Issue - Southern Medical Association

Expired CME Article

Surveillance of the Colorectal Cancer Disparities Among Demographic Subgroups: A Spatial Analysis

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…

Case Report

A Clinical Report of Adverse Health Effects Due to Bed Sharing in Two Children with Spinal Cord Injury and Traumatic Brain Injury

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…

Expired CME Article

Hurricane Katrina: Medical Response at the Houston Astrodome/Reliant Center Complex

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…

Expired CME Article

Adult Health Screening and Referral in the Emergency Department

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…

Case Report

An Adolescent with Abdominal Pain Taking Isotretinoin for Severe Acne

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….

Case Report

An Over-the-counter Omission

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…

Case Report

Pulmonary Infarction Due to Vascular Stent Migration

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…

Original Article

How Do Internal Medicine Residency Programs Evaluate Their Resident Float Experiences?

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…

Case Report

Retinitis Pigmentosa and Hypogammaglobulinemia

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…

Original Article

Retropharyngeal Abscess in Children: The Emerging Role of Group A Beta Hemolytic Streptococcus

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…

Case Report

Sarcoidosis Presenting as Intrascrotal Mass: Case Report and Review

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…

Case Report

Multiple Venous Thromboses in a Young Man with Sarcoidosis: Is There a Relation Between Sarcoidosis and Venous Thrombosis?

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….

Case Report

Cardiac Perforation and Tamponade: A Potentially Fatal Complication During Transjugular Intrahepatic Portosystemic Shunt Placement

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…

Expired CME Article

Black/White Differential Use of Health Services by Young Children in a Rural Mississippi Community

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…

Editorial

Adverse Drug Reactions

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”…

Editorial

Dipyrone (Metamizole) Use in the United States: A Lethal Tango?

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…

Editorial

Medical School Graduates of 2006: “Hooded, but not Hoodwinked”

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…

Editorial

Residency Work Hour Limits: A Little Time Off, A Lot To Consider

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…

Editorial

Retinitis Pigmentosa and Common Variable Immunodeficiency Disease: Associated or Separate?

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…

Editorial

The Emerging Role of Group A Beta Hemolytic Streptococcus as Retropharyngeal Abscess Pathogen in Children-A Change Which Doesn’t Matter?

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…

Editorial

The Katrina Public Health Debacle: Lessons Learned and Lessons Ignored

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

CME Questions: Healthcare Disparities

Expired CME Article Questions: Healthcare Disparities

Expired CME Article

Healthcare Disparities

Expired CME Article – Healthcare Disparities

Expired CME Credit Submission and Evaluation Form

CME Credit – August 2006 CME Topic: Healthcare Disparities

Expired CME Credit Submission and Evaluation Form – Healthcare Disparities

Letter to the Editor

Burst of Autoimmunity with the Emergence of Primary Sjogren Syndrome, Cholestatic Autoimmune Hepatitis and Latent Autoimmune Diabetes of Adults (LADA)

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….

Letter to the Editor

Effect of Statins on Low-density lipoprotein Size: A New Role in Cardiovascular Prevention?

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…

Letter to the Editor

Public Outreach Depression Screening: Collaboration between Medical Education and Integrative Primary Care

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…

Letter to the Editor

Small Bowel Obstruction Caused by Phytobezoar and Associated with Vitamin B12 Deficiency

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….

Medical Webwatch

Medical Webwatch

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…

Acknowledgment

Patient’s Page

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…

SMA Centennial

Looking Back: One Hundred Years in Rheumatology

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…

Article

Metamizole Use Among Hispanics in Miami: Report of a Survey Conducted in a Primary Care Setting

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…

Review Article

Unicameral (Simple) Bone Cysts

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…

Review Article

Wegener Granulomatosis: A Case Report and Update

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…