Objective:The literature suggests that colorectal cancer mortality in Texas is distributed inhomogeneously among specific demographic subgroups and in certain geographic regions over an extended period. To understand the extent of the demographic and geographic disparities, the present study examined colorectal cancer mortality in 15 demographic groups in Texas counties between…
Abstract:This paper explores the possibility that bed sharing may carry particular risks for children with special healthcare needs (CSHCN). Two cases of CSHCN who may have sustained adverse health effects from bed sharing are described. These two case reports indicate that CSHCN may be particularly susceptible to risks associated with…
Abstract:On September 1, 2005, with only 12 hours notice, various collaborators established a medical facility-the Katrina Clinic-at the Astrodome/Reliant Center Complex in Houston. By the time the facility closed roughly two weeks later, the Katrina Clinic medical staff had seen over 11,000 of the estimated 27,000 Hurricane Katrina evacuees who…
Introduction:The United States Public Health Service (USPHS) recommends using all available patient encounters to provide preventive healthcare to patients. Many studies have demonstrated the importance of performing preventive care in the emergency department (ED). These studies have used the ED as a location for patient identification and treatment, rather than…
Abstract:A 19-year-old female patient is presented who was taking isotretinoin for severe, nodulocystic acne. She subsequently developed abdominal pain during the course of treatment, thought to be related to an adverse reaction to the medication. A concerning side effect of isotretinoin is hypertriglyceridemia, which may be a cause of pancreatitis….
Abstract:Despite the widespread use of over-the-counter (OTC) medications, their utilization is rarely ascertained at hospital admission. Presented here is an interesting case of acute renal failure and hemolytic anemia attributable to a commonly utilized OTC medication. The chronic use of phenazopyridine accounted for all of these findings. Upon discontinuation, everything…
Abstract:The case of a patient who developed pulmonary infarction after a vascular stent migrated to her pulmonary artery is presented. Stent migration is a known complication of vascular stents. The incidence is reported to be as low as 3%. Cases have been reported of successful retrieval of the stents. There…
Objectives:We surveyed the nation’s internal medicine residency training program directors to determine the range and frequency of existing methods by which float experiences are evaluated. Methods:We sent questionnaires to the program directors of all 396 internal medicine residency training program sites in the country. Information requested included program characteristics, months…
Abstract:This report describes a family demonstrating an unusual association of retinitis pigmentosa and hypogammaglobulinemia. The proband in this family suffered from another rare illness, ie, Sertoli cell only syndrome. The incidence of retinitis pigmentosa is 1 in 5,000 and that of common variable immunodeficiency state is 1 in 100,000, making…
Background:Because of a recent increase in the number of cases of retropharyngeal abscess (RPA) admitted to our hospital, we reviewed the incidence, microbiology, and treatment outcome of RPA during an 11-year period (1993–2003). Methods:A retrospective review of medical records of children with RPA. Results:Sixty-seven children (46 males) with RPA were…
Abstract:Sarcoidosis is a multisystemic disease that usually involves the lungs and lymph nodes, but almost any organ can be involved. Genitourinary involvement with sarcoidosis is extremely rare. We report the case of a 30-year-old African-American male who presented with a right-sided intrascrotal mass and diffuse lymphadenopathy. On further workup, he…
Abstract:We describe the case of a 33-year-old African-American male who presented with multiple deep venous thromboses of the upper and lower extremities. Hypercoagulable workup was unrevealing. A chest x-ray showed bilateral hilar lymph node enlargement. Mediastinoscopy with hilar lymph node biopsy was performed. Lymph node histopathologic examination showed noncaseating granulomas….
Abstract:Transjugular intrahepatic portosystemic shunt (TIPS) is a low-resistance channel between the hepatic vein and the intrahepatic portion of the portal vein. This is an important addition to the therapeutic armamentarium against portal hypertension. Complications are either technical or due to the creation of a shunt. Procedure-related mortality is about 0…
Background and Objectives:Use of health services in rural communities has not been well studied. We explored how black and white children used health services in a rural Mississippi community. Methods:Data were prospectively collected for 396 children attending a private practice to determine if race was associated with the use of…
Physicians are confronted daily with new information about new drugs, old drugs, using these agents in different ways, at different doses and comprehending the safety profiles with all of these medications. These medications may be completely new drug entities, structurally diverse compounds, new formulations of older drugs and even “me-too”…
The nonsteroidal agent dipyrone (metamizole) was banned by the United States Federal Drug Administration (FDA) in the late 1970s after it was associated with myelotoxicity. This toxicity and, specifically, the development of agranulocytosis remain a topic of discussion within the medical literature. Less debatable, but perhaps more surprising, is the…
During medieval times, the hood was used by all classes of people as a head covering with a shoulder cape to protect from the cold. It was eventually adopted by monks and university students and by the 15th century, had became a token of graduation. The word “wink” originally meant…
The culture of graduate medical education is changing. Over the last decade, forces both inside and outside the medical community have initiated a re-examination of how this country trains physicians. One area that has received significant attention is the extended work hours historically experienced by medical residents. In June of…
Retinitis pigmentosa (RP) and common variable immunodeficiency disease (CVID), both debilitating disorders, are genetically and phenotypically heterogenous.1–3 In this issue of the Southern Medical Journal, Starr and colleagues4 report their clinical findings of three generations in which both RP and CVID appear to occur together. Retinitis pigmentosa, which can be…
Usually, a case of retropharyngeal abscess (RPA) in children represents a suppurative stage in the evolution of lymphadenitis in the retropharyngeal space, secondary to infection elsewhere in the head or neck (eg, sinusitis, tonsillitis, otitis). Modern medicine has contributed to a significant decrease in childhood RPA incidence and mortality. In…
Better planning for disaster relief is clearly important on a national basis, as the large loss of life in New Orleans following hurricane Katrina has made abundantly clear. Even apart from concerns resulting from manmade disasters, there are abundant ecological threats with the potential to damage large population centers. These…
Expired CME Article Questions: Healthcare Disparities
Expired CME Credit Submission and Evaluation Form – Healthcare Disparities
To the Editor:Primary Sjogren syndrome (pSS) is a systemic autoimmune disorder characterized by the simultaneous presence of keratoconjunctivitis sicca and xerostomia in the absence of other connective tissue diseases. Although pSS is an autoimmune exocrinopathy, the involvement of nonexocrine organs, such as the liver, kidneys and lungs, has been reported….
To the Editor:Cardiovascular diseases still represent the first cause of death in most of the industrialized countries. An effective prevention includes the treatment of a series of risk factors: smoking, hypertension, diabetes, obesity and dyslipidemia.1 Statins represent a class of cholesterol-lowering drugs as inhibitors of the hydroxymethylglutaryl-coenzyme A reductase enzyme…
To the Editor:Depression in the primary care setting is often undertreated and under-recognized, especially within the public health sector. Because depression is associated with medical illness, poverty, and minority status, a group of Tulane medical students recognized the need for a public health depression-screening program in New Orleans. With the…
To the Editor:A 57-year-old male patient presented with vomiting 2 hours after a meal; he had also been experiencing abdominal pain, constipation and obstipation for 2 weeks. One week earlier, at another healthcare center, an upper gastrointestinal system endoscopic examination showed phytobezoar at the bulbus, reflux gastritis and gastric ulcer….
Pediatric Education, http://www.pediatriceducation.org is an interesting reference library of regularly updated cases. It is curated by Donna M. D’Alessandro,, MD, and Michael P. D’Alessandro,, MD, and is said to be a “Pediatric Digital Library and Learning Collaboratory intended to serve as a source of continuing pediatric education.” The website can…
New Screening Techniques for Colon Cancer”Virtual colonoscopy”CT colonography, often referred to as “virtual colonoscopy,” provides 3-dimensional images of the colon via CT scanning. While this procedure does not utilize traditional scopes, the standard colonic purge and bowel inflation are still required. This procedure takes less time than a normal colonoscopy…
A clinician’s experience in 1906 evaluating and managing a new patient with inflammatory polyarthritis would be very different compared with today. While common conditions of inflammatory polyarthritides such as rheumatoid arthritis or systemic lupus were known, the clinician’s ability to establish a specific diagnosis would be based solely on his…
Background: Metamizole (dipyrone) is a myelotoxic, nonsteroidal anti-inflammatory agent that has been banned from the US market since 1979. However, dipyrone may be purchased in some areas of the US. We conducted a survey in a primary care setting in Miami, Florida to determine the prevalence of metamizole possession and…
Since their original description by Virchow, simple bone cysts have been studied repeatedly. Although these defects are not true neoplasms, simple bone cysts may create major structural defects of the humerus, femur, and os calcis. They are commonly discovered incidentally when x-rays are taken for other reasons or on presentation…
Wegener granulomatosis (WG) is a systemic disease of unknown etiology characterized by necrotizing granulomatous inflammation, tissue necrosis, and variable degrees of vasculitis in small and medium-sized blood vessels. The classic clinical pattern is a triad involving the upper airways, lungs and kidneys. Ninety percent of patients present with symptoms involving…
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