Issue - Southern Medical Association

Editorial

The Self and Asperger Syndrome

In this issue of the Southern Medical Journal Arora et al.1 present three patients with preexistent histories of Asperger syndrome (AS) later complicated by psychotic symptoms. These reports show improvement in psychosis with neuroleptic medications in two out of the three cases. The course of symptoms and response add to…

Editorial

Thrombocytosis in Patients with Polycystic Ovary Syndrome: Reactive or Culpable?

Polycystic ovary syndrome (PCOS) affects about 6-10% of women in the reproductive age-group, and is a common cause of female infertility. PCOS is a heterogeneous endocrine condition which in its classic phenotype is characterized by hyperandrogenism, chronic ovulation abnormalities, and the presence of polycystic ovaries on ultrasound.1 About 60% of…

Editorial

Is It Time for Carotid Artery Stenting in Low-Risk Patients?

Carotid artery stenting (CAS) has been increasingly adopted as a less invasive endovascular option of carotid revascularization in varied clinical populations. The SAPPHIRE (Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy) trial1 first demonstrated the superiority of CAS using embolic protection devices over carotid endarterectomy (CEA)…

Original Article

Protected Carotid Artery Stenting in Patients at High Risk for Carotid Endarterectomy

Objectives: To compare the 30-day, six-month, and one-year outcomes of carotid artery stenting (CAS) and carotid endarterectomy (CEA) in male veterans, and to identify any predictors of adverse outcomes. CAS has been shown to be non-inferior to CEA in patients at high-risk for CEA. The outcome of CAS compared to…

Review

Diffuse Alveolar Hemorrhage

Diffuse alveolar hemorrhage (DAH) is a life-threatening disorder characterized clinically by the presence of hemoptysis, falling hematocrit, diffuse pulmonary infiltrates and hypoxemic respiratory failure. It refers to bleeding that originates in the pulmonary microvasculature instead of the parenchyma or bronchial circulation. DAH should be considered a medical emergency due to…

Review

Diffuse Alveolar Hemorrhage

Commentary Bleeding into the alveolar spaces is the main characteristic of diffuse alveolar hemorrhage (DAH) and is due to disruption of the alveolar-capillary basement membrane. This is caused by injury or inflammation of the arterioles, venules, or alveolar septal (alveolar wall or interstitial) capillaries. Hemoptysis is the usual presenting symptom,…

Case Report

Isolated Unilateral Absence of the Right Pulmonary Artery

Isolated unilateral absence of the right pulmonary artery is an uncommon congenital disorder that may remain undiagnosed for prolonged periods of time. A brief overview of isolated unilateral absence of the right pulmonary artery is presented with a description of the typical clinical and radiographic findings associated with this anomaly.

Case Report

Gastrointestinal Kaposi Sarcoma with Appendiceal Involvement

Kaposi sarcoma is a vascular tumor manifesting as nodular lesions on skin, mucous membranes, or internal organs. This is a case of a 42-year-old human immunodeficiency virus- (HIV) positive bisexual male, not on highly active antiretroviral therapy (HAART) since diagnosis four years ago. He presented with a three-day history of…

Case Report

Constrictive-Like Physiology in Severe Pulmonary Hypertension: The Effect of the Valsalva Maneuver

We describe the case of a 37-year-old female with severe pulmonary hypertension on intravenous Remodulin® and Tracleer® who experienced presyncope following a six-minute walk. A transthoracic echocardiogram, in addition to showing the usual findings of chronic pulmonary hypertension, also demonstrated a noticeable increase in both mitral annular systolic and early…

Case Report

Constrictive-Like Physiology in Severe Pulmonary Hypertension: The Effect of the Valsalva Maneuver

Commentary Pulmonary hypertension is defined as elevation of the mean pulmonary artery pressure to greater than or equal to 25 mm Hg. The condition can be found in a wide range of clinical conditions and there is a wide diversity of causes. Its symptoms are nonspecific, making the workup and…

Letter to the Editor

Thrombocytopenia Following 90Yttrium Glass Microsphere Liver Radioembolization

To the Editor: We read with interest the article by Yang et al1 describing a case of profound transient thrombocytopenia after 90Yttrium resin microsphere therapy for surgically unresectable hepatocellular carcinoma (HCC). We have also recently encountered this uncommon adverse sequella of liver radioembolization after 90Yttrium glass microsphere (TheraSphere®; MDS Nordion,…

Spirituality/Medicine Interface Project

Spirituality and Cancer: An Introduction

A diagnosis of cancer is likely to precipitate spiritual reflection, if not spiritual crisis. It may even precipitate theological questions, challenging the understanding of God or one’s relationship with ultimate considerations, certainly existential issues when confronted with the possibility of nonexistence. We know that death is inevitable, but for much…

Spirituality/Medicine Interface Project

The Role of Spirituality in Hippocratic Medicine

To anyone studying the role of spirituality in Western medicine, the first few lines of the Hippocratic Oath should be of interest: “I swear by Apollo the Physician and Asclepius and Hygieia and Panaceia and all the gods, and goddesses, making them my witnesses, that I will fulfill according to…

Spirituality/Medicine Interface Project

Reflections on Cancer and Spirituality

As a psychiatrist and minister, I would like to reflect on my experience of cancer in the context of my spirituality. I discerned many spiritual aspects of my experience, both subjective and communal.

Spirituality/Medicine Interface Project

Spirituality and Medicine: Dying with Grace

I would like to share my experience of treating a patient with terminal illness, who had emigrated from India and practiced Hinduism. He was a 78-year-old male who came to the United States three years previously to live with his son. It was difficult for him to get adjusted to…

Spirituality/Medicine Interface Project

Understanding the Role of Religion in Cancer Care in Appalachia

Religion and spirituality may influence outcomes in cancer prevention and therapy and contribute to cancer disparities in deeply religious communities like the Appalachian region of the United States. Finding a method to bridge this division is essential to reduce cancer health disparities in this population. Religious beliefs may lead patients…

Spirituality/Medicine Interface Project

The Need for a New "New Medical Model": A Bio-Psychosocial-Spiritual Model

My experiences as a cancer patient have helped me understand the complexity of illness in ways which I could not fully appreciate as a physician trying to be attentive to my patients. My experiences with managed care helped me appreciate that our system of healthcare finance fundamentally misconstrues the nature…

Spirituality/Medicine Interface Project

Spirituality and Pediatric Cancer

Spiritual beliefs are an important source of comfort and support to many cancer patients and their families, but they may play a particularly large role when the patient is a child. Parents facing a child’s serious illness and possible death, and children themselves trying to make sense of illness, suffering,…