Potentiating the Adverse Effects of Zolpidem in a Patient with Alcohol Dependence and SSRI use
Nitin Chopra, Abner Rayapati and Aarti Patel
Article Type: Case Report | First Published: July 29, 2015
Though rare, zolpidem has been implicated in perceptual disturbances. Zolpidem elimination can be reduced with liver or kidney pathology. Concomitant Selective Serotonin Reuptake Inhibitor (SSRI) and alcohol use have increased susceptibility to delirium. This case describes a 63 year old Caucasian male, seen by the consulting service, having depression and alcohol dependence, presenting with auditory and visual hallucinations with paranoid delusions. He was prescribed zolpidem 10mg for several years, but reported doubling his dose recently, until stopping the medication 7 days prior to hospita...
Left Atrial Versus Biatrial Maze Procedures in Atrial Fibrillation: Initial Institutional Randomized Trial with Literature Overview
Walid Ben Ali, Pierre Page, Jean Lambert, Michel Carrier and Denis Bouchard
Article Type: Research Article | First Published: July 27, 2015
The objective of study is to compare in a randomized fashion biatrial and left atrial Maze by continuous event recorder at one year follow-up. Methods: From January 2011 to December 2012, 19 patients were prospectively enrolled. Patients were allocated in 3 groups regarding their rythm, 7 continuous atrial fibrillation, 8 paroxysmal atrial fibrillation and 4 sinus rhythm with atrial size above 45 mm. Patients were randomized to receive left atrial or biatrial or not receive a Maze. Patients were followed prospectively for 1 year. The interrogation of the recorder was done at 6 and 12 months......
An Unusual Foreign Body in the Neck: A Case of Sternal Wire Migration
O'Connell BP, DeNino WF and O'Rourke AK
Article Type: Case Report | First Published: July 26, 2015
Migration of sternal wires is a rare, but potentially serious, complication of median sternotomy and there are a limited number of reports in the literature regarding such migration. Most of these reports document cardiac and/or vascular injuries related to thoracic migration of stainless steel wires. Imran et al. reported bilateral pneumothoraces due to lateral displacement of sternal wires. Rungatscher et al. described sternal wire segments adjacent to, and inside of, the sternal insertion of the sternocleidomastoid muscle resulting in an intramuscular hematoma, but the wire itself had not m...
A Review: Are All Inhaled Fibres, Such as Asbestos, Toxic?
Sumayah Abdul-Jabbar and Luigi G Martini
Article Type: Review Article | First Published: August 05, 2015
Exposure to asbestos is well known to have a causal relationship with the development of lung cancer. In order to understand the mechanism of this toxicity an extensive review was undertaken. Findings were able to show that the morphology of the asbestos (which is fibrous) has a marked correlation with its toxicity. It is this morphology that mutually contributes to enhanced aerodynamic properties making asbestos ideal for deposition in the lungs as well as giving it mutagenic properties. Therefore, it is inappropriate to ignore the intrinsic property of fires, especially due to an increase in...
Postmenopausal Calcified Pedunculated Large Subserous Leiomyoma: A Case Report
Ozhan Ozdemir, Cemal Resat Atalay, Mustafa Erkan Sari, Ertugrul Sen and Mehriban Nebioglu
Article Type: Case Report | First Published: August 03, 2015
A 72-year-old postmenopausal and nullipar woman presented with abdominopelvic pain and a palpable mass in the right lower quadrant. Ultrasonography showed a large, hyperechoic, solid mass. Contrast-enhanced computed tomography (CT) of the abdomen demonstrated a well-circumscribed mass. Rutine laboratuary tests and tumour markers revealed as normal. Total abdominal hysterectomy and bilateral salpingo-oophorectomy is the surgery of choice in this case. Histopathological examination confirmed a calcified leiomyoma. The majority of uterine leiomyomas are confidently diagnosed sonographically....
Plasmacytoma Located in the Posterior Mandible: A Case Report
Yavuz Findik, Timucin Baykul and Ummugulsum Alkis
Article Type: Case Report | First Published: August 03, 2015
Plasma cell neoplasm is characterized by a monoclonal neoplastic proliferation of plasma cells and solitary plasmocytoma of bone (SPB) is a localized form. SPB is most frequently seen in vertebrae and secondarily in long bones. Its presence in jaws is extremely rare. Here we report a unique case of plasmacytoma in the left side of mandible, a chronology for diagnosis of the lesion is also reviewed along with clinical, and radiographic evidence....
Common Errors in the Measurement of Blood Pressure
Article Type: Short Communication | First Published: August 03, 2015
Norman Kaplan said "The measurement of blood pressure is likely the clinical procedure of greatest importance that is performed in the sloppiest manner." It is of great importance that common and often overlooked errors in the measurement of blood pressure be addressed. Firstly, I would like to emphasize the importance of proper cuff size. It is well known that miscuffing or using an improper cuff size can lead to an inaccurate blood pressure measurement....
Evaluation of Empirical Antibiotic Therapy for the Treatment of Community-Acquired Urinary Tract Infections (CA-UTI)
Joao Pedro Aguiar, Filipa Alves da Costa and Patricia Cavaco Silva
Article Type: Research Article | First Published: July 28, 2015
Objectives: To characterize the pattern of indication of antibiotic regimens for CA-UTI; to evaluate the adequacy of antibiotic empirical therapy in CA-UTI and the resistance profile of the bacterial isolates. Methods: An observational study was conducted, where the prevalence and resistance profiles of the microorganisms involved and the pattern of antibiotic indication were investigated through a cross-sectional approach. Patients presenting with UTI symptomatology and antibiotic indication were recruited through pharmacies in the Lisbon area. Upon inclusion, participants collected a urine s...
Expanding the Art-Science of Chronic Disease Management in Primary Care: A Lifestyle Medicine Perspective
Article Type: Perspective | First Published: August 01, 2015
Changes in living patterns typically result in changes in disease structures within a society. The 'epidemiological transition', which describes the shift from infectious to chronic diseases for example, is common as countries shift from agrarian to industrial lifestyles. Population levels of obesity for example change as societies become more developed, with equivalent BMIs pre development apparently less dangerous than during or after development, as shown recently in China. Health practices then need to be modified to deal with such changes: Hence, the rise of a discipline of Lifestyle Medi...