The effect of naloxone on the preoperative gastric volume and pH

The effect of 4 mg oral naloxone on preoperative gastric volume and pH of gastric aspirate was studied in a double-blind, randomized study. Twenty patients received 10 ml of naloxone (4 mg) mixed with 10 ml of orange juice, and 20 patients received 10 ml of isotonic saline mixed with 10 ml of orange juice, 2 h before surgery. Gastric content was obtained immediately after intubation of the trachea. No significant difference in gastric volume and pH of gastric aspirate was found between the two groups. It is concluded that naloxone does not affect gastric emptying and gastric acid secretion to a degree great enough to protect against aspiration of gastric contents into the lungs.     

Clinical Results of Dynamic Cardiomyoplasty

Thirty-five cardiomyoplasty procedures were performed in five patients with dilated and 30 patients with ischemic cardiomyopathies. Russian-made cardiomyostimulators (CMS) were implanted in these patients. Twenty-one patients underwent a one-step procedure using a left thoracotomy for cardiomyoplasty, while in 14 patients, a two-step procedure that included a mid-line sternotomy was carried out. During the average follow-up period of 9 ± 2.1 months, studies were carried out that showed in survivors improved clinical functional status and decreased heart failure symptoms. Evidence of revascularization of the ischemic myocardium from the latissimus dorsi muscle (LDM) wrap was obtained by angiography and radioactive scintigraphy. In five patients, the CMS had to be removed due to complications, and in all these patients, their clinical functional status deteriorated following the cessation of cardiomyostimulation.     

Addison-Biermer anemia: the clinical problems during diagnosis and therapy]

Analysis is made of the diagnostic and therapeutic problems related to Addison-Biermer anemia based on studying disease histories of 15 patients afflicted with the disease and placed under the author's observation. Under the outpatient conditions, the disease, in many cases, is not diagnosed accurately whereas the treatment is carried out without any control. The diagnostic role of examining the bone marrow puncture biopsy, reticulocyte and erythrocyte sedimentation crisis, gastric secretion, and the neurological status is outlined. Among rare complications of the treatment with vitamin B12, abacterial feverish reactions, hypertonic crises and cerebral circulatory disorders are recorded. Emphasis is laid on the necessity of oncological apprehension both in the period of the patients' entry into the stage of remission and in long-term dynamic observation.