December 2007, Volume 100 - Issue 12

Clinical Considerations and Practical Recommendations for the Primary Care Practitioner in the Management of Anemia of Chronic Kidney Disease

Jan N. Basile, MD

Abstract: Anemia is prevalent in patients with chronic kidney disease (CKD) and is a risk factor for poor disease outcome. Anemia acts as a risk multiplier, significantly increasing the risk of death in anemic versus nonanemic CKD patients with similar comorbidities....

(pp 1200-1207)

Reduced Fracture Rates Observed Only in Patients With Proper Persistence and Compliance With Bisphosphonate Therapies

Stuart L. Silverman, MD, Deborah T. Gold, PhD, Joyce A. Cramer, BS

Abstract: Numerous studies have analyzed data from administrative claims databases to determine persistence and compliance with bisphosphonate therapy for osteoporosis; several of these studies have also examined how persistence and compliance with therapy affect fracture outcomes....

(pp 1214-1218)

Endophthalmitis Associated With Intravenous Drug Use

Kian Keyashian, MD, Preeti N. Malani, MD

Abstract: Infectious complications related to IV drug use represent an important source of morbidity and mortality among this population. We report an informative case of endogenous endophthalmitis related to injection of cocaine mixed with lemon juice. Clinicians should remember...

(pp 1219-1220)

Papulonecrotic Eruption in a 44-Year-Old-Man

Michael A. Jacobson, MD, Ross B. Pollack, MD, John C. Maize, Jr, MD

Abstract: A patient is described who presented with the acute onset of widely distributed necrotic papules mimicking pityriasis lichenoides et varioliformis acuta. A skin biopsy revealed granulomatous inflammation and spirochetes were demonstrated. Serologic testing confirmed...

(pp 1221-1222)

What Is a Miracle?

Daniel P. Sulmasy, OFM, MD, PhD

Abstract: Based on arguments from theology and the philosophy of science, a miracle may be defined as: (1) a real, individual event, the occurrence of which must be (or must have been), at least in principle, susceptible to empirical verification; (2) an event which must be extremely...

(pp 1223-1228)

The History of Thinking About Miracles in the West

Jakub Pawlikowski, MD, MPhil

Abstract: Phenomena considered to be miracles have been present in human culture since its origins. There have been astronomical, meteorological, and biological occurrences, and they have attracted the attention of ordinary people, artists, and thinkers. Each of these groups has...

(pp 1229-1235)

19 Years Experience With the Southern Region Burn Conference

Alan R. Dimick, MD, FACS

Abstract: This editorial explains the development of the annual Southern Region Burn Conference. In 1985, the American Burn Association (ABA) established 10 regions in the United States. These regions were patterned after the same regions the American College of Surgeons Committee on...

(pp S1-S2)

The Role of the Physician in Certifying Miracles in the Canonization Process of the Catholic Church III

John Collins Harvey, MD, PhD

Abstract: Physicians play a very important role in the theological processes known as beatification canonization in the Catholic Church. In the first millennium of the Christian era, martyrs and other individuals who lived exemplary lives of Christian perfection in the opinion of the...

(pp 1255-1258)

Waiting for a Miracle … Miracles, Miraclism, and Discrimination

Julian Savulescu, BMed Sci, MB, PhD, Steve Clarke, PhD

Abstract: We argue that the use of publicly funded medical facilities for patients who are waiting for a miracle amounts to discrimination against atheists, agnostics and advocates, of faiths that do not accept miracle claims. The only exception is when this use can be justified by...

(pp 1259-1262)

Responding to Patient Beliefs in Miracles

Robert D. Orr, MD, CM

Abstract: In situations of critical illness, when healthcare professionals have declared that survival or recovery is extremely unlikely, people of faith usually pray. They may pray for continued life, or they may pray for peaceful death. Not surprisingly, even people whose faith has...

(pp 1263-1267)

Cardiovascular Disease is an Independent Risk Factor for Chronic Kidney Disease

Ivan Monserrate, MD, Jan N. Basile, MD

Abstract: Chronic kidney disease (CKD) is a significant problem in the United States, and its incidence is increasing at an alarming rate. Nearly 20 million Americans are affected by CKD and some 20 million more are at risk of developing it.1,2 While a diagnosis of CKD can be made by...

(pp 1185-1186)

Living Donor Kidney Transplantation

Stephen J. Wigmore, MD

Abstract: Living donor kidney transplantation (LDKT), reviewed in this issue of the Southern Medical Journal1 does indeed represent a major advance in the treatment of end-stage renal disease. Graft outcomes are superior compared with well-matched cadaveric kidney transplants and...

(pp 1188-1189)

Medications Don’t Work If Patients Don’t Take Them

E Michael Lewiecki, MD, FACP, FACE

Abstract: “Keep a watch also on the faults of the patients, which make them lie about their taking of things prescribed. For through not taking disagreeable drinks, purgative or other, they sometimes die. What they have done never results in a confession, but the blame is thrown on...

(pp 1190-1191)

Diagnosis of Group A β-Hemolytic Streptococcus Using the Breese Clinical Scoring System

Mehmet Karacan, MD, Cahit Karakelleoğlu, MD, Zerrin Orbak, MD

Abstract: This study was planned to determine the effectiveness of the Breese scoring system for the diagnosis of streptococcal pharyngitis and to evaluate its significance in different age groups. The research population was divided into two age groups. Group 1 consisted of children...

(pp 1192-1197)

December 2007 CME Questions


Abstract: Expired CME Article...

(pp 1198)

Highlights from the 19th Annual Southern Region Burn Conference


Abstract: ...

(pp S3-S18)

Living Donor Kidney Transplantation: Medical, Legal, and Ethical Considerations

Anil S. Paramesh, MD, FACS, Mary T. Killackey, MD, Rubin Zhang, MD, FASN, Brent Alper, MD, Douglas P. Slakey, MD, MPH, Sander S. Florman, MD, FACS

Abstract: The use of living donor kidneys has dramatically increased the number and success of kidney transplants across the world. But questions remain regarding the subjection of a healthy individual to surgery for the benefit of another. Donors do have medical and financial risks....

(pp 1208-1213)

CME Topic Form


Abstract: ...

(pp 1199)

Are Clinical Scoring Systems for the Diagnosis of Group A β-Hemolytic Streptococci Pharyngitis Useful?

Robertino Mera, MD, PhD

Abstract: Acute bacterial pharyngitis is the third most commonly seen infectious disease and the second most common reason for which antibiotics are prescribed. Children with acute, untreated pharyngitis spread group A streptococci (GAS) by airborne salivary droplets and nasal...

(pp 1187)

The Diagnosis of Dementia

Ronald C. Hamdy

Abstract: The clinical diagnosis of probable dementia, although daunting, is really quite simple and should not be too time consuming provided the examiner is focused, organized, and methodical. The criteria for this diagnosis are clearly stated in the Diagnostic and Statistical...

(pp 1184-1185)

Is There a Role for Acupuncture in Fibromylagia?

Victor S. Sierpina

Abstract: In a recent systematic review of the use of acupuncture for fibromyalgia,1 the authors conclude that “acupuncture cannot be recommended for fibromyalgia.” I take issue with this broad conclusion on several counts. First, they found only five eligible studies and of...

(pp 1183-1184)

Medical Webwatch

Jim Young

Abstract: Exploring Nanotechnology is a subsection of the National Cancer Institute website. It is a gentle educational experience that provides background information and explanations of current nanotechnology. It uses animated...

(pp 1277)

In Appreciation


Abstract: The editor and staff of the Southern Medical Journal would like to extend their appreciation to those who served as reviewers during 2007. The editorial staff apologizes for any omissions or...

(pp 1279-1280)

Miracles and Medicine: An Annotated Bibliography

Joan Kub, PhD, APRN, BC, MA.TH, Sara Groves, DrPH, APRN, BC

Abstract: The search for scholarly articles with the word “miracle” in the title resulted in limited findings. There was a subset of articles addressing miracles from the perspective of saints, religions, or healers. These seemed to be focused on examining the legitimacy of...

(pp 1273-1276)

Eye on Religion: A Jewish View on Miracles of Healing

Aaron L. Mackler, PhD

Abstract: Jewish tradition understands a miracle as a wonder that manifests God's beneficent power. A miracle (nes in Hebrew) could be supernatural, but it need not be. While God has the ability to act in a manner that goes against the “orders of creation” (sidrei breishit) that...

(pp 1252-1254)

Distinguishing Denial From Authentic Faith in Miracles: A Clinical-Pastoral Approach

Daniel P. Sulmasy, OFM, MD, PhD

Abstract: Is it possible to distinguish between authentic religious faith in a miraculous cure and the psychiatric syndrome of denial in the face of serious illness? There are, of course, atheists who consider all religious beliefs delusional, and, therefore, would not accept the...

(pp 1268-1272)

Miraculous Medical Recoveries and the Islamic Tradition

Faiz Khan MD

Abstract: As an extension of a concept known as tawheed,* nothing lies outside of The Jurisdiction of Divine Intervention; nor is God the deist's watchmaker, winding up reality and watching various Newtonian-like mechanized processes play themselves out.† Once this latter deist...

(pp 1246-1251)

Eye on Religion: Miracles in the Chinese Buddhist Tradition

Chün-fang Yü

Abstract: Books on Buddhism for general readers rarely mention miracles. Instead, the emphasis is usually on the life of the Buddha, his teachings, and the monastic order, the so-called “Three Treasures.” This is a heritage left by the European scholars who first became...

(pp 1243-1245)

Patient’s Page

Stephanie M. Norris MS, RD, LD/N

Abstract: Milk Myths and Misconceptions Although three servings of dairy are suggested for part of a balanced diet, all kinds of myths and misconceptions about milk abound. How could something so simple become so...

(pp 1278)

Miracles: A Christian Theological Overview

Charles Pinches PhD

Abstract: Miracles function centrally in Christianity, perhaps more centrally than in any other religious tradition. This is because its holy text, the Bible, tells us story after story, and many of these are about miracles. Indeed, while the Bible includes lists of commands,...

(pp 1236-1242)