Southern medical journal
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Southern medical journal · Aug 2007
Is it Clostridium difficile infection or something else? A case-control study of 352 hospitalized patients with new-onset diarrhea.
Clostridium difficile-associated diarrhea (CDAD) is a leading cause of nosocomial diarrhea in the United States, and may be associated with significant morbidity and occasional mortality. Diarrhea is also very common among hospitalized patients and is often related to a variety of factors not related to C difficile infection. ⋯ Among hospitalized patients with diarrhea who underwent testing for C difficile toxin, age 75 years or older, hospitalization for 7 days or greater, and recent exposure to cefazolin or levofloxacin were important predictors of a positive CDTT. These findings may help in the initiation of early presumptive treatment for CDAD, and appropriate isolation of higher risk patients before results become available. In addition, consideration of these risk factors may help in deciding whether a CDTT should be repeated when the first test is negative. Our study also supports more judicious use of antibiotics, particularly cefazolin and levofloxacin, in reducing the risk of CDAD in hospitalized patients.
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Southern medical journal · Aug 2007
Case ReportsRapid development of an axillary mass in an adult: a case of cystic hygroma.
Cystic hygroma is a congenital anomaly of lymphatic origin, which mainly develops during childhood. Its development in adulthood, however, has been proposed to be related to several predisposing factors such as trauma, infection, tumor growth or iatrogenic stimuli. ⋯ We describe an unusual case of a cystic hygroma which developed rapidly in the axillary region of a female patient in the absence of any predisposing factor. The diagnostic workup and the need for surgical excision of the mass to obtain an accurate, histologic diagnosis is presented.
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Southern medical journal · Aug 2007
Editorial Comment ReviewType 2 diabetes and Hispanic culture: two kinds of insulin resistance.
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Southern medical journal · Jul 2007
Osteoporosis preventive care in white and black women in community family medicine settings.
Osteoporosis has been studied predominantly in white postmenopausal women. ⋯ Disparities in osteoporosis preventive care were found between black and white women, after adjustment for other osteoporosis risk factors.
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Southern medical journal · Jul 2007
Review Case ReportsWernicke encephalopathy complicating lymphoma therapy: case report and literature review.
Thiamine deficiency can occur in any disease that results in inadequate intake or excessive loss of vitamin B1. In addition to increased thiamine consumption secondary to high cell turnover, cancer patients frequently have reduced oral intake as a direct result of their cancer or from cancer treatments. ⋯ We report a case of Wernicke encephalopathy in a nonalcoholic patient with lymphoma. Although thiamine deficiency rarely potentiates clinical sequelae in cancer patients, it is important to recognize the risk and the clinical signs and manifestations so that prompt therapy can be initiated to reverse morbidity.