129 e-Letters

published between 2016 and 2019

  • 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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  • Is it really ischemic?
    Kushal Naha

    I would like to raise two specific questions with regard to the RBBB seen in this patient. Firstly, how are the authors certain that this patient did not have a pre-existing benign RBBB with a superimposed NSTEMI? Did they have an older ECG for comparison? Secondly, in addition to the presence of RBBB, this ECG also shows an S1Q3T3 pattern suggestive of RV volume overload, although the tachycardia seen in PE is absent. D...

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  • . Aborted sudden cardiac death associated with an anomalous right coronary artery
    Rienzi A. Diaz

    I thank Dr. Veloso for his comments regarding our case report [1]. Directly from the consensus statement he cites [2], his opinion is valuable, but feel that aborted sudden death conveys a better picture due to successful resuscitation with CPR and defibrillation, a description already used by other authors [3].

    Rienzi A Diaz, MD, FACC, EACVI, Professor of Cardiology

    References: 1) Diaz RA, Valdes J. A...

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  • The expression "aborted sudden cardiac death" should be avoided.
    Henrique H. Veloso

    I read with interest the case reported by Diaz and Valdez (1) regarding a patient who was successfully resuscitated from ventricular fibrillation cardiac arrest while running in a marathon race. The patient had a posterior diagnosis of anomalous right coronary artery arising from the aorta above the left sinus of Valsalva that subsequently runs between the aorta and the pulmonary artery, discovered by a 64-slice multidet...

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