RESUMO
Detection of gadolinium deposits in patients who have repeatedly been administered intravenous gadolinium chelates have given rise to concern regarding the long-term safety of magnetic resonance imaging (MRI) contrast media. Nevertheless, negative long-term clinical effects have not yet been observed. In some publications parallels have been drawn to the sequelae of thorotrast that was formerly used for arterial angiography. In this article the history of thorotrast use is briefly described and in particular why, despite warnings, this substance was used frequently and worldwide. A brief summary of the results of the German Thorotrast Study revealed that high excess rates were only observed for primary malignant liver tumors after a 15-year or longer latency period and to a lesser degree of leukemias, as well as for severe local complications due to paravascular injections, particularly in the neck region. Based on this historical review, we will venture to take stock of the outcome from the "success story" of this contrast agent.
Assuntos
Angiografia/história , Doença Hepática Induzida por Substâncias e Drogas/história , Meios de Contraste/história , Neoplasias Hepáticas/história , Radiologia/história , Dióxido de Tório/história , Alemanha , História do Século XX , HumanosRESUMO
The British Journal of Hospital Medicine is 50 years old. This article takes a look back at articles published during the year of its inception from the British Medical Journal, the Lancet and the Journal of the American Medical Association.
Assuntos
Publicações Periódicas como Assunto/história , Aborto Induzido/história , Acetaminofen/história , Acetaminofen/toxicidade , Adenoma Adrenocortical/história , Alopurinol/história , Alopurinol/uso terapêutico , Analgésicos/história , Analgésicos/toxicidade , Antineoplásicos/história , Antineoplásicos/uso terapêutico , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Pulmão do Criador de Aves/história , Doença Celíaca/complicações , Doença Celíaca/história , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Doença Hepática Induzida por Substâncias e Drogas/história , Dermatite Herpetiforme/complicações , Dermatite Herpetiforme/história , Descoberta de Drogas/história , Gota/tratamento farmacológico , Gota/história , Supressores da Gota/história , Supressores da Gota/uso terapêutico , Rejeição de Enxerto/história , Rejeição de Enxerto/imunologia , Doença Granulomatosa Crônica/história , História do Século XX , Humanos , Medicare/história , Editoração/história , Reino Unido , Estados UnidosRESUMO
Ludwig van Beethoven suffered from various constitutional disorders, most publicly known his deafness. He died in 1827 from a decompensated liver cirrhosis. On his deathbed, admirers cut some ringlets from his head that can nowadays be used for scientific analyses. Hair analyses demonstrated that Beethoven was increasedly exposed to lead in his last 110 living days that may have contributed to the hepatic decompensation. The reason for the lead exposition was probably consumption of wines mixed with lead sugar, but also iatrogenic by lead-containing preparations administered for pneumonia in winter 1826/1827 as well as wound closure after puncturing for ascites four times.
Assuntos
Doença Hepática Induzida por Substâncias e Drogas/história , Pessoas Famosas , Cabelo/química , Intoxicação por Chumbo/história , Chumbo/análise , Cirrose Hepática/história , Música/história , Áustria , Alemanha , História do Século XVIII , História do Século XIX , HumanosRESUMO
BACKGROUND: Paracetamol poisoning has been a clinical problem for over 40 years. This article reflects the content of the Louis Roche lecture given on this topic in 2009. HISTORICAL CONTEXT: Initially key work illustrated the relationship between plasma paracetamol concentration and risk of liver injury facilitating the development of antidote strategies. Much of this work was done in the Edinburgh clinical toxicology unit. DISCUSSION: The antidote most widely used, acetylcysteine, was developed in Edinburgh and subsequently shown to be associated with adverse effects. Studies on this aspect and on key problems remaining in patient management are described. These include the identification of patients at greatest risk of toxicity, in order that they may be targeted for appropriate early intervention. More recent work suggests that the inflammatory response to paracetamol-induced liver injury may offer new targets for drug therapy in this major poisoning. CONCLUSION: Paracetamol poisoning remains a challenging problem, but new approaches to treatment seem possible based on recent experimental studies in animals and humans.