Postgraduate medical journal
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Severe narcosis occurred in a patient with hypoparathyroidism given therapeutic doses of codeine phosphate.
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Growth hormone (GH), prolactin (PRL) and thyrotrophin (TSH) responses to thyrotrophin-releasing hormone (TRH) were studied in 15 insulin-dependent diabetic patients. Basal plasma GH levels were raised above 5 mu./l in 6 patients and following the injection of TRH there was a significant rise in plasma GH levels in 9. ⋯ Basal PRL and TSH levels were normal and rose normally in response to TRH. GH release may be qualitatively abnormal in some diabetics and any such loss of specificity of GH-releasing mechanisms would further contribute to the raised GH levels found in many diabetics which would be of importance if GH is a factor in the aetiology of diabetic microangiopathy.
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Bacterial pyomyositis is common in the tropids but is rare in temperate climates. A patient with aplastic anaemia who had never left the continental United States developed bacterial pyomyositis secondary to Staphylococcus aureus which responded to antibiotics and surgical drainage. Bacterial pyomyositis should be considered in the differential diagnosis of fever and myalgias in the immunocompromised patient.
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Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
Pre-operative intravenous feeding--a controlled trial.
Seventy-four patients with a pre-operative diagnosis of stomach or oesophageal cancer were entered into a randomized, controlled clinical trial to assess the value of a short course of pre-operative intravenous nutrition. The effectiveness of this treatment was assessed by the clinical course and monitored by means of immune and biochemical profiles. ⋯ Clinical benefit was confined to those patients who had a low serum albumin on admission to hospital. It is doubtful whether this limited benefit justifies the routine use of intravenous feeding, with its attendant hazards, in the pre-operative preparation of patients with upper gastrointestinal cancer.