Health of the nation: opening the door to improvements?
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Biomedical subjects
Publications and source records attributed to M George.
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Seventeen nonmenopausal women with symptomatic uterine myomas, diagnosed by clinical examination and confirmed by pelvic ultrasonography, were treated with a delayed-release microcapsule preparation of D-Trp-6-LH-RH (Decapeptyl) injected intramuscularly, every 28 days. The microcapsules were designed to release 100 micrograms/day for 30 days. The mean duration of treatment was 4.7 months (range, 1-11). In all patients, the pituitary-ovarian axis was suppressed after 1 month of treatment, and mean serum estradiol levels fell to 17.3 pg/mL (range, 5-80). There were no significant changes in serum LH and FSH levels. Fifteen patients (83%) experienced an improvement of such symptoms as abdominal pain and bleeding. Enlarged uteri decreased in 81% of patients during the treatment, and in 38% of them the decrease in uterine volume was more than 50%. Among the 12 myomas found in 10 women, 2 disappeared and 9 decreased in volume during the treatment; for 7 myomas the decrease was more than 50%. After Decapeptyl, eight patients did not require any additional therapy, four underwent surgery, and the others were treated with progestins. The side effects were mild, consisting mainly of hot flushes. Our findings suggest that Decapeptyl may be useful for the treatment of uterine myomas.
Interaction between kininase II and anaesthesia is not well described. Twenty two patients treated by kininase II for congestive heart failure are studied during anaesthesia for cardiovascular surgery. A first group of seventeen homogeneous hemodynamic data are reported. High cardiac index contrasts with severe clinical cardiac failure. A second group of inhomogeneous patients are separately described. Vasoconstrictor can be codified in the situation of low systemic resistance with high cardiac index. Preoperative treatment can be continued, under requirement of hemodynamic monitoring.
Seven patients in low-output cardiac failure, resistant to conventional vasodilators and inotropic agents, following surgery with extra-corporeal circulation were given oral captopril, an angiotensin converting enzyme inhibitor. The effects of captopril on haemodynamic and renal function were studied after 2, 6, 12 and 24 hours of treatment. After two hours, there was a mean reduction in systemic arterial resistance of 29%, in pulmonary arterial resistance of 18% and in pulmonary wedge pressure of 15%. The mean increase in the cardiac index was 28%. This marked initial haemodynamic improvement was either maintained or increased over the rest of the 24 hours. By 24 hours there had been a mean increase in urinary sodium excretion of 200%. The urinary sodium/potassium ratio increased from 0.62 to 1.45. Oral captopril thus seems suitable for treating low-output cardiac failure following surgery requiring extra-corporeal circulation.
Material from 108 trophic ulcers from leprosy cases were studied bacteriologically. 4 cases showed growth of pure anaerobes and 69 showed mixed growth of aerobic and anaerobic bacteria. The predominant anaerobes were Fusobacteria (41), anaerobic cocci (30) and Bacteroides (25). Clostridia were isolated only in 10 cases. Metronidazole, chloramphenicol, penicillin and ampicillin were found effective against anaerobes in in-vitro studies.
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