Journal of internal medicine
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Comparative Study
Serum ferritin and transferrin saturation in patients with chronic alcoholic and non-alcoholic liver diseases.
To compare serum ferritin concentration and transferrin saturation in patients with alcoholic and non-alcoholic chronic liver diseases. ⋯ Serum ferritin is more frequently elevated in abusing patients with alcoholic liver disease than in patients with other chronic liver diseases such as autoimmune liver diseases and hepatitis C. Because serum ferritin decreases rapidly during abstinence, the measurement of ferritin for the detection of haemochromatosis in patients abusing alcohol should be postponed until the patients are abstaining. Most of the patients with increased serum ferritin have normal transferrin saturation values which can be used to separate them from haemochromatosis.
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Clinical Trial
Continuous infusion of furosemide in the treatment of patients with congestive heart failure and diuretic resistance.
To assess the value of treatment with continuous intravenous infusion of furosemide (F) in patients with refractory congestive heart failure. ⋯ Continuous infusion of F under careful monitoring of the patient is a safe, controllable and efficient treatment in patients with severe congestive heart failure and diuretic resistance.
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Serious complications after carotid sinus massage are rare. A case is described of monoplegia complicating carotid sinus massage in an elderly patient without symptoms or signs of cerebrovascular disease. We remind physicians of this potential complication and suggest that alternative therapies be considered prior to the use of carotid sinus massage in this age group.
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Systemic mastocytosis is a rare and chronic disorder characterized by a pathologically increased number of mast cells in various tissues and overproduction of mast cell mediators. From a group of 15 patients (10 females, 5 males) with systemic mastocytosis five female patients presented with a history of an anaphylactoid shock reaction to wasp sting. Three of them had no demonstrable specific IgE against wasp or bee venom in serum, and a skin test that was only weakly positive for wasp venom. ⋯ From the latter group two female and three male patients said they had been stung by a wasp in the past. Thus, anaphylactoid shock after Hymenoptera sting can be a presenting symptom of systemic mastocytosis and may be caused by an IgE- as well as a non-IgE-mediated mechanism. In cases of anaphylactoid reaction to Hymenoptera sting, especially when there is no IgE demonstrable in serum or in cases of intolerance of hyposensitization, the diagnosis of systemic mastocytosis should be considered, also in the absence of the clinical hallmarks of urticaria pigmentosa.