Abstract:
:Our seven clinical vignettes illustrate different mechanisms of inappropriate admissions to psychiatric wards and the circumstances and outcome of such admissions, with emphasis on the shared responsibility of psychiatric and nonpsychiatric physicians, the financial consequences, and the implications of such admissions on the profession's public image. Inappropriate admissions create undue tensions and demands on an already overworked psychiatric staff, and raise legitimate issues of quality of care, the need for clinical and administrative guidelines for consultation and transfer, the degree of communication between psychiatry and other specialties, and a host of psychodynamic considerations, somehow overlooked in recent years. The main issue in most cases is the level of communication between the psychiatric and nonpsychiatric camps. Clinical, epidemiologic, and actuarial studies are needed in this area.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Alarcon RD,Walter-Ryan WG,Shaw Ldoi
10.1097/00007611-198507000-00014subject
Has Abstractpub_date
1985-07-01 00:00:00pages
827-32issue
7eissn
0038-4348issn
1541-8243journal_volume
78pub_type
杂志文章abstract::Hepatobiliary tuberculosis (HTB) is uncommon and can be difficult to diagnose. We present our experience with HTB (over a 10-year period). Fourteen patients were identified from a total of 1888 cases of tuberculosis (TB) infection during this period. Five patients had isolated organ involvement [hepatic (n=3) and bili...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e318164ddbb
更新日期:2008-04-01 00:00:00
abstract::This case report describes an accidental ingestion of a gold dental inlay prosthesis that became lodged in the appendix. A nonsurgical approach was pursued because this blunt foreign body posed a minimal perforation risk. A second opinion for an elective appendectomy was chosen by the patient until a preoperative abdo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199807000-00012
更新日期:1998-07-01 00:00:00
abstract::A 36-year-old man was found to have severe pulmonary hypertension and a right-to-left shunt secondary to a patent ductus arteriosus. Attempt at surgical closure was unsuccessful. The patient was followed up for 21 years, and his only significant medical problem is leg weakness to moderate exertion. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198005000-00036
更新日期:1980-05-01 00:00:00
abstract:OBJECTIVE:There is a relation between tumor stage and grade with the risk of cancer recurrence in patients undergoing surgical treatment for kidney cancer. The association of patient comorbidity with disease recurrence is less well characterized. The objective of this study was to explore the association between comorb...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000651
更新日期:2017-05-01 00:00:00
abstract::This is a case which highlights unique diagnostic challenges in the evaluation of a previously healthy patient presenting with a myelopathy initially most concerning for malignancy. However, timely recognition and nonoperative therapy of unexpected spinal sarcoidosis with corticosteroidal therapy was crucial in averti...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181e90745
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVES:Code status specifies the action that healthcare providers should take in the event of cardiac arrest. Studies have shown, however, that patients with do-not-resuscitate/do-not-intubate (DNR/DNI) orders have worse outcomes and do not consistently receive the standard of care. Several studies have demonstrate...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001112
更新日期:2020-07-01 00:00:00
abstract::Reported is the association of condyloma acuminatum and squamous carcinoma of the vulva in three cases and condyloma followed by squamous dysplasia in a fourth case. This association has previously been reported in both male and female genitalia and in the perianal area. In our four cases, cancer or squamous dysplasia...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197705000-00029
更新日期:1977-05-01 00:00:00
abstract:OBJECTIVE:How outside factors affect physician decision making remains an open question of vital importance. We sought to investigate the importance of various influences on physician decision making when clinical guidelines differ from patient preference. METHODS:An online survey asking 469 primary care providers (PC...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000901
更新日期:2018-12-01 00:00:00
abstract::To our knowledge, this is the first known case of a patient with leptospirosis and very elevated CSF, which caused hydrocephalus. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181a0ae80
更新日期:2009-05-01 00:00:00
abstract::Although successful transposition of the ovaries at the time of staging laparotomy for Hodgkin's disease is well documented, little comment has been made on potential complications. This case report of a primary ovarian neoplasm (benign) developing in a transposed ovary serves to alert physicians as to possible ovaria...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198307000-00039
更新日期:1983-07-01 00:00:00
abstract::Any terrorist attack using weapons of mass destruction will result in substantial psychological trauma and stress. Primary care and emergency clinics will likely see patients who have stress-related emotional or physical symptoms, or exacerbations of preexisting health concerns. Significant psychological and behaviora...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000054783.69453.79
更新日期:2003-04-01 00:00:00
abstract::For various reasons, patients seek care at different hospitals within a region, resulting in fragmented medical records at the point of care. In the emergency department, this is a particularly important issue because the emergency department provides open access to all patients and requires rapid high-stakes decision...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e318296ed67
更新日期:2013-06-01 00:00:00
abstract::The patient we have described had lower extremity numbness, paresthesias, constipation, urinary retention, and sexual dysfunction. Laboratory evaluation confirmed a diagnosis of acute intermittent porphyria (AIP). Vitamin B6 and glucose therapy initiated resolution of symptoms. The sensory neuropathy described here is...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1991-05-01 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:BACKGROUND:Several previous studies of invasive Group A streptococcal (GAS) disease have been hindered by small sample sizes (< or = 100 patients) and limited generalizability. METHODS:We conducted a population-based study of invasive GAS disease. The objectives of the study were to describe the clinical features of i...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000051060.95210.9A
更新日期:2003-10-01 00:00:00
abstract::A retrospective study of 45 patients hospitalized with blastomycosis of bones or joints revealed 41 cases of osteomyelitis and 12 cases of septic arthritis. The majority were men (35 [78%] patients) and non-Aboriginal (32 [71%] patients). Median time from the onset of symptoms to hospitalization was shorter in women t...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3180487a92
更新日期:2007-06-01 00:00:00
abstract::We performed 12 arthrodeses of the knee and eight of the ankle, using the Hoffmann device as a compressor-fixator. For the knees, the double rectangular frame was used with the added fixation of a cylinder cast in six cases. In four cases a separate half frame was used in the anterior plane. Posttraumatic arthritis wa...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198311000-00018
更新日期:1983-11-01 00:00:00
abstract:OBJECTIVES:To determine whether prolonged length of stay (pLOS) in ischemic stroke is related to delays in discharge disposition arrangement. METHODS:We designed a retrospective study to compare patients with acute ischemic stroke who experienced pLOS to those who did not experience pLOS. Patients who have had acute i...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0000000000000036
更新日期:2013-12-01 00:00:00
abstract::Intravesical BCG (bacillus Calmette-Guérin) instillation is a first-line treatment for superficial transitional cell carcinoma of the bladder. A rare but severe complication of BCG immunotherapy is the development of disseminated BCG disease, which can result in miliary pneumonitis, granulomatous hepatitis, soft tissu...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31815d4047
更新日期:2008-01-01 00:00:00
abstract::In a retrospective review from 1987 to 1989, we identified seven alcoholics who had severe acute hepatocellular injury soon after using acetaminophen for therapeutic purposes and who had no suicidal intent. All had markedly elevated serum transaminase values (aspartate aminotransferase greater than 4000 U/L) and prolo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199009000-00017
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVES:In this study, we determined patients' attitudes toward discussing firearms and issues of firearms safety with emergency department physicians. We assessed whether patients feel discriminated against should physicians discuss firearms safety, and whether they believed that physician counseling may change how...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000915
更新日期:2019-01-01 00:00:00
abstract::Patients with recurrent thrombosis may have one of the thrombophilias described in recent literature. These clotting disorders may involve abnormalities in platelets, fibrinogen, plasminogen, protein C, protein S, or antithrombin III. There is usually a family history of clotting disorders, since most of these are inh...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:Lichen simplex chronicus (LSC) is a common pruritic disorder resulting from repeated rubbing and scratching. Nighttime pruritus is a common feature in LSC and may disrupt the sleep pattern. The aim of this study is to determine whether there are sleep abnormalities in patients with LSC. PATIENTS AND METHODS...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000215640.97668.3f
更新日期:2006-05-01 00:00:00
abstract::One hundred fifty patients underwent surgery for mitral valve disease between January 1974 and May 1981. There were 98 female and 52 male patients with a mean age of 57 years (+/- 18.6). One hundred forty-six patients were in New York Heart Association functional class III or IV. Pathologic diagnoses included 67% rheu...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198306000-00005
更新日期:1983-06-01 00:00:00
abstract::Conventional rate limits for sinus rhythm--100/min as the tachycardia threshold and 60/min as the bradycardia threshold--were established by consensus and never formally examined. Because clinical experience indicated that both figures were too high, we investigated this formally in 500 normal individuals. Results wer...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199607000-00003
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:To determine whether racial disparities occurred among specialty and allied health inpatient consultations for patients admitted to adult hospital services at an academic hospital. METHODS:A retrospective data analysis of the first 2000 patients, ages 18 years or older, admitted to an academic hospital. RES...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001084
更新日期:2020-04-01 00:00:00
abstract::Sickle cell disease (SCD) is the most common hereditary disorder and affects 30 million people worldwide. Advances in science have improved overall survival in patients with SCD and as such, more patients are reaching reproductive age and are becoming pregnant. SCD in pregnancy leads to multiple complications that put...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.14423/SMJ.0000000000000514
更新日期:2016-09-01 00:00:00
abstract::Between 1972 and 1985, 39 patients with superior vena cava syndrome were admitted to the Medical College of Georgia Hospitals. I have reviewed the hospital courses of these patients and compared clinical and laboratory findings with those reported in previous series. The syndrome was malignant in 34 patients (mean age...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198710000-00011
更新日期:1987-10-01 00:00:00
abstract::A 50-year-old black man was admitted with a diagnosis of a ruptured rotator cuff syndrome two weeks after an injury to the right shoulder and treatment by intra-articular steroid injection. At operation pus and necrotic debris were found in the shoulder joint, but the rotator cuff was anatomically intact. Surgical deb...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198206000-00037
更新日期:1982-06-01 00:00:00
abstract::Seven adults with acute leukemia had a clinical and radiologic diagnosis of neutropenic enterocolitis. Six of the seven patients had granulocyte counts less than 500/microliter. All seven patients responded to intensive medical therapy, including bowel rest, broad spectrum antibiotics, and white blood cell transfusion...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198710000-00008
更新日期:1987-10-01 00:00:00