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A woman with a prolonged unipolar delusional depressive episode, unresponsive to antidepressant treatment, experienced rapid improvement of depressive and psychotic symptoms following the occurrence of two grand mal seizures.
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Another approach involves minimal debridement of the cartilage and letting the wound mature for 6 to 8 months.
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Treatment with low-molecular-weight heparin followed by a heparinoid resulted in slow healing of the ulcers but also allowed the subcutaneous interferon injections to be continued.
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Sometimes the presentation is with diabetic ketoacidosis, requiring insulin treatment, which can nevertheless be reversible.
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A 65-year-old man on warfarin therapy with a sudden spontaneous onset of sub-conjunctival haematoma associated with bloody tears was assessed in the clinic following a referral from an optometrist.
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Protease inhibitors (ritonavir and saquinavir) were added to the treatment and the patient developed progressive ataxia related to carbamazepine toxicity.
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Sustained-release procainamide-induced reversible granulocytopenia after myocardial infarction.
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When he was given an inferior alveolar nerve block, excessive bleeding was noted at the injection site and the dentist advised the patient see an oral and maxillofacial surgeon.
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Due to its low volume of distribution (0.6 L/kg), low protein binding (about 15%) and water solubility, acyclovir is an example of the ideal drug that can be removed by hemodialysis.
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He was afebrile, tachycardic, and tachypneic and had an oxygen saturation of 94% while breathing room air.
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We attribute the clinical and radiographic findings to cytotoxic edema secondary to intrathecal methotrexate.
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We concluded that the recurrent bacteraemia in this predisposed patient was due to re-infection, and that antibiotic treatment (amoxicillin plus an aminoglycoside) resulted in a complete eradication of the infective microorganism.
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Abnormally high urine and bone fluoride confirmed the diagnosis.
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Although isoproterenol has been the mainstay of therapy for chronotropic support in this setting, its availability has been an issue in recent years.
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When there is an alteration in the binding of the anticonvulsant drug to the plasma proteins, however, the relationship between the serum concentration and therapeutic efficacy or toxicity becomes difficult to interpret.
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Flecainide acetate is a sodium channel blocker and a class Ic antiarrhythmic agent with potential life-threatening proarrhythmic and cardioinhibitory properties when taken in overdose.
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Ophthalmologists should be aware of the ocular side effects of IFN therapy and carefully monitor patients for the possible occurrence of hypoalbuminemia and thrombocytopenia.
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OBJECTIVES: To describe the presentation and treatment of acute isoniazid (INH) neurotoxicity appearing at an inner-city municipal hospital.
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This idiosynactic adverse reaction has not been previously described.
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Vancomycin is widely used against methicillin-resistant Staphylococcus aureus infections, but it is associated with many adverse effects such as nephrotoxicity, ototoxicity, gastrointestinal disturbances, blood disorders, and two types of hypersensitivity reactions - an anaphylactoid reaction known as "red man syndrome" and anaphylaxis.
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CONCLUSIONS: We report a typical symptoms of Charles-Bonnet syndrome (CBS) in patients with severe AMD after intravitreal Avastin-injections.
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This increase when clozapine was switched to risperidone and vice versa is consistent with our previous report of elevated serum triglyceride levels in clozapine-treated patients.
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The neuropathological changes had features similar to those seen in leukoencephalopathy with intrathecal administration of methotrexate.
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We tested 136 unrelated patients with familial parkinsonism for SCA2 mutations.
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Clinicians should be aware of factors that affect A1C values, specifically erythrocyte life span.
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RESULTS: Exposure to the vanadium containing catalyst for 120 minutes resulted in a sustained decline in forced vital capacity and forced expiratory volume in one second, while the transfer factor for carbon monoxide did not change significantly.
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Shewanella spp. are an uncommon cause of human infection, with exposure to water being the commonest source.
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We present a case of hemorrhagic stroke after cesarean delivery under combined spinal-epidural anesthesia in an 35-year-old Hispanic patient treated with anticoagulants for protein C deficiency.
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We describe a patient who experienced chronic nausea and an episode of confusion while treated with a small, stable dose of oral morphine in the setting of mild renal insufficiency.
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Concomitant administration of lithium with olanzapine may place patients at risk for NMS.
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Acute pancreatitis is a known, although rare, complication of mesalamine treatment.
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Propafenone's distribution, clearance, and structural similarity to propranolol contribute to its central nervous system effects.
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We report here the case of rituximab administration during the first trimester of pregnancy in a woman with autoimmune hemolytic anemia.
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Clonidine, oral and patch, has been used in adults for the treatment of hypertension and Tourette's Syndrome.
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DESIGN: Two interventional case reports.
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During her third cycle, she again received cisplatin 100 mg/m2 over 30 minutes and developed palmar pruritus, urticaria, and edema.
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Epinephrine and dobutamine were stopped, and norepinephrine (noradrenaline) was successfully used to control the hypotension.
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Identification of the antigenic determinants of FDE-inducing drugs will make predicting safe alternatives in patients with FDE an easier task.
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They were treated with cyclophosphamide for 98 and 44 months respectively.
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Three weeks later he died of Clostridium septicum sepsis caused by necrotizing enterocolitis.
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We point out this case for its striking clinical picture and well-documented relation to immunoreconstitution to draw attention to this IRIS manifestation.
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A diagnosis of aquagenic syringeal palmar keratoderma was made on the basis of these clinical and histopathologic findings.
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Rhodococcus equi has emerged as an opportunistic pathogen usually causing necrotizing pneumonia in immunosuppressed patients but has been found increasingly in extrapulmonary sites.
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Treating physicians must be aware of this potential toxicity from gemcitabine either given concomitantly or followed by radiation.
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A 50-year-old diabetic and hypertensive male patient is reported who had ticlopidine-induced marrow aplasia partially responsive to colony-stimulating factors and corticosteroids, but experienced complete recovery with cyclosporine.
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Similar occurrences in outpatients reported in the literature are reviewed.
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We report a patient with recurrent, increasingly severe episodes of PPE, ultimately complicated by a severe bullous eruption, following successive cycles of high-dose cytarabine for the treatment of acute lymphoblastic leukaemia.
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After 25 months there had been no recurrence of gastrointestinal bleeding.
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The likelihood of an acute respiratory reaction during treatment may therefore depend on the bacillary load, the extent of lung disease present, and its severity may be related to the pre-treatment immune status of the patient.
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The striatum, especially the putamen, has been considered to be responsible for dystonia.
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The clinical diagnosis of lichen planus (LP) was confirmed by histology, which revealed hyperorthokeratosis, hypergranulosis, vacuolar degeneration of the basal layer cells and a dense, band-like lymphocytic infiltrate in the superficial dermis.
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A life-long antiretroviral treatment of congenital HIV disease, associated with a mixed fat redistribution syndrome and osteopenia already occurred during pre-pubertal age.
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STUDY DESIGN: Case report of Baclofen pump catheter failure investigated by radioisotope injection.
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Chronic paroxysmal hemicrania (CPH) is a rare primary headache syndrome, which is classified along with cluster headache and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) as a trigeminal autonomic cephalalgia.
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We conclude that routine therapeutic application of G-CSF in afebrile severe ATDIG is not justified, and in some cases may generate a cascade of iatrogenic adverse events.
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ITO is a rare but curable tumor of the ovary using combination chemotherapy.
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RESULTS: The first patient required admission to the hospital for medical stabilization.
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Monoamine oxidase inhibitors are rarely used in this population, although much evidence and clinical experience would indicate that they can be extremely effective and non-toxic.
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Unusual causes of peritonitis in patients undergoing continuous peritoneal dialysis with emphasis on Listeria monocytogenes.
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The current report describes a man who was prescribed zonisamide for epilepsy and subsequently developed widespread skin rash, acute kidney injury, high-grade fever, eosinophilia, liver dysfunction, lymphadenopathy and an increase in antihuman herpesvirus-6 immunoglobulin G titer.
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At 24 months of age the infant's neurodevelopment was normal.
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However, the patient later succumbed to her leukaemia.
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These nail changes gradually disappeared when the dose of clofazimine was reduced.
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OBJECTIVE: To report the finding of squamous metaplasia within endometrial glands occurring as a result of progestin therapy of hyperplasia.
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We also discuss the apparent increased thrombotic risk in patients receiving a VAD for chemotherapy induced cardiomyopathy and the implications this may have for the choice of VAD.
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This calls for adequate evaluation and monitoring of patients on this drug.
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The therapeutic implications of this clinical sequence are discussed.
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We report an 82-year-old man who developed ventricular tachycardia and Torsades de Pointes (TdP) after oral administration of garenoxacin, a novel quinolone antibiotic agent that differs from the third-generation quinolones, for pneumonia.
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AIMS: To present a case of piloerection after replacing fluvoxamine maleate with milnacipran hydrochloride, and to analyse this effect based on receptor occupancy theory.
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This small series of adult patients with leukaemia illustrates difficulties in treating patients who are practising JW, yet nevertheless provides a significant argument against the prejudicial decision leading to evasion of treatment in these patients.
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We report two cases that developed acute myeloid leukaemia (AML) during tamoxifen therapy for breast cancer.
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New therapeutic approaches are therefore warranted.
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Intravenous pyelogram performed 20 months later following an episode of left-sided colicky pain showed right-sided papillary necrosis.
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Cholestatic liver disease with ductopenia (vanishing bile duct syndrome) after administration of clindamycin and trimethoprim-sulfamethoxazole.
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Diagnosis, treatment, observation and outcome of fetal supraventricular tachycardia in a twin pregnancy.
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We report herein the case of a 69-year-old Japanese man with acquired von Willebrand syndrome associated with monoclonal gammopathy of undetermined significance who developed IgG1-kappa antibodies against von Willebrand factor (VWF).
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This case report illustrates the neurotoxicity unique to HDARAC.
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We describe a continuous infusion regional analgesic technique for pain due to sternal fracture.
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The specimen showed no viable tumor in association with an extensive granulomatous response in both the breast and axillary lymph nodes.
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As of May 28, 2004, to our knowledge, this is the first reported case of rhabdomyolysis following C. mukul ingestion.
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RESULTS: The production of TNF-alpha and IL-6 by the macrophages of the patient in presence of insulin were dramatically increased in comparison with control subjects.
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The disease predisposes to severe vincristine neurotoxicity.
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Following therapy with ABLC her fever abated, her chest X-ray findings improved, and her hepatic function tests improved with eventual resolution.
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After electrolyte supplementation and discontinuation of foscarnet, the symptoms resolved and laboratory indices returned to normal.
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A total gastrectomy with omentectomy and resection of the distal oesophagus in a 69-year-old haemophilia A patient with high inhibitor of 128 Bethesda units is described.
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With the help of intensive supportive care and symptomatic treatment, the patient recovered and was discharged home after a hospital stay of 25 days.
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Cefoxitin-associated renal failure.
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Musculoskeletal complaints were the presenting symptoms in four of 44 children (9%) treated for relapsed Wilms' tumors with ifosfamide, a derivative of cyclophosphamide.
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After seven months' continuous treatment for suspected tuberculosis with rifampicin and ethambutol a nine-year-old boy developed polyarthritis, rash and hepatitis in association with anti-native DNA antibodies and positive antinuclear factor.
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Physicians should be aware of this type of reaction.
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This was the patient's first experience with trimethoprim- sulfamethoxazole, and he was not taking any other medications during the treatment period.
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Among reported cases of CAPD-related peritonitis due to molds (22 Aspergillus spp. and seven zygomycetes), previous bacterial peritonitis was a common event, the related mortality associated with Aspergillus and zygomycetes was 27% and 57%, respectively, prompt removal of the Tenckoff catheter was critical for survival, and most patients were not able to resume CAPD.
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The second was an 82-year-old man receiving ticlopidine for 2 years when, during a febrile episode, he was found neutropenic with marrow aplasia.
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Two weeks after admission, she developed signs of WE including diplopia, ophthalmoplegia, nystagmus, and memory disturbance.
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PURPOSE: To describe the clinical and electrophysiological findings in a young boy with decreased vision possibly due to retinal damage by rifabutin.
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If opioid drugs are administered before a diagnostic hepatobiliary scan, delayed clearance of Tc-IDA from the common bile duct might lead to an erroneous diagnosis and indicate a potentially unnecessary common bile duct exploration.
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In a MEDLINE search (1966 to present, English language, keywords: amniocentesis, chorioamnionitis), no report of Candida chorioamnionitis after serial reduction amniocentesis exists.
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A 62-year-old woman with chronic active hepatitis receiving immunosuppressive drugs was initially admitted with sepsis secondary to an intra-abdominal abscess caused by Klebsiella pneumoniae.
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The girl is alive 23 months after transplantation with complete donor chimerism; both Ph chromosome and bcr/abl RNA are negative.
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The hepatic enzyme disturbances normalized after discontinuation of pegvisomant.
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