Acta medica Scandinavica
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Acta medica Scandinavica · Jan 1988
Randomized Controlled Trial Clinical TrialThe effect of flumazenil (Ro 15-1788) in the management of self-induced benzodiazepine poisoning. A double-blind controlled study.
A double-blind randomized study was performed to evaluate the efficacy and safety of flumazenil, a benzodiazepine antagonist. The study comprised 52 patients admitted to an intensive care unit because of suspected pure or mixed benzodiazepine poisoning. The degree of consciousness was assessed according to a modified Glasgow Coma Scale (MGCS), graded from 4 to 20, immediately before and at consecutive intervals after an i.v. injection of flumazenil or placebo. ⋯ The patients poisoned with a combination of benzodiazepines and other hypnotic drugs responded less, but still highly significantly (MGCS +5.8; p less than 0.001). Flumazenil was well tolerated and the safety of the antidote seems acceptable. It is concluded that flumazenil can facilitate differential diagnosis and that it is an effective tool in the treatment of drug overdosage when benzodiazepines are involved.
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Acta medica Scandinavica · Jan 1988
Case ReportsUnusual manifestation of Langerhans' cell histiocytosis.
An unusual manifestation of the disease Langerhans' cell histiocytosis (LHC) is presented. An 18-year-old man was admitted to the Department of Dermatology after he had been suffering for some time from affections of the skin in the scalp and perianal region which were resistant to treatment. ⋯ In addition to this, he developed a diabetes insipidus, originating in connexion with the present disease. The combination of skin affection in the perianal region, spontaneous bilateral pneumothorax and diabetes insipidus in relation to LHC has not been described previously.
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Acta medica Scandinavica · Jan 1988
Plasma lipids and plasma lipoproteins in diabetics with and without proliferative retinopathy.
The single most important factor related to the development of diabetic retinopathy is the duration of diabetes. Little is known about the underlying mechanisms, but many factors have been suggested to be involved, among them derangements in plasma lipids and plasma lipoproteins. In the present study we examined the relation between plasma lipids, plasma lipoproteins, and the duration of diabetes in Type I diabetics with and without proliferative retinopathy. ⋯ The levels of lipids and lipoproteins did not correlate with the duration of diabetes. Furthermore, no differences were seen between patients with and without proliferative retinopathy. Thus, the present study does not indicate that plasma lipids and plasma lipoproteins play any major role in the development of diabetic proliferative retinopathy.
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Injection of ergonovine has been suggested as a diagnostic test in patients with suspicion of a vasospastic component in the pathophysiology of angina pectoris. However, a thorough case history has been considered by others to give the same information regarding the anginal mechanism. Therefore a bedside ergonovine test (0.075-0.675 mg i.v.) was performed in 21 consecutive patients with effort angina in order to study the relation between the outcome of the test and the case history concerning angina at rest. ⋯ The two patients with atypical chest pain had normal coronary angiograms and in these patients ergonovine provoked the same atypical chest pain but no ECG changes. Thus, a concomitant angina at rest is a common finding among patients with severe effort angina. However, the response to ergonovine was as common in the group with only effort angina as in the group with concomitant rest angina, indicating the limited value of this test in patients with severe angina.
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Acta medica Scandinavica · Jan 1987
Case ReportsPerforated peptic ulcer--a complication in acute salicylate intoxication.
A patient with perforated peptic ulcer following acute salicylate intoxication is presented. The patient had reversible renal failure requiring dialysis therapy, but no abdominal symptoms were noticed until six days after arrival. At this time haematemesis and melaena were observed. Symptoms and objective findings were vague, but further investigations revealed a perforated prepyloric ulcer, which was successfully treated with cimetidine, The delay from intoxication to symptoms has previously been described and might be due to the analgetic properties of salicylates.