eLetters

296 e-Letters

  • Gallstone ileus and fatal gallstone coleus: the importance of the second stone
    Zakiuddin G. Oonwala

    This case report is interesting and revealing for 2 reasons. Gall stone ileus is usually due to benign fistula due to pressure necrosis and duodenal wall eroding through. Gall stone gets impacted in the terminal ileum and cannot pass the so called physiological ileo caecal valve. In this case the gall stone got impacted in (1)the decending colon and not in the terminal ileum and the cause of the fistula turned out to be(2)...

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  • The male vagina is a more accurate term than prostatic utricle.
    Vincenzo Puppo

    The prostatic utricle is a cul-de-sac of the prostatic urethra and extends backward and slightly upward for a very short distance within the middle lobe of the prostate. It is composed of fibrous tissue, muscular fibers, and mucous membrane. The prostatic utricle is 10-12 mm long, sometimes it is 20-25 mm, rarely it is 6-8 cm long.1 It is located in the seminal colliculus (i.e. veru montanum): this is a prominence of the...

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  • Old is Still Gold
    pablo garcia

    A clear exposition of the case using a simple drawing to explain the image. In depth and summarised investigation on the subject. Practical tips for a general surgeon's practice usefull to avoid serious injuries.

    Conflict of Interest:

    None declared

  • A role for MRI or PET?
    Swaroop Revannasiddaiah

    After reading this article, we are prompted to ask whether the use of functional magnetic resonance imaging (fMRI) or a fluoro-desoxy-glucose positron emission tomography (FDG-PET) can help solve ambiguities associated with clinical and computed tomography angioraphy (CTA) based techniques for affirming brain-death.

    Conflict of Interest:

    None declared

  • ID Please
    Paul E. Verweij

    The fungal kingdom is characterized by significant biodiversity within genera and species. Several hundred of fungi have been described as cause of disease in humans. Abdulaziz and colleagues describe a case of invasive fungal disease that supports their plea for more research into polyene and azole combination therapy. In their case report the authors make assumptions that do not take into account the fungal biodiversity...

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  • Missing Clues for the Radiologist
    Amitav Banerjee

    This oversight indicates the shortcomings of present day medical training. The emphasis is on technology and newer diagnostics at the cost of patient centered clinical skills, which included detailed history taking. We are in danger of churning out technicians rather than doctors.

    This case report is a wake up call.

    Conflict of Interest:

    None declared

  • Re:Missing clues for a radiologist
    Tushar Sahasrabudhe

    Many thanks for raising another important point here. The primary responsibility of making diagnosis of a patient lies with the clinician. The radiology is a modality that helps in reaching diagnosis. The clinician is expected to give a detailed note to the radiologist mentioning the case history, clinical findings and his probable diagnosis. This input is of utmost importance to a radiologist for concluding the radiolog...

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  • Missing clues for a radiologist
    David P. O'Keeffe

    The case report unfortunately reflects a common problem where the referring clinician omits to include relevant clinical information. "The chest radiogram was reported by a radiologist, who neither saw the patient personally nor enquired into the patient's history." might well be amended to read "the referring clinician omitted to mention the presence of multiple large cutaneous neurofibromata"

    Rubbish in-rubbish...

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  • Re:The Risk of Probiotic Sepsis
    Alexandre Hertig

    Thank you for the opportunity to reply to the correspondant. Although we agree with him/her on one point, which is that there is no large, randomized study that would allow us to recommend the use of probiotics on a systematic basis in patients receiving a broad spectrum antibiotherapy, we would like to stress out that the majority of the cases reported here are from patients who developed a sepsis after being to probiotic...

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  • The Risk of Probiotic Sepsis
    Antoine Kass-Iliyya

    I read with interest this rare case report of ureteric obstruction secondary to fungal mycella.

    The authors concluded that antibiotics dramatically reduce the commensal flora, compromising the physiological balance that prevents the outgrowth of fungi and they recommended that probiotics should be considered to prevent this complication, which can be severe and life threatening in immunocompromised patients....

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