Aminoglycoside-associated hypomagnesaemia in children with cystic fibrosis

Hypomagnesaemia in children with cystic fibrosis (CF) is under-recognized. We report a child with CF who developed significant hypomagnesaemia following intravenous (i.v.) treatment with aminoglycosides for exacerbations of Pseudomonas aeruginosa infection. Three additional cases have also been observed. Investigations in two patients have revealed excessive renal loss of magnesium. It is postulated that renal tubular damage secondary to the cumulative effects of repeated courses of aminoglycosides resulted in hypomagnesaemia, and we suggest screening for this problem by monitoring serum magnesium regularly in all patients with CF receiving multiple courses of aminoglycosides.     

Decreased plasma benzylamine oxidase in a subgroup of schizophrenia

Plasma benzylamine oxidase (BzAO) activity was analysed in a group of 40 schizophrenic patients and compared with that of healthy controls. Although plasma BzAO was significantly decreased in schizophrenics as a whole, when patients were divided into type I (favourable course) and type II (poor course) it was found that the reduced BzAO activity was only observed in type I. Several clinical features were associated with a low BzAO level. The clinical and biological significance of the identification of a biochemical alteration in a subgroup of schizophrenic patients is discussed, and we suggest that the possibility of BzAO being a marker for prognosis in schizophrenia should be further investigated.     

The double puncture: an effective percutaneous technique for removing complex, multiple renal calculi

Percutaneous nephrostolithotomy, which can require a double puncture, is presently the method of choice in our institution for the removal of renal stones. Patients that underwent this procedure were evaluated to identify the possible reasons for the double puncture. Of 200 patients evaluated, 14 needed a second tract. The three variables that determined whether a second puncture was needed, in order of importance, were number and size of the stones, with second tracts needed in patients with multiple stones and staghorn calculi; anatomical variations of the renal collecting system itself, with bifid systems the most significant anatomic variation; and the dexterity of the radiologist in performing the puncture and the ability of the urologist to extract the stone. Second tracts were needed more frequently in patients who presented with stones in both the lower and middle poles of the collecting systems.     

Pseudo-Kaposi's syndrome of the left lower extremity. The Stewart-Bluefarb syndrome

The authors relate one case of Stewart-Bluefarb syndrome in a 16 year old patient, showing cutaneous lesions with features of Kaposi angiosarcoma. Though there are no signs of direct arteriographic of arteriovenous communications (CAV). The other exams accomplished allow us to maintain CAV as an etiopathogenic hypothesis.     

Mongolian Spots in Sjögren-Larsson Syndrome

Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, typewritten double spaced, and must not exceed two pages of text including references. Two copies of all letters should be submitted along with one copy on disk. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided.     

Traumatic Amputation of a Supernumerary Digit: A 16-Year-Old Boy's Perspective of Suture Ligation

Abstract:   Traditionally, the duplicated digit in an infant with polydactyly is managed by suture ligation and the digit is allowed to auto-amputate. However, painful neuromas may result from this commonly used technique and sharp excision has been suggested as a superior alternative. We present a case of a 16-year-old male who requested revascularization after a traumatic partial amputation of a supernumerary digit on his left hand. He requested revascularization because suture ligation of a duplicated digit on his right hand as an infant had resulted in a neuroma and considerable pain.