This report describes 2 cases of metallosis from metal-on-polyethylene total hip replacements. Case 1 involved a Stryker rejuvenate implant, which has since been recalled. This patient had minimal symptoms, an elevated cobalt level, and loosening. The patient in case 2 had a Dupuys Pinnacle system, with symptoms of weakness, rash, and hip pain. Abnormal laboratory values include elevated sedimentation rate, C-reactive protein, creatinine, cobalt, and decreased hematocrit. Magnetic resonance imaging revealed synovial thickening and extracapsular edema. Although metallosis is a well-established complication of metal-on-metal implants, emerging data reveal that it also may be a problem in non-metal-on-metal implants such as either metal-on-polyethylene or ceramic-on-polyethylene implants, perhaps related to modular corrosion.
Chloramphenicol is one of the most valuable antibiotics available to the physician,1 although in rare instances it may cause severe hematopoietic reactions.2 It is the purpose of this paper to emphasize another apparent severe toxic reaction\p=m-\theoccurrence of optic and peripheral neuritis.
Report of a CaseThe patient was a 20-year-old man who had been in good health until Oct. 21, 1957, when he was treated with penicillin for a "flu-like" syndrome. Three days later genitourinary symptoms occurred; he became systemically ill and was hospitalized. Physical examination at that time showed only costovertebral angle tenderness. He had marked pyuria, and his chest roentgenogram showed a small infiltrate in the upper lobe of his left lung. He was treated with chlortetracycline and his genitourinary symptoms subsided. On Nov. 7, pain developed in his left shoulder, but roentgenograms were normal.
T he Annals of Surgery has recently accepted a paper for publication titled ''Lung Transplantation for Elderly Patients With End-stage COVID-19 Pneumonia'' authored by Dr. Han Weili et al. 1 We are surprised that this article was accepted for a number of reasons. Although COVID-19 is an urgent medical subject, we believe it should not result in lowering requirements of authors and bypassing ethical standards. Quality of academic submissions, due process in medical research, and clearly defined ethical considerations must not be sidelined despite the urgency the medical profession is facing. COVID-19 must not be accepted as a reason to normalize unethical practices.Thepaperraisesseriousethicalconcerns regarding organ procurement and publication standards. First, given the ongoing concerns LETTERS TO THE EDITOR
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