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Cardiac Rupture in a Young Male Cocaine User

To the Editor: A 25-year-old man was found unconscious by his wife in the bathroom of his apartment. She called emergency services and cardiopulmonary resuscitation was promptly initiated within a few minutes. The patient was intubated, transferred to the Emergency Department (ED) of a local hospital, and after 1 hour of advanced cardiac life support […]

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patient's view of surgery looking up at doctors

Appropriate Use of Proton Pump Inhibitors: A Double-Edged Sword

We read with great interest the article published by Wombell et al in the current issue of The American Journal of Medicine. The authors summarize the evidence linking proton pump inhibitors (PPIs) to hospital-acquired Clostridium difficile infection.1 They also provide a description of the possible mechanisms responsible for this association. We commend the authors for their timely contribution to the […]

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Antidepressants and Hyponatremia

It is well known that antidepressants can cause hyponatremia, particularly in elderly patients. This complication can be serious, with delirium, seizure, or even death. In the classic study by Fabian et al,1 paroxetine, a selective serotonin reuptake inhibitors (SSRI), was found to induce hyponatremia in 12% of elderly patients within a mean duration of 9 days. […]

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Lifestyle Risk Factors Increase the Risk of Hospitalization for Sciatica: Findings of Four Prospective Cohort Studies

The purpose of this study is to assess the effects of lifestyle risk factors on the risk of hospitalization for sciatica and to determine whether overweight or obesity modifies the effect of leisure-time physical activity on hospitalization for sciatica. Methods We included 4 Finnish prospective cohort studies (Health 2000 Survey, Mobile Clinic Survey, Helsinki Health […]

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Unexpected Cause of Bleeding

To the Editor: A 46-year-old man was seen by his hepatologist for a follow-up visit after successful treatment of hepatitis C. He reported a general weakness and walking pain for 10 days due to lower limb edema and knee arthralgia. His medical history included an intravenous heroin and cocaine addiction weaned off since 2001 and […]

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