[Placebo controlled, double-blind study of the effectiveness of i.v. prostaglandin E1 in diabetic patients with stage IV arterial occlusive disease].
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Biomedical subjects
Publications and source records attributed to E Grom.
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The acute and long-term hemodynamic efficacy of the positive inotropic and vasodilatory drug pimobendan (5 mg b.i.d.) was compared with that of the angiotensin converting enzyme (ACE) inhibitor captopril (25 mg t.i.d.) in a double-blind, randomized study in 20 patients suffering from chronic congestive heart failure (NYHA functional classes II-III). The hemodynamics at rest and under comparable exercise conditions were always obtained on the first and 14th treatment day before and 2 h following drug administration. Under resting conditions, pimobendan reduced the end-diastolic pulmonary arterial pressure measured 2 h after drug administration by 33% (p less than 0.05) and increased the cardiac output by 16% (p less than 0.05). These effects were maintained after a treatment period of 14 days. Following administration of captopril, no significant hemodynamic changes at rest were noted 2 h after the first dose on day 1 and the last dose on day 14. There was, however, a tendency to continuous decline of the end-diastolic pulmonary arterial pressure over the study period. Under comparable work load (median of 25 W), both substances decreased the end-diastolic pulmonary arterial pressure 2 h following the first dose (pimobendan, -38%, p less than 0.01; captopril, -9%, p less than 0.05). The difference in the magnitude of effect between both treatment groups was statistically significant (p less than 0.01). Following a treatment period of 14 days, the end-diastolic pulmonary arterial pressure before drug administration was significantly reduced (-24%, p less than 0.05) only in the pimobendan group, whereas the reduction in the captopril group (-11%) could not be statistically verified.(ABSTRACT TRUNCATED AT 250 WORDS)
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Through the history of Medicine the author considers the mission of medical profession, its highs and downs. He specially analizes the responsibility of the doctors toward their patients. The author considers that anybody who is not able or self-sacrificed and has no true vocation, should no select the Medicine as his profession.
A short discussion is given of the phylogenesis of visual organ and what the word: "to see" can mean. The author concludes that we still have a long way to understand fully the very complicated mechanism of the vision.
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Pancytopenia developed in a 72-year-old woman after three years of tolbutamide treatment. When tolbutamide was discontinued and the usual treatment of pancytopenia undertaken, the anaemia persisted while the leukopenia and thrombocytopenia were reversed. Pancytopenia during tolbutamide treatment is extremely rare. But the blood picture and platelet count should be regularly checked in all patients receiving sulphonylurea drugs, ten days after starting treatment, every three months for the first year and then once yearly.
Henceforth we mention the observations of one of the authors (E.G.) which were made in 1949 and published in 1956. The author recommends iridectomy of one pillar, intracapsular extraction of the cataract and iridenclesis of the other pillar for the treatment of cases with glaucoma together with cataract. Between the years 1968 and 1976 in the Department of Ophthalmology of the Hospital Universitario de Caracas, 966 cataract extractions were performed; within these, 84 were performed in glaucomatous eyes. In 17 cases the procedure that is used today was performed: iridectomy of one pillar, sphincterotomy, intracapsular extraction and iridencleisis of the other pillar. In other cases, other procedures were used. From our observations we consider that this technique is the most recommended in cases of glaucoma together with cataract.
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