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Affiliation(s)
- Marc Fievez
- Institute of Morphologic Pathology, Loverval (Belgium) and Clinic "Notre Dame de Grâces". Gosselies (Belgium)
| | - Franz Philippart
- Institute of Morphologic Pathology, Loverval (Belgium) and Clinic "Notre Dame de Grâces". Gosselies (Belgium)
| | - Jean Hustin
- Institute of Morphologic Pathology, Loverval (Belgium) and Clinic "Notre Dame de Grâces". Gosselies (Belgium)
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2
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Hauben M, Aronson JK, Ferner RE. Evidence of Misclassification of Drug–Event Associations Classified as Gold Standard ‘Negative Controls’ by the Observational Medical Outcomes Partnership (OMOP). Drug Saf 2016; 39:421-32. [DOI: 10.1007/s40264-016-0392-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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3
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Strickland JR, Aiken GE, Spiers DE, Fletcher LR, Oliver JW. Physiological Basis of Fescue Toxicosis. AGRONOMY MONOGRAPHS 2015. [DOI: 10.2134/agronmonogr53.c12] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- J. R. Strickland
- USDA-ARS, Forage-Animal Production Research Unit; Lexington Kentucky
| | - G. E. Aiken
- USDA-ARS, Forage-Animal Production Research Unit; Lexington Kentucky
| | | | | | - J. W. Oliver
- Veterinary Teaching Hospital, University of Tennessee; Knoxville
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4
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Abstract
A case of ergotism is presented to illustrate the role of duplex ultrasonography in the diagnosis and management of this nonatherosclerotic cause of peripheral arterial disease. Historical aspects of ergotism are discussed together with reference to the relative vulnerability of different segments of the arterial circulation. Our case emphasizes the potential for complete reversibility of the vascular changes if recognized early.
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Affiliation(s)
- Claudia A Liegl
- Vascular Laboratory, St Vincent's Clinic, Darlinghurst, Sydney, New South Wales, Australia
| | - Michael A McGrath
- Vascular Laboratory, St Vincent's Clinic, Darlinghurst, Sydney, New South Wales, Australia
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5
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Abstract
Uncommon arteriopathies encompass a diverse range of diseases, including inherited collagen vascular disorders such as Marfan syndrome, Ehlers-Danlos Type IV, and pseudoxanthoma elasticum; vasculitides, including Takayasu's arteritis, extracranial giant cell arteritis, and Behçet's disease; neurofibromatosis type 1; intimal fibromuscular dysplasia; unusual bacterial and viral infections; and drug-induced arteriopathies. Patients with uncommon arterial disorders may present to the vascular surgeon with common surgical problems, including intermittent claudication, renovascular hypertension, Raynaud's phenomenon, and aneurysmal disease. However, the disease manifestations, expected course, and outcomes may be much different than more common arterial disorders and this can have important surgical implications. This review centers around several interesting cases and the differential diagnoses that should be considered when encountering an unusual clinical presentation. Reference is made to the literature for diagnostic criteria, clinical pearls, and how to avoid pitfalls in the evaluation and management of patients with unusual arteriopathies.
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Affiliation(s)
- Roger F J Shepherd
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA
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6
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Dilmé-Muñoz J, Barreiro-Veiguela J, Yeste-Campos M, Escudero-Rodríguez J, Llagostera-Pujol S, Mestres-Sals J, Viver-Manresa E. Ergotismo: revisión de la bibliografía y presentación de casos. ANGIOLOGIA 2003. [DOI: 10.1016/s0003-3170(03)74809-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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7
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Zavaleta EG, Fernandez BB, Grove MK, Kaye MD. St. Anthony's fire (ergotamine induced leg ischemia)--a case report and review of the literature. Angiology 2001; 52:349-56. [PMID: 11386387 DOI: 10.1177/000331970105200509] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Ergotism, once an epidemic disease, is now a rare disorder. The most common manifestation is acute peripheral ischemia due to vasospasm, with an incidence of 0.001%. We report a case of a middle-age woman who presented with ergotamine-induced leg ischemia, due to chronic use of ergotamine-containing medications for migraine headaches. The diagnosis was confirmed with arteriography results, and she responded well to vasodilator therapy. The pharmacology, clinical presentation, diagnostic approach, and therapy of ergotism are reviewed.
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Affiliation(s)
- E G Zavaleta
- Department of Internal Medicine, The Cleveland Clinic Florida, Fort Lauderdale 33309, USA
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8
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Janssen van Doorn K, Van der Niepen P, van Tussenbroeck F, Verbeelen D. Acute tubulo-interstitial nephritis and renal infarction secondary to ergotamine therapy. Nephrol Dial Transplant 2000; 15:1877-9. [PMID: 11071983 DOI: 10.1093/ndt/15.11.1877] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Janssen van Doorn
- Department of Internal Medicine, Vrije Universiteit Brussel, Brussels, Belgium
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9
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Fukui S, Coggia M, Goëau-Brissonnière O. Acute upper extremity ischemia during concomitant use of ergotamine tartrate and ampicillin. Ann Vasc Surg 1997; 11:420-4. [PMID: 9237002 DOI: 10.1007/s100169900072] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Individual hypersensitivity to the vasoconstrictor effects of ergotamine tartrate has been observed even at doses within recommended limits. Hypersensitivity can be induced by concomitant use with other drugs. The best-documented example of drug-induced hypersensitivity to ergotamine tartrate involves antibiotics of the macrolides class. The mechanism underlying this interaction appears to be interference with metabolism of ergotamine tartrate by the liver. In the present report we describe a case of upper extremity ischemia during concomitant use of ergotamine tartrate and ampicillin. The fact that the effect was not dose-dependent, disappeared when administration of ampicillin was discontinued, and reappeared when administration of ampicillin was resumed suggests that the underlying mechanism in our patient was immunologic. Since immunologic hypersensitivity to the vasoconstrictor effects of ergotamine tartrate is unpredictable, great caution and close surveillance is advisable when ergotamine tartrate is used in association with other drugs.
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Affiliation(s)
- S Fukui
- Service de Chirurgie Vasculaire, Hôpital Ambroise Paré, Boulogne, France
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10
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Gupta VL, Mjørndal TO. Gangrene and renal failure caused by dihydroergotamine used to treat raised intracranial pressure following head trauma. Acta Anaesthesiol Scand 1996; 40:389-91. [PMID: 8721476 DOI: 10.1111/j.1399-6576.1996.tb04453.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A case of peripheral gangrene and renal failure following the use of dihydroergotamine (DHE) for treatment of raised intracranial pressure (ICP) is reported. There have been several reports of vasospasm and peripheral gangrene caused by DHE used in combination with heparin for prevention of deep venous thrombosis. Clinical experience with the use of DHE in head trauma is limited. This case report emphasises the seriousness of the adverse effects associated with the use of this drug.
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Affiliation(s)
- V L Gupta
- Department of Anesthesiology and Intensive Care, Umed University Hospital, Sweden
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11
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de Groot AN, van Dongen PW, van Roosmalen J, Eskes TK. Ergotamine-induced fetal stress: review of side effects of ergot alkaloids during pregnancy. Eur J Obstet Gynecol Reprod Biol 1993; 51:73-7. [PMID: 8282144 DOI: 10.1016/0028-2243(93)90193-g] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A case of sudden fetal stress after accidental administration of ergotamine tartrate (2 mg) suppository is reported. Caesarean section was performed because of unexplained fetal stress. In retrospect, we conclude that it is likely that sudden fetal stress was caused by the severe vasoconstrictive effect of ergotamine. The side effects of ergot derivatives during pregnancy are discussed.
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Affiliation(s)
- A N de Groot
- Department of Obstetrics and Gynaecology, University Hospital Nijmegen Sint Radboud, The Netherlands
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12
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Ghali R, De Léan J, Douville Y, Noël HP, Labbé R. Erythromycin-associated ergotamine intoxication: arteriographic and electrophysiologic analysis of a rare cause of severe ischemia of the lower extremities and associated ischemic neuropathy. Ann Vasc Surg 1993; 7:291-6. [PMID: 8391300 DOI: 10.1007/bf02000258] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Vasospasm associated with ergotamine is a well-known phenomenon. In this case report we present a rare drug interaction between erythromycin and ergotamine at normal doses causing lower extremity ischemia in a 36-year-old woman. Nitroprusside proved to be the treatment of choice. The response was dramatic and took place in a matter of hours in this patient. Ischemic monomelic neuropathy is a recently described entity in which axonal necrosis is caused by a loss of distal extremity blood flow. The association between erythromycin and ergotamine may be a dangerous pharmacologic combination; drugs that have a hepatic cycle with ergotamine derivatives must be used with caution.
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Affiliation(s)
- R Ghali
- Department of Surgery, St. Sacrement Hospital, Laval University, Quebec, Canada
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13
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Abstract
Ergotamine and related compounds have been used for many years in the management of migraine. This review highlights the potential for toxic effects upon the arterial system which may arise from the use of ergot medications. Data on four female patients aged from 30 to 49 years were collected retrospectively from in-patient records and out-patient follow-up between 1978 and 1990. All four patients presented with the symptoms and signs of arterial obstruction and all had been prescribed ergot preparations as treatment and prophylaxis of migraine, for periods ranging from three to 12 years. Two patients had an acute arterial obstruction that resolved completely when the migraine medication was withdrawn. Two had chronic obstructions and radiological and surgical examination gave evidence of arterial stenosis. These two patients were treated with bypass surgery. Review of the literature indicated that other authors had described similar cases but without specifying the methods of data collection. This report supports the findings of others regarding the toxic effects of ergot preparations upon the arterial system, which may take the form of chronic or acute obstruction. General practitioners and physicians should be aware of the possible complications arising from prolonged or excessive use of ergot medications.
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Affiliation(s)
- R Magee
- Princess Alexandra Hospital, Woolloongabba, QLD
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14
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Kozak B, Rösch J. Angiography of occlusive arterial disease below the inguinal ligament. Curr Probl Surg 1991. [DOI: 10.1016/0011-3840(91)90039-r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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15
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Gatterer R, Wruhs O, Havelec L, Polterauer P, Marosi L. [Prevention of thromboembolism in accident surgery--angiospastic complications with DHE-heparin. A multicenter study]. UNFALLCHIRURGIE 1987; 13:263-70. [PMID: 3321657 DOI: 10.1007/bf02588507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In immobilized patients different drugs are used for thromboembolism prophylaxis. Arterial vasospastic complications have recently been reported after Heparin-DHE. In our clinical observation five of these cases were treated. A multicenter study was performed in 82 Austrian trauma units investigating the incidence and outcome of complications of Heparin DHE prophylaxis. 147,290 patients had different drugs for thromboembolism prophylaxis. 61,092 got Heparin-DHE. Complications could be observed at 142 patients but only in the group receiving Heparin DHE. 135 cases were treated conservatively (amputation of limbs became necessary in seven patients). In seven other cases immediate operative exposure of the vessels and balloon catheter dilatation was successfully performed. Vasospasm occurred only in patients with Heparin DHE prophylaxis. It is important to realize this possibility, so that early therapeutic measurements can be taken to avoid unnecessary permanent ischaemic damages and limb amputation.
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Affiliation(s)
- R Gatterer
- I. Universitätsklinik für Unfallchirurgie, Wien
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16
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Wells KE, Steed DL, Zajko AB, Webster MW. Recognition and treatment of arterial insufficiency from Cafergot. J Vasc Surg 1986. [DOI: 10.1016/0741-5214(86)90316-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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17
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Lewis PJ, Noseworthy TW, Fitzgerald AA, Andrews GC, Geeraert AJ. Rapid reversal of ergotamine-induced vasospasm. Neurol Sci 1986; 13:72-4. [PMID: 3955457 DOI: 10.1017/s0317167100035848] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Peripheral ischemia, secondary to ergotamine tartrate and caffeine suppositories is reported in a 48-year-old female. Lower extremity pre-gangrenous changes were unresponsive to surgical sympathectomy, calcium channel blockade, intra-arterial vasodilators and systemic anticoagulation. A dramatic clinical and radiological reversal of the vasospasm was obtained with intravenous sodium nitroprusside when surgical amputation appeared inevitable.
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18
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Doig SG, Fell G, French J. An unusual angiographic appearance of ergot poisoning. AUSTRALASIAN RADIOLOGY 1985; 29:265-7. [PMID: 4074227 DOI: 10.1111/j.1440-1673.1985.tb01708.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Fisher PE, Silk DB, Menzies-Gow N, Dingle M. Ergotamine abuse and extra-hepatic portal hypertension. Postgrad Med J 1985; 61:461-3. [PMID: 4022885 PMCID: PMC2418255 DOI: 10.1136/pgmj.61.715.461] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Arterial complications following ergotamine therapy have been well recognized since the beginning of this century. Venous complications, however, have only rarely been reported. A 48 year old Nigerian woman developed extra-hepatic portal hypertension coincident with a chronic overdosage of ergotamine. The literature elucidating the possible mechanisms involved is reviewed.
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20
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Zimran A, Ofek B, Hershko C. Treatment with captopril for peripheral ischaemia induced by ergotamine. BMJ : BRITISH MEDICAL JOURNAL 1984; 288:364. [PMID: 6419930 PMCID: PMC1444281 DOI: 10.1136/bmj.288.6414.364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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21
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Cuss FM, Colaço CB, Baron JH. Cardiac arrest after reversal of effects of opiates with naloxone. BRITISH MEDICAL JOURNAL 1984; 288:363-4. [PMID: 6419929 PMCID: PMC1444229 DOI: 10.1136/bmj.288.6414.363] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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22
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Corrocher R, Brugnara C, Maso R, Taddei G, Mezzelani P, De Sandre G. Multiple arterial stenoses in chronic ergot toxicity. N Engl J Med 1984; 310:261. [PMID: 6419107 DOI: 10.1056/nejm198401263100414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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23
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Abstract
Three days after initiation of migraine headache therapy with ergotamine tartrate and propranolol, severe acute arterial insufficiency of the lower extremities developed in a 48-year-old woman who had been in general good health. Angiography revealed hypoplastic aortoiliac arteries, with tubular narrowing of the leg arteries. Lower extremity blood pressures rapidly returned to normal with a single intraarterial injection of 25 mg of tolazoline. Cases of peripheral ischemia due to either ergotamine or propranolol have been reported. Combined use of these two drugs may enhance the risk of acute arterial compromise.
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25
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Fielding JW, Donovan RM, Burrows FG, Hurlow RA. Reversible arteriopathy following an ergotamine overdose in a heavy smoker. Br J Surg 1980; 67:247-50. [PMID: 7388303 DOI: 10.1002/bjs.1800670406] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A case of reversible arteriopathy developing in a heavy cigarette smoker taking an overdose of ergotamine is reported. Characteristic radiological changes are illustrated and the aetiology and management of this condition are discussed.
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Abstract
A case of ergotamine overdosage which produced vascular insufficiency in a 26-year-old female is described. She was treated successfully with the intravenous infusions of sodium nitroprusside and low molecular weight dextran, and anticoagulation with heparin. It is suggested that sodium nitroprusside may represent the drug of first choice in this condition.
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27
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28
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Fitzgerald B. Saint Anthony's fire or carpal tunnel syndrome? (a case of iatrogenic ergotism). THE HAND 1978; 10:82-6. [PMID: 710987 DOI: 10.1016/s0072-968x(78)80031-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A case of unilateral upper limb ischaemia from ergot overdosage is presented. An unusual feature was a median nerve neuropathy suggestive of carpal tunnel syndrome. The arteriographic appearances are demonstrated and management discussed.
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29
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Snell NJ, Russell-Smith C, Coysh HL. Myocardial ischaemia in migraine sufferers taking ergotamine. Postgrad Med J 1978; 54:37-9. [PMID: 625457 PMCID: PMC2425030 DOI: 10.1136/pgmj.54.627.37] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Two cases of acute myocardial ischaemia precipitated by oral ergotamine therapy for migraine are described from patients with no previous history of ischaemic heart disease. The relevant literature is briefly reviewed.
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30
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Ravid M, Robson M, Feigl D. Peripheral vascular disease and periodic paralysis caused by drug abuse. Angiology 1976; 27:685-7. [PMID: 1078302 DOI: 10.1177/000331977602701202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- M Ravid
- Department of Medicine, Jaffa Government Hospital, Sackler School of Medicine, Tel Aviv University, Israel
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31
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Senter HJ, Lieverman AN, Pinto R. Cerebral manifestations of ergotism. Report of a case and review of the literature. Stroke 1976; 7:88-92. [PMID: 1258110 DOI: 10.1161/01.str.7.1.88] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A patient with diffuse and focal cerebral dysfunction was found to have absent peripheral pulses. Cerbral angiography revealed evidence of an arteritis with bilateral high grade carotid stenosis. When there was no laboratory confirmation of the arteritis, an iatrogenic etiology (ergotism) was suspected. This was later confirmed by the patient. The pertinent literature on ergotism is reviewed, and it is emphasized that ergotism may develop in patients on therapeutic doses of the drug.
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32
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Semb BK, Molster A, Halvorsen JF, Tvete S. Ergot-induced vasospasm of the lower extremities treated with epidural anaesthesia. SCANDINAVIAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 1975; 9:254-8. [PMID: 1209209 DOI: 10.3109/14017437509138647] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
No reliable treatment to reverse severe ergot-induced vasopasm is available. A case of ergotamine-induced vasospasm of the lower extremities is presented. A combined treatment of vasodilators, infusion of low molecular dextran and high epidural anaesthesia apparently prevented extremity gangrene from occurring.
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33
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Merhoff GC, Porter JM. Ergot intoxication: historical review and description of unusual clinical manifestations. Ann Surg 1974; 180:773-9. [PMID: 4371616 PMCID: PMC1343691 DOI: 10.1097/00000658-197411000-00011] [Citation(s) in RCA: 85] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Clinical ergotism as seen today results almost exclusively from the excessive intake of ergotamine tartrate in the treatment of migraine headache. Although both gangrenous and convulsive symptoms are seen in naturally occurring ergotism resulting from the ingestion of fungus infected rye, only gangrenous ergotism has been reported following the excessive ingestion of ergotamine tartrate. The symptoms of both iatrogenic and naturally occurring ergotism appear to result from regional ischemia caused by ergot induced vasospasm. This report discribes experiences in the diagnosis and management of two patients with unusual manifestations of iatrogenic ergotism. One patient presented with ischemia of all extremities and bilateral foot drop probably due to ischemic damage to the common peroneal nerves, a finding not previously described in ergot intoxication. The foot drop totally resolved in several months following the discontinuation of ergot. A second patient presented with unilateral leg ischemia and transient monocular blindness, both of which resolved after discontinuation of ergot. Both patients displayed typical angiographic findings of ergotism. There is no convincing evidence that any treatment other than discontinuation of ergotamine is of benefit in the treatment of iatrogenic ergotism.
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34
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Herlache J, Hoskins P, Schmidt CM. Ergotism. Unilateral brachial artery thrombosis secondary to ergotamine tartrate. Angiology 1973; 24:369-73. [PMID: 4712163 DOI: 10.1177/000331977302400607] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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