British medical journal (Clinical research ed.)
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Br Med J (Clin Res Ed) · Oct 1984
Randomized Controlled Trial Clinical TrialMetabolic effects of bicarbonate in the treatment of diabetic ketoacidosis.
The effect of intravenous bicarbonate on the changes in intermediary metabolites during the initial treatment of diabetic ketoacidosis was examined in 16 patients. The results were compared with the changes seen in 16 patients receiving intravenous saline. ⋯ No difference in the rate of fall of blood glucose concentration was found. There is no metabolic indication for the use of intravenous bicarbonate in the treatment of diabetic ketoacidosis.
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Br Med J (Clin Res Ed) · Mar 1984
Randomized Controlled Trial Clinical TrialEndotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs.
Large volume, low pressure endotracheal tube cuffs are claimed to have less deleterious effect on tracheal mucosa than high pressure, low volume cuffs. Low pressure cuffs, however, may easily be overinflated to yield pressures that will exceed capillary perfusion pressure. Various large volume cuffed endotracheal tubes were studied, including Portex Profile, Searle Sensiv, Mallinkrodt Hi-Lo, and Lanz. ⋯ It was found that these cuffs when overpressurised impaired mucosal blood flow. This impairment of tracheal mucosal blood flow is an important factor in tracheal morbidity associated with intubation. Hence it is recommended that a cuff inflation pressure of 30 cm H2O (22 mm Hg) should not be exceeded.
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Br Med J (Clin Res Ed) · Jan 1984
Randomized Controlled Trial Clinical TrialPrevention of urinary retention with phenoxybenzamine during epidural morphine.
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Br Med J (Clin Res Ed) · Nov 1983
Randomized Controlled Trial Comparative Study Clinical TrialComparative trial of rectal indomethacin and cryoanalgesia for control of early postthoracotomy pain.
A randomised double blind trial was carried out over the first two days after thoracotomy to compare the analgesic effects of rectal indomethacin 100 mg administered eight hourly, cryoanalgesia, and a combination of both of these with the effects of conventional intramuscular opiate analgesia. Pain scores were significantly reduced with both rectal indomethacin alone and cryoanalgesia alone; these treatments had an additive effect when used in combination. Pain on movement was significantly increased, and indomethacin was more effective in reducing this than cryoanalgesia. ⋯ It is concluded that rectal indomethacin, in this dosage, can provide good, safe analgesia after thoracotomy with minimum administrative difficulty. When used as an adjunct to cryoanalgesia it has an additive effect. There are many potential uses for this drug in other branches of surgery.
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Br Med J (Clin Res Ed) · Oct 1983
Randomized Controlled Trial Comparative Study Clinical TrialSulphasalazine in rheumatoid arthritis: a double blind comparison of sulphasalazine with placebo and sodium aurothiomalate.
Uncontrolled studies have suggested that sulphasalazine may be an effective second line agent in rheumatoid arthritis. Sulphasalazine was therefore compared with placebo and intramuscular sodium aurothiomalate in 90 patients with active rheumatoid arthritis. ⋯ The major toxicity encountered in the group treated with sulphasalazine was nausea or vomiting, or both; this may be related to slow acetylator phenotype. Sulphasalazine appears to be an effective second line agent, and further pharmacokinetic studies might prove useful in diminishing gastrointestinal side effects.