Severe hemorrhagic syndrome due to similarity of drug names.

The names of many drugs look or sound like those of other drugs, which leads to confusion and potentially harmful medication errors. We report a nearly fatal permutation between two drugs including a vitamin K antagonist that resulted in a 68-year-old man being admitted to the emergency department with severe, spontaneous hemorrhagic syndrome. Such problems can be alleviated through actions by regulatory agencies, pharmaceutical manufacturers, health care professionals, and patients.

[Clinical implications of high cobalamin blood levels for internal medicine]. / Implications cliniques de la découverte d'une hypervitaminémie B12 en médecine interne.

PURPOSE: The high incidence of cobalamin (vitamin B12) deficiency results in frequent dosages of this vitamin in a department of internal medicine may reveal paradoxically high blood levels of cobalamin. The objective of the study was to estimate underlying diseases and potential diagnostic relevance of high cobalamin blood levels in internal medicine. METHODS: A retrospective study was conducted, including in-patients from December 2005 to July 2006 presenting high cobalamin blood levels, as determined with our laboratory normal values (200-950 pg/mL). RESULTS: High cobalamin blood level is not unusual (18.5% of all dosages) and, most of time, it is associated with one or several diseases, among which acute and chronic liver diseases (often of alcoholic origin), various neoplasias, malignant hemopathies (myelodysplasia, myeloproliferative diseases, multiple myeloma), renal insufficiency and transient hematologic abnormalities (neutrophilic hyperleucocytosis, hypereosinophilia). Vitamin B12 supplementation and chronic myeloid leukemia represent less than 5% of all hypervitaminemia. There is no correlation between the level of cobalamin blood level and the number of underlying diseases for each patients. However, very high cobalamin blood levels (>1275 pg/mL) are significantly associated to malignant hemopathies (p<0.05). It is noteworthy that most of diagnosed neoplasia were unknown and at a non-metastatic stage. CONCLUSION: Very high cobalamin blood levels are significantly associated to malignant hemopathies among the population of a department of internal medicine. Referent laboratory should actively advertise the numerous diseases involved with high cobalamin blood levels.

Double aortic arch in a dog (Canis familiaris): a case report.

We herein report a case of a double aortic arch in a 10-week-old male dog of no defined race, which presented episodes of regurgitation at the time of weaning. This vascular malformation was characterized by the persistence of two aortic arches, right and left, of varying dimensions. The right aortic arch was observed to be larger. During post mortem examination the vessels of the animal were injected with coloured latex bi-centrifuged CIS 1-4 polisopreno which revealed the patency of the two aortic arches. Concomitantly, dilation of the cranial oesophagus causing constriction was observed, indicating megaesophagus. Apart from the constriction, the oesophagus presented normal morphometric parameters in relation to its dimensions.