A rare case of lipoid pneumonia attributed to amiodarone

A low dose of amiodarone-indused sinoatrial node dysfunction: a case report

We recently treated a case similar to that reported by Mun et al and Chinushi M. Holter ECG demonstrated paroxysmal atrial fibrillation, frequent ventricular ectopy’s, atrial tachycardia. The patient complained of palpitation. We have prescribed and amiodarone (100 mg/day) per day for 2 months. In the second visit, the palpitation attacks were relieved. It was effective in decreasing palpitation and atrial fibrillation. However, the patient was readmitted because of a new complaint of feeling weak, dizziness, confusion, and fainting. Holter monitoring revealed a long sinus pause (4–7,9 seconds). Because such a sinus pause had not been observed before the amiodarone treatment, it is likely that the development of sick sinus syndrome was related to amiodarone. Therefore, it seems inappropriate to apply this incidence of amiodarone-related sinoatrial node dysfunction to patients who are prescribed amiodarone for the treatment of ventricular tachyarrhythmia and atrial fibrillation who have prescribed a lower maintenance dose of amiodarone.

Analysis of Cannabinoid-Containing Fluids in Illicit Vaping Cartridges Recovered from Pulmonary Injury Patients: Identification of Vitamin E Acetate as a Major Diluent

Beginning in June of 2019, there was a marked increase in reported cases of serious pulmonary injury associated with vaping. The condition, referred to as e-cigarette or vaping product use-associated lung injury (EVALI), does not appear to involve an infectious agent; rather, a chemical adulterant or contaminant in vaping fluids is suspected. In August of 2019, the Wadsworth Center began receiving vaporizer cartridges recovered from patients with EVALI for analysis. Having no a priori information of what might be in the cartridges, we employed untargeted analyses using gas chromatography-mass spectrometry and high-resolution mass spectrometry to identify components of concern. Additionally, we employed targeted analyses used for New York medical marijuana products. Here, we report on the analyses of 38 samples from the first 10 New York cases of EVALI for which we obtained cartridges. The illicit fluids had relatively low cannabinoid content, sometimes with unusual Δ9-/Δ8-tetrahydrocannabinol ratios, sometimes containing pesticides and many containing diluents. A notable diluent was α-tocopheryl acetate (vitamin E acetate; VEA), which was found in 64% of the cannabinoid-containing fluids. To investigate potential sources of the VEA, we analyzed six commercial cannabis-oil diluents/thickeners. Three were found to be >95% VEA, two were found to be primarily squalane, and one was primarily α-bisabolol. The cause(s) of EVALI is unknown. VEA and squalane are components of some personal care products; however, there is growing concern that vaping large amounts of these compounds is not safe.