The treatment of streptococcal infections with elkosin N1-(2, 6-dimethyl-4- pyrimidyl) sulfanilamide.
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Biomedical subjects
Publications and source records attributed to A G BOWER.
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As the first step in an attempt to clarify criteria for use of the rocking bed rather than the respirator as an aid to breathing for patients with weakness of respiratory muscle function caused by poliomyelitis, ventilation studies were done on seven patients with pronounced weakness or paralysis of the respiratory muscles. Average tidal air volume was considerably less when the patient was on the rocking bed than when he was in the respirator. Since the tidal air volume with the patient on the rocking bed represents the maximum that can be produced with the apparatus, whereas the volume in the respirator represents the patient's usual tidal air and the respirator is capable of a greater volume if necessary, it is apparent that in cases of complete paralysis of the respiratory muscles the respirator has a large margin of safety, the rocking bed none. From clinical observations made on 51 patients who were put upon the rocking bed-23 of them early in the course of the disease and 28 after they had been ill three months or more-it was concluded that the rocking bed is contraindicated for patients who are febrile and in whom the disease is progressing rapidly, and for those with atelectasis or urinary or pulmonary infection. It must be used with extreme care in the case of patients early in the course of the disease who are not tracheotomized, because of a tendency toward increased accumulation of mucus and the danger of atelectasis. General guides were developed with regard to use of the rocking bed for patients with post-acute poliomyelitis, and somewhat different rules were drawn for use of the apparatus in cases in which there is a chronic respiratory problem.The rocking bed will give artificial respiration in cases of respiratory weakness, but will not provide enough tidal air for the patient with paralysis of the muscles of respiration.
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A brief review of salient facts pertaining to poliomyelitis is presented as an introduction to the other articles which follow, each a part of a symposium concerning this clinical entity in its various phases.
Pronounced alterations occur in the biochemical findings in acute poliomyelitis. These are derived from three major mechanisms: (a) inefficient pulmonary gaseous exchange, resulting in respiratory acidosis; (b) profound changes in nitrogen metabolism, resulting in decreased serum albumin, tissue destruction, and increased urinary nitrogen; (c) losses of electrolytes through extrarenal channels such as lung and tracheal secretions, sweating, and gastrointestinal disturbances. The extent of these alterations may be defined by appropriate serum and urinary biochemical determinations. These determinations are valuable both from a therapeutic and a prognostic standpoint. They also contribute to further understanding of physiologic and pathologic conditions in acute poliomyelitis.
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