Abstract:
BACKGROUND:The nursing home clinician may encounter euthyroid residents with low total serum thyroxine (T4) values associated with certain medications or nonthyroidal illness (NTI). Hypothyroidism may be incorrectly diagnosed and thyroid hormone prescribed. METHODS:We reviewed all T4 determinations and individuals with low T4 and normal thyroid-stimulating hormone (TSH) levels were identified. Pharmacy and medical records were reviewed. RESULTS:We reviewed 1,153 T4 determinations and identified 22 individuals with low T4 and normal TSH values. Eight of the 22 (36%) were being treated with high-dose salicylates, 4 (18%) with phenytoin, 3 (14%) with carbamazepine, and 2 (9%) with prednisone (15 mg/day). Three residents were on two of these medications. None was on prednisone as a single medication. Eight were on none of the medications, and 5 of these had albumin values of < or = 3.2 g/dL (a marker of NTI). After a low T4 value was determined in these individuals, 6 of the 22 were placed on T4 replacement with no documentation of hypothyroidism. In 5 of these, low T4 level could be attributed to a medication effect. CONCLUSIONS:Low total T4 with normal TSH levels are commonly associated with medications and NTI.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Amberson J,Drinka PJdoi
10.1097/00007611-199805000-00005subject
Has Abstractpub_date
1998-05-01 00:00:00pages
437-40issue
5eissn
0038-4348issn
1541-8243journal_volume
91pub_type
杂志文章abstract::Two premature infants were infected with HIV via blood transfusions during the neonatal period. Although neither patient had serum antibody to HIV owing to severe hypogammaglobulinemia, HIV infection was confirmed by finding HIV antigen in the sera of both patients. These cases show that HIV infection can produce seve...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198904000-00005
更新日期:1989-04-01 00:00:00
abstract::A 64-year-old female patient presented with acute cerebellar ataxia. After ruling out vascular, infectious, metastatic, demyelinating, and medication etiologies, a paraneoplastic origin for her illness was determined. A renal mass was discovered and found to be renal cell carcinoma. Her symptoms resolved after a radic...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31816bea80
更新日期:2008-05-01 00:00:00
abstract::Angioedema has not been associated with losartan therapy in hemodialysis patients, as it has been with angiotensin converting enzyme (ACE) inhibitors. We report the case of a hemodialysis patient who previously had angioedema after therapy with ACE inhibitors and again had angioedema while taking losartan. We suggest ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199705000-00020
更新日期:1997-05-01 00:00:00
abstract::Safety restraints have proven effective in the prevention of serious automobile injuries and deaths, but safety education has been ineffective in getting consumers to use restraints. We surveyed the personal and counseling practices of a group of pediatricians over a one-year period to determine whether prenatal and p...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198110000-00003
更新日期:1981-10-01 00:00:00
abstract::The use of psychostimulants as antidepressants remains controversial in the field of psychiatry. While methylphenidate hydrochloride (MPH) and dextroamphetamine (DA) are often considered to be equivalent drugs, differences in their neurobiologic mechanism of action may account for different clinical response patterns....
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199210000-00012
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:In this study, the clinical characteristics, survival, and prognostic factors of 200 patients diagnosed as having chronic lymphocytic leukemia (CLL) were analyzed. METHODS:The medical charts of 200 CLL patients registered to our center between 1984 and 2000 were retrospectively evaluated. RESULTS:Of all pa...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000053674.03385.B7
更新日期:2004-03-01 00:00:00
abstract::Forty consecutive patients having left ventricular (LV) aneurysmectomy were evaluated for surgical risk predictors and were then followed up after operation. Factors evaluated included age, time since last myocardial infarction, NYHA classification, principal indication for surgery, LV end diastolic pressure, LV "A" w...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198005000-00018
更新日期:1980-05-01 00:00:00
abstract::Transfusion in the pediatric age group requires careful consideration of the patient's weight and age because of potential problems with intravascular volume and difficulty with administration of the blood product. Different age groups have varied disease processes that require specific blood components. A correct dia...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1982-06-01 00:00:00
abstract::Blastomyces dermatitidis, a dimorphic broad-based budding yeast endemic to the Mississippi River Valley region, is responsible for morbidity in humans via inhalation and dissemination. The response of acute lung injury, which produces an illness with serious morbidity and an approximately 50% mortality, uncommonly occ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199809000-00012
更新日期:1998-09-01 00:00:00
abstract::A marked increase in the number of cases of shigellosis was reported in Kentucky in 1988. To examine reasons for this increase, we reviewed the 389 cases of shigellosis reported from 1986 through 1989. Ninety-three percent (285/305) of cases due to known species were due to Shigella sonnei. Sixty-two percent (243/389)...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199107000-00002
更新日期:1991-07-01 00:00:00
abstract::Ten bites by Loxosceles reclusa, the North American brown recluse spider, are reported from South Carolina. Envenomation by the brown recluse spider is becoming a public health problem in the United States. The spider reportedly now is found from coast to coast in the southern half of the country and its range is prob...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197607000-00024
更新日期:1976-07-01 00:00:00
abstract::Medical care in resource-limited environments (austere settings) can occur in the context of a disaster, wilderness, or a tactical field operation. Regardless of the type of environment, there are common organizational themes in most successful humanitarian missions that occur in harsh natural or manmade environmental...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31827c5a2e
更新日期:2013-01-01 00:00:00
abstract::A 38-year-old African-American male complaining of pain in multiple joints was initially diagnosed with gouty arthritis concurrent with gonococcal septic arthritis. The diagnosis was made based on arthrocentesis results showing Gram-variable cocci and monosodium urate crystals in the synovial fluid. Final blood and sy...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31819ba3c0
更新日期:2009-04-01 00:00:00
abstract::An unusual intestinal infection with the parasite Metagonimus yokogawai was acquired by an American traveling in the Orient. Diarrhea began abroad, and recurred at intervals until she was seen 1 1/2 years later. Stool examinations resulted in the recovery of small operculated ova characteristic of intestinal or biliar...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197812000-00020
更新日期:1978-12-01 00:00:00
abstract::During the spring term of 1975, rubella was diagnosed in 23 students at Georgetown University in Washington, DC. The cases were concentrated among students from the School of Foreign Service and their close contacts; outbreaks did not appear in other divisions of the university. Rubella immunization of susceptible fem...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1976-08-01 00:00:00
abstract::Family physicians and other medical care providers are beginning to realize the importance of a comprehensive assessment examination for elderly patients. The components of such an examination are well documented, and include not only the standard history and physical examination, but also evaluation of mental health,...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199108000-00005
更新日期:1991-08-01 00:00:00
abstract::We have presented four cases of infarcted appendices epiploicae. Because the clinical picture can be confusing, the diagnosis is frequently delayed or missed. Removal of the infarcted appendix results in cure, with no reported cases of recurrence. The disease can be fatal, four deaths having been reported in the liter...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198603000-00030
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVES:Guidelines have recommended that risk stratification be performed in patients diagnosed with an acute pulmonary embolism (PE). No study has described the use of risk stratification in routine clinical practice. The purpose of this study was to measure the frequency and impact of risk stratification on treatm...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0000000000000053
更新日期:2014-02-01 00:00:00
abstract::Continued improvements in computer technology have led to significant enhancement of clinical teaching. We describe a "digital toolbox" consisting of personally accessible hardware and software products to assist in clinical teaching. The areas covered are computer-assisted diagnosis, digitization and display of clini...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199512000-00003
更新日期:1995-12-01 00:00:00
abstract::Subdural hematomas are among the most common forms of intracranial hemorrhage encountered in clinical practice and are a surgically remediable cause of dementia. When the symptom presentation is subtle or diffuse, a subdural hematoma can be overlooked. This is especially true among elderly people who may exhibit unrel...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199509000-00019
更新日期:1995-09-01 00:00:00
abstract::This case presents a rare type of crescentic glomerulonephritis characterized as IgA deposits predominantly along the glomerular basement membranes (GBM). The patient clinically manifested with rapidly progressive glomerulonephritis (RPGN) without pulmonary hemorrhage or vasculitis-related systematic symptoms. No posi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181817c22
更新日期:2008-09-01 00:00:00
abstract::Dysphagia is a commonly encountered patient complaint. The differential diagnosis for dysphagia is extensive. One long-recognized etiology of dysphagia is cervical osteophytosis. Degenerative joint disease, ankylosing spondylosis, and diffuse idiopathic skeletal hyperostosis (DISH) can all cause cervical osteophyte fo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199708000-00020
更新日期:1997-08-01 00:00:00
abstract::A case of acute febrile neutrophilic dermatosis (Sweet's syndrome) is described in a patient with chronic myelogenous leukemia, with a review of all published reports in the English literature. The disease is characterized by an acute febrile illness with painful plaques involving the extremities, face, and neck, and ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197811000-00010
更新日期:1978-11-01 00:00:00
abstract::The term "top of the basilar" has been used in reference to a group of signs and symptoms of midbrain, diencephalic, and posteroinferior hemispheric dysfunction. It has been attributed to ischemia in the territory of second- and third-order vessels that arise from the uppermost portion of the basilar artery. We report...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198807000-00009
更新日期:1988-07-01 00:00:00
abstract::Continent reconstruction of the lower urinary tract using the appendicovesicostomy (Mitrofanoff principle) is an excellent means of managing many patients with altered bladder function, especially those with good bladder volume and low pressure. Motivated patients unable to perform urethral catheterization because of ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199410000-00009
更新日期:1994-10-01 00:00:00
abstract::When involuntary psychiatric patients are treated on unlocked units, problems may arise as to resource expenditure and the ability to provide optimal psychiatric care. This study investigates the problem and possible solutions. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199306000-00016
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:To deliver effective care, healthcare systems should understand patients' preferences for weight management across a spectrum of needs. Our objective was to describe patients' perceptions of what helps or hinders weight loss and maintenance. METHODS:Semistructured interviews were conducted with patients who ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001196
更新日期:2021-01-01 00:00:00
abstract::Human monocytic ehrlichiosis (HME) is a tick-borne disease transmitted during the summer months in the mid-Atlantic, southeastern and south-central United States. A large proportion of patients presenting with ehrlichiosis must be hospitalized because of the severity of their presenting signs, symptoms and lab abnorma...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31804aa1ad
更新日期:2007-08-01 00:00:00
abstract::The role of antibiotics in large bowel surgery was established by experimental studies indicating that antibiotics could protect a colonic anastomosis subjected to unusual stress. A number of different agents were studied to patients to determine which ones significantly altered the bacterial flora of the colon. Clini...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198212000-00019
更新日期:1982-12-01 00:00:00
abstract:OBJECTIVES:Clostridium difficile infection (CDI) is the most common healthcare-associated infection in the United States. Clinical practice guidelines for the treatment of CDI were updated in 2010 by the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America. An institutional guid...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000428
更新日期:2016-03-01 00:00:00