Two cases of organic psychosis, induced by the new chemotherapeutic agent ofloxacin (Tarivid), are described. According to DSM-III-R and ICD 10 (draft, 1987) both cases present as different, yet well-defined diagnostic categories: the new diagnostic systems appear to be superior and markedly more differentiated than ICD-9, since they provide a more exact and comprehensive description and more specific diagnostic allocation, especially in substance-specific syndromes. The possible involvement of GABAergic and monaminergic mechanisms in this psychotic symptomatology and their relationship to hypersynchronous states are discussed in detail.
This case of osteoid osteoma is reported for two reasons. First, for its rarity and unusual location (it was diagnosed very late) and second because it demonstrates that the history of a painful condition leads to the correct diagnosis, and although clinical investigations may provide corroboratory evidence, they are certainly no substitute. A 23-year-old student experienced spontaneous nightly pain in the distal phalanx of his right hallux. The pain increased over 2 years but with a good response to non-steroidal anti-inflammatory medication. After 9 months X-rays showed a cystic lucency. The patient was seen by a number of consultants, but the diagnosis of osteoid osteoma was delayed. After surgery the diagnosis was confirmed histologically and the pain has not recurred.
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