Predicting deterioration of treated tuberculosis by corticosteroid reserve and C-reactive protein.

Eighteen patients with recently diagnosed pulmonary tuberculosis were studied for factors which could predict, at the outset, reactions to treatment. Abnormally low corticosteroid responses to tetracosactrin were seen in some but not all of the patients who deteriorated while on treatment. Those who deteriorated transiently or died had pre-treatment C-reactive protein (CRP) concentrations above 20 mg/l, which then persisted. As previously observed, those who responded unfavourably were older, had extensive disease and presented with hypoalbuminaemia and hyponatraemia.

Propranolol and blood glucose: simultaneous measurements over a wide range of doses and the effect of propranolol on the glucose tolerance test.

No correlation was found between blood glucose and simultaneous measurements of plasma propranolol concentration in patients with schizophrenia, on a daily dose of 80 mg to 1800 mg of propranolol as an adjunct to phenothiazine medication. The Glucose Tolerance Test (GTT) in ten patients on propranolol and phenothiazines did not differ significantly from those of a matched control group on phenothiazine alone. Two patients with mild diabetes showed no significant change in their GTT after stopping propranolol. These observations accord with the view that relatively high doses of propranolol as an adjunct to phenothiazine medication in schizophrenia are safe from the standpoint of glucose metabolism. This does not apply to the insulin dependent diabetic who is in danger of severe hypoglycaemia when glycogenolysis is blocked by propranolol.