Issue - Southern Medical Association

Review Article

Diabetes Mellitus and the Skin: Recognition and Management of Cutaneous Manifestations

Diabetes mellitus (DM) is a heterogeneous condition characterized by hyperglycemia as a consequence of defects in insulin secretion and variable degrees of insulin resistance. DM is the most common endocrine disorder in the United States, affecting 9.3% of the population (29.1 million people) in 2014. Skin disorders are present in…

Original Article

Relations Between Residential Proximity to EPA-Designated Toxic Release Sites and Diffuse Large B-Cell Lymphoma Incidence

Objectives: Examining the spatial patterns of diffuse large B-cell lymphoma (DLBCL) incidence and residential proximity to toxic release locations may provide insight regarding environmental and sociodemographic risk factors. Methods: We linked and geocoded cancer incidence data for the period 1999–2008 from the Georgia Comprehensive Cancer Registry with population data from…

Review Article

Atrioventricular Accessory Pathways: Mechanisms, Electrocardiograms, and Associated Arrhythmias

An atrioventricular accessory pathway (AP) may be manifest or concealed. When manifest, it leads to preexcitation on the baseline electrocardiogram, which is called the Wolff-Parkinson-White pattern. The degree of preexcitation varies according to the relative conduction speed of the atrioventricular node versus the AP, the AP location, and the AP…

Original Article

Unattended Sleep Studies in a VA Population: Initial Evaluation by Chart Review Versus Clinic Visit by a Midlevel Provider

Objectives: Obstructive sleep apnea (OSA) is a prevalent disorder that is associated with multiple medical consequences. Although in-laboratory polysomnography is the gold standard for the diagnosis of OSA, portable monitors have been developed and studied to help increase efficiency and ease of diagnosis. We aimed to assess the adequacy of…

Review Article

Pharmacogenomics Can Enhance Prescribing of Psychiatric Medications

Many psychiatric patients experience pharmaceutical intolerances, and some of them do not derive optimal efficacy from their pharmacotherapies. Clinical problems such as these may result in prolonged dysfunction, adverse consequences, and repeated changes in medication treatment regimens. Pharmacogenomics is a laboratory method that aids individualized medication selection by predicting drug…

Original Article

Body Mass Index and Physical Inactivity: 2013 BRFSS

Objectives: Examine the odds of adults reporting physical inactivity (PI) across six body mass index (BMI) categories. Methods: We used data from the 2013 Behavioral Risk Factor Surveillance System. Six BMI categories were used. Results: The odds of reporting PI in underweight men and men in the class I, II,…

Original Article

Healthcare Industry Injuries by Patient Contact Status in Kentucky, 2012–2014

Objectives: The healthcare industry continues to have a high number of reported injuries. The purpose of this study was to characterize healthcare industry injuries by patient contact status, identify the occupations associated with healthcare injuries by patient contact status, and determine healthcare injury rates by occupation to gain a better…

Original Article

Frequency of Adverse Events Before, During, and After Hospital Admission

Objectives: Adverse events (AEs) are unintended physical injuries resulting from or contributed to by medical or surgical care. We determined the frequency and type of AEs before, during, and after hospital admission. Methods: We conducted a cohort study of 296 adult hospital patients. We used the standardized Institute for Healthcare…

Original Article

Intravenous Thrombolysis Attenuates Neurologic Deterioration After Ischemic Stroke

Introduction: Although intravenous tissue plasminogen activator (IV tPA) is associated with neurologic deterioration (ND) caused by hemorrhage, whether it attenuates deterioration as a result of other etiologies including progressive stroke remains unexplored. The objective of this study was to determine whether IV tPA is associated with a reduced risk of…

Invited Commentary

Commentary on “Should Antibiotic Allergy Alerts Be Alarming?”

When it comes to choosing an antibiotic for surgical prophylaxis in the “allergic” patient, the “just to be safe” approach is well known to those working in the operating room. As illustrated in the article by Terpening in this month’s issue of the Southern Medical Journal, both the documentation, and…

Editor's Response

Editor’s Response

To the Editor: I appreciate Ms Breiburg and Dr Kuschner taking the time to comment on my editorial entitled ‘‘I’m Dying, but I’m Not Dead Yet: Patient Decisions About Dying and Death.’’1 The authors’ perspectives are particularly germane owing to their service in clinical bioethics to the patients in the…

Review Article

Should Antibiotic Allergy Alerts Be Alarming?

Allergies to various antibiotics are reported by a substantial proportion of patients. As a result, clinical decision support programming generates frequent warnings when prescribing within electronic medical records. For a variety of reasons, the majority of these warnings may be inappropriate. Our improved understanding of the underlying physiology of allergic…


Evaluating Sustainable Development Goal Targets: A Physician’s Perspective

For the next 15 years, the global response to poverty, rising inequality, and other challenges to sustainable development will be guided by the United Nations’ 2030 Agenda for Sustainable Development,1 referred to in its preamble as a “plan of action for people, planet and prosperity.” This agenda comprises 17 Sustainable…

Original Article

Hemophagocytic Lymphohistiocytosis and Bone Marrow Hemophagocytosis: A 5-Year Institutional Experience at a Tertiary Care Hospital

Objective: The purpose of this study was to correlate the significance of bone marrow hemophagocytosis and analyze outcome data in patients with suspected hemophagocytic lymphohistiocytosis (HLH) at a tertiary care hospital during the course of 5 years. Methods: The pathology database of State University of New York Upstate Medical University,…

Letter to the Editor

On “I’m Dying, but I’m Not Dead Yet: Patient Decisions About Dying and Death”

To the Editor: In his April 2016 Southern Medical Journal editorial ‘‘‘I’m Dying, But I’m Not Dead Yet’: Patient Decisions About Dying and Death,’’1 Dr Holt highlights the value of the advance directive and the durable power of attorney for health care in promoting ‘‘[a] meaningful discussion between physician and…

Original Article

Hormonal Contraceptives for Endometrial Cancer Prevention in Obese and High-Risk Women in Virginia

Objectives: Endometrial cancer remains the fourth most common malignancy among US women, and hormonal contraceptives drastically reduce this risk. The study objectives were to assess the prescribing patterns, counseling practices, and knowledge of family physicians and obstetrician/gynecologists (OB/GYNs) regarding hormonal contraceptives, obesity, and cancer prevention. Methods: A 25-question survey was…

Invited Commentary

Commentary on “Diabetes Mellitus and the Skin: Recognition and Management of Cutaneous Manifestations”

Diabetes mellitus (DM) constitutes a major public health problem and a rapidly growing epidemic in the United States.1 The 2014 National Diabetes Statistics Report estimated that 29.1 million people, or 9.3% of the US population, have DM.2

Invited Commentary

Commentary on “Intravenous Thrombolysis Attenuates Neurologic Deterioration After Ischemic Stroke”

In the article “Intravenous Thrombolysis Attenuates Neurologic Deterioration After Ischemic Stroke,” Siegler and Martin-Schild attempt to determine the reduction of neurologic deterioration caused by stroke progression in acute stroke patients who received intravenous tissue plasminogen activator (IV tPA) compared with those who did not in their hospital cohort.1