Comparison of preservative-free and preservative-containing ipratropium bromide

Abstract A double-blind crossover study was performed on 33 children with asthma to compare the effectiveness of nebulized solutions of preservative-containing and preservative-free ipratropium bromide. Both solutions produced bronchodilation. No significant differences were found between the two solutions at any time after nebulization in minimum and maximum changes from baseline value or in the areas under the lung function time curves. The presently formulated preservative-containing ipratropium bromide solution was not shown to be inferior to a preservative-free compound.     

Infection with Chlamydia trachomatis and Neisseria gonorrhoeae in women with lower abdominal pain admitted to a gynaecology unit

Summary. One hundred and sixty-five women admitted to a gynaecology unit with lower abdominal pain were screened for infection with Neisseria gonorrhoeae and Chlamydia trachomatis by members of a department of genitourinary medicine. C. trachomatis alone was detected in 21 patients. N. gonorrhoeae alone was isolated from five patients, and dual infection was present in six patients, giving a total of 32 (19%) patients in whom a sexually transmitted disease (STD) was diagnosed. The combination of an endocervical swab placed in Amies transport medium for gonococcal isolation and an endocervical slide for immunofluorescent detection of chlamydiae proved to be a simple and accurate method of screening for STD. Asaresultof contact tracing, 16 sexual partners of women in whom STD was detected were examined. Three cases of gonocoecal and ninc cases of non-gonococcal urethritis were diagnosed. None of the sexual partners had Symptoms suggestive of genitourinary infection.     

Haemodynamic changes associated with caesarean section under epidural anaesthesia

Summary. Serial haemodynamic investigations were performed in 15 women delivered by elective caesarean section under epidural anaesthesia at 38–40 weeks gestation. Cardiac output was measured by Doppler and cross-sectional echocardiography at the aortic valve. No haemodynamic changes were demonstrable after attainment of surgical anaesthesia (T5 or above). Stroke volume increased 13% after delivery of the placenta and remained elevated until the end of the operation at which time cardiac output was 11% above pre-operative values. Stroke volume and cardiac output fell during the first postoperative day. Heart rate remained elevated at pre-operative values for 48 h after delivery. There was a fall in heart rate and cardiac output between the second and the sixth days after delivery. By 2 weeks after delivery cardiac output was 28% lower than pre-operative values. Compared with pre-operative values, diastolic blood pressure was lower on the first and second postnatal days.     

The physiological and clinical effects of progesterone inhibition with mifepristone (RU 486) in the second trimester

Summary. A double-blind placebo-controlled trial was performed in 20 primigravidae to assess the physiological and clinical effects of oral mifepristone on myometrial contractility and sensitivity in the second trimester. Ten women received 600 mg of oral mifepristone and 10 women a placebo 24 h before abortion was induced in both groups, with extra-amniotic PGE₂ instillation. Intrauterine pressure recordings demonstrated increased spontaneous uterine activity and increased sensitivity to PGE₂ and ergometrine, but no change in oxytocin sensitivity after mifepristone treatment. There were no significant differences in PGE or PGF metabolite concentrations in peripheral maternal plasma over the 24-h study period after treatment between the mifepristone and placebo groups. The mean induction abortion interval in the mifepristone group was 512 (SD 321) min compared with 1128 (SD 606) min in the placebo group (P≤0.02). The mechanism whereby mifepristone provokes enhanced uterine contractility and sensitivity to prostaglandins, with a reduction in abortion times, does not appear to be through endogenous production of PGE or PGF.