Acute naphthalene toxicity presenting with metabolic acidosis: a rare complication

Naphthalene moth ball poisoning in children can present with diagnostic and therapeutic challenges. A 2 year old boy who had accidentally consumed unknown number of moth balls presented 3 d later with vomiting, seizures, methemoglobinemia, hemolytic anemia and altered sensorium. He was managed with red blood cell transfusion, IV Methylene blue and Sodium bicarbonate. Clinical and laboratory parameters normalized. We describe this case as ingestional naphthalene poisoning with rare manifestation of metabolic acidosis, with a good outcome after treatment.     

Italian multicentre trial comparing itraconazole with griseofulvin in the treatment of dermatomycoses. Preliminary results

The results of previous international studies have suggested that itraconazole is significantly superior to griseofulvin in the treatment of tinea corporis/cruris. The aim of our study was to compare the efficacy and tolerability of the two agents in a larger number of patients with dermatomycoses. This study is ongoing in 46 Italian Centers of Dermatology. From this total of 46 Centers, the patients of 16 Centers have been included for the "ad interim" analysis. One hundred and thirty-four patients were randomized to treatment with either itraconazole 100 mg once daily for 15 days (73 patients) or griseofulvin 375–1000 mg daily for a mean of 17 days (61 patients). The patients were assessed clinically and mycologically before entering the trial, at the end of therapy and again 30 days after the end of treatment. Both groups showed a statistically significant improvement in desquamation, erythema and subjective complaints, with a trend in favour of itraconazole, despite the significantly shorter duration of treatment. Thirty days after the end of therapy, microscopic results were negative in 91.5% of the itraconazole group and 71.7% of the griseofulvin group. Cultures were negative in 80% and 65%, respectively. A significantly higher proportion of patients in the itraconazole group than in the griseofulvin group experienced both clinical and mycological recovery. One patient in the itraconazole group and three in the griseofulvin group reported adverse experiences. The preliminary results of this study show that itraconazole is well tolerated and more effective than griseofulvin. Furthermore, itraconazole demonstrated a more rapid action than griseofulvin.     

Statistical evaluation of vectorcardiographic criteria for the diagnosis of posterior myocardial necrosis (author's transl)]

85 vectorcardiograms, characterized by anteriorly oriented horizontal ventricular loop, were analized in order to evaluate if this pattern can be considered diagnostic at all for strictly posterior myocardial infarction. Records were divided into two groups according to positivity or negativity of clinical history for myocardial infarction. Records consistent with right ventricular hypertrophy were ruled out. Nine parameters related to ventricular depolarization and repolarization were measured and the values were submitted to statistical analysis. The study showed that:--selection of the two groups was correct, because of first group's homogeneity and control group's unhomogeneity;--mean values of the nine parameters did not differ significantly in the two groups;--single parameter into each group was unrelated to others. As a consequence, criteria at the time in use for diagnosis of strictly posterior myocardial infarction seem not to be useful, as other conditions beside myocardial infarction or right ventricular hypertrophy are able to determine the same vectorcardiographic pattern.