8 e-Letters

published between 1998 and 2001

  • Drug Treatment for Depression in Patients Inside Rehabilitation Wards
    Salvador Vale

    Sir- Shah and colleagues report (1) about the prevalence of psychiatric disorders affecting elderly people institutionalised in a rehabilitation unit, concludes about depression that it is common among older adults, it is a treatable condition and that in cases which there are cognitive impairments associated to concomitant depression, the cognitive impairments are worsened by the depressive disease. Although the relev...

    Show More
  • Leaders must take a stand on life issues
    Robert A Best

    Dear Sirs: A good friend of mine in Europe, Dr. Gonzalo Herranz MD/Phd emailed me your article, which I found exceedingly well researched as well as well written.

    There is no doubt that Western Civilization is in a culture war, a war "within", a "spreading spiritual malaise" in the words of Irving Kristol. Writing in 1840, Tocqueville imagined a society consumed with such a malaise, in which government, com...

    Show More
  • Cerebral venous sinus thrombosis: heparin or nothing.
    M B Lewis

    A recent review article in your journal gives the impression that the case for heparinisation of patients with cerebral venous thrombosis (CVT) is proven [1]. The largest and most robust study did not come to this conclusion and its results did not achieve statistical significance [2]. Given that CVT has a spectrum of presentations from headache to coma, a blanket approach to treatment in the absence of good evidence and...

    Show More
  • Unsheathed needles: a good idea?
    George Tsavellas

    Dear Editor,

    Whilst Huang and Dutta correctly state that re-sheathing of needles is almost universally condemned, one must also remember that needle-stick injuries can also occur as a result of needles not being re-sheathed. This happened to me as a young house- officer, when a nurse dropped an unsheathed needle from a tray, and it promptly embedded itself int...

    Show More
  • Sympathetic effects via renin release
    Steve Jordan Kane

    Dear Sir,

    This case is extremely useful as an illustration of the varying presentations of phaeochromocytomas. The inclusion of the CT and the details of the differential effects given depending upon the catecholamine released were helpful.

    I might venture a further, perhaps more important, mediator of the dramatic drop in K+ noted in this patient and other phaeos. There are a large number of beta ad...

    Show More
  • Circadian fluctuations in the efficacy of streptokinase thrombolysis may be due to confounders
    Wai-Ching Leung

    Goldhammer et al (1) concluded from their retrospective study of patients treated with streptokinase that efficacy was higher in the early evening hours. There are at least two important confounding variables which may explain these observations. Firstly, it has been previously found that the time of day has an impact not only on the incidence, but also on the severity of AMI (2). Hence, the apparent reduction in effi...

    Show More
  • Adult onset diabetes with hypo to hyperthyroidism
    GR Sridhar

    A 39-year diabetic, for six months had primary hypothyroidism three years ago, normalized with thyroxine. Seventeen months later he was hyperthyroid, reversed by carbimazole (30 mg/d) and recurred on stopping. His thyroid microsomal antibody was positive (1:25,600).

    Thyroid disorders were present in 6.9% adult diabetics in Edinburgh (1). Type 2 diabetes was seen in 7.6% patients with Grave’s thyrotoxicosis in Ja...

    Show More
  • Misconceptions on the treatment of Verrucous carcinoma
    L Reinecke

    The excellent case report on verrucous carcinoma is not only of value because of being a "first" on tumours of the female breast (1), but also of focussing attention on this condition.

    A myth was unintentionally started by Perez-Meza in 1966 (2) when they suggested that there may be a possibility that this tumour could be aggravated by radiation therapy. This started a misconception which is still widely believed...

    Show More