Postgraduate medical journal
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The use of HMG Co-A reductase inhibitors following acute myocardial infarction in hospital practice.
Treatment with a HMG-CoA reductase inhibitor (statin) following a myocardial infarction has been shown to reduce the incidence of subsequent coronary revascularisation, myocardial infarction and cardiovascular death. The majority (89%) of patients admitted to the coronary care unit of our hospital received a fasting cholesterol check as part of a routine coronary care unit protocol. ⋯ Furthermore, those receiving statins were given smaller doses than those used in clinical trials. One way to ensure patients receive adequate treatment with statins, may be to include it as part of a coronary care unit protocol.
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We describe a 39-year-old woman presenting with a painless solitary thyroid nodule, initially without signs suggesting thyroiditis. The serum level of thyrotropin was suppressed whereas those of thyroxine and triiodothyronine were normal. Fine needle aspiration cytology showed no signs of inflammation or malignancy. ⋯ At that time, the diagnosis of subacute thyroiditis was made. Upon treatment with steroids the patient's symptoms as well as the thyroid nodule resolved. This case illustrates that subacute thyroiditis de Quervain may present as a solitary, painless nodule with suppressed thyrotropin and should therefore be considered in the differential diagnosis of such lesions.
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A fatal case of gastric rupture following the Heimlich manoeuvre is reported. This life-threatening complication has only been reported previously in seven patients with a high mortality rate. All patients should be assessed immediately following this manoeuvre for any potentially life-threatening complications.