International journal of clinical practice
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Int. J. Clin. Pract. · Apr 2001
Case ReportsBupropion overdose: a potential problem with the new 'miracle' anti-smoking drug.
Bupropion (Zyban) has recently been launched in the UK as an aid to smoking cessation. As a result of the considerable publicity, there has been unprecedented demand for this new drug in primary care. ⋯ Three recovered with simple supportive measures; one one was critically ill and required admission to the intensive care unit. There are several case reports on bupropion overdose in the US but none so far in the UK.
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Int. J. Clin. Pract. · Mar 2001
Case ReportsAcute adrenocortical crisis: three different presentations.
The adrenal cortex normally produces three principal steroid hormones: the glucocorticoid cortisol, the mineralocorticoid aldosterone, and a small quantity of sex steroids. In primary adrenocortical insufficiency, there is a deficiency of both cortisol and aldosterone with characteristic clinical and laboratory findings. ⋯ Acute adrenocortical crisis is an absolute medical emergency and its presentation is not always typical. We describe three recent cases of acute adrenocortical crisis in our hospital who presented in three different ways in three different wards.
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Int. J. Clin. Pract. · Dec 2000
A cross-sectional survey of the clinical and psychological features of low back pain and consequent work handicap: use of the Quebec Task Force classification.
A hospital-based cross-sectional study examined 657 consecutive referrals with low back pain over two years to a district rheumatology service serving a population of about 250,000 people. Five hundred and thirty-eight had mechanical/degenerative low back pain. The mean age was 48.6 (range 18-80 SD 15.3) years; 64% were women. ⋯ Women were more impaired (p = 0.02) than men but had similar disabilities (mean Roland score 11.7, range 0-24 SD 6.5). Fifty-three per cent of patients were receiving benefits and were significantly more likely to have musculoskeletal comorbidities than those in work (p < 0.025). It is concluded that the Quebec Task Force classification of low back pain impairment is a helpful descriptor and related to both physical and psychological disability and handicap in employment.
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With the increasing use of natural rubber products, latex allergy is becoming a major health concern among patients and healthcare workers. The aim of this study was to determine the availability of a latex allergy protocol and essential latex-free products in theatres. The number of latex allergy complaints among patients and theatre personnel were also studied. ⋯ Overall less than one-third of theatres in the UK have latex-free products set aside for use. A total of 505 patients with latex allergy underwent surgery; of these, there were four deaths, 18 major anaphylaxes and 483 minor complaints such as skin rash; 239 theatre personnel reported latex allergic reactions and one had a severe anaphylactic reaction. The number of cases with latex-related complications might be reduced if all hospitals had a latex allergy protocol and a range of essential latex-free products.