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Y Caraco

Publications and source records attributed to Y Caraco.

46 records · Page 3Linked to original sources

Colchicine intoxication: clinical pharmacology, risk factors, features, and management.

The use of colchicine for acute gouty arthritis dates to ancient times. In recent years, colchicine also has been used successfully for various other rheumatic and nonrheumatic conditions. Colchicine is a safe drug when used according to established therapeutic guidelines. However, toxicity can be considerable if ingested intentionally or if the recommended doses are exceeded. Colchicine intoxication is characterized by multi-organ involvement and by the poor prognosis associated with administration of large amounts of the drug. Therapy is basically supportive and symptomatic because of the rapid distribution and binding of colchicine to the affected tissues. Use of anticolchicine antibodies is a novel approach that has shown promise in experimental models. Important research questions pertain to the effect of liver and kidney disease on colchicine metabolism, use of colchicine levels in the diagnosis of intoxication and for prognostication, and application of immunotoxicotherapy for colchicine poisoning in humans.

Animals↗

Acute nonrheumatic perimyocarditis complicating streptococcal tonsillitis.

Streptococcal infection is a rarely recognized cause of nonrheumatic perimyocarditis. We report a case of a young patient who developed acute perimyocarditis as manifested by diffuse electrocardiogram changes, and markedly elevated cardiac enzymes, concurrently with streptococcal tonsillitis. Despite the dramatic presentation, the patient recovered uneventfully. We conclude that streptococci can involve the heart also directly by a bacterial component or toxin, and not only through a delayed immunologic mechanism as in rheumatic fever. Further studies are necessary to accurately determine the incidence of myocardial involvement during early stages of streptococcal infection.

Adult↗

Septic arthritis of the sternoclavicular joint in healthy adults.

Septic arthritis of the sternoclavicular joint (SCJ) is a rare disorder, and is usually associated with predisposing factors such as contiguous foci of infection, heroin addiction, rheumatoid arthritis and diabetes mellitus. Three cases in previously healthy adults are reported here. The aetiology, clinical manifestations and treatment are briefly reviewed. The considerable difficulty in diagnosing this disorder in adults is emphasized. In summary, diagnosis of septic arthritis of the SCJ in adults requires a high index of suspicion, and must be considered not only in patients with predisposing factors, but also in previously healthy adults.

Adult↗

The incidence and clinical significance of amiodarone and acenocoumarol interaction.

Acenocoumarol sensitivity index (ASI) was calculated in 36 patients receiving amiodarone and acenocoumarol concomitantly, by dividing the acenocoumarol daily dose (micrograms kg-1 day-1) by the prothrombin ratio expressed as International Normalised Ratio (INR). It was found to be significantly lower (4.2 +/- 0.3 micrograms kg-1 day-1) than the ASI (11 +/- 0.6 micrograms kg-1 day-1) determined in 35 patients in the control group, who received acenocoumarol and not amiodarone. In 15 patients, ASI was 13.2 +/- 1.4 and 4.2 +/- 0.6 micrograms kg-1 day-1 before and after initiation of amiodarone therapy, respectively. In 5 patients, ASI was 6.2 +/- 0.6 micrograms kg-1 day-1, while patients were receiving both medications, and 28.1 +/- 6.1 micrograms kg-1 day-1 following discontinuation of amiodarone therapy. ASI determined while patients were on both medications was not affected by the presence of mild impaired renal or liver function. In 7 patients treated with both drugs concomitantly, severe bleeding diathesis developed. It is concluded that amiodarone augmented the anticoagulant effect of acenocoumarol in all patients receiving both drugs. An initial reduction of acenocoumarol daily dose by 50% and further adjustment of acenocoumarol dose according to daily prothrombin ratio is recommended. It is also suggested that acenocoumarol dose should be adjusted after cessation of amiodarone therapy.

Acenocoumarol↗

Shigella sonnei myocarditis.

A 19-year-old male was admitted to our department because of high fever, abdominal pain, and diarrhea. Electrocardiogram (ECG) on admission revealed diffuse ST-T changes which persisted for 5 days. Stool culture grew Shigella sonnei. We conclude that the infection with Shigella sonnei was the cause for these findings which were most probably due to myocarditis. To the best of our knowledge myocarditis as a complication of shigella infestation has never been reported.

Adult↗

Ticlopidine-induced thrombotic thrombocytopenic purpura.

Thrombotic thrombocytopenic purpura (TTP) occurs in association with a wide variety of disorders including infections, connective tissue diseases, and solid organ tumors. It also may coincide with administration of drugs such as mitomycin, metronidazole, oral contraceptives, cyclosporine, and many others. We report the occurrence of TTP in a patient shortly after the initiation of ticlopidine.

Adult↗