Issue - Southern Medical Association

Invited Commentary

Commentary on “Tiotropium in the Treatment of Patients with Asthma”

Neural control of the airways occurs almost exclusively through the vagal nerve, and activation of this cholinergic system results in bronchoconstriction and mucus hypersecretion. The primary transmitter, acetylcholine, released from prejunctional parasympathetic synapses, acts upon muscarinic receptors, of which five distinct subtypes have been identified (M1-M5). Three of these subtypes…

Original Article

Prescriptions for a Toxic Combination: Use of Methotrexate Plus Trimethoprim-Sulfamethoxazole in the United States

Objectives: To determine the frequency of using the potentially toxic combination of methotrexate and trimethoprim-sulfamethoxazole (TMP-SMX) in outpatient practice in the United States. Methods: Data from the National Ambulatory Medical Care Survey for 1993–2010 were used to assess the frequency of using methotrexate with TMP-SMX and associated physician specialties and…

Review Article

Acromioclavicular Osteoarthritis: A Common Cause of Shoulder Pain

Osteoarthritis of the acromioclavicular joint is a frequent cause of shoulder pain and can result in significant debilitation. It is the most common disorder of the acromioclavicular joint and may arise from a number of pathologic processes, including primary (degenerative), posttraumatic, inflammatory, and septic arthritis. Patients often present with nonspecific…

General Information

CME Instructions

CME Instructions

Original Article

Physicians Caring for Physicians: The Perspective of the Primary Care Physician

Objectives: How physicians provide longitudinal primary care to physician-patients (ie, physicians as patients) has not been well studied. The potential challenges of providing care to physician-patients include maintaining professional boundaries and adhering to practice guidelines. The objective was to explore the differences in identifying how physicians perceive caring for physicians-patients…

Invited Commentary

Commentary on “Feeding After Percutaneous Endoscopic Gastrostomy: Experience of Early Versus Delayed Feeding”

Percutaneous endoscopic gastrostomy (PEG) is a common procedure performed in patients with intact gastrointestinal function who are unable to meet their nutritional requirements orally for a multitude of reasons. Developed by Ponski and Gauderer in the 1980s,1 PEG insertion has supplanted surgical placement as a means of establishing an effective…

Original Article

Endoscopic Surveillance for Gastric Ulcers

Objective: Gastric ulcers (GUs) can be caused by a malignancy, and endoscopists are challenged with the question of how to rule out underlying malignancy. Although routine endoscopic surveillance is not advised, it is still overused. The purpose of this study was to explore the practice in our tertiary referral center…

Review Article

Tiotropium in the Treatment of Patients with Asthma

Background: Asthma is a chronic disease with a significant disease burden, and many patients fail to achieve disease control despite recommended medical therapy. Recent evidence suggests that there may be benefits to the use of the long-acting anticholinergic agent tiotropium in patients with asthma. Methods: We performed a systematic review…

Original Article

Patterns of Internet Use by Gastroenterologists in the Management and Education of Patients with Inflammatory Bowel Disease

Aims: To define the patterns of Internet use among physicians who treat inflammatory bowel disease (IBD) and physicians’ perceptions of their patients’ Internet use. Methods: An online survey about physician and patient use of the Internet was created and e-mailed to gastroenterologists nationwide. Surveys were distributed and collected via an…

Original Article

Geographic Variations of Racial/Ethnic Disparities in Cervical Cancer Mortality in Texas

Objectives: To examine how racial/ethnic disparities of cervical cancer mortality vary geographically and to identify factors contributing to the variation. Methods: Using the population-weighted risk difference, the authors investigated geographic patterns of racial/ethnic disparities in cervical cancer mortality in Texas based on data from 1995 to 2008 georeferenced at the…

Original Article

Maternal Mortality in the Mississippi Delta Region

Objective: To compare the maternal mortality rate (MMR) in the Mississippi Delta region of the United States with that of the non-Delta region states. Methods: Analyzed data come from national birth certificate and death certificate data for 1999–2007. Data were aggregated for analysis by region, counties of the Delta Regional…

Invited Commentary

Commentary on “Physicians Caring for Physicians: The Perspective of the Primary Care Physician”

Everyone at some point in his or her life needs health care, and physicians are no exception. When physicians do seek care, little is known about how they view their health care, their perceptions of the benefits and challenges of such care, and what strategies were used to provide health…

Original Article

Analysis of Fall Injuries by Body Mass Index

Objective: To examine the association of body mass index (BMI) and fall injuries. Methods: Data were derived from the 2010 Behavioral Risk Factor Surveillance System and included subjects aged 45 years and older from Texas. The outcome was self-reported falls that resulted in injury to the respondents. Analysis of fall…

Original Article

Feeding After Percutaneous Endoscopic Gastrostomy: Experience of Early Versus Delayed Feeding

Background: Multiple studies have demonstrated that feeding ≤4 hours after placement of a percutaneous endoscopic gastrostomy (PEG) tube is a reasonable option. Many physicians, however, continue to delay feedings until the next day or 24 hours; therefore, we evaluated the safety and effect of early feeding (≤4 hours) after PEG…

Original Article

Using Motivational Interviewing for Smoking Cessation in Primary Care

Objectives: To compare the effects of resident physician motivational interviewing (MI), resident physician MI plus registered nurse (RN), and the standard of care counseling approach— ask, advise, assess, assist, and arrange follow-up (5 As)—on current smokers’ behaviors (readiness to quit, cigarettes smoked per day, current smoking rates), self-efficacy to quit…

Invited Commentary

Commentary on “Maternal Mortality in the Mississippi Delta Region”

In this issue of the Southern Medical Journal, Magann and colleagues present evidence of a significantly greater maternal mortality rate (MMR) in the Mississippi Delta region compared with the non-Delta regions of the United States.1 The MMR is a useful proxy for revealing inequality of high-quality health care. The World…