Southern medical journal
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Southern medical journal · Feb 1994
Anticardiolipin antibodies in a sample of chronic schizophrenics receiving neuroleptic therapy.
Drug-induced antiphospholipid antibodies have been considered insignificant, a belief that has recently been questioned. Previous studies noted an association between chlorpromazine treatment and the presence of anticardiolipin antibodies (ACA), especially IgM ACA, and have suggested that thrombosis might be more likely in the presence of IgG ACA. ⋯ IgG ACA was present in 7 (26%) of the 27, and IgM ACA was present in 5 (19%), yet none had shown any manifestations of cerebrovascular disease since initiation of neuroleptic therapy. These data suggest that drug-induced ACA do not predispose to cerebrovascular disease, even when IgG ACA is predominant.
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Southern medical journal · Feb 1994
Case ReportsFulminant pancreatitis associated with lisinopril therapy.
Adding to the growing awareness of medications that can cause pancreatitis is a small but significant number of reports implicating the angiotensin converting enzyme (ACE) inhibitors. In this report, I describe the case of a patient who had no risk factors for pancreatitis and who was taking no medications known to cause pancreatitis other than lisinopril. The abruptness, severity, and fulminant course of this case of probable ACE inhibitor-induced pancreatitis are unprecedented in the medical literature. ⋯ The medical literature concerning pancreatitis and articles reviewing ACE inhibitors do not make note of the relationship between the two. Greater awareness of this association will promote a higher index of suspicion in appropriate clinical settings. Further reporting of cases and clinical research into the cause and prevention of drug-induced pancreatitis appears to be indicated.
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Southern medical journal · Jan 1994
Multicenter StudyAre emergency physicians too stingy with analgesics?
Several recent reports suggest that emergency physicians do not use adequate analgesia for patients with acutely painful conditions in the emergency department (ED). To quantify the extent of this problem, we retrospectively studied 401 patients who were treated for acute fracture over a 17-day period in eight area-wide emergency departments. ⋯ Only 121 patients (30%) received analgesics while in the ED; neither fracture site, ED setting, or patient age significantly altered analgesic dispensing practices. We conclude that inadequate use of analgesics in patients who come to the ED for treatment of acute fractures is widespread and that efforts aimed at improving the appropriate use of analgesics in the ED are warranted.
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Southern medical journal · Dec 1993
Case ReportsRenal infarction associated with cocaine use and latent protein C deficiency.
We have described the case of a patient with a renal thrombosis and renal infarction associated with cocaine use and protein C deficiency. We propose that patients with similar presentations receive a thorough evaluation for a hypercoagulable state, including protein C levels. Once the diagnosis is made, immediate intervention is required to protect renal function.
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Southern medical journal · Nov 1993
Case ReportsNeuroimaging of arachnoiditis induced by spinal anesthesia.
Despite the simplicity, effectiveness, and safety of spinal anesthesia, arachnoiditis can occur as a complication. The cause of this is often unknown, especially since disposable spinal kits are now normally used. ⋯ This mode of investigation is often sufficient to establish the diagnosis. When necessary, it can be augmented by myelography and CT.