Butane firebreathing in adolescents: a potentially dangerous practice

Firebreathing is sometimes seen in magic acts. This is, potentially, a very dangerous practice without the proper precautions. What follows is a report of an adolescent who became a habitual butane firebreather after imitating this act. He developed hemorrhagic esophagitis and gastritis. The type of adolescent who may experiment with dangerous practices is discussed.     

Lithium, a potentially dangerous drug

Two patients with a bipolar disorder, a woman aged 56 and a woman aged 68, who had used lithium for more than 30 years, were seen with side effects from this medication. Both patients were treated by their general practitioner and had not visited a psychiatrist for many years. The first patient had a chronic lithium intoxication with cerebellar signs and eventually coma, diabetes insipidus, hyperthyroidism, hyperparathyroidism and psoriasis. After 6 weeks of treatment in the intensive-care unit she made a good recovery. The second patient had several lithium side effects. She was diagnosed with diabetes insipidus, hyperparathyroidism due to a parathyroid adenoma, hypothyroidism and a sick-sinus syndrome. A pacemaker was implanted 4 years earlier. The adenoma was surgically removed. After other medication was tried, the patient was once again given lithium, on which she was able to function well. The first patient had lithium concentrations above the therapeutic value for several years and both patients experienced a delay before their signs and symptoms were attributed to lithium. Lithium treatment should be monitored by an experienced psychiatrist.     

Supplement use in sport: is there a potentially dangerous incongruence between rationale and practice?

Background  

Supplement use by athletes is complex and research supports the alarming notion of misinformed decisions regarding supplements.     

The abdominal radiograph: a pictorial review

The plain abdominal radiograph is one of the most frequently requested X-ray examinations by junior surgical and accident and emergency staff. Interpretation is often difficult, but this review outlines normal appearances, suggests a strategy for evaluation, and covers the common pathological appearances seen in hospital practice.     

Diagnostic image (356). A man with a painfully distended abdomen and a mass on the plain abdominal radiograph

A 44-year-old man had abdominal pain, abdominal swelling and constipation. A plain abdominal radiograph showed signs of an ileus and as an unrelated finding an extensively calcified former renal transplant.