ABSTRACT
BACKGROUND: Edema associated with quetiapine has been described in only one case report to date and represents a potentially serious adverse reaction. METHODS: We present a case series of 3 patients who developed bilateral leg edema following initiation of quetiapine. RESULTS: One of these patients had a recurrence of edema with subsequent rechallenge. Another patient developed quetiapine-induced edema following a prior episode of olanzapine-induced edema. All 3 cases present a compelling temporal relationship between the drug challenge and the adverse event. CONCLUSION: Prompt recognition and intervention with discontinuation of the offending agent is important for this potentially serious, seemingly idiosyncratic vascular complication.
Subject(s)
Antipsychotic Agents/adverse effects , Bipolar Disorder/drug therapy , Bipolar Disorder/psychology , Depression/drug therapy , Depression/psychology , Dibenzothiazepines/adverse effects , Edema/chemically induced , Psychomotor Agitation/drug therapy , Adult , Drug Administration Schedule , Female , Humans , Middle Aged , Psychomotor Agitation/psychology , Quetiapine Fumarate , Suicide, Attempted/psychologyABSTRACT
BACKGROUND: The practice of Evidence-based Medicine requires that clinicians assess the validity of published research and then apply the results to patient care. We wanted to assess whether our soon-to-graduate medical students could appraise and apply research about a diagnostic test within a clinical context and to compare our students with peers trained at other institutions. METHODS: 4th year medical students who previously had demonstrated competency at probability revision and just starting first-year Internal Medicine residents were used for this research. Following an encounter with a simulated patient, subjects critically appraised a paper about an applicable diagnostic test and revised the patient's pretest probability given the test result. RESULTS: The medical students and residents demonstrated similar skills at critical appraisal, correctly answering 4.7 and 4.9, respectively, of 6 questions (p = 0.67). Only one out of 28 (3%) medical students and none of the 15 residents were able to correctly complete the probability revision task (p = 1.00). CONCLUSIONS: This study found that most students completing medical school are able to appraise an article about a diagnostic test but few are able to apply the information from the article to a patient. These findings raise questions about the clinical usefulness of the EBM skills possessed by graduating medical students within the area of diagnostic testing.
