Issue - Southern Medical Association

Announcement

Southern Medical Association Announcement 1

2010 Calendar of Events

Case Report

Ménétrier Disease in an Acquired Immunodeficiency Syndrome Patient

Ménétrier disease is a rare disorder of unknown etiology. An overexpression of TGF-α has been proposed to play a role in the pathophysiology. HIV-1 tat gene product has been shown to stimulate TGF-α production leading to a positive feedback autocrine loop. The case of a 41-year-old male with AIDS who…

Original Article

Disability and Health-Related Quality of Life after Breast Cancer Surgery: Relation to Impairments

Background: The aim of this study was to determine the prevalence of impairments relevant to upper extremity following breast cancer surgery and its impact on disability and health-related quality of life. Methods: Sixty-seven female patients being treated with modified radical mastectomy or breast conserving surgery were included. They were evaluated…

Case Report

A Case of Sclerosing Mesenteritis with Rheumatoid Arthritis

Sclerosing mesenteritis (SM) is an uncommon disorder characterized by chronic nonspecific inflammation involving the adipose tissue of the mesentery. The etiology remains unclear. It has been reported in association with and as an initial presentation in some autoimmune diseases. Its clinical presentation and laboratory findings are typically nonspecific and definitive…

Editorial

Postoperative Infections in Posterior Instrumented Fusions

Spinal infection following instrumented posterior fusion poses a difficult diagnostic and therapeutic problem. Accurate early diagnosis is essential to effectively eradicate infection, while the management of infection is still controversial. The article by Jinadatha et al1 in this issue of the Southern Medical Journal provides valuable data on management of…

Announcement

Southern Medical Association Announcement 2

Going Cruising- Southern Style!

Case Report

Transient Attacks of Man-in-the-Barrel Syndrome

A 60-year-old man complained of 20–25 second episodes of bilateral arm paralysis. Neuroimaging disclosed spinal cord compression at the C3-4 level caused by a herniated disc and retrolisthesis. Spinal cord ischemia due to impingement of a vertebral artery or its spinal branch was suspected but could not be substantiated by…

Editorial

The Case for Universal Motorcycle Helmet Laws

The recent trend in motorcyclist fatalities poses an increasing public health concern for the United States. During 2007, 5,154 motorcyclists lost their lives in crashes on US roads, a startling 144% increase over the 2,116 fatalities the nation experienced in 1997. While the increasing popularity of motorcycles accounts for some…

Letter to the Editor

Urinary Atypical Mycobacterium Infection

To the Editor: I read the recent publication by Lin et al1 on urinary Mycobacterium szulgai infection with a great interest. Indeed, this nontuberculosis (non-TB) Mycobacterium infection, similar to other non-TB agents, is well described for induction of lung infection. Thomson and Yew2 noted that attention to pulmonary hygiene and…

Letter to the Editor

Promoting Awareness About Total Laparoscopic Hysterectomy

To the Editor: Hysterectomy is a major gynecological procedure with roughly 600,000 operations performed every year in the United States. It is a surgical operation surrounded by controversy due to the considerable cost inflicted on patients, insurance companies, and the society at large. The United States has one of the…

Review Article

Compression-Caused Peroneal Neuropathy: Commentary from a Biopsychologist

Compression is the most common cause of damage to the fibular head, the site of most peroneal nerve injuries causing foot drop. Circumstances that give rise to these compression injuries include habitual leg-crossing and prolonged immobility. A review of the medical literature does not reveal the existence of a nationwide…

Case Report

Hemorrhagic Cystitis Induced by an Herbal Mixture

A healthy 33-year-old woman consumed a slimming product containing a mixture of herbal remedies without seeking medical advice. Two months later, the patient had hemorrhagic cystitis and discontinued the herbal product. Symptoms spontaneously remitted in a few days. Four months later, she took the same herbal remedy and the hemorrhagic…

Editorial

The Starry Heaven and the Crowded Shelters: Public Health Risks

Starting in 1890, after the most important scientific revolution in microbiology, when Koch first presented his postulates, medicine was never the same. And, not only medicine itself and the medical approach to illness but society and social interventions as well. Administrative measures, such as isolation of presumably transmissible diseases were…

Expired CME Article

Pancreatic Cystic Neoplasms

Pancreatic cysts include inflammatory lesions, low-grade neoplasms, and malignant neoplasms. Cystic neoplasms may prompt investigation because of symptoms such as abdominal pain, distension, jaundice, or nausea, but they are usually incidentally discovered. In the older literature, pseudocysts related to acute and chronic pancreatitis accounted for the majority of pancreatic cysts,…

Expired CME Article

Apneic Disorders Associated with Heart Failure: Pathophysiology and Clinical Management

Cardiovascular diseases remain the most common cause of both morbidity and mortality in the industrialized world. The frequency of sleep-related breathing disorders (SRBD) is significantly increased in individuals with cardiovascular diseases such as heart failure. Given the co-morbidities associated with SRBD coexisting with HF, prompt recognition and early management of…

Case Report

Primary Intradiploic Pterional Epidermoid Cyst

A 72-year-old woman who developed a left temporal protrusion was referred to our center. An MRI showed a heterogeneous mass in the left temple with T2 signal hyperintensity within the intradiploic space of the greater wing of the sphenoid bone, measuring 2.4 × 2.1 cm. The patient underwent a surgical…

Expired CME Article

January 2010 CME Questions

Expired CME Article

Review Article

The Continuation of Oral Medications with the Initiation of Insulin Therapy in Type 2 Diabetes: A Review of the Evidence

The combination of oral medications with insulin is inevitable in the treatment of type 2 diabetes. Unfortunately, there are no consensus statements available to guide the continuation or discontinuation of specific therapies. The clinician treating the type 2 diabetic patient must be aware of the literature regarding use of oral…

Announcement

Southern Medical Association Announcement 3

Guiding the Path Toward Your Financial Goals

Letter to the Editor

Role of Imaging Studies in the Evaluation of Sinus Arrest and Syncope in a Patient with Neurofibromatosis

To the Editor: There is little published data on the occurrence of arrhythmias and conduction abnormalities in patients with neurofibromatosis. Here, we report a rare case of recurrent seizures and syncope in a patient with neurofibromatosis.

Original Article

Weight Problems and Spam E-mail for Weight Loss Products

Background: This study focuses on young adult behaviors with regard to spam e-mails that sell weight loss products. Methods: Participants (N = 200) with and without weight problems were asked if they received, opened, and bought products from spam e-mail about weight loss topics in the past year. Psychological factors…

Letter to the Editor

The Evolving Etiopathogenesis of Retroperitoneal Fibrosis

To the Editor: I read with interest the case report presented by Barquiel et al.1 They state that the presence of autoantibodies against oxidized low density lipoprotein (LDL) and ceroid in the atherosclerotic plaques are paramount to the pathogenesis of retroperitoneal fibrosis (RF). This is not completely true. In the…

Special Section

The Oldest Old Subclinically Hypothyroid Subjects with Pre-Existing Atrial Fibrillation Might not Benefit from Replacement Therapy

To the Editor: Notwithstanding the proposal by Pipili and Cholongitas1 in the August issue of the SMJ, that subclinical hypothyroidism is detrimental to cardiovascular status, it is worth noting that “in the general population of the oldest old, elderly individuals with abnormally high levels of thyrotropin do not experience adverse…

Case Report

Pulmonary Actinomycosis Presenting as a Mass-Like Consolidation

Pulmonary actinomycosis presented as a mass-like consolidation. The diagnosis was not established until clinical suspicion prompted special staining of the pathology material. Response to antibiotics was facilitated by a removal of the airway plug through bronchoscopy. Airway obstruction may contribute to the prolonged medical treatment of pulmonary actinomycosis.

Original Article

The Effect of the 1997 Texas Motorcycle Helmet Law on Motorcycle Crash Fatalities

Objectives: This study seeks to determine the effect of the Texas motorcycle helmet law on fatalities since the repeal of the universal helmet law in 1997. Methods: Texas monthly motorcycle accident data between 1994 and 2004 were obtained from the National Highway Transportation Safety Administration’s Fatality Analysis Reporting System (FARS)…

Case Report

Epstein Barré Virus-Negative Diffuse Large B-Cell Lymphoma in an HIV-Infected Man with a Durable Complete Remission on Highly Active Antiretroviral Therapy Alone

We report a unique case of a human immunodeficiency virus (HIV)-infected man with Epstein-Barré virus (EBV) negative diffuse large B-cell lymphoma (DLBCL) that responded solely to highly active antiretroviral therapy (HAART). Our patient presented with a retroperitoneal mass, high viral load, CD4 288 and began therapy with HAART with marked…

Original Article

Episodic Illness, Chronic Disease, and Health Care Use Among Homeless Persons in Metropolitan Atlanta, Georgia, 2007

Background: Homeless persons are at higher risk for morbidity and mortality from both chronic and episodic illness than the general population. Few data are available on the prevalence of these conditions and uptake of vaccination for prevention. Methods: In March 2007, we administered a cross-sectional survey to a convenience sample…

Case Report

Warfarin-Induced Skin Necrosis

There is a lack of guidelines regarding the selection of patients who need intravenous heparin, duration of intravenous heparin, and future use of warfarin in prevention and treatment of warfarin-induced skin necrosis. This case report emphasizes the challenges in dealing with vitamin K antagonists (VKA) therapy.

Editorial

Man-in-the-Barrel Syndrome and Its Mimics

Man-in-the barrel syndrome (MIBS) is a descriptive term for upper limb paraplegia with preserved mobility of head and lower limb muscles without sensory deficits (brachial diplegia, cruciate palsy, and disproportionate weakness of upper vs. lower extremities), suggesting the patient is constrained in a barrel around the trunk, completely prohibiting upper…

Case Report

Drug-Induced Liver Injury Caused by the Histrelin (Vantus®) Subcutaneous Implant

Drug-induced liver injury (DILI) is the leading cause of acute hepatic failure in the United States. Up to 13% of acute liver failure cases occur due to drugs other than acetaminophen. This clinical diagnosis, made after other causes of liver injury have been excluded, requires establishing a causal relationship between…

Editorial

Continuation of Oral Medications When Insulin Is Initiated

Type 2 diabetes mellitus (T2DM) is a progressive disease characterized by insulin resistance and progressive β-cell dysfunction.1 With the prevalence of T2DM increasing, particularly in younger populations, the use of insulin will become increasingly important as patients develop severe insulinopenia due to a progressive loss of pancreatic β-cell function. The…

Original Article

Postoperative Instrumented Spine Infections: A Retrospective Review

Background: Postoperative infection following posterior instrumentation of the spine is not uncommon and is a potentially catastrophic complication. Removal of the instrumentation is ideal for eradicating infection. However, removal is not always possible from a structural standpoint. An alternative is to treat the patient with antibiotics in combination with irrigation…

Expired CME Article

Difficult Conversations: Anger in the Clinician-Patient/Family Relationship

Date of Original Release: January 1, 2007 Term of Approval: 1 Year • Credit Expires: January 1, 2008 Estimated Time for Completion: 1 Hour Credit Designation: 1 AMA PRA Category 1 Credit™