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RISS 인기검색어
- 검색키워드
- 저자 : ( Eugene Teh ) (검색결과 3 건)
- 무료
- 기관 내 무료
- 유료
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Poster Session : PS 0754 ; Rheumatology ; Is This a Rare Case of Quetiapine Induced Dermatomyositis?
( Eugene Teh ),( Timothy Godffrey ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Quetiapine is commonly used for schizophrenia and bipolar affective disorder. Anti- psychotics can cause acute rhabdomyolysis as part of a neuroleptic malignant syndrome or through a direct toxic effect on myocytes. However, there are no literatures or case reports of quetiapine induced dermatomyositis. In this case report, we described a possible rare case of quetiapine induced dermatomyositis. Mr. J. is a 39 year old Caucasian male who is generally in good health, with past history of Asperger`s syndrome, Tourette`s syndrome, depression and attention defi cit hyperactive disorder. He was commenced on 25mg of quetiapine by his psychiatrist for Tourette`s syndrome. On day two, he developed non-itchy erythematous rash around his eyes, neck and shoulders. At day 9, his quetiapine dose was increased to 50 mg. A week later, he presented to us with swelling of his face, neck, shoulder and right arm with diffi culty using it. He did not report any constitutional symptoms (weight loss, sweats or fever), breathlessness or diffi culty walking. On physical examination, there were no signs of neuroleptic malignant syndrome. There was evidence of Shawl-sign and heliotrope rash. His right proximal limb strength was 3/5 and remaining examination of his lower limbs, cardio-respiratory and abdomen were unremarkable. An initial diagnosis of rhabdomyolysis was made with an elevated creatinine kinase(CK) levels of 9321U/L. He had an MRI of his right arm which showed diffused patchy intramuscular oedema typical for myositis. His CK (12826U/L) increased further with no evidence of renal impairment. His muscle biopsy was conclusive of dermatomyositis. There was no radiological evidence for primary or secondary neoplasia. Vasulitic and infectious disease screen were negative, and biopsy of a colonic polyp did not show any evidence of malignancy. Could this be a rare case of quetiapine induced dermatomyositis or a mere coincidence?
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( Anuk Kruavit ),( Eugene Teh ),( Imogen Clark ),( Emily Shen ),( Vikas Wadhwa Eastern Health ),( Australia ),( University Of Melbourne ),( Australia ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Acute exacerbations of chronic obstructive pulmonary disease(COPD) places signifi cant pressure on the health care system. Studies have shown that music therapy has positive effects on quality of life and increases exercise capacity of patients. Our aim is to evaluate the effects of music on exercise capacity in COPD inpatients. Method: This was a prospective, interventional study invoving patients admitted with an acute exacerbation of COPD. Patients were given a list of song options to select from. Patients will select a preferred song rated as the best motivational score, as per the Brunel Music Rating Inventory. Patients then undertook a 2-minute walking test to assess the distance walked with and without music. A dyspnoea visual analogue scale was used to record the degree of dyspnoea after each walking test. Secondary outcomes included walking time, blood pressure, heart rate, respiratory rate and oxygen saturation with and without music. Results: Seventeen patients were recruited, with a mean age of 73.9 ± 8.6 years. Nine were males and 8 were females. There was a signifi cant increase in the walking distance with music therapy, with a mean increase in distance of 7.94 metres (95% CI, 3.58 - 12.31). There was a non-signifi cant trend that patients could walk for longer with music therapy. Diastolic blood pressure were noted to increase signifi cantly with music therapy, but other physiological parameters did not show any signifi cant changes. The motivational score of the preferred song used did not lead to any signifi cant correlation with the outcome variables. Conclusion: Music therapy with a patient-preferred song may lead to signifi cant clinical benefi ts in hospital inpatients with acute exacerbation of COPD. Larger studies are warranted to provide further evidence for its potential use in routine clinical practice.
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( Scott Shih ),( Eugene Teh ),( Ahmad Rahim ),( Roderick Ryan ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Contemporary medicine has a number of uses for enoxaparin but with potential serious complication of major haemorrhage. We assess the appropriateness of enoxaparin dosing in hospital inpatients with deep vein thrombosis(DVT) and/or pulmonary embolus(PE) in relation to patient`s weight and renal function. Method: A retrospective quality assurance study of medical record data for all inpatients treated for DVT or PE over a six month period from February 2013 to July 2013. Data regarding age, weight, renal function(eGFR & creatinine clearance), enoxaparindosage and subsequent adjustments were reviewed. Doses were considered appropriate if within a +/-15% range of the accepted dosages of 1mg/kg BD or 1. 5mg/kg daily, or 1mg/kg daily if renal failure was present. Results were analysed according to the number of patients either not weighed or possibly weight estimated, the number of patients inappropriately dosed, and the number of patients with renal failure and inappropriately dosed. Results: 296 patient records were reviewed. 32% of patients had weights recorded. One weighed patient did not have renal function tested. Of the remaining 94 weighed patients, 2 patients(2. 1%) were inappropriately dosed. In those with renal failure, 5 patients(71%) were dosed appropriately, while 2 were dosed inappropriately. Patientswith an eGFR of under 30ml/min, 5 patients(83%) were appropriately dosed while 1 patient was not and those with eGRFR of under 50ml/min, 11 patients(68%) were appropriately dosed, while 5 patients were not. Conclusion: It would appear that clinicians at Eastern Health were good at appropriately dosing enoxaparin. Patients with renal failure, appropriate dosing rates were lower. With the large number of patients who were unweighed, there were concerns that a number of patients in the unweighed group who have renal failure are being unwittingly inappropriately dosed.
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