with despair by patients and their families. Therapeutic nihilism was the norm, and for good reason as there was no proven medication to help treat the symptoms of the illness. Today,…

Expired CME Article

Antiphospholipid Syndrome

Expired CME Article – Antiphospholipid Syndrome

Review Article

Complementary and Integrative Approaches to Dementia

This is a review that evaluates complementary and alternative approaches to dementia and places them into an integrative framework. While many therapies in popular use have yet to be supported by “best-evidence” trials or meta-analysis, conventional treatments for dementia are clearly suboptimal. This encourages both health care providers and patients’…

Review Article

Treatments for Alzheimer Disease

As our population ages, the incidence and prevalence of Alzheimer disease (AD) will increase dramatically. A number of therapies have been investigated for the treatment and prevention of AD. Clinicians should be prepared to provide evidence-based answers to inquiries regarding AD treatment. There is insufficient evidence to recommend ginkgo biloba,…

Article

The Patient’s Page

Relaxation therapies can help lower the levels of agitation and stress in Alzheimer patients and their caregivers. Simple techniques such as massage therapy and expressive physical touching are effective in keeping patients calm, by allaying anxiety and creating an environment in which the patient feels safe. Therapeutic touch has been…

Article

Medical Webwatch

The “Fast Facts Index” from the End of Life/Palliative Education Resource Centre (EPERC), Medical College of Wisconsin (http://www.eperc.mcw.edu/ff_index.htm) is intended for educators and clinicians, and has 130 peer-reviewed, one-page outlines of important end-of-life clinical topics. EPERC has “been designed for use by medical school course/clerkship directors, residency and continuing education…

Letter to the Editor

Rapid Decline in Cognition After Tick Bites

Infectious or toxic agents may cause cognitive decline or contribute to its development. We describe a case of dementia rapidly accelerated by tick bites. An 81-year-old male with hypertension, coronary artery disease, and dementia was hospitalized in May of 2003 because of a marked decline in cognition and increasing behavioral…

Letter to the Editor

The Need for a Means of Medical Accident Information Disclosure in Japan

In Japan, considerable attention has been given to the controversial issue of identity disclosure for physicians involved in medical accidents. The importance of name disclosure, done in a responsible manner, is particularly important in cases which potentially involve malpractice. One such case from July 2003, highlights the complexity of the…

Letter to the Editor

Ephaptic Transmission as an Explanatory Mechanism of Radicular Pain

Lower back pain with radicular symptomatology is a common clinical entity that affects hundreds of thousands of people every year. In the vast majority of these cases, disk herniation is evident on the patients’ radiologic evaluation. However, as occasionally encountered in our institution, a fraction of these patients harbor disk…

Letter to the Editor

Sunburn and Swelling: The Edema of Erythema

A 53-year-old physician, who should have known better, became sunburned. He spent several hours on a beach mostly under an umbrella but neglected to apply suntan lotion to protect him from reflected sunlight. By the evening of the first day, it was obvious he had significant sunburn from the dorsum…