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Persistent choreoathetosis in a fatal olanzapine overdose: drug kinetics, neuroimaging, and neuropathology.
Davis LE, Becher MW, Tlomak W, Benson BE, Lee RR, Fisher EC.
Neurology Service, New Mexico VA Health Care System, Albuquerque 87108, USA.
PMID: 15625197 [PubMed - in process]
Complement consumption associated with eczematous cutaneous reaction during infusions of high doses of intravenous immunoglobulin.
Sarmiento E, Micheloud D, Carbone J.
Publication Types:
PMID: 15377375 [PubMed - indexed for MEDLINE]
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Atypical moles in a patient undergoing chemotherapy with oral 5-fluorouracil prodrug.
Fukushima S, Hatta N.
Division of Dermatology, Anamizu General Hospital, Fugeshi, Japan.
We present a patient with multiple pigmented lesions on the palms, soles, oral mucosa and nails after chemotherapy with oral 5-fluorouracil (5-FU) prodrug. Dermoscopically, most of the macules showed similar features, with pigmentation present predominantly on the crista superficialis, while a large, dark macule also showed pigmentation along the sulcus superficialis with irregular hyperpigmentation and depigmentation, suggesting malignancy. However, histologically, both types of lesion showed basal hyperpigmentation and the presence of a small number of large atypical melanocytes. We diagnosed these lesions as pigment flecks induced by 5-FU, and the pigmented lesions gradually diminished after the cessation of chemotherapy. Our findings suggested that immunosuppression and 5-FU led to the development of the atypical pigmented lesions.
Publication Types:
PMID: 15377362 [PubMed - indexed for MEDLINE]
[Imatinib mesylate-induced acute cytolytic hepatitis]
[Article in French]
Rocca P, El Jastimi S, Troncy J, Scoazec JY, Boucher A, Vial T, Trepo C, Zoulim F.
Publication Types:
PMID: 15523233 [PubMed - indexed for MEDLINE]
Change in profile of acute self drug-poisonings over a 10-year period.
Staikowsky F, Theil F, Mercadier P, Candella S, Benais JP.
Service des Urgences, Centre Hospitalier Universitaire Tenon, 4 rue de la Chine-75020 Paris, France. frederik.staikowsky@wanadoo.fr
All acute, deliberate, drug-poisoning-related emergency department visits over two periods of one year, 1992-1993 (P1) and 2001-2002 (P2), were reviewed to investigate trends in substances used for acute self drug-poisonings over a 10-year period. For P1 and P2 respectively, 804 and 830 episodes of acute self drug-poisonings were compared. For the two studied periods, psycholeptic drugs predominated (78 and 77%); however, benzodiazepines declined (67 to 55%; P <0.01) and antidepressants increased (9.5 to 15%; P <0.01). Moreover, the type of antidepressant changed markedly with a decrease of the imipraminic antidepressants (48.4 to 10.7%) and an increase of selective serotonin reuptake inhibitors (31.2 to 74%). The proportion of benzodiazepine-related drugs increased with time (7.9 to 14.1%). The proportion of analgesics was 5.4% for P1 and 7.3% for P2; paracetamol, alone or associated to other compounds, remained the most incriminated. Nevertheless, opioids were more often mentioned during the later period (11.6 to 24.5%). The trend of the different pharmacological families used in acute self drug-poisonings is not fundamentally different over a 10-year period. However, there are some qualitative modifications, which are important for readjusting the emergency physician's toxicological knowledge and public health actions.
PMID: 15625775 [PubMed - in process]
Comment in:
Ingested arsenic, cigarette smoking, and lung cancer risk: a follow-up study in arseniasis-endemic areas in Taiwan.
Chen CL, Hsu LI, Chiou HY, Hsueh YM, Chen SY, Wu MM, Chen CJ; Blackfoot Disease Study Group.
Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan.
CONTEXT: Arsenic has been documented as a lung carcinogen in humans in only a few follow-up studies, which were limited by a small number of cases or the lack of information on cigarette smoking. OBJECTIVES: To elucidate the dose-response relationship between ingested arsenic and lung cancer and to assess the effect of cigarette smoking on the arsenic-lung cancer association. DESIGN, SETTING, AND PARTICIPANTS: A total of 2503 residents in southwestern and 8088 in northeastern arseniasis-endemic areas in Taiwan were followed up for an average period of 8 years. Information on arsenic exposure, cigarette smoking, and other risk factors was collected at enrollment through standardized questionnaire interview. MAIN OUTCOME MEASURES: The incidence of lung cancer was ascertained through linkage with national cancer registry profiles in Taiwan (January 1985-December 2000). The joint effect of arsenic and cigarette smoking was estimated by both etiologic fraction and synergy index. RESULTS: There were 139 newly diagnosed lung cancer cases during a follow-up period of 83,783 person-years. After adjustment for cigarette smoking and other risk factors, there was a monotonic trend of lung cancer risk by arsenic level in drinking water of less than 10 to 700 microg/L or more (P<.001). The relative risk was 3.29 (95% confidence interval, 1.60-6.78) for the highest arsenic level compared with the lowest. The etiologic fraction of lung cancer attributable to the joint exposure of ingested arsenic and cigarette smoking ranged from 32% to 55%. The synergy indices ranged from 1.62 to 2.52, indicating a synergistic effect of ingested arsenic and cigarette smoking on lung cancer. CONCLUSIONS: There was a significant dose-response trend of ingested arsenic on lung cancer risk, which was more prominent among cigarette smokers. The risk assessment of lung cancer induced by ingested arsenic should take cigarette smoking into consideration.
PMID: 15613666 [PubMed - indexed for MEDLINE]
Recovery of a patient from clinical rabies--Wisconsin, 2004.
Centers for Disease Control and Prevention (CDC).
Rabies is a viral infection of the central nervous system, usually contracted from the bite of an infected animal, and is nearly always fatal without proper postexposure prophylaxis (PEP). In October 2004, a previously healthy female aged 15 years in Fond du Lac County, Wisconsin, received a diagnosis of rabies after being bitten by a bat approximately 1 month before symptom onset. This report summarizes the investigation conducted by the Wisconsin Division of Public Health (WDPH), the public health response in Fond du Lac County, and the patient's clinical course through December 17. This is the first documented recovery from clinical rabies by a patient who had not received either pre- or postexposure prophylaxis for rabies.
Publication Types:
PMID: 15614231 [PubMed - indexed for MEDLINE]
Clinical practice. Prophylaxis against rabies.
Rupprecht CE, Gibbons RV.
Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. cyr5@cdc.gov
Publication Types:
PMID: 15602023 [PubMed - indexed for MEDLINE]
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