Swiss medical weekly
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Swiss medical weekly · Dec 1989
Randomized Controlled Trial Clinical Trial[Analgesic effects of an oral dose of clonidine].
Experimental data and anecdotal clinical observations have shown that clonidine, an alpha 2-agonist, has a marked analgesic effect. We investigated clonidine-induced analgesia in response to nociceptive stimuli. On 2 different days 7 normal volunteers received either placebo or clonidine (200 micrograms) orally according to a cross-over, double-blind, randomized, placebo-controlled design. ⋯ Side effects were a moderate fall in blood pressure, sedation and dryness of the mouth. A single oral dose of clonidine induces significant analgesia. These results suggest that clonidine is potentially a worthwhile drug for pain treatment which deserves further clinical investigation.
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Swiss medical weekly · Nov 1988
Randomized Controlled Trial Clinical Trial[Systemic thrombolysis using streptokinase. Experiences at the Civic Hospital of Lugano in the framework of the ISIS-2 study].
With a small group of Swiss hospitals we had an opportunity of participating in ISIS-2, the major study on thrombolysis in acute myocardial infarction. Experience with our microcosm (Ospedale Civico Lugano) was compared with the macrocosm of the results of ISIS-2 in 17,187 randomized patients (in brackets). ⋯ In the ISIS-2 study the combination of thrombolytic therapy with streptokinase, and of antiplatelet therapy with aspirin, showed a reduction of approximately one third in acute mortality of myocardial infarction, stroke and reinfarction. Our experience confirms the reduced incidence of allergic side effects (3.5%), major bleeding (0.3%) and minor bleeding (2.9%) during or after thrombolytic therapy.
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Swiss medical weekly · Sep 1988
Randomized Controlled Trial Comparative Study Clinical Trial[Is there a risk of global respiratory insufficiency with the use of intramuscular midazolam as premedication for bronchoscopy?].
To determine whether midazolam i.m. as premedication for bronchoscopy involves a risk of overall respiratory failure, we compared hydrocodonum (15 mg i.m.) with midazolam (5-7.5 mg i.m., weight related) as premedication in flexible bronchoscopy in two groups of 30 patients. The two groups were comparable. Arterial blood gases were measured before premedication, before bronchoscopy, and 10 and 60 minutes after the procedure. ⋯ Side effects were rare and similar. Confusional states, as reported with midazolam given orally, were not noted. Midazolam administered as reported above is of value as premedication in flexible bronchoscopy.
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Swiss medical weekly · Dec 1987
Randomized Controlled Trial Comparative Study Clinical Trial[Increased risk of bacterial colonization of intravenous catheters covered with transparent adhesive polyurethane bandages, compared to classical gauze bandages].
While transparent polyurethane dressings are increasingly used for the care of intravenous catheters, concern has recently been expressed regarding their microbiological safety. We have therefore compared the rate of intravenous catheter bacterial colonization after randomly assigning intensive care patients to transparent polyurethane (n = 21) or dry gauze (n = 20) dressings. Polyvinyl chloride catheters were inserted and maintained by the nurses. ⋯ Colonizing bacterial species were Staphylococcus epidermidis (11 strains) and S. aureus (1 strain). No catheter-related bacteremia was observed. These data suggest that the colonization rate of intravenous catheters is increased by the use of polyurethane dressings, possibly increasing the risk of septic phlebitis and bacteremia.
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Swiss medical weekly · Sep 1986
Randomized Controlled Trial Comparative Study Clinical Trial[Premedication in fiber optic bronchoscopy from the patient's and the physician's viewpoint--a randomized study for the comparison of midazolam and hydrocodone].
To evaluate side effects and patients' assessment of fiberoptic bronchoscopy under local anesthesia, 122 consecutive patients answered questions from an outside interviewer (an experienced psychiatrist) and not from the endoscopists themselves. The effect of premedication with midazolam (5 mg i.m.) and hydrocodonum (15 mg i.m.) was compared in a randomized study. In a multiple choice questionnaire 68% of all patients indicated considerable fear in the days before bronchoscopy. ⋯ Although they did not remember all the unpleasant side effects, only 77% said they would repeat the procedure with the same premedication, compared with 90% of patients premedicated with hydrocodonum (p = 0.08). Before and two hours after premedication the reaction times had not changed (optical sign, Wiener reaction device) and were identical in the two patient groups. At that time 37% of the patients premedicated with midazolam and 27% of those premedicated with hydrocodonum were still sleepy and could not be regarded as fit for any form of travel.