Clin Med
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Panton-Valentine leukocidin is a cytotoxin produced by Staphylococcus aureus. It was initially discovered by Van deVelde in 1894 due to its ability to lyse leukocytes. ⋯ Panton and Valentine described this strain of S. aureus as a non-life-threatening, soft-tissue infection that caused recurrent furunculosis and abscesses; however, it is currently implicated in more serious and invasive infections in children and young healthy adults. This paper presents a case of the most fatal of these infections: necrotising haemorrhagic pneumonia.
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Recent years have seen several advances in the management of endocrine diseases. These include novel drugs developed as a consequence of better understanding of the pathophysiology of endocrine conditions, as well as improved delivery methods for existing drugs. In this article, we summarise recent studies evaluating several drugs used in the treatment of endocrine disorders.
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There has been significant progress in the management of venous thromboembolism in recent years, with increased awareness and adequate thromboprophylaxis proving successful in reducing the morbidity and mortality associated with this condition. Most hospitals in the UK have specialists who run an anticoagulation clinic and ensure the adequate monitoring of, and compliance with, agents such as warfarin. In this Lesson of the Month, we describe an individual with treated congenital heart disease who developed extensive thrombosis while his warfarin control was considered to be in the therapeutic range.
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Opioids can induce respiratory depression by invoking a centrally mediated decrease in involuntary respiratory rate, which in severe cases can cause a decrease in oxygen saturation. If respiratory depression is opioid induced, both low respiratory rate and low oxygen saturation will be present. ⋯ Naloxone, an opioid antagonist, should be avoided if at all possible but, if essential, titrate slowly to respiratory function administering 20-100 µg intravenously every two minutes. If used as a bolus for a patient on long-term opioids for chronic cancer pain, then refractory pain and symptomatic opioid withdrawal can result.