122 e-Letters

published between 2016 and 2019

  • mistake
    chanan tauber

    In trans sccaphoid perilunate dislocation as shown on the radiographs the lunate is not dorsaly dislocated.the lunate stays in its place the peri lunate carpal bones are dorsaly displaced.

    Conflict of Interest:

    None declared

  • Once again, the "the MRI sequence dilemma!"
    Osama SM Amin MD, FACP

    Many thanks go the authors for reporting this very interesting finding.

    A minor comment, please:

    Figure 1, although it is somewhat blurred and dark, the MRI sequence it contains seems be to the "T2 FLAIR" one, not the T1 with Gadolinium, as the manuscript reads. Therefore, the lesions it demonstrates are the non- suppressed hyper-intensities from the T2-weighted film (which is not shown).


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  • Associated hypoparathyroidism?
    Kushal Naha


    Wilson's disease is known to directly affect parathyroid function resulting in hypoparathyroidism. In a patient with rickets, one would expect secondary hypoparathyroidism. Moreover, this patient likely suffered from vitamin D resistant rickets due to renal calcium and phosphate wasting. Were PTH and serum vitamin D levels assayed in this instance?

    Yours sincerely,

    Kushal Naha, MD

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  • Details and Interpretation
    Brian C O'Neill

    I did like this case report- honestly. However, I required more information to satisfy my curiosity of the case and had reluctance in accepting the conclusion regarding how this case validates the possibility that quetiapine is soley responsible for the apparent positive outcome. I would prefer to know why in 2009 he decided he wanted to curtail his drinking? Given that his recovery co-incided with a diagnosis of bi-polar...

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  • In response to Brunneroma with duodenojejunal intussusception: a rare cause of gastric outlet obstruction
    Andrew Mitchell

    Dear Editor,

    The photomicrograph in this case report is not that of a Brunner gland adenoma. It is of an adenomatous polyp of the surface epithelium.

    Yours sincerely, Andrew Mitchell MD

    Conflict of Interest:

    None declared

  • Breast implant-associated ALCL is ALK negative
    Roberto N. Miranda

    The case report by Parthasarathy et al. illustrates that breast implant-associated anaplastic large cell lymphoma (ALCL) can present as a locally aggressive tumor mass, and that this tumor can be refractory to chemotherapy and radiotherapy. In effect, the authors describe that the tumor was finally felt to be controlled after radical mastectomy including resection of the implant and its surrounding capsule.


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  • Monad sign and air crescent sign are not synonyms
    Akashdeep Singh
    An air crescent sign describes the crescent of air that can be seen in invasive aspergillosis, or other processes that cause pulmonary necrosis.It should not to be confused with the Monad sign which describes the air that surrounds an aspergilloma. Unfortunately, the air around the fungal ball is also crescent shaped and the term air crescent sign is often used interchangeably as in this case report

    Conflict of Interest:

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  • Comment on 'Serotonin syndrome following levodopa treatment in diffuse Lewy body disease'
    P Ken Gillman

    Kushwaha et al (1) make the rather positive assertion, regarding the cause of their patient's symptoms and a possible role of L-DOPA in their genesis, that it is 'fact that levodopa can contribute to [ST] occurrence.' Their writing seems to convey an unwarranted confidence in the strength of this possible, but only remotely possible, association.

    I remind readers that the definition of serotonin syndrome (a.k.a....

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  • Further detail request and query
    David W Bullimore

    Very interesting case with complex and expert care. Wondered why repeated courses off co-amoxiclav were given when it is associated with cholestatic jaundice which while usually self-limiting can be fatal. Do you have IgG4 levels on patient and did patient have eosinophilia at any time?

    Conflict of Interest:

    None declared

  • Re:Is it really ischemic?
    Nitin T Patil

    I have 2 points to make here, and i also agree whether this patient had ischemia in the first place.

    1)In case of ischemia it is known that the Echo shows regional wall motion abnormalities in 1 to 2 minutes, and much earlier than the ECG changes, but in this case, patient had no regional wall motion abnormalities and normal LV function.

    2) This patient might be having a NSTEMI with a preexisting RBBB...

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