154 e-Letters

published between 2013 and 2016

  • 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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  • Re:Regional anesthesia and traumatic extremity fracture - can they safely coexist?
    Raghavendra Mrarappa Ganeshan

    Thank you very much Mr M.A Warner for reviewing our article and sharing your views from the same. We do agree with your suggestion that, there in no 'strong' correlation between the use of peripheral nerve blockage and delay in diagnosis of acute compartment syndrome following surgical procedures on extremities. Among the reported cases of peripheral nerve blockage use in extremity surgeries and where the compartment syn...

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  • A case of misdiagnosis: chronic fluoride intoxication?
    Declan T Waugh

    [Apologies for late edits to letter submitted yesterday, please note there are 3 new references addressing hepatotoxicity of fluoroquinolones that were not in orginal letter].

    Lugg et al (2015) reported a case study of a 16 year old girl born who presented with signs of chronic joint pain, dizziness and non-specific abdominal pains after consuming 3 cups per day of imported herbal green tea (as tea bags) for a p...

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  • Claims of effects of green tea without analysis for tea contamination
    Uli Jung

    I have read with surprise the case report which makes rather wide sweeping claims about green tea being of health concern. After a quick literature review there have been rare cases after prolonged ingestion of green tea extract - but none ever analyzed the extract for components besides green tea. It is not a secret that there are problems with food safety in china, especially pesticide use, so making claims about the p...

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