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By means of the in vitro heparin-induced platelet activation (HIPA) assay it was shown that standard heparin and the LMW heparins Fragmin and Fraxiparin (Sanofi Labaz, Munich, FRG), as well as the enoxaparine Clexane (Nattermann, Cologne, FRG), all induced platelet activation with the patient's serum.
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Because it was not a stocked item in our pediatric emergency cart (as well as at another hospital, necessitating a transfer of a patient with refractory seizures to our hospital), the average delay was 5.8 hours (range, 1.3 to 13 hours) before it was given.
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We report a series of three patients who whilst using topical facial steroids developed advanced glaucoma.
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On-going monitoring of alteplase-treated patients may allow the opportunity to perform rescue intra-arterial therapy.
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We here report our preliminary clinical experience with caspofungin as an additional drug to the standard trimethoprim-sulfamethoxazole regimen.
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Mecasermin [rDNA] (Increlex; Tercica, Inc.) is recombinant insulin-like growth factor-I (IGF-I) that has been approved to treat growth failure in children with severe primary IGF-I deficiency.
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Symptoms were slow to resolve after penicillamine treatment was discontinued, and four of the patients needed corticosteroid therapy.
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However BUN and serum creatinine continued to increase and peaked on the following day at 8.6 mmol/l of urea (24 mg/dl) and 194 mumol/l (2.2 mg/ml), respectively.
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DATA SYNTHESIS: Genetic deficiencies in DPD, the rate-limiting enzyme responsible for 5-FU catabolism, may occur in 3% or more of patients with cancer putting them at increased risk for unusually severe adverse reactions (e.g., diarrhea, stomatitis, mucositis, myelosuppression, neurotoxicity) to standard doses of 5-FU.
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CONCLUSION: The results suggest that olanzapine may be useful in treating patients with clozapine-induced granulocytopenia without the risk of recurrence of hematologic side effects.
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Administration of amantadine was associated with psychotic decompensations in two schizophrenic patients being maintained on concomitant neuroleptic medication.
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The response to surgical drainage and antimicrobial therapy was dramatic in both dogs, but one dog experienced a drug reaction to trimethoprim-potentiated sulfonamide.
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Here, we describe a case of Epstein-Barr virus-associated polymorphic PTLD that developed shortly after treatment for cytomegalovirus reactivation in a lung transplant recipient who was preoperatively seropositive for both cytomegalovirus and Epstein-Barr virus.
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Syndrome of inappropriate secretion of antidiuretic hormone associated with limbic encephalitis in a patient with drug-induced hypersensitivity syndrome.
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However, at the same time, multiple cutaneous violaceous papular-nodular lesions appeared on his left forearm.
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Histopathologically, a degenerative, inflammatory thyroiditis was evident.
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Subsequently he responded to the West Berlin Protocol.
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4-en-VPA (2-propyl-4-pentenoic acid) (5%-21% in plasma) and 4,4'-dien-VPA (2(2-propenyl)-4-pentenoic acid) (4%-7%) have been found as abnormal unsaturated metabolites not detectable in controls.
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One patient who was weaned and survived had multiple thromboembolic strokes.
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We report two cases in which acute paraplegia occurred following compression fracture without retropulsion of bone fragments or significant narrowing of the spinal canal.
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We report a case of calciphylaxis in a patient with normal renal function and hypoparathyroidism, who responded to treatment with sodium thiosulfate.
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CD-20 expression in post-transplant lymphoproliferative disorders: treatment with rituximab.
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We report a case of intrathecal methotrexate neurotoxicity manifesting as left arm weakness and aphasia.
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We describe a patient who developed adrenal insufficiency (AI) after this protocol.
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We presented a patient with status asthmaticus treated with a combination of theophylline and prednisone who developed a perforated gastric ulcer.
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The hepatotoxicity is probably due to (-)-epigallocatechin gallate or its metabolites which, under particular conditions related to the patient's metabolism, can induce oxidative stress in the liver.
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The acronym 'EMPACT' is suggested (E: erythema; M: multiforme; associated with P: phenytoin; A: and; C: cranial, radiation; T: therapy) to best describe this disorder.
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METHOD: Recombinant human growth hormone (rhGH) is a newly approved treatment for weight loss and wasting in patients with AIDS.
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Gemcitabine-induced pericardial effusion and tamponade after unblocked cardiac irradiation.
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Eleven patients developed infection requiring hospitalization while taking leflunomide including: lower respiratory tract infections (3), cellulitis (2), disseminated herpes zoster (2), probable TB liver (1), abdominal sepsis (1), mycotic aneurysm (1) and gastroenteritis (1).
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We assume that rIFN-gamma induced the de novo development of SLE in our patient.
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She had palpable cervicosternal fibrosis measuring 10 x 8 cm, with local inflammatory signs and functional consequences (cough, restricted cervical movement, dyspnoea and bronchitis) with a SOMA scale for grading the long-term side effects of radiation therapy of 19/14.
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Leflunomide-associated weight loss in rheumatoid arthritis.
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These children aged 2.5-15 years were treated for Burkitt's lymphoma, Ewing's tumour, small cell bone tumour or medulloblastoma.
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Three nephrotic patients who had reduced renal function and active renal disease with progressive deterioration of renal function prior to the use of MP developed transient renal failure following an MP pulse therapy.
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Later, more careful research showed that they are not directly associated with the antipsychotic activity of neuroleptic agents.
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A single dose of dichloroacetate (DCA) was associated with a decrease in the serum lactate level by 20%, which persisted for more than 24 h.
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We describe an infant who developed juvenile glaucoma with buphthalmos while receiving systemic steroid treatment.
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The patient described feeling cold with worsening headache and chills approximately one hour after infusion of the first dose of penicillin.
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With these measures PaO2 could be maintained of safe levels but PEEP and high inspired oxygen concentrations were needed postoperatively until the trachea could be extubated on the third postoperative day.
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According to the Naranjo probability scale, the papular eruption was probably caused by methotrexate.
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Although heliox has been used foryears to treat patients with various respiratory complications, it is not currently a common treatment instituted by anesthesia practitioners for the treatment of bronchospasm.
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The patient was treated with full mouth gingivectomy and 2-week recall visits for a period of 2 months consisting of oral physiotherapy instructions, scaling, and topical fluoride application.
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Relevant literature data are discussed.
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Based upon the success of three refractory cases treated by this procedure, recommendation are made for the conversion of standard compressed-air chambers into an emergency saturation mode for therapy.
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Given the paradoxical efficacy of the atypical antipsychotics in pure OCD, the neurobiology and comorbidity of OCD and schizophrenia, as well as the increasing use of atypical antipsychotics, a cautious and rational pharmacotherapeutic treatment approach is recommended.
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CASES: Two postmenopausal women treated with tamoxifen and progestational agents for breast carcinoma developed uterine enlargement and intermittent spotting.
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This condition can manifest as fever, myalgia, arthralgia, and Sweet syndrome, accompanied by distinct magnetic resonance findings involving the lower extremity musculature.
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The present case indicates that the neutropenic colitis can occur under neutropenic conditions induced by the standard-dose chemotherapy for solid cancer.
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Gold-induced pneumonitis is a rare complication of gold salt therapy.
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We describe a patient with a liver abscess due to Entamoeba histolytica, in whom metronidazole therapy (total dose, 21 g over 14 days) was complicated by reversible deafness, tinnitus, and ataxia and who relapsed 5 months later with a splenic abscess.
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A case is reported of a child with fatal pulmonary fibrosis following BCNU therapy.
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Atopic cataracts versus steroid cataracts.
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Hyperpigmentation is one of the cutaneous side effects of chemotherapautic agents, but it is usually accepted as a cosmetic problem.
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METHODS: We describe a patient with MS in remission who had not exhibited any signs of IBD in the past.
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RESULTS: After cessation of topical dipivefrin application and successful surgical repair of entropion, no recurrence of signs or symptoms has been reported.
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We report the case of a 43-year-old man with ITP refractory to steroids and intravenous immunoglobulin who developed acute respiratory distress syndrome (ARDS) after a single infusion of rituximab.
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The patient developed a severe infection of the upper and lower respiratory tract with bilateral pulmonary infiltrates and severe hypoxemia.
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The symptoms of pseudotumor cerebri disappeared within 10 days.
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We conclude that MB is an effective treatment for ifosfamide-induced encephalopathy.
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Diarrhoea, T-CD4+ lymphopenia and bilateral patchy pulmonary infiltrates developed in a male 60 yrs of age, who was treated with oxaliplatinum and 5-fluorouracil for unresectable rectum carcinoma.
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Approximately 70% of the cases manifested as inflammation of internal organs or tissues and 30% manifested as a dermatitis or mucositis.
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Bilateral recurrent pneumothorax complicating chemotherapy for pulmonary metastatic breast ductal carcinoma: report of a case.
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Since its FDA approval in 2002, there are no known citations of ezetimibe-induced pancreatitis.
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The authors report an open study of 30 cases of intradiscal injection of triamcinolone hexacetonide in the treatment of sciatica.
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The baby girl was fed with pasteurized maternal milk, and she had a normal growth.
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CONCLUSION: The profound hypoxemia in this case was likely due to a combination of intra- and extrapulmonary shunt, both augmented by sodium nitroprusside.
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Dihydropyrimidine dehydrogenase (DPD) activity was measured by radioisotopic assay using lysates of peripheral blood mononuclear cells.
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The criterion for severe infection was inpatient hospitalization.
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HHV-6B infection caused or triggered severe gastrointestinal inflammation with intractable diarrhoea and failure to thrive over several months.
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Report of a patient with severe transfusion-related acute lung injury after multiple transfusions, resuscitated with albumin.
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Hiccups can arise from idiopathic, psychogenic and organic causes.
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A spinal haematoma occurring in the subarachnoid as well as in the subdural space in a patient treated with anticoagulants.
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OBJECTIVE: To describe the development of valproate-related reproductive endocrine disorders in women with epilepsy.
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Treatment was given as direct observed therapy (DOT) and sputum cultures, blood chemistry and neurologic examination were undertaken on a regular basis.
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The authors caution that treatment with alprazolam may be complicated by the induction of mania.
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Lethargy in a newborn: lithium toxicity or lab error?
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Pulmonary thromboembolism following total laryngectomy and neck dissection: a case report.
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Diagnosis requires CT scan and direct aspiration and culture of the liver abscess.
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CONCLUSION: The new quinolone derivatives (levofloxacin, sparfloxacin, grepafloxacin, trovafloxacin, gatifloxacin and moxifloxacin), also called gyrase inhibitors, are known for their potential to cause central nervous system-related adverse effects, including headache, dizziness and insomnia.
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The role of chemotherapy in the induction of such secondary tumors after transplantation is discussed, and a proposal for the approach to these patients is suggested.
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Here we present a forty-two-year-old Caucasian female with altered mental status, inability to eat, speak or walk properly, with shaking and vomiting for three days.
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Shortly after the start of surgery, he suffered an allergic reaction that, at first, was difficult to distinguish from the recognised side-effects of intrathecal diamorphine.
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Myoclonic twitching in the lower limbs of a patient who received intrathecal narcotics is described.
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We present a rare case of a thrombus at the aortic arch found 1 month after cisplatin-based chemotherapy in a 50-year-old patient with a diagnosis of small cell lung cancer; there were no symptoms related to the thrombus.
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We believe this is a remarkable potentiation on record in the literature.
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Antithyroid treatment during pregnancy should allow the use not only of PTU but also of CBZ and methimazole.
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Since therapeutic trials have failed, prevention of possible causes is the only way to avoid this rare but severe complication of cardiac surgery.
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Transnasal fiberoptic laryngoscopy revealed a significant laryngeal hematoma, as well as a hematoma on the floor of the mouth and in the tonsil area.
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DISCUSSION: Propafenone is a class 1C antiarrhythmic agent that blocks fast sodium channels in heart muscle and Purkinje fibers similar to the action of encainide and flecainide.
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In case 1, a total daily dose of 25 mg sertraline, with nondetectable sertraline and desmethylsertraline blood levels, resulted in a doubling of the lamotrigine blood level with symptoms of toxicity.
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METHODS: We present a case of intraoperative erection after the initiation of continuous spinal anesthesia that was treated with intravenous glycopyrrolate.
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Therapy was adjusted as required on the basis of BCG sensitivity results.
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However, the clinical role of S-1 in patients with recurrent/metastatic head and neck cancer is still uncertain.
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Dermatological signs are found in 50% of cases, and are often diagnostic.
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In May of 1997 a drug inadvertently injected intrathecally caused severe neurological damage and death to a child.
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We report the case of a lung cancer patient with bronquiloalveolar carcinoma (BAC) presenting with BOOP after chemotherapy with docetaxel and gemcitabine producing severe respiratory insufficiency, and simulating a progression of the tumor.
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A case of a 53-year-old man who developed acute pneumonitis after bleomycin and moderate oxygen administration is presented.
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The novel antipsychotics offer great potential for improving compliance.
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Multiple keratoacanthomas after megavoltage radiation therapy.
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