The popularity of penicillin in general practice.
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Biomedical subjects
Publications and source records attributed to C P Venter.
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Urine volumes and flows as functions of time after oral administration of placebo, furosemide 80 mg and tizolemide 100 mg to sixteen healthy male adults at 08.00 a.m. are described through mathematical models. Accumulated urine volumes after dosing, V, as functions of time, t, are accounted for by sigmoid functions and urine flows are described as dV/dt. No significant differences were found between the 24-hour urine volume mean values after furosemide (2457 ml) and tizolemide (2283 ml) and both were significantly higher than the corresponding mean value after placebo (1369 ml) ( p less than 0.001). Peak diuresis after dosing occurs about 1.5 hours for furosemide, 4 hours for tizolemide and 6 hours for placebo. Fourteen hours after dosing, urine volume amounts to 90% of the 24-hour urine volume after furosemide and to 76% after tizolemide, so that both substances may be regarded as diurnal diuretics.
Intractable congestive cardiac failure, unexplained arrhythmias, changes in the cardiac silhouette and murmurs which change with position are all features which should arouse suspicion of a cardiac tumour. A case of intracardiac haemangiosarcoma of endothelial origin is discussed. The tumour presented as a pulmonary stenosis and extended into the right ventricular myocardium, causing a right bundle-branch block. At first the tumour seemed to be restricted to the endothelium of the pulmonary vascular bed, but it later infiltrated the interstitium and bronchi, cuasing dyspnoea and haemoptysis. After surgical removal of the tumour and reconstruction of the pulmonary outflow tract, the patient was free of symptoms for 14 months. However, rapid tumour growth in the pulmonary arterial system, lung interstitium and right ventricle subsequently recurred. Deep radiotherapy did not cause the tumour to regress.
The physiology and pharmacological management of postoperative pain are briefly discussed. Although narcotic analgesics are still the mainstay in the management of postoperative pain the judicious use of non-narcotic analgesics, anticholinergics, tranquillizers and soporifics as well as the administration of local anaesthetic agents could contribute greatly to the alleviation of postoperative pain and discomfort. Certain regimens for intravenous medication are outlined and strong emphasis is placed on the fact that postoperative pain relief is the duty of the doctor and not that of unskilled nursing staff.
Four cases of dissecting aneurysm of the aorta are discussed. The clinical diagnosis depends on awareness, suspicion, an association of certain preceding conditions and an understanding of the varied manifestations. Sudden, sharp chest pain, aortic valvar involvement and peripheral arterial occlusion are practically diagnostic. A widening of the aortic arch, the exclusion of myocardial infarction electrocardiographically, and an aortogram are helpful in the diagnosis. A dissecting aneurysm of the aorta is an emergency requiring early diagnosis and surgical treatment to improve the survival rate of 10%. Medical treatment is to be preferred for the chronic type of dissection.
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A single-blind, placebo-controlled study was conducted to compare the inhibitory effects of intravenous propranolol on exercise-induced tachycardia in eight matched pairs of healthy black and white volunteers, consisting of equal numbers of men and women. At the beginning of each test session, subjects were exercised on a bicycle ergometer--the load predetermined to increase their heart rates to 160-190 beats/min. Exactly 30 min after having received an intravenous injection of placebo or propranolol (the dose varying from 0.0125 to 0.15 mg/kg), they were subjected to the same exercise load. Heart rates were continuously recorded throughout exercise periods, and readings at 6, 8, and 10 min were compared for pre- and postinjection periods. A washout period of at least 3 days was allowed to elapse between sessions. Postinjection reductions of heart rate in blacks were compared with postinjection reductions in their white counterparts. Analysis of results indicated that the dose-response curve for the heart rate reduction resulting from propranolol for blacks was shifted to the right with respect to that for whites. In clinical terms, this means that to achieve the same degree of beta-blockade in blacks, a larger dose of propranolol is required than for whites, but that the same maximum is attainable.
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