South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Randomized Controlled Trial Clinical Trial
Flunisolide nasal spray in the treatment of perennial rhinitis.
Twenty patients with perennial rhinitis took part in a double-blind, randomized, cross-over comparison of flunisolide nasal spray (Syntaris; Syntex) and its vehicle. The sprays were used twice daily for 4 weeks and a total daily dose of 200 micrograms flunisolide was used. ⋯ Patient and doctor treatment preferences were significantly in favour of the active spray. Side-effects were mainly confined to nasal irritation and occurred equally in both treatment groups.
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An experimental model of haemorrhagic hypotension was standardized using rabbits to investigate the shock lung syndrome over a period of 120 minutes. Acute hypovolaemia was induced by withdrawal of blood under anaesthesia to a mean arterial pressure of 30 +/- 5 mmHg within 10 minutes. The mean leucocyte counts and the release of lysosomal enzymes (acid phosphatase and beta-glucuronidase) in the blood and in lung tissue, as well as the metabolic capacities of lung tissue in terms of protein and lipid biosynthesis, were investigated at set intervals after 30, 60, 90 and 120 minutes. ⋯ The beta-glucuronidase and acid phosphatase contents of the plasma increased with time; beta-glucuronidase activity increased progressively as leucocytes disappeared from the circulation. Concomitantly, the capacity of the lung tissue to synthesize protein and lipids was retarded with time, becoming significantly lower than baseline values after 60 minutes of hypovolaemia. The decline in leucocyte numbers in the circulation correlated well with the increase in beta-glucuronidase activity and the retarded metabolic capacity of the lung tissue.
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Etomidate (Hypnomidate; Janssen) 1,25% in sterile water was given rectally on 100 occasions to 50 male Long-Evans rats in doses ranging from 4 mg/kg to 12 mg/kg. The onset and duration of ataxia and hypnosis (i.e. loss of righting ability) were recorded. Ataxia was observed in all rats, even at the lowest dose levels. ⋯ No mortality was recorded despite the rectal administration of ten times the intravenous lethal dose (LD50) for rats. Histological examination of the rectal and colonic mucosa showed that etomidate 1,25% in sterile water (pH 3,5) caused no significant mucosal change, but undiluted etomidate 12,5% (pH 1,8) caused haemorrhagic necrosis. We conclude that rectal etomidate 1,25% in sterile water is an efficient, predictable, evanescent and safe method of inducing anaesthesia in rats and warrants further investigation in clinical anaesthesia in children.
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Randomized Controlled Trial Comparative Study Clinical Trial
Precautions against intra-ocular pressure changes during endotracheal intubation--a comparison of pretreatment with intravenous lignocaine and diazepam.
Endotracheal intubation after administration of succinylcholine is associated with a rise in intraocular pressure (IOP). That this is likely to have harmful effects in patients with penetrating eye injuries is self-evident. The efficacy of various means of abolishing these effects is debatable. ⋯ IOP, pulse rate and systolic blood pressure were recorded after induction, after intubation and after return of spontaneous respiration. Statistical analysis of the data showed that diazepam diminished the rise in IOP, while lignocaine had little effect (P less than 0,05). It is concluded that pretreatment with diazepam 0,05 mg/kg is beneficial in reducing the ocular risks of endotracheal intubation.