To the Editor: Progressive multifocal leukoencephalopathy (PML) is a progressive demyelinating disease of the central nervous system thought to be caused by the reactivation of JC papova virus that is becoming more prevalent than in the past with the increasing use of monoclonal antibodies for the treatment of neoplastic or…
Pharmacovigilance is the process of identifying, monitoring, and effectively reducing adverse drug reactions. Adverse drug reactions (ADRs) are an important consideration when assessing a patient’s health. The proliferation of new pharmaceuticals means that the incidence of ADRs is increasing. The goal for all health care providers must be to minimize…
Objectives: The primary aim of this study was to determine reasons why health care personnel (HCP) in a public health department chose or refused free influenza vaccinations offered at the worksite. Methods: In an internal review board-approved study, we offered, through a health nurse at the site, self-administered surveys designed…
Hepatitis C is a leading cause of liver failure and transplantation in the United States and a major public health issue. Studies have shown that patients with hepatitis C are at an increased risk of cardiovascular disease, which make statins of particular benefit in this patient population. However, the National…
Objectives: The Maastricht III Consensus agreed that effective treatment for Helicobacter pylori (HP) should achieve an intention-to-treat (ITT) eradication rate above 80%, which is still lacking in patients with type 2 diabetes mellitus (DM). This pilot study was designed to confirm the efficacy of a 14-day sequential treatment regimen in…
It is not appreciated by most physicians that vibrio infections can be acquired from freshwater exposure. A case of non-O1 Vibrio cholerae urinary tract infection associated with freshwater exposure is reported. The potential for vibrios to grow in brachish water and for summer heat to cause evaporation leading to relative…
To the Editor: We read with great interest the article by Bell examining the relationship between nonalcoholic fatty liver disease (NAFLD) and each of the following: metabolic syndrome, obesity, diabetes, and cardiovascular disease.1 We congratulate the author on clarifying these associations and agree that NAFLD should be regarded at present…
To the Editor: A 57-year-old man with no prior medical history complained of a foreign body sensation and a stabbing pain in the right side of the neck after accidental ingestion of a fish bone at breakfast. He attempted to dislodge the fish bone by swallowing some rice, but his…
Objectives: Osteoporosis is a prevalent condition among older people. It is often undiagnosed until patients suffer fragility fractures. Previous studies have shown low rates of initiating osteoporosis treatment during the acute hip fracture hospitalization. It is not clear if this varies by the treating service. We compared the rates of…
We debated long and hard whether or not to publish the paper by Gregory et al1 in the Southern Medical Journal. The reviewers, who were blinded as to the authorship and source of the manuscript, stated that, in reality, this paper adds little to the well-established body of literature. Several…
Osteoporosis is a common skeletal disease that weakens bones and increases the risk of fractures. It affects about one half of women over the age of 60, and one third of older men. With appropriate care, osteoporosis can be prevented; and when present, it can be easily diagnosed and managed….
To the Editor: Congenital anomalies of the coronary arteries are an uncommon but important cause of chest pain and sudden cardiac death. The incidence of coronary artery anomalies has been reported between 0.6 to 1.3% in angiography and 0.3% in autopsy.1 The anomalous origin of left and right coronary arteries…
Prognosis of angiosarcoma, the most common primary malignant cardiac tumor, is very poor. An early detection and treatment may extend survival beyond one year. Newer imaging modalities, including magnetic resonance imaging (MRI), play an important role in the evaluation of cardiac masses. The case of a man admitted to the…
Malignant extragonadal germ cell tumors, though more common in infants and children, are rare. They occur in the body’s midline and may have internal and external manifestations. We report a case of an 11-month-old female with sacrococcygeal extragonadal yolk sac tumor manifesting as a draining subcutaneous nodule after initial treatment…
Objectives: The relevance of placental growth factor was analyzed at the admission of patients with acute coronary syndrome (ACS) without ST elevation in prognosis of fatal outcome after 30 days. Methods: We collected blood samples from 102 ACS patients admitted to the coronary unit with acute chest pain manifesting within…
Warfarin, a commonly prescribed anticoagulant, has many potential drug interactions. We describe a case of intravaginal miconazole potentiating the effects of warfarin in a patient previously stable on a consistent dose of 8.5 mg warfarin daily. Following a course of intravaginal miconazole and a dosage increase to 9 mg daily,…
Objectives: Gastrointestinal stromal tumor (GIST) is a relatively uncommon and predominantly sporadic tumor of the gastrointestinal tract (GIT). Infrequently, it can be associated with other neoplasms, notably GIT carcinomas and, rarely, extra-gastrointestinal tumors. Whether this concomitant occurrence is a causal association or a coincidence is not yet resolved, nor is…
Urachal cyst complications requiring surgical intervention are rarely seen in adults, because the urachus is normally obliterated in infancy. Necrotizing fasciitis due to an infected urachal cyst in an adult female has not been reported. We describe the case of a fifty-year-old female who required aggressive surgical management of abdominal…
Obscure gastrointestinal bleeding has long been a challenging dilemma for gastroenterologists and primary care providers alike. Although many abnormalities can be localized to the small bowel by traditional endoscopic evaluation, deep enteroscopy is often needed to evaluate persistent bleeding of unknown etiology and other conditions. New technology and developments in…
Over 25 years after Barry and Marshall first linked it with peptic ulcer disease, Helicobacter pylori (HP) remains one of the most common infections worldwide.1,2 HP is associated with gastrointestinal problems ranging from simple non-ulcer dyspepsia to uncomplicated or complicated (perforation or bleeding) peptic ulcer disease, mucosa-associated lymphatic tissue (MALT)…
Prolapsed fibroids presenting in pregnancy are rare. Two cases of bleeding prolapsed fibroids, one cervical and the other submucosal, are presented to demonstrate the clinical features and outcomes following surgical treatment during pregnancy. While vaginal myomectomy of a prolapsed cervical fibroid in pregnancy appears safe, prolapse of a submucosal fibroid…
Asthma is a chronic disease characterized by airway inflammation and hyperresponsiveness and is associated with significant yet avoidable mortality and morbidity resulting in considerable individual and societal burden. Inhaled corticosteroids are the most effective class of controller medication available today for treating persistent asthma and are the evidence-based guideline-recommended first-line…
Germinomas are gonadal neoplasms that rarely occur extragonadally in the midline structures of the human body. Newly diagnosed adult cases of pineal gland germinomas are very rare since most of the cases are diagnosed in the mid teens. The estimated incidence of this tumor in western countries is between 0.4–3.4%….
Alagille syndrome is a rare genetic disorder that results in intrahepatic cholestasis. Cardiac involvement mainly involves stenosis of branches of the pulmonary arteries. Aortic valve involvement is less common. To our knowledge, this is the first case of Alagille syndrome associated with severe aortic stenosis due to a bicuspid aortic…
To the Editor: Debate persists about the possible role of Helicobacter pylori infection in the pathogenesis of insulin resistance and type II diabetes. Although several cross-sectional, case-controlled studies have confirmed an association between H pylori infection and insulin resistance in different populations, others failed to demonstrate such association.1,2 To date,…
Objectives: Knowledge, attitudes, and behaviors of college students regarding melanoma and skin protection were examined. Methods: We surveyed 492 students at a mid-sized southern university. The Melanoma Risk Behavior Survey was administered in lecture classes. Results: Mean knowledge score was 10.6 ± 3.8 (24 questions). A majority of participants knew…
Placental growth factor (PIGF) belongs to a family of vascular endothelial growth factors (VEGF) which includes VEGF itself (also known as VEGF-A) and other homologues like VEGF-B, VEGF-C, VEGF-D, VEGF-E, and PIGF. These growth factors bind to vascular endothelial growth factor receptors (VEGFR) and have been implicated in atherosclerotic plaque…
A 66-year-old man with diabetes and hypertension using statin was admitted to the hospital with progressive myalgia. He had been on rosuvastatin for five months. After beginning the use of phosphodiesterase-5 inhibitors, he presented with severe muscle pain and maintained penile erection. Several days after interruption of therapy, muscle pain…
To the Editor: Agnogenic myeloid metaplasia (AMM), also known as chronic idiopathic myelofibrosis or myelofibrosis with myeloid metaplasia, is a clonal disorder of a multipotent hematopoietic progenitor cell of unknown etiology characterized by marrow fibrosis, myeloid metaplasia with extramedullary hematopoiesis, and splenomegaly.1 Secondary myelofibrosis and splenomegaly occur in a variety…
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