OBJECTIVE: To assess the efficacy of various steroidal and nonsteroidal add-back regimes in ameliorating hypoestrogenic side effects of long-term GnRH agonist (GnRH-a) therapy in gynecologic patients. DESIGN: English language literature review. PATIENTS: Gynecologic patients administered GnRH-a as therapy for ovarian hyperandrogenism, premenstrual syndrome, dysfunctional uterine bleeding, uterine leiomyomata, and symptomatic ...

This year's DDW again presented us with an extremely interesting and very up-to-date variety of endoscopic abstracts, dealing with established as well as new technology, and increasingly attempting to evaluate relevant issues such as cost-effectiveness and outcome. As is the case every year, the present DDW Congress Report faces the ...

The effect of apolipoprotein E (apo E) common genotypes on fasting retinyl palmitate (RP) level was studied in 344 white individuals, of which 130 had intimal thickening of the carotid artery ("cases") and 214 were controls. In this sample the common apo E genotypes possessed a statistically significant effect on ...

PURPOSE: To present a case of improvement of ocular motility in a patient with chronic progressive external ophthalmoplegia (CPEO) with Coenzyme Q10. METHODS: Coenzyme Q10 300 mg daily was given for three years with a three-day trial period of 200 mg daily after one year. Ocular ductions were measured by ...

We present a case of magnesium toxic effects that demonstrates the wide spectrum of associated clinical signs and symptoms. As shown by the case report, the literature review, and the MEDWATCH database, physicians frequently neglect to consider hypermagnesemia in the differential diagnosis of this clinical presentation. Abnormal renal function is ...

A patient addicted to khat was successfully treated as an outpatient. He was detoxified with bromocriptine mesylate 1.25 mg. q 6 h which was titrated downward over 4 weeks. Khat is a bush historically indigenous to the Mideast. It has high addictive potential due to its constituent, "cathinone." Cathinone, (1(5) ...

Thrombolytics can cause cholesterol embolization syndrome (CES). This adverse effect has received less attention than other risks of thrombolytic therapy, such as systemic bleeding and hemorrhage, with only sporadic reports of CES in the literature. Risk factors have not been consistently identified and emphasized; therefore, occurrence of CES after thrombolysis ...

OBJECTIVE: To report 2 cases in which oral propantheline reduced the discomfort associated with sweating related to spinal cord injury (SCI), and to review the literature on the management of SCI-related sweating. CASE SUMMARIES: Case 1: A 27-year-old quadriplegic man with an American Spinal Injury Association (ASIA) Frankel class C ...

A relatively enduring and counterintuitive antimanic response to dextroamphetamine in a brain-injured adolescent who had failed trials involving divalproex, lithium, haloperidol, and carbamazepine is described. This finding combined with data from previous reports of antimanic effects of test doses of stimulants imply that such a pharmacological probe may prove relevant ...

OBJECTIVE: To evaluate the effect of computer-assisted interpretation of electrocardiograms (ECGs) on diagnostic decision making by primary care physicians. DESIGN: Randomized controlled trial. SETTING: Primary care physicians' outpatient clinics in or near the Minneapolis/St. Paul metropolitan area. PARTICIPANTS: Forty family physicians and general internists who were members of either of ...

Polydipsia occurs frequently in chronic schizophrenic patients, some of whom develop intermittent hyponatremia. Most therapeutic efforts have tried to control the hyponatremia. Four schizophrenic patients, followed for more than one year, showed improvement on clozapine. Case 1 was an outpatient without history of hyponatremia who improved from polydipsia and psychosis. ...

Many dentists have been surprised by recent media claims of periodontal benefits with a purportedly revolutionary dietary supplement. The research literature on coenzyme Q10's periodontal effects does not extend to the international English language dental literature, which perhaps explains the surprise. A review of the available literature does not give ...

Six subjects who developed individually significant auditory deprivation effects associated with monaural amplification were tracked for 6.2 to 15.1 years from the time of their initial hearing aid fitting. Each subject received binaural hearing aids after the auditory deprivation effect became apparent and used binaural amplification for at least 4 ...

Secretory diarrhea is characterized by painless, large volume, watery diarrhea (usually > 1 L), minimal effect on fasting, and a stool osmolality gap of less than 40. There are numerous causes of secretory diarrhea, including secretagogues, laxatives, medications, endogenous detergents, and bacterial enterotoxins. There are no controlled data on the ...

Three cases of female circumcision are presented together with a literature review. Unfortunately, this procedure frequently results in genital mutilation. Treatment with deinfibulation enables restoration of the external genitalia and vagina. Obstetric and gynaecological complications have been documented, but emotional and psychological effects may be difficult to assess. These women ...

Retinoids are synthetic derivatives of vitamin A. They are administered primarily for dermatological conditions, such as psoriasis, acne, and disorders of keratinization. Toxicity has proven a significant problem with long-term administration of the retinoids. Bone abnormalities mimicking seronegative spondyloarthropathy or diffuse idiopathic skeletal hyperostosis have been described in many cases, ...

Hypersensitivity mimicking gastroenteritis is a rare complication of azathioprine therapy for which the mechanism is unknown. We report a case of devastating diarrhoea and vomiting due to azathioprine treatment in which hypersensitivity to the imidazole moiety of azathioprine was demonstrated. This has important therapeutic implications: in this situation, 6-mercaptopurine, which ...

Minocycline-associated hyperpigmentation is an uncommon side effect. We report the case of a patient with pyoderma gangrenosum successfully treated with oral minocycline but complicated by marked hyperpigmentation in his pyoderma gangrenosum and acne scars. One of the clinical forms of minocycline hyperpigmentation includes dark-blue or black macules in depressed acne ...

Dextromethorphan (DM), the dextrorotatory isomer of 3-hydroxy-N-methylmorphinan, is the main ingredient in a number of widely available, over-the-counter antitussives. Initial studies (Bornstein 1968) showed that it possessed no respiratory suppressant effects and no addiction liability. Subsequently, however, several articles reporting abuse of this drug have appeared in the literature. The ...

OBJECTIVE: To review a case experience and published reports of treatment of supraventricular tachycardia with adenosine in pregnant women. DATA SOURCES: Published reports and clinical experience. DATA SYNTHESIS: Seven pregnant women with supraventricular tachycardia treated with adenosine have been described in the literature. We describe an eighth patient. Treatment has ...

Topically applied anesthetic spray is commonly used as part of premedication for general anesthesia and for endoscopic procedures; it is rarely associated with side effects. In this report, we describe two cases of toxic methemoglobinemia that resulted from topically applied anesthetic spray used before endoscopy. In both cases, standard doses ...

85 cases of apoplexy were treated with scalp acupuncture, including 52 cases by the method of slow-rapid reinforcing-reducing and 33 cases by the method of flat twisting. The total effective rates differed insignificantly between the 2 methods. However, in respects of improving the myodynamia and motile functional disturbances of the ...

Hearing losses resulting from noise exposure have been described for over 150 years. Studies looking at the effect music might have on hearing began more recently in the 1960s. Such work has established a firm association between live rock and roll music and hearing loss in musicians. However, the evidence ...

By needling chiefly an empirical point Shengen with the penetration method, a total effective rate of 96.04% was obtained in 101 cases of apoplectic hemiplegia. In comparison with 38 controls, either the therapeutic effects and courses or other indices observed in the needling group were shown to be encouraging.

A case of a West Indian patient is reported who developed abnormal blue-grey pigmentation on exposed areas of skin following treatment with low dose stelazine. Oculocutaneous melanosis is a well-recognized side-effect of prolonged phenothiazine treatment. In this condition the areas of skin exposed to sunlight develop a violaceous, blue-grey or ...

The neurotoxic effects from chronic exposure to high concentrations of manganese dust are well known from studies of highly exposed miners, as well as from numerous clinical reports. The very first of these reports dates back to the early 19th century (Couper, 1837). A thorough review of the toxicity of ...

Colchicine is an effective medication in the prevention and treatment of amyloidosis of familial Mediterranean fever. Its therapeutic effect depends on the stage of renal disease and the drug dose. To evaluate colchicine effect in AA amyloidosis of other diseases and in primary AL amyloidosis, the literature was reviewed. Findings ...

Methylmethacrylate has been used extensively in the United States since 1971 for the fixation of orthopedic prostheses. A chemical compound that generates a considerable amount of heat as it sets and hardens, it has been known to cause mild to moderate hypotension as well as cardiovascular collapse and death in ...

Only rarely have serious side effects been reported with the use of intravenous dipyridamole. We describe two cases of severe bradycardia, of which one led to asystole, in patients undergoing dipyridamole-thallium studies. The association between beta blocker therapy and the seven reported cases of asystole with dipyridamole is discussed and ...

The p(HEMA) composite is shown to be a possibly effective allografting material for therapy of periodontal disease. Three cases from a clinical pilot study are presented in this report. The p(HEMA) composite may be used alone or as a part of more complex biomaterial, together with tricalcium phosphate ceramics. Further ...

The primary objective of this article is to review information pertinent to and emphasize the seriousness of a potential adverse monoamine oxidase inhibitor (MAOI)-serotonin uptake inhibitor interaction by considering, within the context of preclinical data, clinical cases in which an MAOI and fluoxetine hydrochloride, a specific serotonin uptake inhibitor, were ...

This case report concerns a woman thought to have a low blood count myelodysplastic syndrome who responded poorly to cytosine arabinoside. She was treated with Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) and had an adverse reaction resembling a capillary leak syndrome. Later on, an episode of post-transfusion hemoglobinuria led to the ...

Acrylates are compounds used in a variety of industrial fields and their use is increasing. They have many features which make them superior to formerly used chemicals, regarding both their industrial use and their possible health effects. Contact sensitization is, however, one of their well known adverse health effects but ...

Sixty-two cases of neurocysticercosis (NCC) were examined over a period of five years. Convulsive seizure was the commonest presentation (57%). The other modes of presentation included features of raised intracranial pressure (19%) meningoencephalitis (9%), "Stroke" like onset (4%) and progressive dementia (6%). Clinical signs were scanty. Six patients had papilloedema, ...

A case of severe hyponatremia in a polydipsic 64-year-old man is described. He was unsuccessfully treated with both demeclocycline and lithium carbonate. However, low-dose captopril reversed the polydipsia and resulted in sustained normal serum sodium levels. We believe the antidipsogenic effect of captopril may benefit some patients with polydipsia and ...

We present four case reports of elderly hearing-impaired persons demonstrating a binaural interference effect. Performance measures were poorer when stimulation was binaural than when it was monaural. In the first case the effect is shown for aided speech recognition scores. In the second case it is shown in topographic brain ...

A 50 year-old female ingested 10 seeds from the pods of the Wisteria plant due to curiosity and the perception that they were edible beans. Subsequent toxic effects included headache, gastroenteritis, hematemesis, dizziness, confusion, diaphoresis, and a syncopal episode. She continued to feel tired and complained of being dizzy 5 ...

Dyskinesia is a recognized but uncommon side-effect of treatment with phenytoin. Two additional cases of dyskinesia during treatment with phenytoin are described; both had radiographically documented thalamic infarctions. The reported experience to date with movement disorders induced by phenytoin is reviewed and the clinical features summarized. The available experimental evidence ...

This review, which will be presented in seven parts is concerned with the use of rapeseed meal as an animal feeding stuff. The presence of glucosinolates in the meal limits its use due to a number of antinutritional and physiological effects. Whilst not in itself exhaustive, this review updates earlier ...

In the context of the European project, the diffusion of 10 selected cases of minimally invasive therapy (MIT) in the Dutch health care system was documented and analyzed. In each case the diffusion pattern resulting from the balance of stimulating and impeding factors is described, and summarized in a matrix ...

The retruded maxilla in the Class III skeletal pattern could be effectively corrected with the protraction facemask in selected cases. A review of the different types of orthopaedic appliances used in Class III treatment, the rationale for facemask therapy, the effect of this treatment and the factors affecting stability is ...

There is no report of the effects of 'Ecstasy' (3,4-methylenedioxymethylamphetamine) poisoning in childhood. The case of a 13 month old boy who ingested one capsule of Ecstasy is reported. Neurological and cardiovascular side effects predominated, which responded well to treatment with a chlormethiazole infusion.

Intranasal betamethasone sodium phosphate drops (Betnesol) are frequently used to relieve nasal congestion due to polyposis. We report a case of significant hypothalamic-pituitary-adrenal suppression secondary to the long-term use of intranasal betamethasone drops. This case emphasizes that the topical application of potent corticosteroids may produce systemic effects.

Hypersomatotropism is accompanied by a significant increase in GFR and RPF. A case of a patient with acromegaly and supranormal renal function as measured by inulin and p-aminohippurate clearances is reported. The literature regarding the effects of growth hormone on renal function is reviewed, and the potential mechanisms of action ...

Droperidol has both anti-emetic and neuroleptic properties and its epidural administration has been reported (Naji et al. 1990). Its side effects when administered via this route are not known. We report a case of long-term (2 months) epidural administration of droperidol to a cancer patient who was receiving epidural morphine ...

We report three cases of acute Achilles tendonitis following administration of isotretinoin for acne vulgaris. In this rarely documented side-effect, the symptoms were intimately related to the isotretinoin therapy. Modification of dose regimes permitted control of the tendonitis and an eventual successful response to isotretinoin therapy. Oral isotretinoin has been ...

We tested experimentally the hypothesis that decreasing capillary red blood cell (RBC) density (dRBC) reduces the tissue diffusing capacity of frog skin to CO (DtiCO) and O2 (DtiO2). The effects of dRBC on CO2 transport were also assessed. C18O, O2, and CO2 transport between the skin and a cutaneous sample ...

Benign paroxysmal torticollis is a self-limiting condition occurring during infancy. It resolves by the age of two to three years. Periodic episodes of torticollis may randomly alternate from side to side and be associated with other symptoms. The aetiology is unknown and no treatment is effective. It is relatively uncommon, ...

Recent literature on caring for people with serious mental illnesses reflects a growing belief in the effectiveness of case management services for this population. This article reviews recent outcome studies on case management to assess the extent to which prevailing claims that it is effective are supported empirically. Based on ...

We have attempted to review body fluid distribution by compartments so that the reader understands the physiology of ICF and ECF, and the relationship between interstitial and intravascular fluids. Crystalloids such as NS and RL are distributed to the ECF, whereas colloids primarily remain intravascular for longer periods. Although effective, ...