The American journal of the medical sciences
-
Case Reports
An unusual cause of thyrotoxic periodic paralysis: triiodothyronine-containing weight reducing agents.
Thyrotoxic periodic paralysis resulting from exogenous thyroid hormone administration (thyrotoxicosis factitia) has been rarely reported. We describe a 23-year-old man who presented with limbs paralysis upon awakening in the morning. Pertinent history revealed that he took drugs containing triiodothyronine (64 mug) and propranolol (40 mg) twice daily for weight reduction in the past month and discontinued these drugs 3 days before admission. ⋯ Despite normal serum free triiodothyronine and thyroxine levels, the suppressed concentration of thyroid stimulating hormone indicated hyperthyroidism. The low radioiodine uptake (4%) and serum thyroglobulin level (2 ng/mL) were consistent with thyrotoxicosis factitia. This is the first reported case of exogenous triiodothyronine-induced thyrotoxic periodic paralysis, which may have been precipitated by the withdrawal of propranolol.
-
Glycohemoglobin (HbA1c) estimation is the gold standard for assessing long-term glycemic control in diabetic patients. Some hemoglobin variants interfere with HbA1c assay, thus, limiting its utility. ⋯ However, hemoglobin N-Baltimore has not been reported to give false HbA1c estimation. We present a woman with mistaken diagnosis of diabetes due to hemoglobin N-Baltimore that produced a spuriously elevated HbA1c level.
-
To assess the incidence and risk factors for fat embolism syndrome. ⋯ The incidence of the fat embolism syndrome depends on the bone involved, whether fractures are isolated or multiple, the age of the patient and the gender. It rarely occurs as a result of medical conditions.
-
Clinical Trial
Intermittent suction of oral secretions before each positional change may reduce ventilator-associated pneumonia: a pilot study.
That ventilator-associated pneumonia (VAP) can be reduced by continuous and/or intermittent subglottic suction highlights the importance of clearance of oropharyngeal secretions. We prospectively evaluated the usefulness of intermittent suction of oral secretions before each positional change in reducing VAP. ⋯ Intermittent suction of oral secretions before each positional change may reduce VAP occurrence in ICU patients.