Combination of fluvoxamine and analgesics can cause serotonin syndrome

Serotonin syndrome is a potentially severe acute adverse reaction to a serotonin agonist. It is characterized by cognitive and behavioral changes, autonomic dysfunction and neuromuscular abnormalities. The growing use of SSRIs is related to the frequency of the syndrome. The aim of our presentation was to describe a unique case of severe hyperserotoninergic state caused by a single dose of fluvoxamine and an analgesic drug. Physicians who prescribe SSRIs should be aware that the patient is not a medical specialist and needs detailed information on any new drug he has been prescribed (AU)

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[Vascular age assessment in smokers]. / Vaskularna dob pusaca.

AIM: Smoking is the most harmful social habit and is the origin of many diseases including direct damaging of arterial walls. The aim of this study was to assess the possible differences in vascular age of smokers versus never smokers, measured in common carotid artery (CCA). METHODS: The study included healthy volunteers with age and sex risk factors for cerebrovascular disease development. Measurements in CCA were performed in M mode on an Aloka 5500 Prosound ultrasound platform bilaterally. Carotid intima-media thickness (IMT), carotid interadventitial diameter (CID) and carotid interadventitial diameter change (CIDc) were recorded, and carotid interadventitial strain (CIS) was calculated. Median age subanalysis was performed for IMT, CIDc and CIS. Mann-Whitney statistics was used to determine group differences. RESULTS: There were 121 subjects, 80 women and 41 men, mean age 47.43 +/- 14.15 years. There were 23 (19%) current smokers, 17 (14%) occasional smokers, 11 (9%) past smokers, and 70 (58%) non-smokers. A statistical increase in IMT was found in the group of previous smokers (the eldest) in the left CCA (P < 0.05). CIDc and CIS were statistically higher in the right CCA in the group of current smokers (P < 0.05 both). Older subjects had an increase in IMT values in both CCA and decrease in CIDc and CIS in the right CCA. CONCLUSIONS: The results indicated cigarette smoking to primarily cause an increase in CIDc, whereas CIS remained preserved. Smoking influences vascular age. Additional studies are necessary to address the issue in a greater number of smokers.

[Still's disease in adulthood--case report of a female patient and review of the literature]. / Stillova bolest odrasle dobi--prikaz bolesnice i pregled literature.

A 29-year old women with adult onset Still's disease (AOSD) was presented. On addmision to hospital the patient was febrile, with sore throat, arthralgia/arthritis and myalgia. The patient had lymphadenopathy on the neck, and laboratory findings showed leukocytosis with neutrophilia, accelarated erythrocyte sedimation rate (ESR), increased reactants of acute inflammation and normocytic anemia. During the diagnostic process, infectious, hematologic and neoplastic diseases were ruled out and the diagnosis of AOSD was made. The therapy with metilprednisolone 1 mg/kg of body weight was started. One month latter, the clinical status of the patient improved as well as laboratory findings. The dose of steroids was tappered to 16 mg per day. After 6 months of therapy, steroids were stopped and patient was followed further one year and she was free of symptoms of disease.