Issue - Southern Medical Association

Expired CME Credit Submission and Evaluation Form

CME Credit—July 2005 CME Topic: Diagnostic Tests for Rheumatic Disease

Expired CME Credit Submission and Evaluation Form – Diagnostic Tests for Rheumatic Disease

Review Article

Metabolic Issues in Patients with Severe Mental Illness

This article reviews the epidemiology of weight gain and diabetes mellitus in general and in patients with severe mental illness in particular. Body mass index is defined, and possible predictors for weight gain in patients receiving antipsychotic medications are also enumerated. Information on risk of association with type 2 diabetes…

Case Report

Extreme Hyperkalemia

Hyperkalemia is a potentially fatal condition and is defined by a serum potassium level (K+) of greater than 5.5 mmol/L. The associated prevalence of cardiac arrhythmia increases directly with the degree of hyperkalemia. The danger in the majority of hyperkalemia cases is cardiac dysrhythmia, and often ventricular fibrillation or asystole…

Case Report

Calciphylaxis: A Rare Association with Alcoholic Cirrhosis. Are Deficiencies in Protein C and S the Cause?

Calciphylaxis is a rare condition of induced systemic hypersensitivity in which tissues respond to appropriate challenging agents with a sudden local calcification. It is characterized by acute calcium deposition in the medial layer of small and intermediate dermal vasculature that can lead to epidermal ischemia, ulceration, and necrosis. Calciphylaxis typically…

Case Report

Cutaneous Carcinoma with Mixed Histology: A Potential Etiology for Skin Cancer Recurrence and an Indication for Mohs Microscopically Controlled Surgical Excision

Cutaneous carcinomas with mixed histology describe nonmelanoma skin cancers which have more than one histologic subtype. These include basal cell carcinomas with concurrent aggressive growth patterns (such as sclerosing, infiltrating, micronodular, keratinizing, and tumors with perineural involvement) and nonaggressive growth patterns (such as superficial, nodular, and follicular) and squamous cell…

Original Article

Postpartum Hemorrhage After Cesarean Delivery: An Analysis of Risk Factors

Objective: To determine the incidence and risk factors for postpartum hemorrhage (PPH) associated with cesarean delivery. Methods: Blood loss at cesarean delivery was measured and defined as 1,000 to 1,499 mL or greater than 1,500 mL and/or the need for a blood transfusion. Variables were identified and evaluated to determine…

Original Article

Association of Type 2 Diabetes Mellitus and Seroprevalence for Cytomegalovirus

Background: Infection is known to play a role in type 1 diabetes, but there is a paucity of information on its role in diabetes mellitus type 2. We examined the seroprevalence of selected viruses in a group of predominantly Hispanic patients with type 2 diabetes and control subjects without diabetes….

Original Article

Pilot Study on Gastric Electrical Stimulation on Surgery-associated Gastroparesis: Long-term Outcome

Objectives: Patients with postgastric surgery gastroparesis are often unresponsive to conventional medical therapy. Gastric electrical stimulation (GES) with the use of high-frequency and low-energy neural stimulation is an approved technique for patients with idiopathic and diabetic gastroparesis. Methods: We hypothesized that GES would improve symptoms, health resource utilization, and gastric…

Original Article

Measurement of Central Venous Pressure from a Peripheral Intravenous Catheter in the Lower Extremity

Objectives: The measurement of central venous pressure (CVP) is used to assess intravascular status. Although this is usually accomplished by placement of a central venous catheter (CVC), there are circumstances when placement of a CVC may be technically difficult or impossible. The current study investigates the feasibility of measuring CVP…

Case Report

Acute Hepatitis E Infection in a Visitor to Louisiana

A man from Africa had been visiting Mississippi and Louisiana when he had development of acute hepatitis. Although hepatitis E is endemic to many parts of the world and has been associated with large outbreaks, it has remained relatively uncommon in this country. With growing foreign travel and an ever-increasing…

Case Report

Bisphosphonate-associated Scleritis: A Case Report and Review

An 86-year-old female was treated for osteoporosis with alendronate, an aminobisphosphonate. Six weeks after alendronate therapy began, scleritis developed in the patient’s right eye. The alendronate was discontinued, and, with the administration of prednisone, the symptoms of scleritis fully resolved. Rechallenge resulted in recurrence of the symptoms. Bisphosphonates are commonly…

Case Report

Reversible Encephalopathy Secondary to Paratyphoid Infection and Concomitant Acute Hepatitis A

Reversible encephalopathy has been described in association with typhoid fever as well as nontyphoidal salmonella infections. A diagnostic dilemma as to the cause of encephalopathy may arise when there is coexistent acute viral hepatitis and suspicion of fulminant liver failure. The authors report a patient who presented with acute icteric…

Case Report

Hyperinsulinemic Hypoglycemia Precipitated by Weight Loss

Objective: To describe a case of hyperinsulinemic hypoglycemia precipitated by weight loss. Methods: We present a detailed case report and results of a related literature search on hyperinsulinemic hypoglycemia precipitated by weight loss. Results: The presence of an insulinoma was unveiled by voluntary weight loss and reduction of insulin resistance….

Self-Assessment Examination (Historical)

CME Questions: Diagnostic Tests for Rheumatic Disease: Clinical Utility Revisited

Expired CME Questions – Diagnostic Tests for Rheumatic Disease: Clinical Utility Revisited

Expired CME Article

Diagnostic Tests for Rheumatic Disease

Expired CME Article – Diagnostic Tests for Rheumatic Disease


Hypoglycemia – An Enigmatic Dilemma

Hypoglycemia is a common disorder with a diverse etiology. True hypoglycemia, however, is probably less common than generally perceived, particularly as symptoms are commonly mimicked by a host of other disorders, both endocrine and nonendocrine. There are often individual variations in symptomatology of hypoglycemia, and some individuals can tolerate it…


Cutaneous Carcinoma with Mixed Histology

It is accepted that different histologic subtypes of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) exist, and that these subtypes differ in their biologic aggressiveness. In this issue of the Journal, Cohen and Nelson make a convincing argument that mixed histology BCCs and SCCs could represent a cause…


The Patient’s Page

Warfarin is one of the most commonly prescribed cardiovascular medications in this country, which, when taken as prescribed, has very few side effects. There are, however, potential contraindications when taken in combination with herbal medications. The following herbs should be avoided if you are currently taking warfarin. Ginseng—A common and…


Medical Webwatch

Visit Harvard’s Digital Journal of Ophthalmology “Grand Rounds” for cases described under “History,” “Examination,” “Ancillary Testing,” “Treatment,” and “Diagnosis.” The cases are liberally illustrated with intraocular photographs, gross appearance, visual field charts, CT scans, blood tests, etc. Cases are submitted from institutions around the world and are archived back…

Letter to the Editor

Complete Resolution of Fibrosing Mediastinitis with Corticosteroid Therapy

Fibrosing mediastinitis, also known as sclerosing mediastinitis or mediastinal fibrosis, is characterized by an excessive fibrotic reaction in the mediastinum, which can produce compromise of the trachea, great vessels and other mediastinal structures.1There is no effective medical therapy known for this disease. We present a case of fibrosing mediastinitis, which…

Letter to the Editor

Herbal Interaction with Warfarin

The recent article on preventing warfarin-related bleeding1 is an excellent review on the subject. Unfortunately, the author failed to discuss herbal medicines, many of which interact with warfarin.2–5 Because 33% of American patients take herbal medicines2 and as warfarin is one of the most commonly used cardiovascular drugs, physicians need…

Letter to the Editor

Hypertensive Disease Management Community Outreach Program in Hispanics

The Hispanic-American community is the fastest growing minority population in the United States. It is estimated that Hispanics will constitute the largest minority group in the United States by the year 2010.1 This rapid growth has considerable implications for the health status of this medically under-served population of Americans.2 Traditionally,…