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January 2, 1954


Author Affiliations

Consultant Cardiologist U. S. P. H. S. Hospital Staten Island, N. Y.

JAMA. 1954;154(1):82. doi:10.1001/jama.1954.02940350084028

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To the Editor:—  In a recent report in The Journal (153:788 [Oct. 31] 1953), Steinbrocker and associates recorded their extensive experience in the management of the shoulder-hand syndrome and presented a challenging comparison between sympathetic block and corticotropin and/or cortisone therapy. Although these authors found that steroid administration gave almost as good results as stellate block, they regard the latter as the treatment of choice for shoulder-hand syndrome. According to their view, the great advantages of sympathetic block are the rarity of contraindications, the usually shorter period of treatment without further maintenance therapy, and the reduced likelihood of complications. The preference of these authors for stellate ganglion block appears to stem primarily from their belief that cortisone or corticotropin may foster thromboembolic phenomena in some patients, especially those with vascular disease. Steinbrocker and associates cited two possible instances of thrombotic complications caused by hormone therapy in their series but

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