294 e-Letters

  • 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