It is now possible to achieve complete remission in the majority of patients with acute promyelocytic leukemia (APL) if all-trans retinoic acid (ATRA) is administered as a single agent or in combination with cytotoxic chemotherapy. Despite its positive influence on recovery, ATRA is not without the potential for toxicity. It…
We report the case of a 59-year-old woman who presented with fever and a cutaneous ulcer on her left ankle. In addition to Staphylococcus aureus growth from a blood culture, S aureus and Mycobacterium tuberculosis were both isolated from tissue specimens. This case highlights that osteomyelitis may be concurrently caused…
Cerebral venous sinus thrombosis represents less than 1% of all strokes, being an uncommon entity with a wide spectrum of clinical scenarios. We present a 45-year-old Hispanic female with a history of long-term oral contraceptive use who was diagnosed with cerebral venous sinus thrombosis due to a heterozygous carrier mutation…
Since its FDA approval in December 2005, sorafenib (Nexavar®) has been in use for the treatment of metastatic renal cell carcinoma. With this increased use have come reports of adverse effects of sorafenib. To the best of the authors’ knowledge, they are the first to describe an 80-year-old Asian male…
To the Editor: Timely preoperative evaluation and medical optimization during the perioperative period are critical for improving outcomes in patients hospitalized for urgent hip fracture repair (UHFR).1 With rapid growth of the hospitalist movement, hospitalists are increasingly providing consultation services for UHFR patients and the effectiveness of hospitalists in the…
Influenza virus infections result in 200,000 hospitalizations and 38,000 deaths per year in the United States, despite widely available information about influenza and influenza prevention efforts via vaccination programs.1 The Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Reports provide abundant data on the status of influenza-like illnesses…
To the Editor: Helicobacter pylori infection has been recognized as a major cause of several gastroduodenal diseases, including chronic atrophic gastritis, gastric and duodenal ulcers, MALToma, and gastric cancer.1,2
To the Editor: Acute tumor lysis syndrome (TLS) is a serious, potentially life-threatening complication of cancer therapy requiring prompt recognition and aggressive management. It occurs particularly in patients with lymphoproliferative diseases during potent myelosuppressive therapy.1 To our knowledge, acute spontaneous TLS in solid tumors is extremely rare and has not…
In this issue, the focus of the Southern Medical Journal’s Spirituality/Medicine Interface Project is on what physicians need to know about spirituality and mass catastrophe. As used here, spirituality involves religious beliefs, practices, and traditions, but also more broadly includes a search for the sacred,1 ultimate truth, or ultimate reality….
Postdisaster settings are often chaotic, with considerable need to meet challenges as feasible with available resources and personnel. Based on experience in international settings and domestic disaster relief following Hurricane Katrina, the authors describe a general approach to responding to catastrophes. This is not meant to be a specific roadmap,…
Cancer entered my life like a tsunami. I speak metaphorically, of course. Catastrophes like a malignant diagnosis, the loss of a loved one, or any of the various disappointments of life arrive unexpectedly, sweep away everything that is familiar, and leave disorganization and the need to adjust to a new…
Here in New York City, some refer to “life before 9/11,” contrasting it to where we are today. Often I have heard, “Life has changed; things will never be the same,” not referring simply to the increased security measures and the need for vigilance.
Providing healthcare to victims of a disaster is a demanding, and at times overwhelming, task. Physicians, as caregivers in these situations, may find themselves facing significant spiritual uncertainty and personal spiritual distress. There has been very little written about the spiritual needs of physicians in general, and nothing dealing with…
The day after 9/11, I stood outside St. Vincent’s Hospital in Lower Manhattan and gazed at pictures of people missing from the World Trade Center. Flowers and candles created a shrine-like atmosphere as we absorbed the fact that there were few survivors. The pictures were eerily similar with name, description,…
Driving rain and howling wind assaulted the city. Their homes gone, cold and weary, they found refuge in the safety of the shelter. Volunteers had prepared a hot meal that sustained them. In the shelter, some sleep, others share stories of shattered homes. Tomorrow they will again face their struggles;…
There is an old joke that describes the traditional rites surrounding Jewish holidays (at least Passover, Hanukkah and Purim): “They tried to kill us, G-d saved us, let’s eat.”
Buddhists make up a large proportion of the population of many countries around the world, including Thailand (95%), Cambodia (90%), Myanmar (88%), Bhutan (75%), Sri Lanka (70%), Tibet (65%), Laos (60%), Vietnam (55%), Japan (50%), Macau (45%), and Taiwan (43%), and with a growing number of adherents in the West….
Background: Tobacco use during pregnancy is associated with adverse child outcomes. There is evidence that religiosity/spirituality is associated with less tobacco use. This study aims to investigate the association further, including an assessment of overall religiousness and specific aspects of religiosity/spirituality. Methods: 404 pregnant women receiving prenatal care in three…
Background: The FluSTAR Surveillance System covers most of the United States, providing local and national information on influenza and influenza-like illness that is updated twice weekly. Methods: Descriptive statistical analyses were performed to explore demographic characteristics, symptoms, vaccination status, and treatment of patients tested for influenza, using a rapid test…
This article reviews one of the basic tools of evidence-based medicine, the calculation and interpretation of Number Needed to Treat (NNT) and Number Needed to Harm (NNH). Especially appealing is the simplicity of extracting this information from journal articles that report binary outcomes, such as medication response or emergence of…
Smoke-free laws significantly impact indoor air quality. However, the temporal effects of these laws on indoor air pollution have not been determined. This paper assesses the temporal impact of one smoke-free law on indoor air quality. This quasi-experimental study compared the indoor air quality of nine hospitality venues and one…
Smokeless tobacco (ST) use is common, especially in southern and rural areas. It is expected to become more popular with the recent move to sell more ST in areas where indoor smoking is banned. ST use usually starts in adolescence, which places this group at high risk. Nicotine dependence occurs…
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The accompanying paper presented in this issue of the Southern Medical Journal reinforces concepts of data analysis that are of great importance for clinical psychiatrists. Despite enormous advances in the biologic understanding of mental illness, psychiatry remains an empirical medical specialty, whose outcomes data often cannot be interpreted in light…
Over 380 agents are known to cause drug-induced respiratory disease (DIRD), and the list continues to grow.1 Moreover, because this list includes agents utilized by a variety of specialists and subspecialists, no area of medicine is immune. To minimize the potential morbidity and mortality from DIRD, it behooves all physicians…
Extrapulmonary tuberculosis (TB) represents approximately 20% of all TB infections, which translates into 400 million cases worldwide. Patients with extrapulmonary disease are more likely than not to have a normal CXR, a negative PPD, and a 40 to 50% chance of underlying human immunodeficiency virus (HIV) infection.1–3 The implication of…
This article explores the history of lupus erythematosus from the origins of the name to the most modern therapeutic advances. The review includes information about the origin of the name “lupus,” the first clear description of the skin lesions, the discovery of the systemic and discoid forms, and further advances…
Video Lectures on Bioelectromagnetism http://butler.cc.tut.fi/∼malmivuo/bem/bembook/in/vi.htm is an essential adjunct to an online textbook that aims to “… raise the readers’ interest in bioelectromagnetism and provide the background that will allow them to delve into research and practical applications in the field. We also hope that the book will facilitate the…
Saving Lives: Secondhand Smoke Laws Smoking is the leading cause of preventable death, but the danger from tobacco smoke has made secondhand smoke the third preventable cause of death in the United States. Secondhand smoke contains about 4,000 chemicals, approximately 50 of which can cause cancer. Secondhand smoke may cause…
The September 11, 2001, terrorist attacks were traumatic and stressful for many individuals. Three to five days after the attacks, 44% of adults reported experiencing at least one symptom of stress.1 Sixteen percent of these adults continued to experience at least one stress symptom two months later.2 In the midst…
To better understand Islamic perspective of coping with catastrophe, it is useful to briefly describe the early years of Prophet Muhammad’s mission, a time when he and his companions were constantly coping with traumatic events. Nearly 600 years after Jesus, the Arabian Prophet Muhammad preached the worship of one God,…
Frank Livingston, a 65-year-old married black male, was the owner of a convenience store in New Orleans before Hurricane Katrina hit on August 29, 2005. The hurricane not only flooded his business, but also destroyed his home where he and his wife had lived for 30 years and had raised…
Smith BW, Pargament KI, Brant C, et al. Noah revisited: Religious coping by church members and the impact of the 1993 Midwest flood. J Community Psychol 2000;28:169–186.This study documents the important role that churches play in responding to disasters, particularly in small rural communities. Small churches in rural areas played…
Over the past decade, India and the United States of America have experienced a number of traumatic mass disasters that have tested their resources in responding to the needs of individuals in distress, survivors, and communities. India experienced sectarian riots in the state of Gujarat in 2002; a massive and…
Although physicians are not clergy or spiritual care experts, they play an important role in addressing the spiritual needs of disaster survivors. There are at least six reasons why physicians should communicate with patients about spiritual issues1: first, many patients are religious and want physicians to be aware of their…
The nature and timing of psychological and social interventions depend heavily on how much time has elapsed since the disaster event. Survivors and family members go through distinct psychological phases after the onset of a disaster. Adachi and colleagues1 have divided the time periods following disaster into four phases, each…
In the United States, a formal system of emergency preparation and response exists at the federal, state, and local levels. The focus of this emergency management system (EMS) is to minimize damage and to meet the physical needs of disaster victims. Less developed is a system that meets the emotional…
In the arena of human life, with its triumphs and tragedies, people often look to their spiritual resources as they face life’s many mysteries. Given the frequency with which they enter this arena, emergency responders such as police, fire, and EMS personnel are just as, if not more likely, to…
To the Editor: Boerhaave syndrome represents a diagnostic dilemma for the physician. Boerhaave syndrome is an uncommon condition where there is esophageal rupture following forceful vomiting. Rarer causes would include status asthmaticus, hyperemesis gravidarum, prolonged coughing or hiccups, defecation, parturition, seizures, weightlifting, and blunt injury to the chest or abdomen.
To the Editor: The recent America’s Health Rankings (AHR) conducted by the American Public Health Association and Partnership for Prevention on behalf of the United Health Foundation represents just another attempt at creating global measures of health, which inevitably results in junk science. The AHR study ranks states in the…
To the Editor:A 30-year-old woman presented with a prolapsed, nonreducible anal mass of 3 weeks’ duration. It was associated with pain, episodes of rectal bleeding, and yellow discharge. Her past medical and surgical history was significant for morbid obesity, and she was status post tubal ligation. Physical examination revealed a…
To the Editor: Environmental tobacco smoke (ETS) exposure has adverse health effects for children and adults,1–3 and widespread concern about ETS exposure has aided in the successful passing of legislation to implement state-wide clean indoor air policies. In addition, there is increasing interest in hospitals enforcing comprehensive smoke-free workplace (SFW)…
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