Subject(s)
Hypertension/epidemiology , Adult , Aged , Female , Humans , Industry , Male , Middle Aged , Norway , Occupational MedicineSubject(s)
Hypertension/epidemiology , Adult , Aged , Follow-Up Studies , Humans , Industry , Male , Middle Aged , Norway , Occupational MedicineABSTRACT
The metabolism of alpha-methyldopa was studied in 5 patients with febrile reactions to the drug, and compared with the metabolism in 5 patients without such reactions and in 4 normal subjects. A depression of the drug metabolism was found in drug fever patients, which may affect either the intestinal mucosal conjugation of the drug or the hepatic transformation. The decreased metabolism is assumed to be a possible causative mechanism of the adverse reaction.
Subject(s)
Fever/chemically induced , Methyldopa/adverse effects , Adult , Aged , Female , Humans , Hypertension/drug therapy , Male , Methyldopa/metabolism , Methyldopa/therapeutic use , Middle AgedABSTRACT
In a prospective study of digitalis intoxication in 649 patients on maintenance treatment with digitoxin a low incidence of digitalis toxicity was found, namely, 5.8 per cent. This is mainly due to a more careful use to digitalis glycosides. It is especially important to reduce the dose of digitoxin in the liver and partly excreted metabolized in the liver and partly excreted through the kidneys as metabolities. Serum half-time of digitoxin is shortened in patients with impaired renal function. Patients with reduced renal function may be treated with digitoxin in the same doses as individuals with normal renal function. This is in contrast to patients treated with digoxin. Digitoxin should therefore be the cardiac glycoside of choice in treatment of patients with renal failure. Digitoxin is further rapidly eliminated in patients with reduced liver function in spite of its extensive hepatic metabolism. In this study extracardia symptoms were found equally often as cardiac signs of toxicity. Patients intoxicated usually had several symptoms and signs of toxicity at the same time. The specificity of commonly used symptoms and signs a digitalis intoxication is very low. In this study atrial tachycardia with block, which has been considered to be an important cardiotoxic arrhythmia, very seldom was found in digitalis intoxication. There is an overlap in digitalis serum concentration between toxic and nontoxic patients. The diagnosis of toxicity was made on clinical grounds. Most of the intoxicated patients had high serum concentrations, but some had concentrations in the normal or low range. Apart from being a guide to the diagnosis of digitalis intoxication, serum digitalis levels may further be a guide to underdigitalization of cardiac patients, especially patients in sinus rhythm.
Subject(s)
Digitoxin/adverse effects , Age Factors , Aged , Arrhythmias, Cardiac/chemically induced , Body Weight , Digitoxin/administration & dosage , Digitoxin/blood , Female , Humans , Kidney Diseases/blood , Liver/metabolism , Male , Middle Aged , Prospective StudiesABSTRACT
In a prospective study on digitalis intoxication, low serum magnesium was found in 90 patients, while 388 patients had values above 1.5 mEq/l. Hypomagnesemia was more frequent in women than in men, in those with low body weight and in those with advanced heart failure. More patients with hypomagnesemia than those without had nausea, anorexia, fatigue, flickering of vision and atrial tachycardia with block. Patients with hypomagnesemia also had lower serum potassium than normomagnesemic patients. There was, however, no significant difference in the prevalence of digitalis intoxication or in serum digitoxin concentration. Nor was there any correlation between serum digitoxin and serum magnesium levels.
Subject(s)
Digitalis Glycosides/poisoning , Magnesium/blood , Body Weight , Digitoxin/blood , Female , Humans , Male , Potassium/blood , Prospective Studies , Sex FactorsABSTRACT
Chromosome analysis and conventional cytology have been done on serous effusions from 35 patients, 21 of whom had a final clinical diagnosis of malignant disease and 14 of non-malignant disease. Sixteen of the malignant cases were previously untreated. Cytology disclosed nine cases as malignant, three as suspect malignant and nine as normal. The comparable figures for chromosome analysis were 14 malignant, two suspect malignant, and five normal. Neither of the methods gave false positive results in the small series of non-malignant disease. In the present study chromosome analysis has thus provided greater diagnostic accuracy than cytology on serous effusions of malignant disorders.
Subject(s)
Cytodiagnosis , Genetic Techniques , Neoplasms/diagnosis , Aged , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Neoplasms/genetics , Neoplasms/pathologyABSTRACT
Diazepam is a valuable drug in cases of acute myocardial infarction. The 10 mg intravenous loading dose and the subsequent 15 mg oral dose of diazepam administered three times daily produced safe, pleasant sedation, and reduced the need for analgesics. A much reduced excretion of catecholamines was recorded. It is presumed that diazepam causes a lower stress reaction, which is beneficial in diminishing the incidence of malignant arrhythmias and preventing the existing myocardial injury from spreading.
