1978 | D MATTINGLY MARY BRADLEY P J SELLEY A RICHARD WRAY J TEMPLETON JAMES D LAIRD
A patient developed abdominal pain and passed a melena stool, leading to hospital admission. His hemoglobin level dropped to 8.5 g/dL, and his prothrombin time exceeded 3 minutes. Generalized hemorrhage was evident through Cullen's sign and leg bruising. Despite hospital treatment with intravenous prothrombin time and vitamin K, the patient succumbed to cardiac failure three weeks later. The authors suggest that sulfinpyrazone, which displaces oral anticoagulants from protein binding sites, may have potentiated warfarin activity, leading to this outcome. They recommend against using sulfinpyrazone in patients on oral anticoagulants outside the hospital.
A radio broadcast by Kennedy discussed the cost-benefit ratio of serum alpha-fetoprotein (AFP) screening for neural tube defects. The author used a computer program to calculate the cost-benefit ratio under different assumptions and found it to be between 0.11 and 0.30, significantly lower than Kennedy's 0.62. The ratio is influenced by the amniocentesis rate and the incidence of neural tube defects. The author suggests that a serum AFP screening program with a low amniocentesis rate could achieve a better cost-benefit ratio than routine amniocentesis for women with a history of neural tube defects.
A 24-year-old factory worker experienced a grand mal seizure shortly after lumbar myelography using metrizamide. The authors recommend strict indications for myelography, sitting upright for a couple of hours post-procedure, and hospitalization for 24 hours to reduce the risk of complications.
The author shares concerns about the quality of biochemical assays performed in ward-side rooms. A quality control scheme was implemented, but two wards produced inaccurate results. The author emphasizes the importance of proper use of extralaboratory biochemical analyses to avoid patient harm.A patient developed abdominal pain and passed a melena stool, leading to hospital admission. His hemoglobin level dropped to 8.5 g/dL, and his prothrombin time exceeded 3 minutes. Generalized hemorrhage was evident through Cullen's sign and leg bruising. Despite hospital treatment with intravenous prothrombin time and vitamin K, the patient succumbed to cardiac failure three weeks later. The authors suggest that sulfinpyrazone, which displaces oral anticoagulants from protein binding sites, may have potentiated warfarin activity, leading to this outcome. They recommend against using sulfinpyrazone in patients on oral anticoagulants outside the hospital.
A radio broadcast by Kennedy discussed the cost-benefit ratio of serum alpha-fetoprotein (AFP) screening for neural tube defects. The author used a computer program to calculate the cost-benefit ratio under different assumptions and found it to be between 0.11 and 0.30, significantly lower than Kennedy's 0.62. The ratio is influenced by the amniocentesis rate and the incidence of neural tube defects. The author suggests that a serum AFP screening program with a low amniocentesis rate could achieve a better cost-benefit ratio than routine amniocentesis for women with a history of neural tube defects.
A 24-year-old factory worker experienced a grand mal seizure shortly after lumbar myelography using metrizamide. The authors recommend strict indications for myelography, sitting upright for a couple of hours post-procedure, and hospitalization for 24 hours to reduce the risk of complications.
The author shares concerns about the quality of biochemical assays performed in ward-side rooms. A quality control scheme was implemented, but two wards produced inaccurate results. The author emphasizes the importance of proper use of extralaboratory biochemical analyses to avoid patient harm.