Southern medical journal
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Southern medical journal · May 1976
Comparative Study Clinical TrialNaloxone in the parturient and her infant.
Eighteen women in labor received analgesia with moderately large total doses of meperidien. Various doses of naloxone (8, 12, 18, 27, 40, or 60mug/kg of body weight) were given intravenously to the mothers before delivery in an attempt to find the dose that would prevent neonatal narcotic depression. Maternal and neonatal blood gas values, Apgar scores, and postnatal neurobehavioral examinations were used to assess the effects. ⋯ After the naloxone injection, the mothers showed an improvement in consciousness and blood gas values. When the study infants, as a group, were compared with control infants, there was very little difference in blood gas values or neurobehavioral examination. Infants in the groups receiving naloxone in doses of 18, 27, and 40mug/kg compared most favorably with the control infants, indicating that naloxone may be effective in preventing neonatal narcotic depression.
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Penetrating injuries of the laryngotracheal area require immediate maintenance of an adequate airway and prompt surgical exploration and repair. Two basic principles are illustrated by case reports: repairing major vessels before doing the laryngotracheal repair and using adjacent tissues to repair traumatic defects. We suggest a team approach at operation.
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Southern medical journal · May 1976
Hypophysectomy in the treatment of disseminated carcinoma of the breast and prostate gland.
Transsphenoidal hypophysectomy offers gratifying palliative relief of pain to patients with metastatic cancer of the breast and prostate. This report represents the results of two years' experience with this procedure at Emory University School of Medicine. The physiologic rationale and clinical indications for hypophysectomy are described, as is the operative technic using the open transsphenoidal microsurgical approach. ⋯ Pain was the preoperative indication for surgery in 41, while three patients were operated on for extensive disease without pain. Satisfactory relief of pain was obtained in 76% of the patients with prostatic cancer and in 83% of the breast cancer patients. While the results are gratifying with regard to relief of pain, the duration of follow-up is not sufficient to comment on the value of the procedure in significantly prolonging life.
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Southern medical journal · May 1976
Clinical significance of the biotransformation of inhalation anesthetics.
Inhalation anesthetics, a class of drugs formerly believed to be biologically inert, are now recognized to undergo considerable biotransformation. The viscerotoxicity of certain anesthetics on kidney and liver can be explained in terms of metabolism. The entity of "halothane hepatitis" remains mechanistically and diagnostically a mystery, but if it exists, it could be due to abnormalities of biotransformation.