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CASE: A multipara with a twin gestation presented with premature labor at 31 weeks.
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Recommendations that may help prevent these adverse systemic effects in premature infants include: (1) avoidance of excess subconjunctival anesthetic doses, (2) preoperative administration of systemic atropine to minimize the oculocardiac reflex, (3) consideration of an analgesic agent to decrease the pain and exhaustion, and (4) cardiorespiratory monitoring in a hospital setting, with an intravenous line in place, at the time of treatment.
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Potential predisposing factors.
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The potential occurrence of EMD in all three patients raises the possibility of accelerated myocardial rupture, as EMD is one of the clinical hallmarks of this condition.
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In this report we present four patients treated with a combination of different psychotropic drugs, in whom asterixis was triggered either by adding carbamazepine (CBZ) to a treatment regimen, or by increasing its dosage.
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The clinical course suggests that caffeine, which is present in oolong tea, was mainly responsible for the rhabdomyolysis as well as the delirium, although severe hyponatremia has been reported to cause rhabdomyolysis on rare occasions.
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Finding an effective therapy for this subgroup of patients with severe recurrent HCV is a priority.
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CONCLUSION: The combination of FSGS with leukemia poses a management challenge to the clinician in terms of further treatment with potentially nephrotoxic drugs, complications of nephrotic syndrome (including infections), and timing of renal transplantation.
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A 27-year-old man who had a history of bronchial asthma, eosinophilic enteritis, and eosinophilic pneumonia presented with fever, skin eruptions, cervical lymphadenopathy, hepatosplenomegaly, atypical lymphocytosis, and eosinophilia two weeks after receiving trimethoprim (TMP)-sulfamethoxazole (SMX) treatment.
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When vague symptoms develop during desmopressin therapy, hyponatremia must be considered as part of the differential diagnosis.
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Itraconazole-related increased vincristine neurotoxicity: case report and review of literature.
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Imatinib mesylate (Gleevec) is widely-used in the treatment of chronic myeloid leukaemia (CML) and gastrointestinal stromal tumour.
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Nimodipine: evidence for clinically significant gastrointestinal side-effects.
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Craniotomy was performed in one of these patients to control the hemorrhage; in the other three, 0.5 to 2 cc of thrombin (5000 U/cc) was slowly injected via the biopsy cannula, resulting in immediate control of bleeding in all three cases.
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Patients must be instructed to recognize early symptoms of this severe infection and call the surgeon immediately.
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Bronchoscopy with BAL can be successful in establishing the diagnosis of ELP by demonstration of a high lipid-laden macrophage index.
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Patient 1 had an arterial thrombosis, whereas Patient 2 had a venous thrombosis.
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With this initial therapy we have had no treatment failures.
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A significant number of Asians reside in Australia, and consequently patients with nasopharyngeal carcinoma are an increasing clinical problem.
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The case of a 65-year-old male migraine patient with spontaneous internal carotid artery dissection is presented.
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Topical capsaicin as an adjuvant analgesic for the treatment of traumatic amputee neurogenic residual limb pain.
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The ECG at the onset of CHB suggested block to have occurred in the trifascicular conduction system.
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It is present in approximately 2% of the population and is estimated to cause symptoms<5% of the time.
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This case report describes two patients with acute obstetric disseminated intravascular coagulation in whom the use of heparin resulted in marked clinical improvement.
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Both patients developed cardiogenic shock and were treated unsuccessfully with thrombolysis.
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Neonates present with an immature physiology and biochemistry with respect to drug metabolism.
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A maculopapular rash and a fever developed 2 weeks later.
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Only few reports exist on iodine-induced hypothyroidism after a single injection of the iodized radiopaque dye Lipiodol.
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At 8 years 1 month of age, phenytoin was first administered.
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Because conservative therapy was not helpful for spinal stenosis and neuroclaudication, a left L2 transforaminal epidural injection was attempted, but a posterolateral fusion mass made this procedure impossible.
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Other case reports of second malignant neoplasms (SMN) following acute leukemia are cited; available data suggest that the overall risk of SMN in AML may be in the range of 6%.
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One plausible explanation is HSV reactivation secondary to localized immunosuppression from corticosteroid injection.
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The allopurinol hypersensitivity syndrome is a rare adverse drug reaction.
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Our search of the literature found no published pediatric pharmacokinetic data.
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CONCLUSION: It is critical that oncologists remember that the theoretical benefits of available anti-neoplastic interventions must be carefully and constantly weighted against the potential harm they may cause.
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Except hypothyroidism after radioiodine treatment (euthyroid under substitutional therapy), she suffered from no other diseases.
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The induced hyperglycaemia could not be controlled sufficiently, despite a high dose of insulin (> 110 units/day), suggesting the existence of insulin insensitivity and hyperinsulinaemia.
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According to the Naranjo adverse drug reaction probability scale, the likelihood that temozolomide was responsible for the adverse drug reaction of fever was probable (score of 6).
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The infiltrate was treated with a combination of topical polyhexamethylene biguanide, chlorhexidine, atropine sulfate, and oral itraconazole and resolved within 2 months.
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Two cases of toxic reaction to lithium carbonate are reported.
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A 51-yr-old nonsmoking male patient without any history of previous allergies, asthma, hay fever, or urticaria developed attacks of asthma when captopril was added to the nadolol and dyazide treatment for his high blood pressure.
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While this report is anecdotal, any new drug warrants intense monitoring for unexpected toxicities in the post-marketing period.
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Botulinum therapy was discontinued and nonsteroidal anti-inflammatory medication markedly reduced the new symptoms, which completely resolved within 3 months.
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Twenty-four hours after the administration of gemcitabine, a symmetric, bullous, herpetiform eruption appeared on his trunk and upper limbs.
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The day after clozapine was stopped, while he was still receiving clomipramine 150 mg/d, he began behaving oddly, started sweating profusely, shivering, and became tremulous, agitated, and confused.
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A case of toxic hepatitis caused by combination therapy with methotrexate and etretinate in the treatment of severe psoriasis is presented in a 47-year-old woman.
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Methanol toxicity can cause severe central nervous system insult in which a characteristic pattern of bilateral putaminal injury is noted on brain imaging studies.
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Simvastatin-induced rhabdomyolysis following cyclosporine treatment for uveitis.
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The clinical and allergologic features of this case strongly suggest type IV hypersensitivity.
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This fatal complication occurred despite a careful selection of the patient and the presence of a lytic state.
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OBJECTIVE: This case study provides practical information for general practitioners in the detection, assessment and management of patients with cough mixture opioid dependence.
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We suggest that irinotecan offers an effective treatment option for children with recurrent brain stem glioma and other genetic variants except UGT1A1 may be a risk factor for irinotecan-induced toxicity.
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Three patients, in whom tumour overkill by cytotoxic treatment, including high dose methotrexate with folinic acid rescue, resulted in the 'phosphate shower syndrome' (hyper-uricaemia, hyperkalaemia and hyperphosphataemia with hypocalcaemia and tetany, with metabolic acidosis and acute renal impairment) are described.
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Concurrent use of warfarin and 5-fluorouracil has resulted in elevated international normalized ratios (INRs).
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The nephrotic syndrome developed in a patient receiving therapy with gold for rheumatoid arthritis.
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Induction of glycosuria and hyperglycemia by topical corticosteroid therapy.
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Excluding other causes, Pentasa-associated pancytopenia was considered.
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Familiarity with and critical appraisal of the literature on pulmonary infiltration in immunocompromised patients can contribute to a clear diagnostic and management plan.
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Adverse effects are typically limited to treatment site erythema and erosion.
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She subsequently survived despite the development of convulsions, severe lactic acidosis (pH 6.86), hyperthermia (Temp 40.5 degrees C) and rhabdomyolysis.
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Recombinant human interferon-alpha has been used in the treatment of several cancers, but there have been several reports that it may exacerbate psoriasis or trigger off its onset.
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This case report describes a patient who was previously prescribed alendronate (Fosamax) and presented with postoperative hypophosphatemia and hypocalcemic tetany after bowel preparation with Fleet Phospho-Soda.
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In all three cases, an alleviation of headache intensity from severe to moderate was observed.
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Aggressive management of doxorubicin-induced cardiomyopathy associated with 'low' doses of doxorubicin.
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After 3 months of pharmacological wash out, patient become pregnant and manifested this severe malformation.
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Acute leukopenia associated with silver sulfadiazine therapy.
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Blood findings during blast transformation were heterogeneous, including normal blood morphologic findings in 1 patient, leukocytosis with circulating blasts and basophilia in 1, and marked pancytopenia in 1.
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On the fifth day of tocolysis with magnesium sulfate, nifedipine, terbutaline and betamethasone, edema developed in both labia.
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One patient required urgent liver transplantation for fulminant hepatic failure after the brief use of black cohosh.
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We report the spectrum of ocular toxicity following accidental inoculation of latex of Calotropis procera (Sodom apple) in 29 eyes between January 2003 and December 2006.
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Arterial hypertension associated with topical ocular use of phenylephrine in dogs.
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We diagnosed this case as danazol induced thrombocytopenia.
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PURPOSE: To report a case of traumatic flap dehiscence and Enterobacter keratitis 34 months after LASIK.
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Despite surgery and combination therapy with voriconazole, caspofungin, and terbinafine, the patient died 8 months after transplantation.
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Rush disease, or aggressive posterior ROP (AP-ROP), progresses rapidly to stage 5 disease without exhibiting the classical course that includes stages 1-3.
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Clofazimine induced nail changes.
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This case illustrates the potential decoupling of PSA response from disease status in flutamide withdrawal.
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Failure of intravenous ribavirin in the treatment of invasive adenovirus infection following allogeneic bone marrow transplantation: a case report.
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CASE SUMMARY: A 65-year-old patient chronically treated with the selective serotonin reuptake inhibitor (SSRI) citalopram developed confusion, agitation, tachycardia, tremors, myoclonic jerks and unsteady gait, consistent with serotonin syndrome, following initiation of fentanyl, and all symptoms and signs resolved following discontinuation of fentanyl.
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New onset diabetes mellitus (DM) and diabetic ketoacidosis (DKA) among patients using atypical antipsychotics is of clinical importance [1,2,5,7-10].
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Capecitabine 1500 mg taken by mouth twice daily was prescribed as the salvage chemotherapy.
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However, one patient exhibited severe hypersensitivity reactions including cardiac arrest and apnea, and another four patients developed eruptions, hypotension, and tachycardia soon after administration of CBDCA.
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Thus, tardive seizures in our cases are thought to be related to piperacillin and cefotiam.
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Catheterization revealed 90% midstenosis of the left anterior descending artery, which was successfully treated with percutaneous transluminal coronary angioplasty (PTCA) and stent placement.
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Although myelosuppression is mild, immunosuppression and superinfection are potential hazards of treatment with DCF.
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This was treated immediately with oral acyclovir.
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CONCLUSIONS: Intravitreal injection of triamcinolone is a commonly performed treatment for many retinal conditions.
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In addition, the deletion of chromosome no. 20, described as characteristic for PV, was found in 3 cells.
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The polycystic changes disappeared from the ovaries in 2 of the women after valproate therapy was discontinued, and the 2 women who had gained weight and developed amenorrhea while being treated with valproate lost weight and resumed menstruating after the change in medication.
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Chymopapain is a useful drug when used properly for lumbar disc disease and has the potential of eliminating three-fourths of lumbar disc surgery.
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Hypoglycemia induced by long-acting somatostatin analogues in a patient with nonfunctional neuroendocrine tumor.
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Fever, pulmonary infiltrates, and pleural effusion following acyclovir therapy for herpes zoster ophthalmicus.
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The association with etanercept therapy and granulomatous reactions is discussed along with the differential diagnosis.
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The rebound phenomenon in which HBV proliferates abruptly has not been experienced after withdrawal of lamivudine.
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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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Rebound headache after withdrawal of ergot alkaloids may lead to self-medication and overdosage, with subsequent risk of ergotism.
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After the patient underwent conservative treatment, the new symptoms resolved, and follow-up MR imaging and computed tomography demonstrated resorption of the epidural air in the lumbar region.
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Hormone therapy with leuprolide acetate (Lupron) is frequently used to treat prostate cancer, a common malignancy expected to be diagnosed in >180,000 men in the United States this year.
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Low serum Na+ and hypoosmolality in the absence of volume depletion, clinically manifest edema, and unaltered renal, adrenal, cardiac, or thyroid function suggest that this antiarrhythmic drug produced the syndrome of inappropriate antidiuretic hormone secretion (SIADH).
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Acute colonic diverticular perforation presenting as left ear pain and facial swelling due to cervical subcutaneous emphysema in a patient administered corticosteroids.
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