ABSTRACT
Intranasal administration of diazepam may be a practical alternative to the conventional acute medication of seizures, such as status epilepticus. Nine healthy students participated in an open crossover study on intranasal versus intravenous administration of diazepam (2 mg). Blood samples were collected, pharmacodynamic tests were performed, and the volunteers filled out questionnaire. Peak concentration was achieved after 18+/-11 min and the bioavailability was 50.4+/-23.3%. A pharmacodynamic effect was observed after about 5 min, but the dose, even for i.v. administration, was too low to generate a strong measurable effect. The results indicate that intranasally administered diazepam may be an effective alternative to i.v. administration in relief of seizures, e.g. in an acute situation when a physician or nurse is not available on location.
Subject(s)
Anticonvulsants/therapeutic use , Diazepam/therapeutic use , Seizures/drug therapy , Administration, Intranasal , Anticonvulsants/administration & dosage , Anticonvulsants/pharmacokinetics , Clinical Trials as Topic , Diazepam/administration & dosage , Diazepam/pharmacokinetics , Humans , Injections, Intravenous , Reference ValuesABSTRACT
Heterotopic salivary tissue can occur in the upper part of the neck and may be confused with other causes of neck masses. The embryologic basis of the heterotopic salivary tissue is considered to be heteroplasia of the epithelium of the cervical sinus of His. Heterotopic salivary tissue should be surgically excised. The diagnosis is easy if there is a draining sinus, but if there is not a sinus, the diagnosis is usually made coincidental to the removal of the mass as part of the evaluation of a neck mass. Benign and malignant neoplasms can arise in such heterotopic salivary tissue.
Subject(s)
Choristoma/diagnosis , Head and Neck Neoplasms/diagnosis , Salivary Glands , Adult , Choristoma/surgery , Female , Head and Neck Neoplasms/surgery , Humans , MaleABSTRACT
A retrospective review of 211 consecutive patients with classic Meniere's disease was performed to determine the efficacy of diagnostic studies. The patients' ages averaged 47 years and ranged between 8 and 86 years. Females outnumbered males 1.3 to 1. Left and right ears were affected with equal frequency and, in 12% of patients, the disease was bilateral. Audiologic patterns were flat in 42%, rising in 7%, peaked in 32%, and sloping downward in the remaining 19%. Electronystagmography was normal in 21% of the patients and demonstrated canal paresis in 65% and directional preponderance in 14%. Studies of glucose metabolism were abnormal in 2 of the 204 patients tested. The 7 patients not tested had a previous diagnosis of diabetes mellitus. Thyroid function studies were abnormal in 1 of the 208 patients studied. The 3 patients not studied were known hypothyroid. FTA-abs was positive in 12 patients and special radiographic studies of the petrous apex were normal in all cases. Conclusions suggested by this study are that audiology, electronystagmography, and treponemal antigen tests for syphilis are cost effective in evaluating patients with Meniere's disease. Studies of glucose metabolism and thyroid function, however, are probably not indicated in patients without a history suggestive of a metabolic disorder and specialized radiographs of the petrous apex should be reserved for patients suspected of having acoustic neuroma.
