Southern Medical Journal back issues from December 2006:
2007 CME calendar of events.
Dec 01, 2006 ... Southern Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. * Licensed exclusively to SMA Services Inc. for marketing and distribution. REGISTER TODAY! ...
Integrated, collaborative disaster response networks.(Editorial)
Dec 01, 2006; ... Following the one year anniversary of Hurricanes Katrina and Rita, and the recent and current publications in the Southern Medical Journal regarding medical preparedness during times of disaster (1,2) it is appropriate to reflect on what we have learned and what we should we do differently ...
MALT lymphomas--a closer look in the Genomics era.(Editorial)
Dec 01, 2006; ... In 1832, an article titled "On some morbid appearances of the absorbent glands and spleen" was published in the journal 'Medico-Chirurgical Transactions'. (1) The author was Thomas Hodgkin (Fig. 1). Thus began an era of the study of a distinct group of tumors involving the lymphatic ...
Drug-drug interactions and statin therapy.
Dec 01, 2006; ... Drug-drug interactions (DDIs) among widely and chronically prescribed medications are a relevant health issue in clinical practice. Reported incidences in outpatients range from 9.2% to 70.3% for drug interactions of any severity and from 1.2% to 23.3% for those considered of major ...
Angiotensin-converting enzyme (ACE) inhibitor-induced acute pancreatitis: in search of the evidence.(Editorial)
Dec 01, 2006; ... Drug-induced pancreatitis is estimated to be responsible for nearly 2% of cases of acute pancreatitis. (1) Angiotensin-converting enzyme (ACE) inhibitors are some of the most widely prescribed medications. The occurrence of acute pancreatitis with several different ACE inhibitors including ...
Hurricanes Katrina and Rita: evacuee healthcare efforts remote from hurricane affected areas.(Original Article)
Dec 01, 2006; ... Abstract: Hurricanes Katrina and Rita produced the largest evacuation due to a natural disaster in United States history. Many people were evacuated or rescued from New Orleans and the Gulf Coast, resulting in a need for mass disaster shelters and medical care for months following the ...
Facing the malpractice crisis: academic physicians' willingness to accept quick fix solutions.(Original Article)
Dec 01, 2006; ... Background: We sought to determine the willingness of academic physicians to accept strategies to contain institutional malpractice costs. Methods: We surveyed all 270 Department of Medicine physicians at a large academic center. Respondents were asked about their knowledge ...
Chart documentation of informed consent for operative vaginal delivery: is it adequate?(Original Article)
Dec 01, 2006; ... Objectives: To determine the documentation frequency of informed consent for women undergoing a trial of nonemergent instrumental delivery. Study Design: A retrospective chart review of instrumented vaginal deliveries from 1992 to 2005 was performed. Cases were identified from a ...
Spirituality and depressive symptoms in primary care outpatients.(Original Article)(Clinical report)
Dec 01, 2006; ... Background: Although many studies have examined the relationship between religiosity and depressive symptoms in patient populations, there has been little work to understand and measure the effect of spirituality on depressive symptoms. Objective: The purpose of this study was ...
Southern Medical Journal CME topic: heart failure management.(CME Topic)
Dec 01, 2006 ... Need Heart failure is a prevalent and morbid chronic disease that occurs in stages. Progression through these stages can be slowed with optimal medical therapy. Initial workup for patients with newly diagnosed heart failure is directed at identifying the underlying cause of left ...
Update in the approach to and management of heart failure.(CME Topic)
Dec 01, 2006; ... Abstract: Heart failure (HF) is a prevalent and morbid chronic disease that patients experience in stages. Progression through the stages of HF can be slowed with optimal medical therapy. Although HF remains a clinical diagnosis made at the bedside, measurement of serum brain natriuretic ...
CME questions: update in the approach to and management of heart failure.(CME Topic)
Dec 01, 2006 ... 1. Stage A heart failure (HF) describes which of the following patient groups? a. Patients with structural heart disease who have past or current HF symptoms. b. Patients at risk for developing HF but without evidence of structural heart disease. c ....
Advances in the endoscopic management of patients with pancreatic and biliary malignancies.(Review Article)
Dec 01, 2006; ... Abstract: Major advances in endoscopic techniques to diagnose and manage pancreatic biliary diseases have fundamentally changed the approach to these difficult clinical challenges. The diagnosis of benign and malignant pancreatic-biliary diseases is much more readily obtained through a ...
Patent foramen ovale: assessment, clinical significance and therapeutic options.(Review Article)(Clinical report)
Dec 01, 2006; ... Abstract: Foramen ovale plays an important function in the fetus but is of no physiologic significance after birth and closes in most individuals. In about one fourth of the population, however, foramen ovale remains open for life and has been associated with cerebrovascular accidents, ...
Pharmacologic management of chronic insomnia.(Review Article)(Clinical report)
Dec 01, 2006; ... Abstract: Chronic insomnia is a common disorder that is under recognized, under diagnosed and under treated. Initial assessment should focus on identifying and treating, if present, any secondary causes of insomnia. Primary insomnia can be treated with behavioral and/or pharmacological ...
Primary mucosa-associated lymphoid tissue (MALT) lymphoma occurring in the rectum: a case report and review of the literature.(Case Report)(Disease/Disorder overview)
Dec 01, 2006; ... Abstract: The primary extranodal B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) is a distinct clinical pathologic entity that develops in diverse anatomic locations such as the stomach, salivary gland, thyroid, lung, and breast; however, colorectal involvement is rare. ...
Lipid lowering inefficacy of high-dose statin therapy due to concurrent use of phenytoin.(Case Report)(Clinical report)
Dec 01, 2006; ... Abstract: HMG-CoA reductase inhibitors ("statins") are the most commonly prescribed lipid lowering agents. Most of the statins are metabolized by the CYP450 cytochrome system. A number of medications either induce or inhibit this system which leads to changes in the bioavailability of the ...
Recurrent acute pancreatitis probably secondary to lisinopril.(Case Report)(Clinical report)
Dec 01, 2006; ... Objectives: Few data exist about the incidence of drug-induced acute pancreatitis in the general population. Although angiotensin-converting enzymes are generally well tolerated, acute pancreatitis has been reported in a few subjects treated with captopril, enalapril, and lisinopril ....
Hypertrophic cardiomyopathy and symptomatic conduction system disease in cardiac amyloidosis.(Case Report)(Clinical report)
Dec 01, 2006; ... Abstract: Cardiac involvement is the most important prognostic factor in primary amyloidosis (AL). The clinical presentation of amyloid cardiomyopathy is varied and may manifest as heart failure, brady or tachyarrhythmias, syncope, angina and rarely with features of hypertrophic ...
A case of skin hypopigmentation secondary to a corticosteroid injection.(Case Report)
Dec 01, 2006; ... Abstract: A 47-year-old African-American male presented complaining of Achilles tendon pain. The patient was treated for three weeks with a nonsteroidal anti-inflammatory agent with minimal pain relief. The tendon was subsequently injected with triamcinolone acetonide and five months ...
Metastatic malignant pleural mesothelioma to the breast.(Case Report)(Clinical report)
Dec 01, 2006; ... Abstract: A 51-year-old woman suffered from dyspnea for several days before she came to an outside clinic for help. Pleura biopsy was performed and the histologic diagnosis was malignant mesothelioma. Sixteen months later, a palpable left breast lump was noted. Physical ...
Invasive aspergillosis in immunocompetent patients.(Letter to the editor)
Dec 01, 2006; ... To the Editor: We read with interest the case report by Garcia and colleagues regarding an apparently immunocompetent individual. (1) As the authors state, invasive aspergillosis is mainly encountered in patients suffering from severe immunodeficiency, such as hematologic malignancy, or in ...
Recovery from Munchausen syndrome.(Letter to the editor)
Dec 01, 2006; ... To the Editor: In 1998, I published an article in the SMJ entitled, "Breaking the Silence of Factitious Disorder." (1) Through the article, a patient, dubbed "Cathy," sought to inform physicians not only about the range of factitious illness behaviors in which she had engaged, but also ...
Hepatotoxicity after low-dose cyclophosphamide therapy.(Letter to the editor)
Dec 01, 2006; ... To the Editor: Hepatotoxicity during high-dose cyclophosphamide (CYC) therapy has been reported, (1,2) but hepatitis due to low-dose CYC treatment has rarely been described. (3) We report a 40-year-old male patient diagnosed with primary scleroderma, treated with D-penicillamine (D-PEN) ...
Edematous obstructive sleep apnea patients have low normal serum albumin levels.(Letter to the editor)
Dec 01, 2006; ... To the Editor: Previous research has shown that unexplained edema is associated with obstructive sleep apnea (OSA) in women. (1) Moreover, OSA has been shown to cause edema, for nasal continuous positive airway pressure reduces the amount of edema in OSA patients. (2) It is unclear why ...
Closure of round cutaneous postoperative wounds with the purse string suture.(Letter to the editor)
Dec 01, 2006; ... To the Editor: The intradermal (1-3) and cuticular (4) purse string sutures are inexpensive, rapid procedures which are easily learned and can be useful for the complete (1,2) or partial (3,4) closure of cutaneous surgical wounds. They are especially suited for the repair of round, ...
An adolescent with chest pain.(Letter to the editor)
Dec 01, 2006; ... To the Editor: Chest pain in adolescents and young adults is a common presentation in the emergency department. Chest pain in children is rarely caused by organic conditions; however, it requires careful evaluation as many noncardiac conditions may present with chest pain. This report ...
Payment as motivator in Iranian medical students' attitudes toward research.(Letter to the editor)
Dec 01, 2006; ... To the Editor: We performed a study regarding medical student attitudes toward research at Shiraz University in Iran. We found that the majority of Iranian medical students believed that payment was an important factor in encouraging research activities. We questioned 70 medical ...
Primary aldosteronism and secondary hyperparathyroidism of the vitamin D deficiency.(Letter to the editor)
Dec 01, 2006; ... To the Editor: The relationship between vitamin D, parathyroid hormone (PTH) and hypertension has been discussed in the literature. However, to our knowledge, primary aldosteronism associated with vitamin D deficiency has not been reported. We present a patient with simultaneous ...
Post Abortion Survivor Syndrome (PASS): signs and symptoms.(Letter to the editor)
Dec 01, 2006; ... To the Editor: Observations of psychiatric patients led me to believe that some were deeply affected by pregnancy losses, particularly abortion; both theirs and their parents'. It appeared that there were deep existential conflicts, experienced by survivors that result in many psychiatric ...
Percutaneous computed tomography-guided needle aspiration drainage of spinal epidural abscess.(Letter to the editor)
Dec 01, 2006; ... To the Editor: Spinal epidural abscess is an uncommon disease but one with potentially devastating neurologic consequences if not diagnosed and treated appropriately. Historically, surgical intervention has been widely accepted as the mainstay of treatment in most instances. However, ...
Baseline electrocardiographic changes as determinants in the prognosis of cerebrovascular accidents.(Letter to the editor)
Dec 01, 2006; ... To The Editor: The effect of brain injury on the heart was demonstrated in experimental animals in the 1930s. (1) Subsequently, several studies have investigated the effect of brain injury on the heart, but few have addressed the prognostic significance of these changes. (2) This study was ...
Prolonged livestock exposure and elevated serum IgE associated with pulmonary fibrosis.(Letter to the editor)
Dec 01, 2006; ... To the Editor: A 48-year-old man presented to the pulmonary clinic with a 2-year history of a persistent dry cough, dyspnea, and an abnormal chest x-ray. The patient smoked 20 cigarettes daily for 20 years. He worked in an animal research laboratory for 12 years. He was exposed to ...
Medical webwatch.(Special Section)(Icarus.med.utoronto.ca/NeuroExam/)(Asseenfromhere.com)(Ti.ubc.ca/pages/letter.html)(Website list)
Dec 01, 2006; ... The three icons on the front page of The Neurological Exam http://icarus.med.utoronto.ca/NeuroExam/ are hyper-linked to short audiovisual tutorials that describe cranial, motor, and sensory examination technique. The explanations progress slowly through each procedure and are excellent for ...
Patient's page.(Special Section)(patient health management)(Reprint)
Dec 01, 2006; ... Spirituality and Health: What Your Doctor Needs to Know Many patients feel hesitant to talk to their physician about spiritual matters, but when religion or spirituality is an important part of a person's life, doctors should be made aware of this fact, especially if one's faith ...
A historical look at hypertension: celebrating 100 years with the Southern Medical Association.(Special Section: SMA Centennial)
Dec 01, 2006; ... As the Southern Medical Association (SMA) celebrates its 100th year anniversary, it is appropriate to look back on how the Southern Medical Journal (SMJ) has influenced the diagnosis and treatment of hypertension over the past century. Hypertension, as we currently know it, had ...
To condone or to condemn? On the ethics of stem cell research.(Special Section: Spirituality/Medicine Interface Project)
Dec 01, 2006; ... Depending on the origin of the cells, stem cell research can be classified into embryonic or nonembryonic stem cell research. In the latter group, cells are harvested from a variety of hosts without detriment to the donor. Embryonic stem cell research, on the other hand, entails the ...
The sound of science: the power to bless or to burn.(Special Section: Spirituality/Medicine Interface Project)
Dec 01, 2006; ... Throughout history, but particularly over the course of recent years, advances in the biomedical sciences have granted humankind an ever-greater understanding and mastery over itself. In this perpetual revolution, perhaps there has been no greater chapter than that of the much-heralded ...
Promethean medicine: spirituality, stem cells, and cloning.(Special Section: Spirituality/Medicine Interface Project)
Dec 01, 2006; ... Abstract: Every ethos implies a mythos. That is, every ethical system depends upon some fundamental story disclosing its assumptions about human nature, freedom, good and evil, and the workings of the universe. A romanticized version of the myth of Prometheus, who stole fire from the gods ...
Internal morality of motherhood and integrity of physicians in the era of assisted reproductive technologies (ARTs).(Special Section: Spirituality/Medicine Interface Project)(Viewpoint essay)
Dec 01, 2006; ... Assisted reproductive technologies (ARTs) (1) have posed significant new ethical challenges about the characteristics, meaning and values of creation of human life and human person, parenthood, medicine, and society. By increasing reliance on ARTs, (2) human procreation may become a ...
Cloning: US and global perspectives.(Special Section: Spirituality/Medicine Interface Project)
Dec 01, 2006; ... It has been said that the cloning of Dolly the sheep in 1996 bifurcates the history of the world. It announces to humankind that we are in line to become not only the creators of our own selves, but, in sad tandem, also its creatures, the products of our own inventive selves, Homo sapiens ...
Human embryonic stem cells: a justification for their use in medical therapeutics.(Special Section: Spirituality/Medicine Interface Project)
Dec 01, 2006; ... It seems widely accepted that the United Kingdom (UK) has led the way in introducing legislation to regulate clinical practice in assisted reproduction. The UK Human Fertilization and Embryology Act was passed in 1990 and has been mimicked by similar legislation in many other countries ....
Current status of research using human embryonic stem cells.(Special Section: Spirituality/Medicine Interface Project)
Dec 01, 2006; ... Stem cells are undifferentiated and pluripotent--they are able to transform into a number of mature cell types, given the correct environment. A stem cell culture is capable of self-replication and, hence, has a theoretically infinite capacity for self-renewal. In essence, stem cells can ...
"No" to embryonic stem cells.(Special Section: Spirituality/Medicine Interface Project)
Dec 01, 2006; ... There are two types of human embryonic stem cell (hESC) research: one using embryos left over from in vitro fertilization (IVF) treatment, the other using cloned embryos. In the United Kingdom (UK), the Human Fertilisation and Embryology Authority (HFEA) has granted licenses to clone ...
"Yes" to adult stem cells.(Special Section: Spirituality/Medicine Interface Project)
Dec 01, 2006; ... Every life, especially every human life, is precious to God. Even the human embryo that comes into existence in the laboratory is precious to God. Hence, it is not for us to take the life of a human embryo, whatever its provenance. An ethical alternative to the use of embryonic ...
Integrative research: the approach at the Harvard Stem Cell Institute.(Special Section: Spirituality/Medicine Interface Project)
Dec 01, 2006; ... Perhaps no area of biologic research has so excited the public imagination in the past decade as stem cell science, which both the general public and scientific community believe holds great promise for future therapies for disease and traumatic injury. Even though the science is in its ...
Eye on religion: understanding the cultural/religious melange in treating Japanese patients.(Special Section: Spirituality/Medicine Interface Project)
Dec 01, 2006; ... Until late 19th century, Japanese health care was closely tied to medical practices that migrated from China. Herbal preparations and poultices, external physical manipulations, moxibustion, astrology, divining procedures, shamanism, and appealing to ancestors and deities were all methods ...
Eye on religion: Buddhism and medicine.(Special Section: Spirituality/Medicine Interface Project)(Viewpoint essay)
Dec 01, 2006; ... For those not familiar with Buddhism and seeing Buddhism as a religion, they might be fascinated by some common threads that inform both medicine and Buddhism. We will explore both the commonality and differences of emphasis or perspective. Crucial to both Buddhism and medicine ...
Eye on religion: by the brush and by the sword: Daoist perspectives on the body, illness, and healing.(Special Section: Spirituality/Medicine Interface Project)(Viewpoint essay)
Dec 01, 2006; ... Daoism (Taoism) has been called China's indigenous high religion, and stands alongside Confucianism and Buddhism as one of the Three Teachings (sanjiao) of that civilization. While many readers in the West may possess at least a passing familiarity with classical texts such as the Daode ...
Selected annotated bibliography on stem cell research and cloning.(Special Section: Spirituality/Medicine Interface Project)(Bibliography)
Dec 01, 2006; ... Rosenthal N. Prometheus's vulture and the stem-cell promise. N Engl J Med 2003;349:267-274. More questions than answers exist surrounding the powers and potential of stem cells. A great deal of uncertainty abounds about both embryonic and adult stem cells, much of which has been ...