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It is generally thought that doses below 500-550 mg/m2 are safe but, when objective measures of cardiac function are used, it becomes apparent that degrees of cardiac failure occur at doses below this.
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The 2 cases direct our attention to at least 3 important points regarding safe administration of ECT shortly after the occurrence of PE, that is, careful evaluation of cardiac function and residual deep vein thrombosis before the start of an ECT course, adjustment of anticoagulants, and prevention of recurrent deep vein thrombosis and PE by methods in addition to anticoagulant therapy (fluid infusion, use of support hose, and timely ECT).
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Subsequently, the patient developed pulmonary emboli documented by angiography.
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This report suggests the importance of searching for the presence of C. difficile and its toxin in patients with diarrhea after undergoing cancer chemotherapy since C. difficile may cause severe colitis.
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Severe steroid-induced glaucoma following intravitreal injection of triamcinolone acetonide.
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Herpes zoster ophthalmicus and syndrome of inappropriate antidiuretic hormone secretion.
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With drug rechallenge two days later, ventricular tachycardia recurred within minutes.
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Use of the Naranjo probability scale showed the relationship of itraconazole therapy and the occurrence of acute hepatitis as probable.
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These results provided consistent evidence that the selective absence of VWFMs with large to medium molecular masses in this patient is caused by the heightened clearance of a complex of IgG inhibitor and VWFMs from the circulation, presumably through IgG binding to the Fc receptor of macrophages.
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Autoinfection occurs in the setting of immunosuppression when invasive larvae penetrate the gut wall and cause disseminated infection.
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Failure of coagulation was confirmed by thrombelastography and in both cases routine coagulation tests revealed a prolonged kaolin cephalin clotting time (KCT).
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Development of obsessive-compulsive behaviour following cortisone treatment.
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RESULTS: Since January 2002, 171 patients with RA have commenced taking leflunomide.
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At ophthalmic review, the tumour had apparently completely regressed.
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METHODS/RESULTS: This paper presents a new case of rifabutin uveitis and a review of the various published reports to date.
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It is concluded that cyclophosphamide and thiotepa in obese patients should not be dosed on the basis of BSA incorporating TBW since the patient will be overexposed.
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The patient had tolerated both general and local anaesthesia on several previous occasions.
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Record et al. have recommended oral loading in selected patients.
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Two weekly injections of 25 mg of the tumour necrosis factor alpha inhibitor etanercept led to a rapid improvement of his psoriatic arthritis, as well as regression of the pustular eruption, while residual erythema was still present.
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CONCLUSION: Gemcitabine-induced recall pneumonitis is a rarely reported phenomenon and should be taken into account even after extended time interval to the previous radiotherapy.
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Clinicians should be vigilant when monitoring for cardiotoxicity in patients receiving pentamidine throughout the duration of therapy.
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The level of aspartate aminotransferase (AST) was 44 U/L, and that of alanine aminotransferase (ALT) was 69 U/L.
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She experienced two separate episodes of observed fits whilst on an initial daily dose of 125 mg and, subsequently, on a daily dose of 237.5 mg.
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CLINICAL PRESENTATION AND INTERVENTION: A 50-year-old male with chronic hepatitis C received treatment with alfa-interferon and ribavirin for 52 weeks.
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Her antecedent medical history included stable, mild renal function impairment, mitral regurgitation, atrial fibrillation, recurrent transient ischaemic attacks and cholelithiasis.
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Following the widespread use of GVO, more severe complications such as needle cementation, fistula formation, embolic sequels, recurrent septicemia, etc., have been reported.
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His symptoms resolved within 2 weeks of discontinuing the isoniazid.
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Cutaneous seeding is a rare complication of interventional ultrasound procedures.
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The concomitant use, however, of colchicine and statin has been associated with the rapid onset of muscle weakness.
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Only one patient, the youngest, did well on risperidone therapy.
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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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One year later, she experienced a fatal hepatitis B virus (HBV) reactivation.
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The thrombus occupied almost half the right atrial cavity and hit the tricuspid valve with each heartbeat without obstruction of tricuspid inflow.
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Bisphosphonates inhibit bone turnover and result in increased bone-mineral density.
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Although various other cardiac events have been reported in literature, a series of patients having transient asymptomatic bradycardia has not been reported in the literature as yet.
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As children are often unable to describe their symptoms verbally, their akathisia can be misdiagnosed as worsening of their psychosis, prompting an unnecessary increase in their neuroleptic dose.
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A 41-year-old woman was treated according to a diagnosis of depression, which was her 6th episode.
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A 14-year-old female developed systemic lupus erythematosus (SLE)-like symptoms, rash, fever, leukopenia and positive anti-nuclear antibody (ANA) two weeks after administration of carbamazepine (CBZ; Tegretol) used against benign Rolandic epilepsy.
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Fundus examination revealed resolution of cystoid macula edema.
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Amiodarone hydrochloride, a new antiarrhythmic agent, has been associated with pulmonary toxicity characterized by cough, dyspnea and diffuse pulmonary infiltrates.
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On admission rhabdomyolysis had begun to improve despite a worsening of the hyponatremia (113 mEq/L).
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Two brief periods of analgesia were achieved with deep subcutaneous infiltration of bupivacaine.
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Chronic ischemic changes in the white matter may have been an additional factor in the causation and, most likely, in the duration of his status.
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The cases of two asthmatic patients who became hypokalemic after inhalation of normal doses of albuterol are presented.
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The failure of high doses steroids to alter the course of illness and to completely suppress the thyroidal inflammatory process is highlighted.
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We report marked QT prolongation and torsades de pointes in a setting of flash pulmonary edema resulting from acute myocardial ischemia in a patient who was being treated with dofetilide for atrial fibrillation.
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Although it is difficult to be certain of the direct link of amiodarone on the basis of a single case, it is reasonable to presume that this histopathology is associated with amiodarone-induced hypothyroidism and that involution changes represent the hypofunctional status of this drug-induced disorder.
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A patient with the Wolff-Parkinson-White syndrome presented with incessant orthodromic atrioventricular tachycardia following initiation of procainamide therapy.
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The resuscitation attempt was unsuccessful, and the patient was pronounced dead.
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In these cases, the pregnancy can be protected through anticoagulation treatment, but there may be exceptions to this.
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Although transient increases in ectopy after bretylium therapy have been described, presumably due to catecholamine release, the occurrence of life-threatening ventricular arrhythmia leading to cardiac arrest has not previously been emphasized.
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Since complete surgical excision was not feasible, she was treated with repeated multiple local injections of triamcinolone acetonide.
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Antibiotic irrigation of the capsular bag to resolve low-grade endophthalmitis.
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Our case is that of a 44-year-old woman, along with a review of the literature.
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PURPOSE: To report patients who presented to the oculoplastics department for repair of cicatrical entropion after topical use of dipivefrin.
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We can speculate that the overexpression of VEGF induced by local ischemia and inflammation can make these patients more likely to have CNV.
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However, 9 months later, while still asymptomatic, routine physical examination revealed a recurrent right lower quadrant tumor.
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Although the patient's symptoms are consistent with those of the condition, she did not respond to treatment with haloperidol, flunarizine, or propranolol.
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I saw two patients with kala-azar resistant to sodium stibogluconate who developed cardiac arrest after amphotericin infusion (in spite of tolerating a test dose).
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BACKGROUND: Nocardia asteroides is an opportunistic infection caused by an aerobic actinomycete, which, in the immunocompromised host, can be associated with severe invasive disease with a predilection for the brain.
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These drugs, phosphodiesterase 5 (PDE5) inhibitors, help men with ED obtain and sustain an erection, improving both sexual function and sexual performance satisfaction.
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Pursuing a diagnosis in a Caribbean man.
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Ibuprofen overdose is usually characterized by GI upset, dizziness, and mild sedation.
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CONCLUSIONS: Clinicians should be aware of this adverse reaction when facing similar complex neurologic symptoms in patients who are receiving the antibiotic treatment described here, especially vancomycin.
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Clinical evaluation of SMS 201-995.
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CONCLUSIONS: Neurosurgeons will be faced with another devastating complication of thrombolytic therapy, as long as the available drugs are being used.
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A child in whom a phenobarbital hypersensitivity drug reaction developed which consisted of fever, a pruritic desquamating erythrodermic rash, alopecia, icterus, protein-losing enteropathy, myositis, and nephritis, is described.
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The syndrome of inappropriate antidiuretic hormone (SIADH) secretion is a common consequence of neurologic and pulmonary infections as well as drug intake and many other clinical situations.
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Use of lamotrigine to augment clozapine in patients with resistant schizophrenia and comorbid alcohol dependence: a potent anti-craving effect?
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High-dose methotrexate is used in malignant hemopathies and solid tumors in children.
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The latter form (Macrodantin) is reported to engender less gastrointestinal intolerance but it can produce the same adverse effects as the conventional form--liver damage, acute and chronic pulmonary reactions, peripheral neuropathy, blood dyscrasias and allergic reactions--and does so just as rapidly and floridly; one such case is reported here.
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Olanzapine-induced hyperglycaemic coma and neuroleptic malignant syndrome: case report and review of literature.
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The episodes became more frequent in the following months, causing several falls and requiring visits to the emergency department, but no acute coronary event was diagnosed.
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However, an association of Ritalin with glaucoma has been reported.
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Methamphetamine abuse has been increasing in California and may exceed cocaine abuse in some regions.
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Malignant mixed mullerian tumor of the uterus in a patient taking raloxifene.
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The diagnosis was based on the rapid onset of renal failure, presence of eosinophilia, skin rash, and characteristic renal biopsy finding, following the administration of ampicillin.
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Venous thrombembolism, thrombophilic defects, combined oral contraception and anticoagulation.
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It is estimated that the real incidence if TIAA is higher, and many cases, initially presented as agranulocytosis +/- thrombocytopenia, might be true aplastic anemias, not proven by marrow aspiration or trephine biopsy.
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A 56-year-old woman with scleroderma developed rapidly progressive glomerulonephritis with epithelial crescents associated with hemoptysis after 27 months of D-penicillamine therapy and a cumulative dose of 1,200 g.
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An electrophysiologic study revealed an intermittent advanced (His-Purkinje) block within the atrioventricular conduction system.
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Although the great majority of these events occur at sites of vascular interruption, major gastrointestinal, retroperitoneal, genitourinary, and central nervous system hemorrhage are known to occur.
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Central nervous system toxicity associated with meperidine use in hepatic disease.
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OBJECTIVE: The purpose of this study was to determine whether desensitization to NPH insulin, as well as standard insulin desensitization, could control allergic symptoms in a patient allergic to both NPH and regular insulin.
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The relationship between tardive OGC and clozapine is still unknown.
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BACKGROUND: With the increasing use of implantable cardioverter-defibrillators (ICDs), device complications are becoming more common.
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The patient experienced pain relief after the first application.
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She experienced deterioration in vision following the commencement of treatment due to a Jarisch-Herxheimer reaction.
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Valproate 960 mg (30 mg/kg) was infused over 1 hour.
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At final follow-up, the patient complained of a grade 4/5 hemiparesis, facial nerve palsy, and hearing loss in his left ear.
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This is a diagnosis that should be considered in patients with prostate cancer who present with hip pain in the absence of biochemical evidence of disease progression.
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We cared for a toddler in whom severe respiratory distress developed after VVR was applied directly under her nose.
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As a result, one of these individuals had premature death.
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Steroid therapy is an effective method of protecting the airway in some patients with hemangiomas.
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This compound, used by adults in the child's home, had caused accidental theophylline poisoning, mimicking diabetic ketoacidosis.
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Discontinuation of dalteparin on day 4 led to resolution of symptoms.
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Anastrozole-associated sclerosing glomerulonephritis in a patient with breast cancer.
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She suffered from epigastric discomfort.
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In each case, a surgical opinion was required.
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This led to a rapid unfavorable progression of hepatitis B, which was recently acquired and subsequently evolved into a severe cholestatic and fibrosing chronic hepatitis, causing multiple end-organ failure, and ultimately, death.
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