Issue - Southern Medical Association

Original Article

Utility of Lower Extremity Doppler in Patients with Lower Extremity Cellulitis: A Need to Change the Practice?

Objectives: Cellulitis and deep vein thrombosis (DVT) in the lower extremities (LE) often have similar presentations: erythema, swelling, and calf tenderness. The overlap of these symptoms often results in physicians ordering unnecessary LE Doppler ultrasounds in patients with LE cellulitis. This practice leads to subjecting patients to unwarranted procedures and…

Review Article

When Should a Patient with a Nonvariceal Upper Gastrointestinal Bleed Be Fed?

Nonvariceal upper gastrointestinal hemorrhage is a common cause for admission to the intensive care unit. Most patients are prohibited from oral or enteral feeding for 72 hours despite different risks for rebleeding. Fasting is believed to improve the ability to control intragastric pH, stabilize clots, and reduce the risk of…

Invited Commentary

Commentary on “Two Types of Prehospital Systems Interventions that Triage Low-Acuity Patients to Alternative Sites of Care”

Throughout the developed world, availability of care in an emergency department (ED), often as part of an inpatient care facility, is a staple ofthe social safety net. In the United States annual usage rates continue to climb, with a record 134 million visits nationwide in 2012.1 Of these patients, approximately…

Original Article

Two Types of Prehospital Systems Interventions that Triage Low-Acuity Patients to Alternative Sites of Care

Objectives: This study retrospectively compared alternatives for navigating low-acuity patients in two emergency medical services systems. System A involved a response to every 9-1-1 request with an “evaluate, treat, and refer” process, in which paramedics decided whether patients could be treated on-scene and referred to a primary care provider or…

Invited Commentary

Commentary on “Antithrombotic Therapy Practices in Older Adults Residing in the Long-Term Care Setting”

In this issue of the Southern Medical Journal, Kozikowski and colleagues present a retrospective review that attempts to explore the pattern of antiplatelet/anticoagulant use by physicians when caring for older adult patients in a long-term care facility.1 The information collected by the researchers illustrates that physicians have varied patterns of…

Original Article

Investigation of Pertussis Cases in a Texas County, 2008–2012

Objectives: Within the past 25 years, there has been a dramatic increase in the incidence of pertussis cases in the United States. As such, this investigation reports on the high-risk groups and describes risk factors of pertussis cases in a large Texas county. Methods: This study was a cross-sectional analysis…

Original Article

Antithrombotic Therapy Practices in Older Adults Residing in the Long-Term Care Setting

Objectives: To explore physician practice patterns with regard to antithrombotic therapy, including antiplatelets and anticoagulants, in long-term care residents and compare resulting embolic complications. Methods: Conducted between August 2012 and March 2013, this study was a retrospective chart review of 400 residents of a long-term care facility. Electronic charts from…

Original Article

Fetal Mortality in the Delta

Objectives: To compare the fetal mortality rate in the Delta counties of a state in the Mississippi Delta region of the United States with that of the non-Delta counties of the same state. Methods: Hospital discharge data for maternal hospitalizations were linked to fetal death and birth certificates for 2004–2010….

Original Article

Streptococcus bovis Bacteremia: Association with Gastrointestinal and Liver Disease in a Predominantly Hispanic Population

Objectives: Streptococcus bovis bacteremia has been associated with gastrointestinal diseases, especially colon cancer, neoplastic colon polyps, and other malignancies of the gastrointestinal tract. Studies have suggested an association with chronic liver parenchymal and biliary tract disorders. We report a series of patients with S. bovis bacteremia in a county hospital…

Review Article

Relative Merits of Low-Carbohydrate Versus Low-Fat Diet in Managing Obesity

Objectives: Although low-fat diets (LFD) have been the cornerstone of dietary guidelines for weight reduction, low-carbohydrate diets (LCD) continue to gain attention and popularity. Which diet can achieve significant and sustainable weight loss in unclear, however. Our objective in this study was to compare LCDs with LFDs and their impact…

Invited Commentary

Commentary on “Relative Merits of Low-Carbohydrate Versus Low-Fat Diets in Managing Obesity”

The article ‘‘Relative Merits of Low-Carbohydrate Versus Low-Fat Diets in Managing Obesity’’ by Alexandraki and colleagues in this issue of the Southern Medical Journal is a detailed study of research published between January 2001 and October 2014.1 It compares the effects of low-carbohydrate diets versus low-fat diets on weight loss…

Invited Commentary

Commentary on “Streptococcus bovis Bacteremia: Association with Gastrointestinal and Liver Disease in a Predominantly Hispanic Population”

Streptococcus bovis (S. bovis) is a Gram-positive cocci that includes four major species, all of which are a small percentage of the normal flora of the gastrointestinal tract. Bacteremia of S. bovis has been associated with both colonic neoplasia and chronic liver disease. In this issue of the Southern Medical…

Invited Commentary

Commentary on “Patient Selection for Drip and Ship Thrombolysis in Acute Ischemic Stroke”

In this issue of the Southern Medical Journal, Lyerly and colleagues report their findings from a retrospective analysis comparing patients who were ‘‘dripped and shipped’’ from an outside hospital to their academic stroke center with those who presented directly to their center and were treated on-site with intravenous tissue plasminogen…

Original Article

Toward Successful Implementation of Speech Recognition Technology: A Survey of SRT Utilization Issues in Healthcare Settings

Purpose: To evaluate physician utilization of speech recognition technology (SRT) for medical documentation in two hospitals. Methods: A quantitative survey was used to collect data in the areas of practice, electronic equipment used for documentation, documentation created after providing care, and overall thoughts about and satisfaction with the SRT. The…

Original Article

Patient Selection for Drip and Ship Thrombolysis in Acute Ischemic Stroke

Objectives: The drip and ship model is a method used to deliver thrombolysis to acute stroke patients in facilities lacking onsite neurology coverage. We sought to determine whether our drip and ship population differs from patients treated directly at our stroke center (direct presenters). Methods: We retrospectively reviewed consecutive patients…