Issue - Southern Medical Association

Original Article

Surgical Treatment of Acute Type II and Rostral Type III Odontoid Fractures Managed by Anterior Screw Fixation

Objectives: In the present study, the authors comment on their experience with anterior odontoid screw fixation in the management of odontoid fractures, in an attempt to further assess the safety and the efficacy of this procedure. Materials and Methods: A retrospective analysis of 50 consecutive patients with reducible type II…

Expired CME Credit Submission and Evaluation Form

CME Credit—September 2005 CME Topic: Insulin Resistance and Inflammation in Polycystic Ovarian Syndrome

Expired CME Credit Submission and Evaluation Form – Insulin Resistance and Inflammation in Polycystic Ovarian Syndrome

Review Article

Current and Potential Uses of Imiquimod

Imiquimod, an imidazoquinoline amine, is an immune response modifier first FDA-approved for the treatment of external genital and perianal warts in 1997. Since its appearance on the market, its antiviral and antitumor properties have been used in the treatment of a variety of dermatologic conditions. In this review article, the…

Case Report

Group C Streptococcal Sepsis Complicating Fournier Gangrene

Fournier gangrene is a life-threatening necrotizing fasciitis of the perineal-scrotal area that occurs in diabetic males. Patients typically present with systemic toxicity and significant inflammatory changes in the scrotum and perineum. Most cases of Fournier gangrene are polymicrobic and require urgent surgical débridement and broad-spectrum antibiotic therapy. We describe a…

Case Report

Mycobacterium Tuberculosis Infection of a Presumed Charcot Joint

A 65-year-old male with peripheral neuropathy and small lymphocytic lymphoma presented with erythema and edema of the left foot. A Charcot midfoot was diagnosed and treated with a total contact cast and restricted weight bearing. However, subsequent analysis of bone and synovial fluid months later revealed Mycobacterium tuberculosis infection. Key…

Case Report

Unusual Endoscopic and Microscopic View of Enterobius vermicularis: A Case Report With a Review of the Literature

Enterobius vermicularis has the broadest geographic range of any helminth and is the most common intestinal parasite seen in the primary care setting. Underappreciated is the fact that it is not always a benign disorder and could even cause life-threatening medical problems. Visualization of the actual worms during endoscopy is…

Case Report

Coccidioidomycosis Diagnosed in South Carolina

Primary care physicians in the Eastern United States rarely consider coccidioidomycosis in the differential diagnosis of pulmonary infections or febrile illnesses. However, the mobility of the population mandates consideration of this diagnosis, particularly in patients with fever and cough that do not resolve rapidly and in patients with adenopathy on…

Case Report

Kaposi Sarcoma Secondary to Pulmonary Tuberculosis: A Rare Case

Kaposi sarcoma commonly occurs in HIV-positive and immunocompromised patients. We describe a case of Kaposi sarcoma that developed in an HIV-negative patient with tuberculosis. The Kaposi sarcoma completely regressed with antituberculous therapy without the institution of chemotherapy. The patient remained disease-free after a follow-up period of 20 months. Patients with…

Case Report

Sarcoidosis Mimicking Disseminated Testicular Cancer

Sarcoidosis rarely involves the genitourinary system or the spinal cord. This report describes a case of sarcoidosis with a scrotal mass, a mass compressing the spinal cord, and lesions in the liver and spleen. This case illustrates an uncommon manifestation of sarcoidosis, which may mimic disseminated testicular cancer. Key Points…

Case Report

Necrotizing Lymphadenitis Associated with the Phenytoin-induced Hypersensitivity Syndrome

A 32-year-old black female was started on phenytoin for seizure prophylaxis following the clipping of an aneurysm. This was stopped after 3 weeks when she developed a generalized skin rash. Over the next week she developed fever, sore throat, dysphagia, and headache. She had an erythematous throat with white exudates…

Case Report

Beneficial Effect of Immunosuppressive Drugs on Parry-Romberg Syndrome: A Case Report and Review of the Literature

Progressive facial hemiatrophy, also known as Parry-Romberg syndrome (PRS), is characterized by slowly progressive atrophy of one side of the face, primarily involving the subcutaneous tissues and fat. Involvement of the central nervous system with impairment of neurologic function occurs infrequently. At present, there is no agreement as to whether…

Case Report

Left Ventricular Endocardial Calcification in a Patient with Myeloproliferative Disease

The case of a 57-year-old male with a history significant for myeloproliferative disease, chronic renal failure, hypertension, and prostate cancer is described. His complete blood count was remarkable for neutrophilia and, notably, eosinophilia. Subsequent to two syncopal episodes, a transthoracic echocardiogram was performed as part of the workup, which showed…

Case Report

Four Primary Tumors of Lung, Bladder, Prostate, and Breast in a Male Patient

We present a very rare case of quadruple cancers in a 65-year-old male patient. It is a case of both synchronous and metachronous primary malignant neoplasms occurring in four different organs. Immunohistochemical stains showed tumor cell nuclei to be negative for p53 over-expression. To our knowledge, this is the first…

Case Report

Reversible ST-segment Elevation Associated with Atelectasis of the Left Lung

A 22-year-old male with cerebral palsy and respiratory failure had acute reversible ST-segment elevation in the inferior leads during acute collapse of the left lung, which resolved with re-expansion of the left lung several hours later. This suggests that major lung actelectasis needs to be added to the group of…

Letter to the Editor

Fatal Trichosporon asahii Septicemia in a Guatemalan Farmer with Acute Lymphoblastic Leukemia

Trichosporon species are found in nature; predominantly in soil, water, and on plants. They have been cultured from many animal droppings, including cattle, sheep, and goat.1 The six Trichosporon species associated with human infection are Trichosporon asahii, Trichosporon mucoides, Trichosporon asteroides, Trichosporon cutaneum, Trichosporon inkin, and Trichosporon ovoides. Of these,…

Letter to the Editor

Unintentional Carbon Monoxide Poisoning Cases in Ciudad Juárez, Mexico

In the last 12 years, governmental reports indicate that 1,381 people living in Ciudad Juárez, México have been intoxicated, and 167 killed by carbon monoxide (CO) poisoning.1 Studies in the U.S. have identified low temperatures and small heating and cooking appliances as risk factors2–4 but have not addressed northern Mexico….

Letter to the Editor

Double Balloon GliaSite in the Management of Recurrent Glioblastoma Multiforme

Glioblastoma multiforme (GBM) is the most common and aggressive of the malignant adult primary brain tumors.1 Despite significant advances over the last several years in imaging capability, neurosurgical techniques, and radiation treatments, the prognosis for individuals diagnosed with malignant primary brain tumors remains poor. The median survival for patients with…

Letter to the Editor

Response to Type 2 Diabetes: Epidemiologic Trends, Evolving Pathogenic Concepts, and Recent Changes in Therapeutic Approach

I recently read with interest the Rizvi article in the November issue of the Southern Medical Journal.1 The author neatly outlined some important issues regarding epidemiology and pathophysiology of type 2 diabetes. A discussion about the treatment of this disease was also presented. Although the merits of combining insulin to…

Original Article

Telithromycin for the Treatment of Acute Bacterial Maxillary Sinusitis: A Review of a New Antibacterial Agent

Objective: Telithromycin, the first approved ketolide antibiotic, was developed to treat community-acquired respiratory tract infections, including acute bacterial maxillary sinusitis (ABMS). A previously published study showed that a 5-day course of 800 mg telithromycin once daily is as effective as a 10-day course in the treatment of ABMS. Materials and…

Original Article

Use of Complementary and Alternative Medicine by Parents of Children with HIV Infection and Asthma and Well Children

Objective: Although the use of complementary and alternative medicine (CAM) in children is increasing, little is known about its use in children with human immunodeficiency virus (HIV) infection. This study investigated the use of CAM by parents of children with HIV infection (H), children with asthma (A), and well children…

Original Article

Pre-event Willingness to Receive Smallpox Vaccine Among Physicians and Public Safety Personnel

Background: Planning for voluntary smallpox vaccination of health and safety officials began in December 2002. Materials And Methods: Surveys were conducted among physicians and fire and police department personnel in Atlanta, Georgia. Information on demographics, willingness to receive smallpox vaccine, self-reported knowledge level, and potential vaccine contraindications was analyzed. Results:…

Original Article

Does Physician Benchmarking Improve Performance of Laparoscopically Assisted Vaginal Hysterectomy?

Background: Benchmarking techniques were implemented to optimize operating time and charges associated with laparoscopically assisted vaginal hysterectomy (LAVH). Materials and Methods: The baseline LAVH profile over a period of 4 years (167 cases) was compared with 1-year data (47 cases) after a benchmarking educational program (disseminating data ranking performance by…

Original Article

Knowledge of the Principles of Judicious Antibiotic Use for Upper Respiratory Infections: A Survey of Senior Medical Students

Objective: Senior medical students (n = 2,433) from 21 accredited medical schools in New England and the mid-Atlantic states were surveyed to evaluate their knowledge of and compliance with principles of judicious antimicrobial use, as defined by the Centers for Disease Control and others. Materials and Methods: A self-administered questionnaire…

Expired CME Article

Insulin Resistance and Inflammation in Polycystic Ovarian Syndrome

Expired CME Article – Insulin Resistance and Inflammation in Polycystic Ovarian Syndrome

Expired CME Article

Questions for CME: Insulin Resistance in Polycystic Ovarian Disease

Expired CME Article Questions – Insulin Resistance in Polycystic Ovarian Disease

Expired CME Article

Insulin Resistance in Polycystic Ovarian Disease

The classic polycystic ovarian syndrome (PCOS) was originally described by Stein and Leventhal as the association of amenorrhea with polycystic ovaries and, variably, hirsutism and/or obesity. It is estimated that 5 to 10% of women of reproductive age have PCOS. Although insulin resistance is not part of the diagnostic criteria…

Editorial

Imiquimod

In this issue of the Southern Medical Journal, Yuchi Chang and Stephen Tyring present an interesting review of the dermatologic product imiquimod (Aldara, 3M Pharmaceuticals) in their article “Current and Potential Uses of Imiquimod”. Although approved by the United States Food and Drug Administration since 1997 as a topical treatment…

Editorial

The Right to Life Versus the Right to Live

In our modern technologically sophisticated age, the right to life has all but overwhelmed the right to live. Preoccupied with delaying death, the inherent value of life is often compromised. Earlier this spring, the media was suffused with coverage of Terri Schiavo, and, indeed, the Southern Medical Journal recently added…

Editorial

Hematogenous Vertebral Osteomyelitis Due to Staphylococcus aureus in the Adult

Hematogenous vertebral osteomyelitis (HVO) is becoming increasingly common in the developed Western countries. An aging population, frequent use of intravascular catheters for diagnostic and therapeutic procedures with complicating bacteremia, hemodialysis, frequent invasive procedures, and IV drug abuse are important predisposing factors.1 Staphylococcus aureus is the most important pathogen in HVO.2…

Article

Medical Webwatch

To access Critical Appraisal of Biomedical Literature by Alan O’Rouke of the Wisdom Centre, Sheffield University, free registration is required at http://www.wisdomnet.co.uk/ with the seminar residing at http://www.wisdomnet.co.uk/ebpsem2.html. The appraisal provides algorithms for the evaluation of primary research and review articles. It also introduces critical evaluation of web sites. The…

Article

The Patient’s Page

Cast Care If you’ve ever had to wear a cast, you know that it won’t be long before it begins to itch. It can be maddening and relentless, and despite your physician’s warnings about scratching it with, say, a coat hanger, sometimes the urge can be overwhelming. Giving in to…

Letter to the Editor

Cast Abscess

Patients who present with fractures are often given the choice of treatment with nonoperative casting or surgery. While surgery is invasive and carries the risk of infection, casting is considered to be conservative, and the risk of infection is often thought to be eliminated. Complications inherent to cast applications that…

Letter to the Editor

Substance-abuse Slang Terms and Implications for Cultural Groups Including Orthodox Jews

The article by Hamid et al1 regarding the numerous medical and slang terms used to describe various types of substance abuse is quite comprehensive. One area not discussed is the implication of recognizing these terms for diverse cultural populations. Culture and language are important factors for predicting substance abuse.2 An…

Letter to the Editor

Pleural Effusion as Presentation of Metastatic Adenocarcinoma of Prostate

Prostate carcinoma is one of the most common malignancies in men,1 and spreads most frequently to bone, lung, and liver.2 Pleural involvement is rare. Pleural effusion as determined by autopsy ranged from 2.3 to 5%.3,4We describe two elderly male patients with adenocarcinoma of the prostate and secondary pleural effusion. Our…

Article

Hematogenous Vertebral Osteomyelitis Due to Staphylococcus aureus in the Adult: Clinical Features and Therapeutic Outcomes

Objective: Staphylococcus aureus is the most common cause of hematogenous vertebral osteomyelitis in adults. To better define clinical features and therapeutic outcomes, the charts of 40 adult patients with S aureus hematogenous vertebral osteomyelitis were retrospectively reviewed. Methods: Retrospective chart review using standardized data collection form. Results: S aureus hematogenous…