Volume 1997, No. 3 February 15, 1997
Identifieur interne : 002592 ( Istex/Corpus ); précédent : 002591; suivant : 002593Volume 1997, No. 3 February 15, 1997
Auteurs :Source :
- Clin-Alert [ 0069-4770 ] ; 1997-01.
English descriptors
- Teeft :
- Abdominal examination, Abdominal pain, Abdominal tenderness, Acute pancreatitis, Arachnoid cyst, Arbitration award, Authors state, Bile duct syndrome, Bile ducts, Blister pack, Circuit court, Defendant neurosurgeon, Emergency room, Enalapril, Epidural catheter, First episode, First patient, Fracture, Fresh blood, Gastroenterol, Hospital admission, Ileocecal valve, Laboratory test values, Last pill, Liver function test values, Malpractice verdicts settlements experts, Medical records, Medication, Methotrexate, Methotrexate therapy, Minocycline, Month interruption, Neck extension, Neurosurgeon, Operative procedure, Operative report, Other causes, Pancreatitis, Portal tracts, Rheumatoid arthritis, Right foot, Second patient, Serum amylase level, Spinal, Spinal aura, Stress fracture, Sudden onset, Symptom, Weight loss.
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DOI: 10.1177/006947709703500103
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ISTEX:23B6686C150EEA9083BFDC2AD435B721FB25F4C8Le document en format XML
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Pellenberg</json:string><json:string>Disability</json:string><json:string>George HatheB</json:string><json:string>Dirk Franzen</json:string><json:string>Heath</json:string><json:string>George</json:string><json:string>Donna L Ptogler</json:string><json:string>Wales Hosp</json:string></persName><placeName><json:string>San Diego</json:string><json:string>Palermo</json:string><json:string>Seattle</json:string><json:string>Brussels</json:string><json:string>MA</json:string><json:string>Salem</json:string><json:string>Italy</json:string><json:string>Belgium</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>Hubbel et al</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/M70-J8ZL84J3-D</json:string></ark><categories><wos></wos><scienceMetrix></scienceMetrix><scopus><json:string>1 - Life Sciences</json:string><json:string>2 - Pharmacology, Toxicology and Pharmaceutics</json:string><json:string>3 - Pharmacology</json:string><json:string>1 - Life Sciences</json:string><json:string>2 - Pharmacology, Toxicology and Pharmaceutics</json:string><json:string>3 - Toxicology</json:string></scopus></categories><publicationDate>1997</publicationDate><copyrightDate>1997</copyrightDate><doi><json:string>10.1177/006947709703500103</json:string></doi><id>23B6686C150EEA9083BFDC2AD435B721FB25F4C8</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/M70-J8ZL84J3-D/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/M70-J8ZL84J3-D/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/M70-J8ZL84J3-D/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Volume 1997, No. 3 February 15, 1997</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://scientific-publisher.data.istex.fr">Sage Publications</publisher><pubPlace>Sage CA: Thousand Oaks, CA</pubPlace><availability><licence><p>sage</p></licence></availability><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-0J1N7DQT-B"></p><date>1997</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Volume 1997, No. 3 February 15, 1997</title><idno type="istex">23B6686C150EEA9083BFDC2AD435B721FB25F4C8</idno><idno type="ark">ark:/67375/M70-J8ZL84J3-D</idno><idno type="DOI">10.1177/006947709703500103</idno><idno type="article-id">10.1177_006947709703500103</idno></analytic><monogr><title level="j">Clin-Alert</title><idno type="pISSN">0069-4770</idno><idno type="eISSN">1530-812X</idno><idno type="publisher-id">CLA</idno><idno type="PublisherID-hwp">spcla</idno><imprint><publisher>Sage Publications</publisher><pubPlace>Sage CA: Thousand Oaks, CA</pubPlace><date type="published" when="1997-01"></date><biblScope unit="volume">35</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="17">17</biblScope><biblScope unit="page" to="24">24</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1997</date></creation><langUsage><language ident="en">en</language></langUsage></profileDesc><revisionDesc><change when="1997-01">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/M70-J8ZL84J3-D/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus sage not found" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" dtd-version="2.3" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">spcla</journal-id><journal-id journal-id-type="publisher-id">CLA</journal-id><journal-title>Clin-Alert</journal-title><issn pub-type="ppub">0069-4770</issn><publisher>
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</publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1177/006947709703500103</article-id><article-id pub-id-type="publisher-id">10.1177_006947709703500103</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Volume 1997, No. 3 February 15, 1997</article-title></title-group><pub-date pub-type="ppub"><month>1</month><year>1997</year></pub-date><volume>35</volume><issue>1</issue><fpage>17</fpage><lpage>24</lpage><custom-meta-wrap><custom-meta xlink:type="simple"><meta-name>sagemeta-type</meta-name><meta-value>Journal Article</meta-value></custom-meta><custom-meta xlink:type="simple"><meta-name>search-text</meta-name><meta-value>17 Volume 1997, No. 3 February 15, 1997 SAGE Publications, Inc.1997DOI: 10.1177/006947709703500103 ~No . 27 INDOIETHACIN Enteropathy A 56-year-old woman with a long history of ankylosing spondylitis was prescribed indomethacin 150 mg daily. However, on her own initiative, she had been taking no less than 300 mg daily. Five months before hospital admission, the patient began to experience episodes of abdominal colicky pain of progressive intensity and duration, twenty to thirty minutes after eating. Sometimes the pain was accompanied by the appearance of well defined abdominal masses of variable location, coinciding with the peak of pain and disappearing with its diminution. This was followed by delayed postprandial vomiting; she reported weight loss since onset of her symptoms. On examination, her abdomen was distended, and she experienced generalized pain on palpation. Abdominal x-ray examination showed marked distention of the bowel loops and air-fluid levels. Because her episodes of pain continued, exploratory laparotomy was performed, showing an unyielding invagination containing an elastic mass with typical pathologic features of inflammatory fibroid polyp. A 16 cm small intestine resection and an end-to-end anastomosis were performed after which, the patient had no further symptoms. The authors state that abundant fibrous tissue formation is the common feature of all subsets of NSAID-induced lesions of the small or large bowel that later evolve to a fibrous stricture, diaphragm-like or flat, or, in rare instances, to formation of inflammatory fibroid polyp.- Indomethacin ['Indocin'l Miniz-Grijalvo 0 et al (Servicio de Medicina Interna Hosp Univ Virgen del Rocio., Avd. ~lanuel Siurot, s/n, 41013 Sevilla Spain) Could fibroid polyp be a manifestation of enteropathy induced by nonsteroidal anti-inflammatory drugs? Amer J Gastroenterol 92:170-171 (Jan) 1997 18 No. 28 MINOCYCLINE Lupus-Like Syndrome ' A 21-year-old woman developed pain and stiffness in her wrists, fingers, knees, elbows, shoulders, cervical spine, and ankles in conjunction with fever, sore throat, malaise, and fatigue. When her symptoms became severe, she was admitted to hospital. Based on results of clinical tests, a possible lupus-like syndrome was diagnosed. She was treated with prednisone with resolution of her symptoms. Eight months after the first lupus-like episode, while the patient was still taking prednisone, her symptoms recurred. The prednisone dosage was increased and hydroxychloroquine was added to her treatment regimen. Both drugs were stopped 10 months later. After she had been without treatment for 9 months, a dermatologist prescribed minocycline for treatment of her acne. After taking 2 tablets, the patient complained of arthralgia in her wrists, proximal interphalangeal joints, cervical neck, and shoulders. Minocycline was discontinued, and the pain disappeared within a week without treatment. A month later, rechallenge with only one tablet of minocycline provoked the same symptoms. At this time, it was learned that the patient had previously received minocycline for 14 months before the first episode of lupus-like symptoms and for some weeks before the second flare-up of symptoms. The authors believe that anti-nuclear antibody assays during the course of lupus-like symptoms in patients receiving minocycline should contribute to better management of their symptoms.- Minocycline ['Minocin'] ] Masson C et al (Service de Rhumatologie CHU d'Angers 49033 Angers cedex 01 France) Minocycline-related lupus. J Rheum 23:2160-2161, 1996 No. 29 TRIMETHOPRIM-SULFAMETHOXAZOLE Vanishing Bile Duct Syndrome Five days after a therapeutic course of trimethoprim-sulfamethaxazole 160/800 mg for treatment of prostatitis, a 57-year-old man developed jaundice. Laboratory test values showed elevated liver function test values. Drug-induced cholestasis was suspected, and trimethoprim-sulfamethoxazole was discontinued. Because of persistent abnormalities on liver function tests, a liver biopsy was performed and showed severe intrahepatic cholestasis and bile ducts in fewer than 25 percent of the portal tracts. He was referred seven months later for progressive cholestasis. Physical examination showed only icterus and mild hepatomegaly. Prednisolone was started for the possibility of drug-induced liver injury; however, nine months after the development of jaundice, the patient complained of persistent nausea, frequent emesis, and weight loss. Liver function test values were elevated. Because of clinical deterioration, he underwent an orthotopic liver transplantation. Histologic sections of his liver showed extensive fibrosis and almost complete loss of bile ducts from the portal tracts. The authors wish to alert physicians to the potentially serious hepatotoxicity associated with this commonly used drug.- Trimethoprim-Sulfamethoxazole ['Septra'] Yao f et al (Div Gastroenterol Dept Med Univ California San Diego Med Cen 200 West Arbor Dr San Diego CA 92103-8413) Trimethoprim- sulfamethoxazole-induced vanishing bile duct syndrome. Amer J Gastroenterol 92:167-169 (Jan) 1997 19 No. 30 PHENYLPROPANOLAHINE Acute Psychosis A 3-1/2-year-old girl developed mild headache and fever. The following day she was diagnosed with a viral syndrome. On the fourth day of her illness she developed nasal congestion and cough, with resurgence of fever. Her mother observed her daughter having an episode of neck extension and eyes rolling back, which lasted for several minutes. On the following day, the patient appeared somewhat disoriented, with her eyes "wandering around," and she had several more episodes of neck extension and eye rolling. She progressed to almost continuous tremulousness with some stiffening of her extremities. She remained responsive to questioning through all of these episodes. The child had received no medications other than occasional acetaminophen and appropriate doses of an over-the-counter (OTC) cold preparation 'Triaminic DM' containing 5 mg dextromethorphan and 6.25 mg of phenylpropanolamine per 5 cc which she had taken orally three times in the preceding 24 hours. On hospital admission, following a further episode of dystonia, the child was given diphenhydramine with prompt and complete amelioration of her dystonia. Retrospectively, her mother was able to relate exacerbations of the dystonia to each of the three doses of cold medicine administered before hospital admission. The authors state that this child had an acute dystonic reaction (ADR) to a commonly used, nonprescription cold medication. They stress that increased awareness of ADRs should foster earlier recognition and treatment and thus avoid some unnecessary studies.- Heath H14 & Allen JK (Group Heal Cooperative 3814 NE 110 St Seattle WA 98125 [Dr Heath]) Acute dystonia following standard doses of a cold medicine containing phenylpropanolamine. Clin Pediat 36:57-58 (Jan) 1997 No. 31 SPINAL LUMBAR SURGERY Performed at Wrong Level . Failure To Disclose Error Legal Action The 38-year-old plaintiff underwent operation on her lumbar spine, performed by the defendant neurosurgeon. The defendant performed the operation at L2-3 rather than at L3-4 as intended. The error was disclosed by an MRI performed eight months after operation. The defendant continued to treat the plaintiff for an additional four months without disclosing his error to her. The plaintiff claimed that the defendant was negligent in failing to verify the surgical site through multiple intraoperative films before removing the disc material and that his failure to notify her of the error constituted a breach of fiduciary duty. The parties settled for $550,000.- Inez Dantley v. George Hathe\.¡s, H.D., Prince George's County (ND) Circuit Court, Case No. CAL95-00560. Neurosurgeon performs lumbar spinal surgery at wrong level, and fails to disclose error to patient for four months - $550,000 verdict for Maryland woman. Med Malpractice Verdicts Settlements & Experts 13:28 (Jan) 1997 20 No. 32 BLISTER PACK Gastrointestinal Hemorrhage An 82-year-old woman with long-standing hypertension and minor ischemic stroke had been taking indapamide 2.5 mg daily for several years. Except for deterioration visual acuity in recent months, the patient was healthy and had been taking her medication, which was provided in unit-dose form, without assistance. She experienced vague abdominal pain for several days and her family had sent her to the emergency room because she had had sudden onset of fresh bleeding per rectum the evening before hospital admission. On examination, her hemoglobin level was 7.4 g/dL and she had fresh blood on rectal examination. The patient was treated conservatively for what was at first presumed to be intestinal hemorrhage, probably of colorectal origin. However, the patient continued to pass large amounts of fresh blood. Flexible fiberoptic colonscopy finally showed a tablet in a blister pack lodged at the ileocecal valve. A 1.5 cm ulcer with stigmata of recent hemorrhage was found at the terminal ileum. The blister pack was grasped with forceps and removed from the ileocecal valve. The blister pack consisted of a sharp, rigid rectangular base with an intact indapamide tablet in the center. In summary, the authors emphasize that self-administration of unit-dose (blister pack) medications, without supervision, can be dangerous in disabled elderly patients.- Chan FKL et al (Dept Med Prince of Wales Hosp Shatin New Territories Hong Kong) "Blister pack"-induced gastrointestinal hemorrhage. Amer J Gastroenterol 92:172-173 (Jan) 1997 No. 33 ANESTHETIC INJECTION THROUGH EPIDURAL CATHETER Nerve Damage . Legal Action The plaintiff, a man in his forties, was scheduled for operation on his left lung. The night before operation, he stated that he had suffered a compression fracture of his spine eight years previously. The defendant anesthesiologist, who had access to this information, placed an epidural catheter in the plain- tiff's back in the area of the previous fracture, in order to administer an anesthetic for post-operative pain. After the operation and epidural, the plaintiff complained of excruciating pain, but doctors continued to inject anesthetics. The plaintiff had suffered permanent nerve damage, which causes numbness and pain in his leg and foot, and a slight limp. The plaintiff claimed that injury is likely when anesthetics are injected into or near scar tisue, that the anesthesiologist was negligent in failing to consult his medi- ' cal records, and that he could have used other methods to control pain. He also claimed that the epidural should not have been administered while he was asleep, as this prevented him from reporting neurologic changes, and that when he first complained of pain after the operation, doctors should have consulted a neurologist instead of continuing to inject the anesthetic. The parties settled before trial for $175,000.- Dloore v. Hubbel et al, Boone County (F10) Circuit Court, Case No. 89CC- 034701. Missouri man suffers nerve damage from injection of anesthetic through epidural catheter in area of prior spinal compression fracture. $175,000 settlement. Med Malpractice Verdicts Settlements & Experts 13:5 (Jan) 1997 21 No. 34 LAMINECTOriY Spinal Aura Cut . Permanent Disability Failure To Report In Operative Report Or To Repair Legal Action The defendant neurosurgeon cut the plaintiff's spinal aura during decompressive laminectomy. As the defendant did not dictate the operative report until ten months after operation, it was unclear whether he recognized or attempted to repair the cut aura. In the operative report, he did not mention cutting the plaintiff's spinal aura, nor did he tell the plaintiff that the spinal had been cut during the first operation, producing a cyst. Four months after the initial procedure, the defendant performed a second operation to repair the arachnoid cyst; the cyst was not repaired. The neurosurgeon did not discuss the operative procedure with the plaintiff at all, and the consent form signed by the plaintiff did not accurately describe the operative procedure to be performed. The neurosurgeon denied involvement in a third operative admission at which no operation was performed, despite medical records reflecting that the neurosurgeon was the admitting physician. The plaintiff continues to have an arachnoid cyst the size of a baseball, which impinges upon nerve roots. The plaintiff suffered fifty percent permanent partial impairment of the whole person; further surgery will not improve the plaintiff's condition. A total settlement of $575,000 was made.- Unnamed Patient v. Unnamed Neurosurgeon and the Indiana Department of Insurance, Patient's Compensation Fund, unknown Indiana venue. Spinal aura cut during laminectomy - Failure to note in operative report or repair . Permanent disability . $575,000 net settlement in Indiana. Med Malpractice Verdicts Settlements 7 Experts 13:27-28 (Jan) 1997 No. 35 ANTIBIOTIC THERAPY Anaphylactic Shock . Death . Legal Action A 13-year-old boy was shot in the head with an air rifle; the pellet embedded in his head. The defendant neurosurgeon prescribed antibiotics, even though he had been advised that the boy was allergic to certain antibiotics. The antibiotics were administered, the patient went into anaphylactic shock, and died. The boy's parents brought suit and an arbitration award of $1,616,471.05 was given.- ' Henry E. Hogler and Donna L Ptogler v. Dirk Franzen, N.D., Palm Beach County (FL) Circuit Court, Case No. 95-5199 ~1A. Antibiotics given during treatment for air rifle pellet in head causes anaphylactic shock and death of Florida teenager - Neurosurgeon had been informed of allergy to antibiotics, but prescribed them anyway - Over $1.6 million arbitration award. Med Malpractice Verdicts Settlements & Experts 13:23 (Jan) 1997 22 No. 36 ENALAPRIL Acute Pancreatitis Patient 1: A 63-year-old man was admitted to hospital with abdominal pain. He had been taking enalapril for 5 months. His last pill was taken 10 hours before his symptoms developed. On examination, the patient had abdominal tenderness and an elevated serum amylase level of 1100 U/L. Ultrasonography showed pancreatic edema. Other causes of acute pancreatitis were excluded and the patient was discharged on the eighth day. He had no recurrence of acute pancreatitis during 37 months of follow-up. Patient 2: A 66-year-old man presented to the emergency room with abdominal pain. The only medication that the patient had taken before his symptoms developed was enalapril which was started 3 months earlier. He had taken his last pill 5 hours before his symptoms developed. On examination, the patient had abdominal tenderness and a serum amylase level of 900 U/L. Ultrasonography showed an edematous pancreas. No other causes for the pancreatitis were found and over the next 5 days the patient's symptoms disappeared; he was discharged from the hospital and could not be located for follow-up. Patient 3: A diagnosis of acute pancreatitis was made in a 65-year-old woman following an ultrasonography, CT scan, and significant increase in serum amylase to 980 u/L. The patient had been treated with enalapril 20 mg daily for a year before hospital admission. After the seventh hospital day, the patient was discharged. Ten days later, enalapril was re-introduced. Six hours after re-exposure to enalapril 20 mg, the patient developed severe upper abdominal pain, vomiting, and hypotension; she was re-admitted to the hospital. Abdominal examination showed diffuse tenderness in the upper quadrants and bowel sounds were not audible. Her serum alkaline phosphatase level, AST, amylase, calcium, and tirglycerides were elevated. A CT scan showed intrapancreatic necrosis and a large amount of peripancreatic fluid. The patient's pain disappeared one week after admission. Leukopenia, fever, and the absence of bowel movements persisted for three weeks. At the fourth week a CT scan showed three pseudocysts that slowly disappeared 5 months after dismissal from the hospital. The patient was healthy after 34 months of follow-up. The authors conclude that enalapril is associated with pancreatitis and that, even though this association is infrequent, if pancreatitis is suspected, the drug should be discontinued, replaced with a different medication, and enalapril should not be re-introduced.- Enalapril ['Vasotec'] ' Maringhine A et al (Via Croce Rossa 224,90146 Palermo Italy) Enalapril- associated acute pancreatitis: Recurrence after rechallenge. Amer J Gastroenterol 92:166-167 (Jan) 1997 23 No. 37 METHOTREXATE Osteopathy . Stress Fractures Two postmenopausal women with long-standing rheumatoid arthritis developed multiple stress fractures during treatment with weekly doses of methotrexate 7.5 mg orally. The first patient, a 57-year-old woman, had been undergoing corticosteroid treatment for 8 months when she presented with sudden onset of pain and inability to bear weight in the right foot. X-ray examination showed a stress fracture of the second metatarsal on the right. Five months later, the pain recurred in the right forefoot, and in addition to the second, partially consolidated metatarsal fracture of the right foot still visible on x-ray, two recent stress fractures of the third and fourth metatarsals on the right were diagnosed. Four weeks later, after a cast was removed, an additional new stress fracture of the proximal first metatarsal bone of the right foot was seen. The treatment with methotrexate was not interrupted. Comparison of bone mineral content before methotrexate therapy and 5 years later during methotrexate therapy showed no important bone loss at the lumbar level; however, there was an extreme loss of cortical bone at the distal radius. The second patient, a 76-year-old woman with an 18-year history of seropositive rheumatoid arthritis was started on oral methotrexate 7.5 mg weekly. The dosage was decreased to 5 mg weekly because of good disease control. Approximately three years after starting methotrexate therapy, the patient complained of pain in the right lower leg. A stress fracture of the distal third of the right tibia was seen on x-ray. Methotrexate therapy had to be discontinued at this time because of pancytopenia and liver test abnormalities. Bone mineral content measurements showed stable values at the lumbar site before methotrexate therapy and a half year after methotrexate therapy was stopped; however, a major loss was observed at the radius measurements. The authors state that both of these patients have many predisposing factors leading to osteoporosis and stress fractures which were present before methotrexate therapy was initiated. Both patients were postmenopausal and had long-standing rheumatoid arthritis. The first patient had a history of a distal tibial fracture after a minimal trauma. The second patient had had cortical osteopenia for 5 years. They stress that treatment with methotrexate in patients with rheumatoid arthritis should be considered an additional risk factor for osteoporosis. They believe that futher, longterm, prospective studies are needed to support this theory.- Methotrexate [ ' Folex , ' IMexatel] ] Maenaut K et al (Div Rheumatol U.Z. Pellenberg Weligerveld 1, B-3212 Pellenberg Belgium [Dr J Dequeker]) Methotrexate osteopathy, does it exist? J Rheum 23:2156-2159, 1996 24 No. 38 MINOCYCLINE Acute Hepatitis . Drug-Related Lupus A 19-year-old man experienced sudden weight loss, asthenia, anorexia, and malaise. His only medication was minocycline which he was taking for treatment of facial acne. He had taken the drug intermittently during 20 months as follows; (a) 100 mg daily for 4 months and 50 mg daily for 1 month followed by a 2 month interruption, (b) 50 mg daily for 4 months with a one month interruption, and (c) 100 mg daily for 11 months. On examination, his laboratory test values showed elevated liver function test values..No diagnostic procedure was performed and the patient continued to take minocycline 100 mg daily. Six months after onset of his symptoms, after which he had taken minocycline for 25 months, of which 16 months were continuously at 100 mg daily, the patient stated that he had experienced joint and muscular symptoms. His erythrocyte sedimentation rate was elevated to 64 mm/hour and his anti-nuclear antibodies (ANA) were psoitive. The relationship between minocycline and hepatitis was not immediately recognized and the patient continued to take the drug at the same dosage for about 5 additional months. Because the patient was taking no other medications and retrospective dosages, on serum samples collected shortly after hepatitis diagnosis, showed high values of IgG, very high titers of anti- cardiolipin antibodies, ANCA, and anti-rlPO antibodies, these parameters confirmed the co-existence of symptomatic acute hepatitis and minocyclin-related lupus. The authors recommend careful clinical surveillance and monitoring of hepatic enzymes and ANA in patients with any clinical symptoms suggesting hepatitis or lupus while taking minocycline.- Minocycline [ ' 1`iinocin' j Golstein PE et al (Dept Gastroenterol Hopital Erasme Univ Libre de Bruxelles 808 route de Lennik, B-1070 Brussels Belgium) Acute hepatitis and drug-related lupus induced by minocycline treatment. Amer J Gastroenterol 92:143-146 (Jan) 1997 Photocopy Permission: Where necessary, permission is granted by Clin-Alert, Inc. for libraries and others registered with the Copyright Clearance Center (CCC), 21 Congress St., Salem, MA 01970, to photocopy articles herein for the fee of S2.00 per copy of each page. Payment should be sent direct to CCC with a photocopy of the page copied. Copying prohibited. Special requests should be addressed to the publisher. ISSN 0069-4770/83 $2.00 per page.</meta-value></custom-meta></custom-meta-wrap></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Volume 1997, No. 3 February 15, 1997</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Volume 1997, No. 3 February 15, 1997</title></titleInfo><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>Sage Publications</publisher><place><placeTerm type="text">Sage CA: Thousand Oaks, CA</placeTerm></place><dateIssued encoding="w3cdtf">1997-01</dateIssued><copyrightDate encoding="w3cdtf">1997</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><relatedItem type="host"><titleInfo><title>Clin-Alert</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">0069-4770</identifier><identifier type="eISSN">1530-812X</identifier><identifier type="PublisherID">CLA</identifier><identifier type="PublisherID-hwp">spcla</identifier><part><date>1997</date><detail type="volume"><caption>vol.</caption><number>35</number></detail><detail type="issue"><caption>no.</caption><number>1</number></detail><extent unit="pages"><start>17</start><end>24</end></extent></part></relatedItem><identifier type="istex">23B6686C150EEA9083BFDC2AD435B721FB25F4C8</identifier><identifier type="ark">ark:/67375/M70-J8ZL84J3-D</identifier><identifier type="DOI">10.1177/006947709703500103</identifier><identifier type="ArticleID">10.1177_006947709703500103</identifier><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-0J1N7DQT-B">sage</recordContentSource></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/M70-J8ZL84J3-D/record.json</uri></json:item></metadata><author></author><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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