Tamponade due to hemopericardium after streptokinase therapy for pulmonary embolism

A 67-year-old man was given intravenous heparin and then streptokinase for an acute severe pulmonary embolism. The next day a large pericardial effusion developed, with tamponade. Aspiration of blood (500 ml) from the pericardial sac produced prompt relief. The possibility of hemopericardium causing tamponade should be considered on unexplained worsening of cardiac status in a patient who has recently received streptokinase for pulmonary embolism or myocardial infarction.     

When nurses and teachers strike: public perceptions of 'the betrayal'

This article examines how the public perceived both teachers and nurses during their first strikes in Victoria. How did the community react when two previously trusted groups of essential service workers "closed shop" and walked out. Reactions towards the teachers' and nurses' actions by the press, politicians and those members of the public who expressed themselves via the media are examined. While many of the arguments used in the public debate were similar, the most significant difference in the public's reaction was related to the gender of the leaders of the respective industrial organizations.     

Amyotrophic cerebellar hypoplasia

Summary Lower motor neuron degeneration, cerebellar hypoplasia, atrophy of pons, olives, and cerebellum, sclerosis of thalamus and pallidum, and deficient myelination were found in a 2-months-old baby with laryngeal paralysis, mental retardation, progressive amyotrophy, and slow nerve conduction velocity. Such changes seem characteristic of an unusual syndrome previously referred to as cerebellar hypoplasia in Werdnig-Hoffmann disease, or anterior horn cell disease with pontocerebellar hypoplasia. Although the pathologic changes in lower motor neurons are indistinguishable from those in other cases of infantile spinal muscular atrophy, the consistent reproducibility of a complex pathologic pattern suggests that this is probably a manifestation of a separate disease process. The term amyotrophic cerebellar hypoplasia (ACH) is a convenient designation for the syndrome.Supported in part by National Institutes of Health grant no. RR75     

Topical tacrolimus therapy of resistant cutaneous lesions in lupus erythematosus: a possible alternative

Objective. To determine the efficacy of tacrolimus ointment0.1% on resistant cutaneous lesions in patients with lupus erythematosus. Methods. Twelve patients with skin manifestations were studied.Six had discoid lupus (DL), four subacute cutaneous lupus erythematosus(SCLE) and two systemic lupus erythematosus (SLE). All patientshad extensive skin lesions refractory to previous treatment.Patients received topical tacrolimus 0.1% for a minimum of 6weeks and response was evaluated by physicians’ and patients’assessment and documented with photographs at baseline and atthe end of the treatment. Results. Eleven of 12 patients completed the therapy. One patientwith DL discontinued because of side-effects—peeling anda burning sensation. Six patients were clearly improved, onepatient had a minor remission of his face lesion while in fourthe rashes remained the same. Two patients with SCLE had significantregression of their lesions while the other two had no improvement.In DL, two had certain improvement, one minor improvement andtwo were without response. The patients with SLE had significantamelioration of their extensive photosensitive rash. Conclusion. Tacrolimus ointment 0.1% may be an effective alternativein patients with severe resistant cutaneous manifestations inlupus erythematosus. KEY WORDS: Tacrolimus, Cutaneous lupus erythematosus