Drug-Induced Methaemoglobinaemia
I read the case report of cocaine induced methemoglobinemia¹ in the recent edition of the acute medicine journal with interest.
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Correspondence
We read with interest the article by Rogers et al in the recent edition of Acute Medicine, regarding the evaluation and management of adrenal failure. It was noted that the investigation and diagnosis of adrenal failure during pregnancy was not discussed; we feel this is an important omission, which was highlighted recently by a young woman who presented to our medical take, two weeks post-partum following her first pregnancy with clinical features in keeping with an Addisonian crisis.
Correspondence
I read with interest the article by Langford et al in the recent edition of Acute Medicine, summarising the NICE guidance for the management of venous thromboembolic diseases.1 This highlights the recommendation that CTPA should be the investigation of choice for patients with suspected pulmonary embolism (PE), in view of its clinical and cost effectiveness.
Correspondence
In the latest edition of the journal, catheter-directed thrombolysis was reviewed (1), and does appear to be an attractive therapeutic option for treatment of deep venous thrombosis, both in prevention of postthrombotic syndrome and avoidance of anticoagulant therapy. I have one concern about the procedure with regards to the quoted bleeding rates. A systematic review reported high bleeding rates at 31% though major bleeding rates were low (2)
Correspondence
I read with interest the review article on the management of toxological emergencies , published in the last edition of the journal (E. Banham-Hall, R. Mallinson: Poisoning and toxological emergencies – acute trends and practice. Acute Medicine 2009 8(2) p17-21).