ABSTRACT
The successful treatment of patients with pyoderma gangrenosum by means of the local application of sodium cromoglycate solution is reported. One of the patients also had chronic active hepatitis and a background history of ulcerative colitis. Possible mechanisms underlying the apparent success of this form of treatment are discussed.
Subject(s)
Cromolyn Sodium/therapeutic use , Pyoderma/drug therapy , Skin Ulcer/drug therapy , Administration, Topical , Aged , Colitis, Ulcerative/complications , Cromolyn Sodium/administration & dosage , Female , Hepatitis/complications , Humans , Male , Middle Aged , Pyoderma/etiology , Skin Ulcer/etiologyABSTRACT
To compare the results of home and hospital treatment in men aged under 70 years who had suffered acute myocardial infarction within 48 hours 1895 patients were considered for study in four centres in south-west England. Four-hundred-and-fifty patients were randomly allocated to receive care either at home by their family doctor or in hospital, initially in an intensive care unit. The randomised treatment groups were similar in age, history of cardiovascular disease, and incidence of hypotension when first examined. They were followed up for up to a year after onset. The mortality rate at 28 days was 12% for the random home group and 14% for the random hospital group; the corresponding figures at 330 days were 20% and 27%. On average, older patients and those without initial hypotension fared rather better under home care. The patients who underwent randomisation were similar to those whose place of care was not randomised, except that the non-randomised group contained a higher proportion of initially hypotensive patients, whose prognosis was poor wherever treated. These results confirm and extend our preliminary findings. Home care is a proper form of treatment for many patients with acute myocardial infarction, particularly those over 60 years and those with an uncomplicated attack seen by general practitioners.
Subject(s)
Home Care Services , Hospitalization , Myocardial Infarction/mortality , Adult , Aged , Angina Pectoris/therapy , Home Nursing , Humans , Hypotension/complications , Male , Middle Aged , Myocardial Infarction/therapy , Recurrence , Time FactorsSubject(s)
BCG Vaccine , Leukemia/mortality , Age Factors , Antigens , Black People , Child , Child, Preschool , Follow-Up Studies , Humans , Infant , Infant, Newborn , Leukemia/immunology , Leukemia/prevention & control , Mononuclear Phagocyte System/immunology , Retrospective Studies , Sex FactorsSubject(s)
Cromolyn Sodium/therapeutic use , Rhinitis, Allergic, Seasonal/drug therapy , Adolescent , Adult , Aged , Airway Resistance/drug effects , Analysis of Variance , Child , Clinical Trials as Topic , Cromolyn Sodium/administration & dosage , Cromolyn Sodium/pharmacology , Female , Humans , Lactose , Male , Middle Aged , Nasal Mucosa/drug effects , Placebos , Powders , Respiration/drug effects , Smell/drug effects , Spirometry , Time Factors , Vital Capacity/drug effectsABSTRACT
This is a preliminary report of a co-operative study of 1,203 episodes of acute myocardial infarction in men under 70 years in four centres in the south west of England. The mortality at 28 days was 15%. A comparison is made between home care by the family doctor and hospital treatment initially in an intensive care unit: 343 cases were allocated at random. The randomized groups do not differ significantly in composition with respect to age; past history of angina, infarction, or hypertension; or hypotension when first examined. The mortality rates of the random groups are similar for home and hospital treatment. The group sent electively to hospital contained a higher proportion of initially hypotensive patients whose prognosis was bad wherever treated; those who were not hypotensive fared rather worse in hospital.For some patients with acute myocardial infarction seen by their general practitioner home care is ethically justified, and the need for general admission to hospital should be reconsidered.