The Medical journal of Australia
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Drugs which interfere with the voltage-activated inward displacement of calcium ions into excitable cells, including those of the myocardium, atrial and ventricular nodes, and smooth muscle cells, have become known as calcium antagonists. These drugs are a heterogeneous group, and differ from one another in chemistry, tissue specificity, potency and bioavailability. ⋯ The therapeutic applications of these compounds include the relief of angina pectoris, and the management of hypertension, ischaemic heart disease and, in certain instances, arrhythmias. Calcium antagonists are also useful in the management of oesophageal achalasia, Raynaud's disease, and hypertrophic obstructive cardiomyopathy, and may be of use in premature labour.
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We report the case of a patient who ingested sea water to combat disabling postural hypotension secondary to autonomic failure. While drinking approximately 900 mL of brine each day he had no symptoms and felt well. Serum biochemical analysis showed a very significant hyperchloraemia. Persistent diarrhoea eventually forced the patient to discontinue this most unorthodox form of treatment.
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Four different subpopulations in South Australia, which were expected to have high rates of hepatitis B infection (Asians, Aboriginals, homosexual men, and drug addicts) were examined for their contribution to the total reservoir of hepatitis B surface antigen (HBsAg) carriers and to the total annual incidence of acute hepatitis B infection in South Australia. Age-specific prevalence data were also examined to assess the ages at which infection is commonly acquired. ⋯ Three different age-related patterns of acquisition of infection were recognized--among Southeast Asians and Aboriginals, homosexual men and drug addicts, and the general community, respectively. The above approach, and to some extent the general findings, should be applicable to other similar communities in the formulation of effective policies for the control and prevention of hepatitis B infection.
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Five cases of industrial nail gun injury are described. These cases demonstrate the variety of injuries inflicted by such tools, and stress the potential for lethal accidents if strict safety standards are not observed. The wide range of these injuries is discussed in a review of other reports of such injuries; the causes of these industrial accidents and current safety requirements are described.