Issue - Southern Medical Association

Original Article

Seroprevalence of Toxocara Antibodies in Patients with Adult Asthma

Toxocariasis is a common worldwide infection. Asthma, considered to be one of the most common chronic diseases, is a serious global health problem. Toxocara may be a possible etiologic agent of asthma. The aim of this study was to investigate whether there is an association between adult asthma and Toxocara…

Case Report

Cholera-like Presentation in Vibrio fluvialis Enteritis

We describe a patient who presented with cholera-like diarrhea seven days after eating shellfish at a seafood buffet on the Gulf Coast. The patient’s stool culture grew only Vibrio fluvialis on TCBS agar, and his diarrhea and profound acidosis completely resolved within 24 hours of initiating antibiotics. To our knowledge,…

Case Report

Acute Myocardial Infarction Following the Use of Intranasal Anesthetic Cocaine

The use of cocaine has become largely obsolete in modern medical practice; however, it is still used by otolaryngologists for topical anesthesia in head and neck surgeries. We present the case of a 68-year-old woman who developed a myocardial infarction after the use of topical cocaine during nasal sinus surgery,…

Case Report

Concomitant Intracranial Aneurysm and Carotid Artery Stenosis: A Therapeutic Dilemma

Concurrent occurrence of carotid artery stenosis and intracerebral aneurysm is uncommon and poses a therapeutic dilemma. We report a patient with bilateral carotid artery stenosis and a 2.5 cm left middle cerebral artery aneurysm who simultaneously underwent a successful stent-assisted coiling for his intracerebral aneurysm and left carotid artery angioplasty…

Original Article

Death Certificates Are Not Reliable: Revivification of the Autopsy

Background: Medicine assumes that vital statistics are accurate, but they are only as good as the death certificates. Objective: To evaluate the accuracy of death certificates in reporting vital statistics with an emphasis on cardiac deaths. Design: A population-based retrospective study within one community hospital. Patients: During the study period,…

Case Report

Dermatomyositis and Esophageal Cancer

Objective: A case of dermatomyositis and esophageal cancer is described. Case Report: A 58-year-old male recently diagnosed with esophageal cancer was admitted to the hospital with complaints of progressive dysphagia, generalized muscle weakness and skin rash. The weakness started symmetrically in the proximal limb muscles. He also developed a characteristic…

Review Article

What Should We Eat? Evidence from Observational Studies

Observational studies provide a wealth of important correlations between diet and disease. There is a clear pattern of dietary habits that is associated with reduced rates of a multitude of common illnesses, including heart attack, cancer, stroke, diabetes, and hypertension. In some cases, interventional studies have proven the benefits of…

Expired CME Article

Management of Gastroesophageal Reflux Disease

Gastroesophageal reflux disease is the most common and expensive digestive disease with complex and multi-factorial pathophysiologic mechanisms. Transient inappropriate relaxation of the lower esophageal sphincter is the predominant mechanism in the majority of patients with mild to moderate disease. Hiatal hernias and a reduced lower esophageal sphincter pressure have a…

Case Report

A Case of Inflammatory Pseudotumor in the Spleen

A case of an inflammatory pseudotumor of the spleen is presented. A 43-year-old woman was hospitalized for a detailed examination due to pancytopenia, which was diagnosed during an examination related to left upper quadrant abdominal pain. Physical examination revealed a 2 to 3 cm splenomegaly. Reticulocyte count was 4% and…

Case Report

No Poinsettia this Christmas

Poinsettia is one of the most delightful decorations during the Christmas season. Natural rubber latex and poinsettia share some common allergen proteins. Hence, people with latex allergy may develop cross-reactivity with poinsettia. We report the case of a 50-year-old white female with a history of latex allergy, who developed a…

Original Article

Patient Understanding and Use of Oral Contraceptive Pills in a Southern Public Health Family Planning Clinic

Objective: To assess patient understanding and use of oral contraceptive pills (OCPs) and determine if these are associated with literacy. Methods: Four hundred OCP users from a southern public health family planning clinic were orally tested post visit for literacy, demographics, contraceptive knowledge, OCP use, side effects, and adherence. Results:…

Case Report

Mitochondrial Disorder Aggravated by Propranolol

Although there are indications that β-blockers affect the skeletal muscle in therapeutic dosages, their influence on mitochondrial disorders is unknown. A 52-year-old woman developed double vision, myalgias, muscle cramps, and hip and thigh muscle stiffness. Clinical neurologic examination revealed ptosis, dysarthria, sore neck muscles, weakness and wasting of the thighs,…

Original Article

Monteggia Fractures and Variants: Review of Distribution and Nine Irreducible Radial Head Dislocations

One hundred and twenty one cases of Monteggia fractures (68) and Monteggia fracture equivalent variant transolecranon fracture dislocations (53) in adults were reviewed to determine the frequency of Bado types and the occurrences of irreducible radial head dislocations. The distribution of Monteggia fractures was 53 Bado type I, two Bado…

Original Article

Outcomes in Gestations Between 20 and 25 Weeks with Preterm Premature Rupture of Membranes

Background: Preterm deliveries complicate 11% of all births within the United States. In the urban inner city population, this figure approaches approximately 18%. In one quarter to one third of these deliveries, preterm premature rupture of the membranes (PPROM) has been a causative factor. Objective: The purpose of this study…

Review Article

Primary Stroke Center: Basic Components and Recommendations

Stroke is the leading cause of disability and the third leading cause of death in the United States. The brain attack coalition (BAC), whose members belong to several professional medical societies, formed a working group to explore the factors and elements that are associated with better clinical outcome after acute…

Case Report

Positive C-ANCA and Cavitary Lung Lesion: Recurrence of Wegener Granulomatosis or Aspergillosis?

A case of a cavitary lung lesion in the right middle lobe of a 34-year-old woman who presented with hemoptysis is presented. The patient had a 2-year history of Wegener granulomatosis that had been treated with cyclophosphamide and corticosteroids. Although the patient gradually achieved remission of her disease, she developed…

Case Report

A Case of Laryngotracheal Stenosis Masquerading as Asthma

This report describes the case of a 21-year-old male that presented in respiratory failure caused by laryngotracheal stenosis (LTS) related to remote endotracheal intubation. The patient sought treatment for respiratory complaints in the weeks prior, and had a poor response to treatment for asthma. Currently, LTS is predominantly seen as…

Editorial

Intracranial Aneurysm and Carotid Artery Stenosis

In this issue of the Southern Medical Journal, Navaneethan et al1 present a timely discussion of a difficult and uncommon dilemma of concomitant atherosclerotic cervical carotid artery stenosis and a giant middle cerebral artery aneurysm. Over the past decade, treatment strategies for both of these conditions have evolved considerably and…

Editorial

Is this Adverse Drug Reaction as Clear Cut as Previously Thought?

“Doctor, we may have a problem.” It is a statement that strikes fear into the heart of any medical practitioner, but is frequently encountered with respect to adverse drug reactions. It is perfectly reasonable for the medical profession to expect that a medication will help or heal rather than harm;…

Editorial

New Lung Lesion in Immunocompromised Host-Correct Diagnosis Despite a False Positive ANCA

Pulmonary vasculitides are rare, yet occur frequently enough that the clinician must be adequately aware of their clinical manifestations and laboratory features. Unrecognized, the consequences can be devastating, since untreated patients with vasculitis syndrome can suffer significant morbidity and mortality. More devastating is the scenario where, because of suspected vasculitis,…

Editorial

Peripheral Arterial Disease in Patients with Diabetes Mellitus

Diabetes mellitus magnifies the risk of cardiovascular morbidity and mortality.1 Besides the well-recognized microvascular complications of diabetes, such as nephropathy and retinopathy, there is a growing epidemic of macrovascular complications, including diseases of the coronary arteries, peripheral arteries and carotid vessels, particularly in the burgeoning type 2 diabetic population.2 Despite…

Editorial

Premature Delivery Following Premature Rupture of Membranes: Increasing Frequency with Disappointing Outcome

Over 4,000,000 infants are born each year in the United States. Preterm delivery, primarily as a result of preterm labor (PTL) and preterm premature rupture of the membranes (PPROM), is the greatest contributor to newborn and infant morbidity and mortality, far exceeding other complications of pregnancy. In spite of many…

Expired CME Article

CME Questions: Management of Gastroesophageal Reflux Disease

Expired CME Article Questions: Management of Gastroesophageal Reflux Disease

Expired CME Credit Submission and Evaluation Form

CME Credit – July 2006 CME Topic: Management of Gastroesophageal Reflux Disease

Expired CME Credit Submission and Evaluation Form – Management of Gastroesophageal Reflux Disease

Letter to the Editor

Anterior Tongue Metastasis from Lung Cancer

Tongue metastasis during the natural course of many neoplasms, including lung cancer, is extremely rare, and the prognosis of these patients is rather poor. Reported incidences vary between 0.2 to 1.6%.1,2 We herein describe a case of anterior tongue metastasis in a patient with squamous cell carcinoma of the lung.

Letter to the Editor

Effect of a Multidisciplinary Clinic for the Treatment of Refractory Hypertension

Multiple reasons exist for hypertension to be resistant to medical therapy. Since multidisciplinary clinics have been shown to be effective for treating many chronic disorders, such as diabetes mellitus, heart failure, pain, asthma, rheumatoid arthritis, and HIV,1,2 we created a multidisciplinary clinic dedicated exclusively to the treatment of refractory hypertension,…

Letter to the Editor

Enbrel-induced Interstitial Lung Disease

Etanercept is a recombinant fusion protein consisting of the extracellular domain of the human 75 kDa TNF-alpha receptor linked to the Fc portion of the human IgG molecule.1 It acts as a competitive inhibitor of TNF-alpha.Adverse effects associated with etanercept have included injection site reactions, tuberculosis reactivation, rash, induction of…

Letter to the Editor

Macrophage Activation Syndrome Associated with Systemic Onset Juvenile Rheumatoid Arthritis

Coagulation abnormalities in systemic onset juvenile rheumatoid arthritis (JRA) could be due to two different pathogenic mechanisms; one caused by vasculitis and the other induced by macrophage activation syndrome (MAS). MAS is now widely recognized as a severe, potentially life-threatening complication of systemic onset JRA; therefore, early diagnosis and immediate…

Letter to the Editor

Paraganglioma of the Hepatic Duct: A Personal Commentary

In 1980, we reported a case of paraganglioma of the hepatic duct in a 37-year-old man.1 At that time, we claimed that our case was the first such report in the English literature. The acceptance and subsequent publication of this case report was not easy. We received six rejections from…

Letter to the Editor

Refractory Metabolic Acidosis in Small Cell Cancer of the Lung

Lactic acidosis has been often documented in patients with hematological malignancies such as leukemia and lymphoma, but its occurrence in solid tumors has been rarely reported.1–5 We report a patient with small cell carcinoma of the lung with extensive liver metastases who had fatal high anion gap metabolic acidosis secondary…

Letter to the Editor

Response to Cardiovascular Toxicity

I enjoyed reading the recent review on the cardiovascular effects of cocaine by Karch,1 but was disappointed that our ideas and research regarding cocaine’s electrophysiology and its ability to provoke arrhythmias2–5 were not cited. In particular, the readers of the Journal are referred to a 2002 publication5 that we prepared…

Letter to the Editor

Response to Diagnosis of Appendicitis

The article by Mathis et al1 in SMJ in December 2005 reports 150 cases seen by emergency department physicians with a “discharge diagnosis of appendicitis.” Flaws in their study serve to negate the conclusions drawn. They acknowledge that the retrospective study had a bias associated with a higher complication rate…

Letter to the Editor

Response to Dr. Bauman”s Letter

Dr. Bauman is correct. I should have cited his work, especially since I have followed it with interest over the years. In partial self-defense, I should point out that the paper was based on an invited talk given mainly to forensic pathologists and forensic practitioners who, like myself, must assign…

Medical Webwatch

Medical Webwatch

COPD-X at http://www.copdx.org.au/guidelines/index.asp is an acronym derived from the guidelines of the Australian Lung Foundation and the Thoracic Society of Australia and New Zealand. The guidelines have been developed for the management of chronic obstructive pulmonary disease as part of a national COPD program, and have been verified by their…

Acknowledgment

Patient’s Page

Diet and Heart Disease If you are concerned about heart disease, you probably know that you should cut back on your fat intake, especially saturated and trans fats. In fact, the statistics linking heart disease with saturated fat intake are staggering. Replacing 5% of saturated fat consumption with unsaturated fat…

SMA Centennial

Sports Medicine: The Last 100 Years

Sports medicine has evolved during the 20th century. Before World War II, there were minor developments in the field, but in the last half of the 20th century, sports medicine has progressed to new millennium status. Sports medicine developed throughout the 50s and 60s, introducing total joint replacement, endoscopic techniques,…