Primary care is considered an essential element of a highly developed health delivery system. Accumulated evidence derived from population studies consistently shows that a highly functioning primary care system, when used at its optimum capacity, provides affordable health care, improved quality of life and accessibility, and decreased disease burden and…
In addressing the question as to why students are not choosing careers in internal medicine at rates seen in the past, I was reminded of a conversation I had with my mentor1 Frederic C. Bartter, MD (FCB) in May of 1982 one year before his death,2 just days before I…
Adverse drug reactions (ADRs) are commonplace these days. With so many pharmaceuticals used to treat so many varied diseases in patients of varying types, it is no wonder that ADR case reports have become common. In this issue of the Southern Medical Journal Ji et al1 document a case of…
Chronic obstructive pulmonary disease (COPD) is a group of pulmonary diseases that share the characteristic of airflow limitation, which is progressive and not fully reversible. In the case of COPD, most commonly, a patient’s lungs are affected, but involvement of the extrapulmonary organs, such as the heart, also occurs. The…
The National Institutes of Health (NIH) reports that 26.2 percent of Americans 18 years and older suffer from a diagnosable mental disorder within a given year, and six percent of that number have a serious mental illness.1 This significant portion of the population has specific and unique needs within the…
Objectives: The transmission of drug-resistant human immunodeficiency virus 1 (HIV-1) has important implications for the antiretroviral management of newly diagnosed individuals, increasing the risk of suboptimal treatment outcomes. The study objective was to characterize rates and factors associated with transmitted drug-resistant HIV-1 infection among newly diagnosed South Carolina (SC) residents….
Postpartum depression (PPD) is a cross-cultural form of major depressive disorder that affects some 13% of women and can have serious health consequences for both the mother and her child. Easy-to-use, reliable, self-administered screening tools are available. PPD may have a variety of etiologies, which include changing plasma levels of…
We present the case of a 56-year-old woman with a one-month history of recurrent, migratory oligoarthritis. Laboratory tests were normal except for positive antinuclear antibody (ANA) titers. Imaging studies were normal. Palindromic rheumatism (PR) was considered as a diagnosis. In this brief report, we discuss the etiopathogenesis, clinical presentation, prognosis…
To the Editor: We read with great interest the article by Yetkin et al,1 which evaluated the potentials of cerebrospinal fluid (CSF) viscosity as a diagnostic modality for meningitis. The study was well designed and conducted, but we wonder if the authors considered confounding factors such as protein concentrations in…
Scientific Paper Abstracts Abstracts of Scientific Papers from Annual Meeting The following Poster Abstracts, presented at the Southern Medical Association’s Annual Scientific Assembly in Orlando, Florida, November 4–6, 2010, have been recommended by individual specialty reviewers and accepted for publication in this journal. Information on Poster Abstracts accepted and presented at the Annual Scientific Assembly…
The therapeutic decision, a good example for choice theory, can become a hard task when many options exist in the absence of well-defined criteria to support it. The difficulties are greater in infectious diseases, where the treatment or chemoprophylaxis often needs to be initiated in the absence of resistance data…
Objective: To better understand and characterize the challenges facing internal medicine from the perspective of internal medicine residency program directors. Methods: In 2007, internal medicine program directors were surveyed by the Association of Program Directors in Internal Medicine (APDIM). An open-ended question asked: “What are your major concerns regarding internal…
Background: The prevalence of Helicobacter pylori (H pylori) in Turkey is high and eradication rates are low. As a result, alternative treatment strategies are required. Objectives: To evaluate the status of H pylori eradication in Turkey by comparing the results of this study to other studies reported in the literature….
Objectives: Carbapenem-resistant Klebsiella pneumoniae (CRKP) has been increasingly reported all over the world. In this study, we aimed to investigate the risk factors for the acquisition of nosocomial CRKP infections. Methods: We conducted a case-control study with data collected from thirty-nine patients with nosocomially acquired CRKP infection between July 2006…
Objectives: To investigate the correlation between the clinical characteristics of chronic idiopathic urticaria (CIU) and the results of autologous serum skin test (ASST). Methods: This prospective observational study was performed in the Motahari Allergy Clinic and included 69 patients referred to the clinic with a diagnosis of CIU. ASSTs were…
Objective: We evaluated the morphological and parametric characteristics of the periodontal microcirculation in patients diagnosed as having hypercholesterolemia and high levels of low-density lipoprotein (LDL). Methods: Forty patients were recruited, 20 of whom were affected by hypercholesterolemia and 20 of whom were considered healthy. A videocapillaroscopic examination was carried out…
Diagnosis of chronic obstructive pulmonary disease (COPD) in primary care is complex, as many clinical symptoms are similar to asthma and heart disease, which may lead to misdiagnosis and suboptimal disease management. Spirometry is the best method for diagnosing COPD and distinguishing between COPD, asthma, and cardiovascular diseases. Airway obstruction…
Nephrolithiasis is a major cause of morbidity involving the urinary tract. The prevalence of this disease in the United States has increased from 3.8% in the 1970s to 5.2% in the 1990s. There were nearly two million physician-office visits for nephrolithiasis in the year 2000, with estimated annual costs totaling…
Combination of pegylated interferon and ribavirin has been the standard program for hepatitis C virus (HCV) infection. Pulmonary complications, although uncommon, have been reported in association with the use of interferon, and pleural effusion is rare. We report the second case of pleural effusion and interstitial pneumonitis in a patient…
Falls are caused by many factors in older patients. Medications have been shown to be a risk factor for falls, and studies have shown that patients taking more than five total medications may have a two-fold increased risk of impaired balance. A more recent model suggests only medications with sedating…
Hereditary spherocytosis (HS) is a familial hemolytic disorder with marked heterogeneity. A refractory chronic leg ulcer is an uncommon complication of HS, reported in fewer than two percent of patients. We present the case of a 28-year-old man who was suffering from a leg ulcer and was unresponsive to treatment…
Atomoxetine (Strattera®, Eli Lilly and Co.) is the first non-stimulant drug in the United States (US) to be approved for the treatment of attention deficit hyperactivity disorder (ADHD). In the past, physicians have been concerned about the safety of a variety of ADHD medications. As a result, non-stimulant drugs were…
To the Editor: We read with interest the paper on an unusual cause of chest pain by Chakraborty et al1 in the September 2009 issue of the Southern Medical Journal. We would like to share our experience.
To the Editor: We would like to thank Drs. Hong-Liang Zhang and Jiang Wu for their valuable comments on our paper, “Cerebrospinal Fluid Viscosity: A Novel Diagnostic Measure for Acute Meningitis” (South Med J 2010 Sep; 103(9): 892–5).1 Briefly, they have commented on the result of cerebrospinal fluid (CSF) viscosity…
To the Editor: I read the recent report on Helicobacter pylori (HP) and beta-2 microglobulin with great interest.1 In that article, Dincer et al concluded that “the serum beta-2 microglobulin level cannot be used as a simple marker of HP intensity and severity of inflammation in gastric endoscopic biopsies.” Of…
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