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J M Conemans

Publications and source records attributed to J M Conemans.

10 recordsLinked to original sources
PubMed1998

[Factitious insulinoma].

A 32-year-old woman was admitted with signs of recurrent hypoglycaemia. Within 72 hours hypoglycaemia was successfully provoked by prolonged fasting. Also, blood samples demonstrated high levels of serum insulin and C-peptide and the insulin-glucose ratio was abnormally high. An insulinoma was strongly suspected. However, extensive imaging displayed no tumour in the pancreas. The patient also had extensive psychological and social problems. The psychiatrist suggested a factitious disorder. High serum concentrations of insulin and C-peptide in combination with the psychiatric disorder led to the suspicion of abuse of sulfonylurea derivatives by the patient. This was confirmed by toxicological screening. A patient with unexplained hypoglycaemia, especially if an insulinoma cannot be detected, should be suspected of abusing sulfonylurea derivatives.

Adult↗
PubMed1998

[Contact allergy to eyedrops containing beta-blockers].

In six patients (4 women aged 80, 62, 43 and 52 years and 2 men aged 58 and 51 years), who used eyedrops containing beta-blockers for the treatment of glaucoma, allergic contact dermatitis of the eyelids was diagnosed. Three were allergic to metipranolol, 2 to levobunolol and 1 to timolol. In literature, less than 50 cases of hypersensitivity to beta-blockers in eye medication have been reported. There are, however, reasons to assume that sensitization is more frequent: (a) not all patients are referred by the ophthalmologist to the dermatologist; (b) false-negative reactions to patch tests with the commercial preparations and with beta-blockers are not infrequent; (c) they are not routinely tested because beta-blockers are difficult to obtain in pure form; (d) cross-reactions with other beta-blockers are infrequent, and changing to another preparation therefore usually solves the clinical problem. Nevertheless it is advisable to test a battery of beta-blockers (befunolol, levobunolol, metipranolol, timolol) in allergic patients. A test preparation of 2% in water or 3%-10% in petrolatum may be suitable. Control testing in non-exposed individuals is necessary to exclude irritation reactions.

Adrenergic beta-Antagonists↗
PubMed1998

Tissue concentrations after a single-dose, orally administered ofloxacin in patients with diabetic foot infections.

We studied the penetration of orally administered ofloxacin at the site of diabetes-related foot infections in patients with a planned debridement of the lesion. A total of nine patients received 800 mg of oral ofloxacin 120 to 150 minutes before surgery. During surgery, vital margin tissue and a serum sample were obtained. Serum and tissue concentrations of ofloxacin were measured. From seven patients sufficient amounts of tissue were obtained. Mean serum concentration was 7.0+/-3.5 mg/liter; mean tissue concentrations was 11.5+/-8.4 mg/kg. Mean serum and tissue concentrations exceed the minimal inhibitory concentration90 (MIC90) of commonly involved pathogens. This indicates that orally administered ofloxacin can be an effective treatment for infected diabetic foot lesions.

Administration, Oral↗
PubMed1991

Systemic allergic contact dermatitis from intravesical instillation of the antitumor antibiotic mitomycin C.

6 cases of contact allergy to the antitumor antibiotic mitomycin C from intravesical instillation are described. Reports suggest that up to 9% of patients treated with mitomycin C for chemoresection/prevention of superficial bladder cancer will develop cutaneous side-effects. Patients may present either with vesicular dermatitis of the hands and feet and/or dermatitis of the genitals, or with more widespread eruptions. Probably most, if not all, skin reactions are caused by contact allergy. The distribution is suggestive of systemic contact dermatitis from mitomycin C absorbed from the vesical mucosa.

Administration, Intravesical↗
PubMed1990

Contact allergy to furazolidone.

A case of occupational contact allergy to furazolidone, used as an animal feed additive and as an antimicrobial drug in veterinary medicine, is described. The patient did not react to furazolidone 2% pet. Using PEG-400 and alcohol as patch test vehicles resulted in positive patch test reactions. No cross-reactions were observed to other nitrofuran derivatives (nitrofurazone, nitrofurantoin) or to furfural. The literature on contact allergy to nitrofurans is reviewed.

Adult↗