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We report two cases of unexplained hypothyroidism in patients taking oral ciprofloxacin (figure). Nursing staff gave levothyroxine. Prescription charts showed no drug administration errors. Patients did not have nausea, vomiting, or diarrhoea. Unexplained hypothyroidism in patients taking oral ciprofloxacin ### Case 1 An 80 year old woman with advanced thyroid cancer had maintained suppressed concentrations of thyroid stimulating hormone and stable free thyroxine by taking 125 μg levothyroxine daily. She was admitted with a pathological fracture of the femur and complicating osteomyelitis. After four weeks' treatment with oral …

Intervention against cardiovascular risk factors such as hypertension, dyslipidaemia and smoking is necessary to reduce the increased mortality associated with diabetes mellitus.The case notes of 2003 patients with diabetes in general practice in Rogaland, Salten and Aker were reviewed in order to assess the quality of diabetes care including the treatment of risk factors for cardiovascular disease.287 out of 1417 patients below the age of 76 had known cardiovascular disease. Of these, 57.5% were treated with a statin and 61 % were taking aspirin. 118 patients had had a myocardial infarction, 69.5% were on a statin and 60.2% were taking aspirin. 776 (38.7%) of the patients in the study had been diagnosed as suffering from hypertension, 40.3% were on therapy with one anti-hypertensive agent, 28.6% received two agents and 12.1% were on three or more anti-hypertensive agents. Only 57.5% of patients, who according to current national guidelines ought to be on a statin as secondary prevention, received such a treatment. Smoking habits were recorded in 35.1% and weight in 45 % of the patients.There is considerable room for improvement with regard to intervention against known risk factors for cardiovascular disease in patients with diabetes treated in primary care.

To evaluate whether measurement of albumin creatinine ratio (ACR) on a spot urine specimen can replace a timed overnight collection of urine albumin excretion rate (UAER) in patients with diabetes in primary care.Patients with diabetes attending Rønvik Health Centre were asked to bring a timed overnight collection of urine for measurement of UAER. They were also asked to void a urine specimen for measurement of albumin creatinine ratio.Primary health care.One-hundred-and-six persons with diabetes (47 women, 59 men) aged 13 to 78 years.The sensitivity and specificity of ACR with cut-off values of 2.5 mg/mmol for men and 3.5 mg/mmol for women compared to UAER with cut-off value of 20 mg/24 h was 90%.Spot urine ACR analysed on a DCA 2000 can replace a timed (overnight) collection of urine and measurement of UAER when diabetic patients are reviewed in general practice. This simplifies procedures for the patient as a timed urine collection is no longer necessary. Another advantage is that the results are available after 7 min.