ABSTRACT
Migraineurs often seek office-based treatment for acute headache. To compare the efficacy and side effect profile, we entered 27 migraineurs into a prospective, randomized, double-blind study where each patient received either 75 mg meperidine with 25 mg promethazine IM or .5 mg dihydroergotamine with 10 mg metoclopramide IV. After 1 hour, pain relief was similar in the two groups, but side effects were significantly greater in the meperidine with promethazine regimen group. The dihydroergotamine with metoclopramide regimen is effective, and has minimal side effects, making it an attractive method for office-based treatment of acute migraine.
Subject(s)
Dihydroergotamine/administration & dosage , Meperidine/administration & dosage , Metoclopramide/administration & dosage , Migraine Disorders/drug therapy , Promethazine/administration & dosage , Acute Disease , Adult , Ambulatory Care , Dihydroergotamine/adverse effects , Double-Blind Method , Drug Combinations , Female , Humans , Male , Meperidine/adverse effects , Metoclopramide/adverse effects , Middle Aged , Promethazine/adverse effects , Prospective StudiesABSTRACT
Immediate breast reconstruction avoids or lessens the psychosocial trauma associated with a disfiguring mastectomy. The complications seen in this small patient sample are not in excess of those seen in patients undergoing delayed reconstruction. Fifteen immediate breast reconstructions were performed at the time of mastectomy for cancer. Flap or implant reconstruction alone was determined on an individual basis. No delays in the initiation of adjuvant chemotherapy or hormone therapy were caused by the reconstructions. There were no instances of total flap loss or wound infection. One implant was lost due to exposure. Other complications were similar to those associated with modified radical mastectomy alone. These preliminary results suggest that immediate breast reconstruction at the time of mastectomy may be offered with safety to newly diagnosed breast cancer patients.
