Thyrotoxic hypokalemic periodic paralysis case report and review of the literature.

A rare complication of hyperthyroidism consists of sudden diffuse muscle weakness associated with severe hypokalemia. The clinical presentation is similar in most respects to familial periodic paralysis; however, the therapies proven to be effective differ in the two syndromes. A case of thyrotoxic hypokalemic periodic paralysis is presented and the literature is reviewed.

Rabeprazole is superior to ranitidine in the management of active duodenal ulcer disease: results of a double-blind, randomized North American study.

Objective: The primary purpose of this study was to compare the efficacy and tolerability of rabeprazole versus ranitidine in the treatment of patients with active duodenal ulcer disease.

Methods: This multicenter, double-blind, randomized, parallel-group study enrolled 376 patients. Patients were randomly assigned to receive rabeprazole 20 mg administered once daily in the morning (q.

Reducing the risk of needlestick injury associated with implanted ports.

Implanted ports give many of our patients a sense of freedom that they have not known since they have been sick. Between infusions, they do not have to be reminded constantly of their illness through an external vascular access device. However, this patient advantage does carry some degree of risk for the nurse working with the patient and the device.

Left ventricular apex visualization: the value of magnetic resonance imaging.

Ventricular apex visualization is crucial to the evaluation of left ventricular structure and function. Not only is it necessary for accurate ejection fraction calculations; but the apex is also the segment most vulnerable to myocardial infarction, infarct expansion, aneurysm, and mural thrombi. While echocardiography is often unsuccessful, particularly in the large body habitus, nuclear magnetic resonance imaging assured apex visualization in both short and long axis planes in our series of 20 consecutive patients across a wide range of age and body habitus.

Free radicals, oxidative stress, oxidized low density lipoprotein (LDL), and the heart: antioxidants and other strategies to limit cardiovascular damage.

The heart is the most susceptible of all the organs to premature aging and free radical oxidative stress. Clinical research has clearly documented the role of free radical damage and the progression of numerous degenerative diseases, particularly cardiovascular disease. This may be the result of acute ischemia-reperfusion injury, endothelial damage of hyperhomocysteinemia, as well as chronic oxidative damage secondary to lipid peroxidation.

Primary osteosarcoma of the bladder: a case report and review of the literature.

Primary osteosarcoma of the bladder is an extremely rare neoplasm. Fewer than 30 cases have been reported in the world's literature, some of which may not meet the strict modern criteria for inclusion in this group. The authors report a case of such a neoplasm occurring in an 86-year-old man and review the clinical presentation, histopathology and clinical course of this unusual tumor.

An historical review of rupture of the heart.

In 1649 William Harvey noted the autopsy findings of a patient with spontaneous rupture of the heart. Additional reports by Nicholls, Morgagni, Hodgson, Quain, Vulpian, and others describing the dramatic clinical and pathological features of cardiac rupture appeared during the following 250 years. These reports are cited in order to document and trace an increasing awareness that acute myocardial infarction caused by obstructive coronary artery disease was the most frequent cause of this catastrophic event.

Nursing input into the purchase decision reveals costs not included in the price tag.

Working collaboratively with the institution's nurses not only will provide a more comprehensive view of products being considered for purchase but will also uncover the costs of bringing in a product that are not specified on the price tag.

Searching the literature: more resources to make the purchase decision.

Searching the literature is easier than ever with the advent of CD-ROM. Cost effective and simple to use, this technology is being used for clinical patient management as well as health care administration. For the materiel manager, literature searches can provide additional information, and access to research and other data to assist in making objective, informed, defensible purchasing decisions.

Chronic mexiletine therapy for suppression of ventricular arrhythmias.

One hundred patients with a 70% or greater reduction of ventricular premature contractions (VPCs) from baseline during 12 weeks of mexiletine therapy were continued on treatment for an additional 9 months. Fifteen patients did not have follow-up examinations. The response of the remaining 85 patients during this extended period of open-label mexiletine administration is described.

Ear infections.

Infections of the ear are among the most frequent causes for patients to seek care in the ED. Although most infections are fairly simple to diagnose and treat, the anatomic complexity of the ear, its shared innervation with other body structures, its proximity to other body systems, and the risk of serious complications necessitate an orderly approach to the care of these problems. This article outlines an approach to the history, physical examination, diagnosis, and management of these infections.