Action of L-α-methyldopa-hydrazine on the blood pressure of patients receiving levodopa

The blood pressure and pulse rate have been compared in a 'double blind, cross over' study involving twenty patients with idiopathic Parkinsonism receiving maximum tolerated dosage of levodopa with and without an extracerebral decarboxylase inhibitor, L-alpha-methyldopahydrazine. The supine and erect systolic pressures were significantly higher and the erect pulse rate significantly lower during administration of L-alpha-methyldopahydrazine. The implications of these observations are discussed.     

Exogenous estrogens and development of breast and endometrial cancer

The risk of breast cancer and endometrial cancer in 1483 menopausal and postmenopausal women who had received estrogen therapy for other than contraceptive use was examined. The incidence and mortality rates of the study cohort (cohort A) were compared with the age-specific cancer incidence and mortality rates of the female populations of Ontario (cohort B) and of Saskatchewan (cohort C). A significant difference was found in each of the two comparisons between the observed and expected survival curves for breast cancer incidence and breast cancer mortality. However, the incidence rate of endometrial cancer in the study cohort (cohort A) did not differ significantly from the rates of the reference populations (cohorts B and C). The results suggest that the women in the study may have received some protective effect against breast cancer by taking estrogens, but the estrogens did not protect them against endometrial cancer and may indeed have predisposed them to this cancer.     

Use of ipratropium aerosol in the long-term management of asthma

In order to assess the efficacy and safety of ipratropium in the long-term management of chronic asthma, 20 stable and ambulatory asthmatics were followed for 1 year. Clinical and spirometric examinations were performed on all 20 patients at the start of the study and on six other occasions. FEV1, FVC, MMFR, heart rate, and blood pressure were recorded immediately before and 30, 60, 120, and 180 min after the administration of 40 micrograms of ipratropium. During these visits, patients were asked to rate their breathing during the preceding period, describe (any) side effects, and assess the impact of ipratropium in their inhalation. During their visits, significant improvements in FEV1 and FVC (p less than 0.05) were noted for a majority of the patients. As the study progressed, more and more patients were observed to experience significant improvements in their FEV1, FVC, and MMFR. All ECG measurements and biochemical tests were normal. Side effects of minimal severity were reported on two occasions during the 100 patient-visits. Our study indicates that an ipratropium-based regimen is efficacious, safe, and well received by chronic asthmatics.     

Obstructive jaundice secondary to benign hepatic cyst

A case of hepatic cyst causing obstructive jaundice is presented. Following percutaneous aspiration of the cyst, the jaundice was relieved. Modern interventional radiologic techniques can provide prompt diagnosis and treatment, thus avoiding major surgery and prolonged hospitalization.     

Comprehension and awareness of symptoms in women with dyspepsia

BACKGROUND: Overlapping symptoms of gastro-oesophageal reflux disease and dyspepsia are a problem for physicians and patients. AIM: This study explored comprehension of dyspepsia symptoms and associated medical terminology among women with symptoms of dyspepsia. METHODS: The US women aged > or = 18 years with dyspepsia (defined by Rome II criteria) were recruited in two phases, via direct mail, the Internet, clinical investigators and/or gastroenterologists. In phase I, subjects took part in an hour-long telephonic interview comprising open-ended questions relating to symptom frequency/duration, triggers/patterns and severity. During phase II, subjects took part in a 45-min telephonic interview, which explored their understanding of dyspepsia symptoms and their predominant or most bothersome symptom. RESULTS: Subjects with 'pure' dyspepsia (without overlapping symptoms of gastro-oesophageal reflux disease or irritable bowel syndrome) were sought, but of 777 subjects screened, most were excluded because of gastrointestinal comorbidities (irritable bowel syndrome, gastro-oesophageal reflux disease). Only 85 (11%) subjects had 'pure' dyspepsia of whom 11 withdrew. Of the 74 subjects interviewed, 70% were unfamiliar with the term 'dyspepsia'. Subjects reported several symptoms, including bloating (65%), gas (50%), nausea (41%) and discomfort (36%). Most subjects could distinguish between symptom bothersomeness and severity, and between pain and discomfort. Terms such as 'satisfactory relief', 'central upper abdominal discomfort', 'early satiety' and 'postmeal fullness' were often misunderstood. CONCLUSIONS: Subjects with 'pure' dyspepsia are rare, because of comorbidities. Dyspepsia-related terminology is often misunderstood by subjects.