Abstract:
:The association of hypercoagulation and cancer, a well established pattern of disease, often leads to pulmonary emboli in an already compromised patient. Anticoagulation therapy in these patients is occasionally complicated by several factors including thrombocytopenia, which may result in a life-threatening situation of hemorrhage versus pulmonary emboli. Mechanical intervention may prevent pulmonary emboli from reaching the lungs, thereby negating the use of anticoagulants in the patient with thrombocytopenia. In this clinical trial, ten patients with cancer and thrombocytopenia complicated by recurrent pulmonary emboli received the Kim-Ray Greenfield filter. There were four men (two with colon carcinoma and two with chronic lymphocytic leukemia) and six women (four with breast carcinoma, one with colon carcinoma, and one with chronic lymphocytic leukemia). Pulmonary emboli were documented in all patients by comparative ventilation/perfusion lung scans, arterial blood gas determinations, and chest x-ray films. In each case anticoagulation was begun, but in six of the ten patients hemorrhage developed and anticoagulation had to be discontinued. The Kim-Ray Greenfield filter was subsequently placed in all ten patients in the infrarenal inferior vena cava (eight via a jugular approach and two via the femoral vein) without complication, and anticoagulation was discontinued. All patients had follow-up to time of death, ranging from six to 26 months (mean 11 months). In no patient was recurrent pulmonary emboli detectable based on clinical evidence, nor in autopsy reports in three of the ten patients. There should be increased usage of the Kim-Ray Greenfield filter in patients with malignancy, thrombocytopenia, and pulmonary emboli.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Whitney BA,Kerstein MDsubject
Has Abstractpub_date
1987-10-01 00:00:00pages
1246-8issue
10eissn
0038-4348issn
1541-8243journal_volume
80pub_type
临床试验,杂志文章abstract:BACKGROUND:Postpneumonectomy electrocardiographic (ECG) changes have not been well-defined. METHODS:We reviewed the clinical data and the preoperative and postpneumonectomy ECGs of 15 patients who had pneumonectomy. RESULTS:All postpneumonectomy ECGs showed a higher heart rate and two (13%) showed diffuse ST elevatio...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2000-10-01 00:00:00
abstract::We have described a patient with unilateral adrenal hyperplasia, a rare cause of primary aldosteronism, and reviewed the literature on this subject. The treatment of this disorder appears to be surgical. Whether its pathogenesis is related to the more common varieties of primary aldosteronism is open to speculation. ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198901000-00021
更新日期:1989-01-01 00:00:00
abstract::This article explores the history of lupus erythematosus from the origins of the name to the most modern therapeutic advances. The review includes information about the origin of the name "lupus," the first clear description of the skin lesions, the discovery of the systemic and discoid forms, and further advances whi...
journal_title:Southern medical journal
pub_type: 历史文章,杂志文章
doi:10.1097/SMJ.0b013e318073c9eb
更新日期:2007-09-01 00:00:00
abstract::After a pilot study had suggested that a drug augmented delayed hypersensitivity, we conducted a control study in which 19 normal volunteers had the same skin test battery applied as in the pilot study, on two occasions one month apart with no intervening treatment. No change was observed in delayed hypersensitivity r...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198609000-00009
更新日期:1986-09-01 00:00:00
abstract::This paper reviews 218 patients who had outpatient meniscectomy at the University of Virginia between January 1974 and June 1977. Only one patient (0.46%) returned before his scheduled visit. Three patients (1.4%) had superficial wound infections. One (0.46%) had a pulmonary embolus several weeks postoperatively. Twel...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198007000-00018
更新日期:1980-07-01 00:00:00
abstract:OBJECTIVES:Program directors have noted that first-year residents struggle with many of the patient care responsibilities they assume as they enter the US graduate medical education system. A national description of medical students' patient care experience in advance of graduation has not been published. We sought to ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000738
更新日期:2017-12-01 00:00:00
abstract::This study investigated the efficacy of perioperative antibiotics in preventing bacteremic infection of vascular suture lines, Dacron grafts, and bovine heterografts. One hundred forty-nine dogs had either segmental excision of the abdominal aorta with primary repair, Dacron prosthesis, or bovine heterograft placement...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197710001-00019
更新日期:1977-10-01 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::Blastomycosis in children is relatively infrequent. Further, osteomyelitis of the frontal bone, which prior to the antibiotic era occurred more frequently and was mostly due to pyogenic cocci, is rare today. We described a case of frontal osteomyelitis in a child due to blastomycosis which occurred in the absence of f...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197802000-00028
更新日期:1978-02-01 00:00:00
abstract::The macerated stillborn fetus represents at least one third of all perinatal deaths. Microscopic examination of these specimens is often unrewarding. We have reported a clinically unsuspected cytomegalovirus infection in a second trimester macerated fetus. Cells suggestive of CMV inclusions were identified by light mi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199011000-00036
更新日期:1990-11-01 00:00:00
abstract::Twelve cases of Shigella sonnei infection, with two deaths, occurred at a custodial institution in Donelson, Tennessee, in April and May 1973. Nine of the cases and both deaths were in patients hospitalized at the institution's infirmary. The patients with nosocomial shigellosis were significantly younger and had been...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197610000-00026
更新日期:1976-10-01 00:00:00
abstract::We have reported a case of spontaneous dissection of the internal carotid artery, with MRI and angiographic findings. We conclude that MRI is a beneficial noninvasive test for the detection and study of carotid artery dissection. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199109000-00021
更新日期:1991-09-01 00:00:00
abstract::Mesenteric occlusion is a rare and usually fatal complication of rheumatoid arthritis (RA). We report a patient with RA who had an acute condition of the abdomen, with clinical evidence of perforated bowel confirmed by histologic study. The successful result in this case is attributed to early surgical intervention. A...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198007000-00034
更新日期:1980-07-01 00:00:00
abstract::The oropharyngeal function study is a videotaped radiographic examination of the oropharynx and cervical esophagus used in patients who are at major risk for aspiration because of swallowing difficulty. Preceding the radiographic evaluation, the patient is assessed clinically by a swallowing therapist who attends the ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199002000-00013
更新日期:1990-02-01 00:00:00
abstract::Sarcoidosis rarely involves the genitourinary system or the spinal cord. This report describes a case of sarcoidosis with a scrotal mass, a mass compressing the spinal cord, and lesions in the liver and spleen. This case illustrates an uncommon manifestation of sarcoidosis, which may mimic disseminated testicular canc...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000163306.54629.35
更新日期:2005-09-01 00:00:00
abstract::Extreme bilateral protrusio acetabuli is an unusual complication of hematologic disease. We have described a patient with sickle cell anemia who had this complication probably as a result of osteopenia. Thus sickle cell anemia should be added to the list of potential causes of protrusio acetabuli. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199003000-00018
更新日期:1990-03-01 00:00:00
abstract::Granular cell tumors (GCT) are rare, usually benign neoplasms of Schwann cell origin. Since discovery in 1926, fewer than 80 cases of GCT involving the lung have been reported. This report presents a 45-year-old male who presented with symptoms consistent with chronic pancreatitis associated with night sweats, weight ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000182134.44098.01
更新日期:2005-10-01 00:00:00
abstract::In a patient with an asymptomatic left upper lobe pulmonary arteriovenous fistula, preoperative chest roentgenograms simulated bronchogenic carcinoma, but no overt feeding vessel was demonstrated. Intraoperatively no lesion could be palpated. Postoperative evaluation revealed a pulmonary arteriovenous fistula. This en...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198307000-00017
更新日期:1983-07-01 00:00:00
abstract::Range-gated pulsed Doppler echocardiography has been reported to be a useful noninvasive bedside technic for detecting ductal left-to-right shunting in premature infants. We studied 30 premature infants with a birth weight of less than 1,500 gm, using a 5 MHz system developed by Advanced Technology Laboratories. An um...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198109000-00023
更新日期:1981-09-01 00:00:00
abstract::Massive ovarian edema is a rare tumor-like condition of the ovary characterized by marked enlargement of one or both ovaries due to marked accumulation of edema fluid in the ovarian stroma. This paper reviews the literature on massive ovarian edema and presents a case associated with androgenic manifestations. ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199511000-00015
更新日期:1995-11-01 00:00:00
abstract::We studied 67 patients who had operation for perforated peptic ulcer. Operative treatment included plication with omentum (Graham closure) in 27 patients, vagotomy and pyloroplasty in 32 patients, or vagotomy and antrectomy in eight patients, depending on antecedent ulcer history, degree of contamination, and general ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198310000-00006
更新日期:1983-10-01 00:00:00
abstract::Disorders of the foregut are an increasingly common cause of symptoms in Western populations. This review summarizes recent advances in the understanding and treatment of gastroesophageal reflux disease, dyspepsia and celiac disease. ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.smj.0000242808.91797.3d
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVES:This study evaluated the role of ankle-brachial index (ABI) as an effective screening test of coronary artery disease (CAD) in the Hispanic population. METHODS:This was an observational cross-sectional study, based on a retrospective review of the medical management of the study patients using already avail...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e318189aabc
更新日期:2008-11-01 00:00:00
abstract::We describe two cases of drug-induced hypertriglyceridemia, one associated with interferon alfa-2b and the other with asparaginase, each of which is mediated through a different mechanism. Hypertriglyceridemia caused by these medications is not listed as an adverse reaction in the Physicians' Desk Reference, one of th...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199909000-00013
更新日期:1999-09-01 00:00:00
abstract::One hundred fifty-seven pregnancies complicated by different degrees of diabetes, toxemia, and hypertension were studied with serial urinary placental estrogen determinations. A simple and fast method for total placental estrogen determination was used. The level of total estrogen excretion was related to Apgar score ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197510000-00009
更新日期:1975-10-01 00:00:00
abstract::Bleeding is the most serious complication of thrombolytic therapy and limits its usefulness. We have reported a case of epidural hematoma, a rare occurrence after combined therapy with tissue plasminogen activator (TPA) and heparin. We emphasize that in patients treated with thrombolytic agents, any trauma may increas...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:Benchmarking techniques were implemented to optimize operating time and charges associated with laparoscopically assisted vaginal hysterectomy (LAVH). MATERIALS AND METHODS:The baseline LAVH profile over a period of 4 years (167 cases) was compared with 1-year data (47 cases) after a benchmarking educationa...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000176713.71878.63
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVES:The need for colonoscopy is common among diabetic patients. However, there are no standards per se for bowel preparation in patients with type 2 diabetes. In this study, we evaluated the efficacy, safety, and tolerability of sodium phosphate (NaP), and the quality of bowel cleansing in relation to glycemic c...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181f20b13
更新日期:2010-11-01 00:00:00
abstract::Coronary heart disease (CHD) is the leading cause of morbidity and mortality in patients more than 65 years old. Within this population, elevated cholesterol levels are prevalent and associated with increased risk of CHD. Despite increasing emphasis on lipid-lowering treatment in the elderly population, questions rema...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Many hospitalized anemic patients do not undergo appropriate evaluation. We hypothesized that specific clinical variables were likely to be important in triggering evaluation for iron deficiency anemia. METHODS:We prospectively identified 637 consecutive anemic patients without acute gastrointestinal bleedi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181520392
更新日期:2007-10-01 00:00:00