Prozac or Prilosec for Gastric Ulcer?

Abstract

We cannot acknowledge receipt of your letter, but we will notify you when we have made a decision about publication. We are unable to provide prepublication proofs. Please enclose a stamped, self-addressed envelope if you want unpublished material returned to you. Financial associations or other possible conflicts of interest must be disclosed. Submission of a letter constitutes permission for the Massachusetts Medical Society, its licensees, and its assignees to use it in the Journal 's various editions (print, data base, and optical disk) and in anthologies, revisions, and any other form or medium. ؒ August 22, 1996The New England Journal o f Medicine Correspondence Management of Acute Mesenteric IschemiaTo the Editor: The Clinical Problem-Solving article entitled "The Invisible Patient" (April 4 issue) 1 describes a patient who died of bowel ischemia that manifested clinically several hours after coronary angiography. The discussant attributed the ischemic event to the dislodgment of an atheromatous plaque by arterial catheterization. Two days earlier, however, the patient had undergone cardioversion for atrial fibrillation of unknown duration. The discussant rejected the possibility of a left atrial thrombus as a potential embolic source because two days had elapsed since cardioversion.Thromboembolism occurring hours to days after the restoration of sinus rhythm is a well-known complication of cardioversion for long-standing atrial fibrillation.2 This complication may occur even in the absence of a preexisting left atrial thrombus at the time of cardioversion, because of a delay between the restoration of sinus rhythm and the resumption of atrial mechanical activity. 3 In fact, the function of the left atrial appendage may worsen transiently after cardioversion, as demonstrated by Fatkin et al. 3 For this reason, anticoagulation therapy is commonly administered for several weeks before and after cardioversion for atrial fibrillation lasting longer than 48 to 72 hours.In this case, an intracerebral arteriovenous malformation was considered a contraindication to anticoagulation therapy. Although the results of echocardiography were interpreted as normal, this imaging study does not provide ample visualization of thrombi in the left atrial appendage. It is therefore possible that cardioversion promoted mesenteric embolism, either by dislodging a preexisting thrombus or by facilitating its formation in a stunned atrium in the absence of anticoagulation therapy. Cardioversion without previous anticoagulation therapy has recently been demonstrated to be safe when transesophageal echocardiography is used to rule out a preexisting left atrial thrombus. 4 We believe that because of the contraindication to anticoagulation therapy, transesophageal echocardiography was required. This course of action might have prevented the patient's death. Had a left atrial thrombus been demonstrated, the decision to perform cardioversion could have been deferred. Had transesophageal echocardiography ruled out a left atrial thro...

Trade mark cluttering-evidence from EU enlargement

“…The review of invented names for ethical drugs in Europe began in 1999 when EMA set up the Invented Name Review Group (NRG). This happened in response to papers in medical journals (Costable Jr and McKinley, 1996;Raffalli et al, 1997) which reported medication errors resulting from confusion caused by similar names given to ethical drugs, e.g. Losec 10 and Lasix 11 .…”

“…1 The aim is to protect consumers from medication errors that result from drug name confusion. Medical journals have repeatedly reported instances of confusion deriving from similar brand names for ethical drugs (Costable Jr and McKinley, 1996;Raffalli et al, 1997). Instances of lethal medication errors due to the confusion of drug names are documented.…”

What's in a Name? Lack of Pronunciation in Consumer Medicine Information

“…Good communication is of importance when dealing with similar sounding medicine names. [3][4][5][6][7][8][9][10] Health professionals and patients tend to confuse drugs with similar names, thereby threatening patient safety. One out of four medication errors voluntarily reported in the US involves this type of drug-name confusion.…”

“…There are several examples of errors arising from similar sounding medicine names. 4,[7][8][9][10] In one, a hospitalised patient reported taking Paxil (paroxetine) at home, but was actually taking Plavix (clopidogrel). 8 The admitting physician misinterpreted the patient's pronunciation as Paxil and prescribed it.…”