Perennial allergic rhinitis (PAR) can have a significant impact on a patient’s quality of life. While allergen avoidance is the first line of management for PAR, complete avoidance is difficult. Therapeutic options available for PAR include intranasal corticosteroids (INS), H1-antihistamines, decongestants and local chromones, as well as immunotherapy. For mild…
Paracoccidioidomycosis (South American blastomycosis) is a systemic infection caused by a dimorphic fungus (Paracoccidioides brasiliensis). It is common in the rural areas of Latin America. The majority of the reported cases come from Brazil, Colombia and Venezuela. Paracoccidioidomycosis is the most important systemic mycosis of the tropical Americas and can…
A 42-year-old patient presented acutely with bacteremic pneumococcal pneumonia along with metastatic pneumococcal infection of the hip joint. Diagnostic evaluation revealed evidence of a pre-existing bilateral hip osteonecrosis. The osteonecrotic changes were attributed to chronic alcohol abuse and/or an old motor vehicle accident. Appropriate therapy was promptly instituted and the…
Warfarin is the most widely used oral anticoagulant and is indicated for many clinical conditions. Levofloxacin, a fluoroquinolone, is one of the most commonly prescribed antibiotics in clinical practice and is effective against Gram-positive, Gram-negative, and atypical bacteria. While small prospective studies have not revealed any significant drug-drug interaction between…
To the Editor: The recent American College of Chest Physicians conference has recommended more prolonged periods of anticoagulant treatment in patients with venous thromboembolic disease (VTD).1 For example, it has suggested that patients with a first episode of idiopathic VTD be considered for indefinite anticoagulant treatment.1 However, the incidence of…
To the Editor: Numerous reports have pointed to an increased prevalence of blood type A in patients with gastric cancer. Aird et al1 were the first to study ABO blood groups in a large number of patients with gastric cancer, noting an excess of group A, and a deficiency of…
To the Editor: Perforation of the esophagus is a formidable challenge. Successful therapy for esophageal perforation depends on the length of the perforation itself, the time elapsed between rupture and diagnosis, and the underlying health of the patient. Location and size of the perforation, delayed diagnosis, and delay in initiating…
To the Editor: Dysphasia is rarely a presenting feature of tuberculous, more often associated with direct esophageal involvement.1,2 Very few cases of tuberculosis mediastinal lymphadenopathy causing dysphasia have been reported from the Asian subcontinent and even fewer from the West. We came across a similar case, interesting not only from…
The depressive disorders, among all the psychiatric disorders, have been most closely correlated with ordinary spiritual experience. And the burden of depression is increasing throughout the world.1,2 Patients who struggle with depression find themselves reaching to the very core of their faith traditions. In some faith traditions, even a severe…
Depression is one of the strongest predictors of suicide, especially when accompanied by hopelessness.1 People often commit suicide when they perceive that there is no way out of an intolerably painful situation, or when they see no purpose or meaning to a life of seemingly unending suffering. Depressive illness can…
Importance of Spirituality for Well-being Spirituality is defined as a search for—and a means of reaching—something beyond human existence, creating a sense of connectedness with the world and with the unifying source of all life—an expression of a profound need of people for coherent meaning, love, and happiness in their…
Depression in children and in adolescents refers to an enduring mood change with associated changes in important aspects of daily functioning, such as attention, appetite, and sleep. Suicidal behavior is a symptom, not a diagnosis, linked to depression. While depression is a condition with multiple etiologic factors, most can be…
The interpersonal aspects of religion, in addition to the intrapsychic experiences of spirituality, offer protection to adults against depression and suicide. Three lines of evidence support this statement. First, each of Erikson’s adult life stages focuses upon relational crises that must be surmounted to grow;1 second, involvement in religious observances,…
Suicide in the elderly is a tragedy and, sadly, is not a rare event. In 2003, 31,484 Americans committed suicide, making it the 11th leading cause of death in the US, and the 18th leading cause of death in the elderly.1 Rates of completed suicide are highest among older men,…
Over 30,000 people commit suicide each year in the United States. While the reasons in each case may be complex, the decision that life is not worth living is an expression of existential despair. Most studies show an inverse relationship between religious involvement and suicide.1,2 This paper reviews ways that…
A discussion of resources available must address the point at which a person (patient) becomes suicidal, what medical, psychological and spiritual condition she is in, and to whom she can turn for help. Given the high correlation between suicide and severe depression, ideally, the patient would have options for emergent…
Hypertension is a major independent risk factor for cardiovascular disease and mortality. Despite more than five decades of the expansion of therapeutic regimens for hypertension, the treatment of hypertension still remains a therapeutic challenge. Data from the third National Health and Nutrition Survey (NHANES III) suggest that only 29 to…
Allergic rhinitis is a one of the most common chronic diseases, affecting 10 to 30% of adults and up to 40% of children.1 Allergic rhinitis is typically categorized based on the timing of the rhinitis symptoms as either seasonal or perennial. One problem with this description is that certain allergens…
Background: The aims of this study are to define the length of the respiratory syncytial virus (RSV) season throughout Florida and evaluate the American Academy of Pediatrics (AAP) guidelines on the administration of palivizumab in light of the Florida data. Methods: We retrospectively analyzed four seasons of monthly RSV surveillance…
Background: Osteoporosis has been studied predominantly in white postmenopausal women. Materials and Methods: We performed a cross-sectional survey of a random sample of 400 women aged 45 years and older enrolled in a family medicine community-based research network. Participants responded to 42 items regarding osteoporosis screening and prevention during primary…
Background: The authors aimed to evaluate whether local periodontal therapy may influence plasma lipid levels in patients with periodontitis. Methods: Fifty patients (31 females and 19 males, age 36-66 yr) were randomly assigned to the treatment and control groups. Lipid profile and dental variables were measured at baseline and at…
This review summarizes the current state of knowledge about drugs, other chemical substances, and toxins on blood pressure. Many classes of drugs, such as steroids, sympathomimetic amines, immunosuppressive agents, nonsteroidal anti-inflammatory agents, antidepressants, erythropoietin, substances of abuse and other agents can induce transient or sustained hypertension, exacerbate well-controlled hypertension, antagonize…
Thiamine deficiency can occur in any disease that results in inadequate intake or excessive loss of vitamin B1. In addition to increased thiamine consumption secondary to high cell turnover, cancer patients frequently have reduced oral intake as a direct result of their cancer or from cancer treatments. However, Wernicke encephalopathy…
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In this issue of the Southern Medical Journal, Dr. Oz and colleagues1 report on the beneficial effect of periodontal treatment in hypercholesterolemic patients suffering from periodontitis.
Respiratory syncytial virus (RSV) is the most common pathogen causing disease in children worldwide. In the US, RSV infection is the leading cause of infant hospitalization. A small group of diagnostic codes—RSV alone, bronchiolitis secondary to RSV, unspecified bronchiolitis and unspecified pneumonia—are found in at least 120,000 annual admissions in…
Background: HCV infection with concurrent or superinfection with HAV or HBV has the potential to worsen the liver status of HCV-infected individuals. This study evaluates if patients’ race or gender influenced whether HAV or HBV serologic status was determined for the purpose of providing immunization. Methods: Medical records of consecutive…
Pathology Outlines Case of the Week http://www.pathologyoutlines.com/case1.htm PathologyOutlines.com pays contributors $35 for every published case and at the time of writing, there are 77 cases listed. The cases can be reviewed on their website or by email subscription. Each case consists of a short history accompanied by images of microscope…
Question: I am overweight, and my doctor says I have high blood pressure. Is it safe for me to take a weight loss product? Answer: For patients who have hypertension, most physicians would advise against taking a weight loss product. There are many products on the market that contain ingredients…
To the Editor: Upper airway diseases resulting in obstruction can be caused by blockage secondary to tumor or cyst inside the larynx, compression of trachea by a goiter or airway collapse seen in obstructive sleep apnea. Failure to recognize the etiology and correct the condition promptly can be disastrous because…
To the Editor: With interest, we read the article by Fox et al1 on a 29-year-old African-American female in whom left ventricular hypertrabeculation (LVHT), also known as noncompaction, was detected upon investigation for heart failure from dilative cardiomyopathy. The presentation raises the following concerns:
No discussion of depression and spirituality can be complete without a discussion of depression and culture, for culture and religion/spirituality are so intertwined. The negotiation between religion and culture ranges from ongoing discussions by mainline Christian theologians about the proper stance of religion within culture1 to commentaries on the dramatic…
Ann, a 73-year-old widow who lived alone in a small North Carolina town, consulted me because she felt she was too self-absorbed. Ann is a retired social worker and spends much of her time with her 44-year-old schizophrenic son, Fred, who has been repeatedly hospitalized for acute psychotic episodes. About…
Selected Annotated Bibliography on Depression and Suicide Blazer, Dan MD, PhD St. John of the Cross. Dark Night of the Soul. New York, Image Books, p 1959.Saint John of the Cross (1542–1591), a Catholic mystic, was a major figure in the Catholic Reformation A Spanish mystic and Carmelite friar, he…
The encounter with a person who struggles with suicidal thoughts, who has attempted suicide, or who is the loved one of someone who has committed suicide raises profound questions about how to respond to this person in deep pain. Curiously, the specialization of the caregiving professions fractures this single person…
Seventh Day Adventists (SDA) are Christians in the Protestant tradition. Key issues are belief in a creator God, the divinity of Christ, belief in salvation by grace (rather on works or on the day of the week kept holy), belief in the scriptures as the final authority for faith and…
Spirituality is woven into the fabric of Mormon (LDS) religion and culture. LDS people (of the Church of Jesus Christ of Latter-day Saints) consider themselves deeply Christian. They bless the sacrament weekly, in remembrance of Christ’s body and blood, “that they may … witness unto thee, O God, the Eternal…
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