113 e-Letters

published between 2004 and 2007

  • Delirum in older terminal illness
    Angel J. Romero-Cabrera

    Editor: We agree with Harris (1) that delirium is a common condition shows a high prevalence in advanced diseases, especially in palliative care practice. Elderly patients have particular characteristics (comorbidities, polipharmacy, and cognitive, social and functional impairment)leading them to terminal illness and this topic is an important aspect in the daily geriatric assistance management (2). Thus, medical doctors m...

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  • channelopathies cell volume and bipolar disorder
    Joe R Nweton

    Dear sir,

    In 1999 I postulated abnormal cell size, action potential speed and thus dyscoordination for bipolar disorder. (Med Hypotheses Jan 1999 77-83)

    Anormal cell volumes were then confirmed in several studies.

    Several other linked and associated genes (possibly involving cell size) are also suggested in genetic studies.(Psychiatric Genetics Feb 2007 Newton JR)

    The recent genome-...

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  • Levodopa-induced dyskinesia in Parkinson’s disease: role of serotonergic neurons
    Sandip Kumar Dash

    Dear Editor,

    I have read the review article by Bhomraj et al (1) with interest and found it to be very useful in our day to day practice and also have updated information. However I would like to add few things to the patho physiology of levodopa induced dyskinesia.

    In Parkinson’s disease formation of dopamine from exogenous administration of levodopa, storage and release takes place in the remaining d...

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  • Current antiviral strategies in HCV related cryoglobulinaemic vasculitis
    Francesco Iannuzzella

    Dear Editor,

    As GS Braun and colleagues have rightly pointed out in their well written review, for hepatitis C virus (HCV) associated cryoglobulinaemic vasculitis, antiviral strategies aiming at cure of HCV infection is clearly superior to conventional immunosuppression.[1] Unfortunately, the authors did not discuss the optimal antiviral strategy to use in the case of HCV related mixed cryoglobulinaemia (MC) synd...

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  • Iatrogenic Hyponatraemia due to 5% Dextrose Infusion.
    Kamran Khan

    Dear Editor,

    The authors of this article deserve appreciation for such a detailed description of pathophysiology and treatment of hyponatraemia. It is a very pertinent discussion of a not so uncommon problem in hospitalised patients. The authors have briefly mentioned use of 5% Dextrose infusion as a cause for hyponatraemia in postoperative patients. This is a very valid point and needs further discussion.

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  • Clinical findings are not enough.
    Weekitt Kittisupamongkol

    Dear Editor

    In excellent review of Hyponatremia by Biswas and Davies (1) they do not emphasize that clinical assessment correctly identified only 47 percent of hypovolemic patients and 48 percent of normovolemic patients (2). Moreover, McGee et al. reported that a large postural pulse change (> or =30 beats/min) or severe postural dizziness is required to clinically diagnose hypovolemia due to blood loss, alth...

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  • Comments to Diabetic and endocrine emergencies
    Viktor Rosival
    Dear Editor,

    In the recent review "Diabetic and endocrine emergencies (1) several important issues have been omitted or incompletely explained.

    1. On p 79, the authors write "In DKA, the severe deficiency in insulin and increased counter-regulatory hormones lead to increased lipolysis and production of ketone bodies and resulting metabolic acidosis. It is...
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  • Reliability of cardiac markers and acute coronary syndrome
    Kaushik Sanyal

    Dear editor,

    Troponin T and Troponin I have highly sensitive and specific monoclonal antibodies, released as ternary (T-I-C) or binary (I-C) or free trop T. There is also a fractional cross-sectional reactivity with skeletal Trop T even though it is considered as a long term prognostic marker of morbidity which helps in the stratification of chest pain. Trop T rises due to myocardial involvement. Patients without...

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  • Dear Editor
    Peter SC Wong

    Dear Editor

    We agree with Dr Jolobe that symptoms of cardiac ischaemia should not be limited to chest pain alone. Our study inclusion criteria included all patients who had one or more troponin T blood tests, irrespective of their presenting symptoms and diagnosis of acute coronary syndrome or not. Our findings showed that chest pain was absent in 43% of patients with acute coronary syndrome and raised troponin...

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  • Do We Ever Learn From History ?
    Dr. Herbert H. Nehrlich

    Dear editor,

    A good question indeed. Manfred von Ardenne of Dresden did much to investigate hyperthermia and its, at times, devastating influence on cancer cells. He achieved this with whole body (except for the head) immersion in hot water initially. Later, he experimented with heating the core temperature of the body using the sauna to which he later added oxygen.

    I had the pleasure of communicating wi...

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