Southern medical journal
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Hemoptysis is an important symptom that requires broad evaluation, including invasive procedures. Nevertheless, in a considerable number of patients, the cause of hemoptysis may not be adequately determined despite extensive investigations. ⋯ Therefore, there is an urgent need for increased awareness of the disease in order to avoid unnecessary, expensive and sometimes dangerous medical treatment and manipulations. We report a case of Munchausen hemoptysis as a reminder that factitious origins should be added in the differential diagnosis of hemoptysis of unclear etiology.
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Southern medical journal · Jan 2006
Comparative StudyEffect of ciprofloxacin and levofloxacin on the QT interval: is this a significant "clinical" event?
The widespread use of the fluoroquinolones has raised the question of the cardiac safety of these medications. This widespread use of this class of antibiotics has displayed their safety profile, which is actually more favorable than many other drug classes. The cardiac toxicity issue at the center of this discussion is the prolongation of the QT interval leading to torsade de pointes. Ciprofloxacin and levofloxacin, two of the more commonly used fluoroquinolones, are considered less likely than other fluoroquinolones to prolong the QT interval. The authors set out to evaluate the effect on the QT interval of patients after administration of ciprofloxacin and levofloxacin. ⋯ Neither levofloxacin nor ciprofloxacin significantly prolonged the mean QTc interval over baseline. When electrolyte deficiencies in one of the patients evaluated were taken into account, this also held true for the longest QTc interval. There is, therefore, evidence that taking ciprofloxacin or levofloxacin, assuming that there are not any concurrent risk factors, will not cause a significant prolongation in the QT interval.
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Southern medical journal · Jan 2006
Comparative StudyComparison of ilioinguinal-iliohypogastric nerve block versus spinal anesthesia for inguinal herniorrhaphy.
This study was carried out to determine the optimal anesthetic technique for use in elective herniorrhaphy. ⋯ The use of IHNB for patients undergoing herniorrhaphy resulted in a shorter time-to-home readiness, quicker oral intake post surgery, and no need for recovery room care, when compared with the use of SA.
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Acetaminophen (APAP) is the most common drug overdose in pregnancy. Available data regarding APAP overdose in pregnancy is limited to case reports and a small prospective case series. APAP has been demonstrated to cross the placenta and in toxic doses may harm the fetal and maternal hepatocytes. ⋯ Only English language papers were reviewed. Articles were selected on the basis of relevance to the topic. Pertinent citations found in the selected articles were also reviewed.