Biomedical subjects
Publications and source records attributed to O M Edwards.
Renal function was assessed in 18 patients who had consumed 2 to 30 kg of paracetamol. No relationship was found between the total amount of paracetamol taken and any aspect of renal function studied. No patient had clinically significant renal impairment. Thirteen of the patients showed no significant deterioration of renal function over a period of about one year during which they consumed an additional mean 2 kg of paracetamol.
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Oxytetracycline given to two patients with impaired renal function produced clinical deterioration and increasing azotaemia. Both patients improved when oxytetracycline was stopped. In general tetracycline should not be used in patients with poor renal function, but if it is necessary the blood urea level should be checked frequently.
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A case of benign intracranial hypertension associated with generalized oedema is reported in a normotensive pregnant patient with long-standing insulin-treated diabetes mellitus. Following treatment with bed rest, chlorthalidone and dexamethasone the condition resolved and a healthy infant was delivered. This condition, not previously reported in a diabetic pregnancy, must be differentiated from other causes of bilateral optic nerve abnormalities associated with retinal haemorrhages and oedema, including diabetic retinopathy, diabetic optic neuropathy, accelerated hypertension and cerebral mass lesions. Treatment is required to prevent permanent visual impairment due to pressure on the susceptible optic nerve of the diabetic patient and to avoid the metabolic consequences to both mother and fetus of poor nutritional intake due to nausea.