eLetters

85 e-Letters

published between 2005 and 2008

  • 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...

    Show More
  • 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...
    Show More
  • 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...

    Show More
  • 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...

    Show More
  • 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...

    Show More
  • confounding factors when defining the cut-off level for NT-pro BNP
    oscar,m jolobe

    Dear editor

    The cut off level for NT-pro BNP proposed by the authors(1) should take into account the fact that blood levels of this parameter may be lower in subjects with body mass index equal to or exceeding 30 kg/metre squared despite left ventricular end diastolic pressures which exceed those of counterparts with lower body mass indices(2). Lower cut-off levels might then have to be devised in obese subjects....

    Show More
  • atypical presentations of acute coronary syndrome include left bundle barnch block and absence of ch
    oscar,m jolobe

    Dear editor

    In the above study acute coronary syndrome(ACS) was defined as the presence of ischaemic cardiac symptoms (presumably, chest pain)(1), and it was not made clear whether or not this was to the exclusion of a pain-free presentation(2) characterised, instead, by, for example, sudden onset left ventricular failure or "collapse"(3). In the "worst case scenario" exclusion of ST segment elevation (STEMI) patient...

    Show More
  • Health’s sector in Cuba: looking better performance.
    Frank C. Alvarez-Li

    Dear Editor

    Cuba represents an important alternative example where modest infrastructure investments combined with a well-developed public health strategy have generated health status measures comparable with those of industrialized countries (1). However the economic crisis which began in 1991 after the withdrawal of the Soviet Union wreaked havoc on many aspects of Cuban society. Although the impact on health in...

    Show More
  • Isolated systolic hypertension, ageing and control in Cuba
    Pedro O. Orduñez

    Dear Editor,

    Isolated systolic hypertension and ageing is common in Cuba too and we wish to share our more recent results.

    Cienfuegos is the demonstration area for the Action Plan for the Multifactorial Reduction of Noncommunicable Diseases in Cuba. As a part of this project, a baseline was taken to obtain up-to-date information on the prevalence and control levels of hypertension (HBP). There are 76,803 inhab...

    Show More
  • the possible role of acidosis-related capillary permeability in adult respiratory distress syndrome
    oscar,m jolobe

    Dear Editor,

    Although adult respiratory distress syndrome (ARDS) is a complication common to both ketotic and non-ketotic diabetic decompensation (1), being arguably attributable to the development of adverse osmotic gradients which generate pulmonary oedema (2), the fact that ARDS is much commoner in diabetic ketoacidosis (DKA) than in hyperosmolar non-ketotic (HONK) diabetic decompensation (3)(4)(5) suggests that th...

    Show More

Pages