Twenty-four-hour intragastric acidity and clinical trial of bedtime enprostil 70 μg compared with ranitidine 300 mg in duodenal ulcer

The effects of bedtime 70 micrograms and twice daily 35 micrograms doses of enprostil on 24-hour intragastric acidity were investigated in nine duodenal ulcer patients in remission. Median nocturnal acidity decreased significantly by 30% with 35 micrograms twice daily, and by 48% with 70 micrograms at bedtime. In a clinical trial using bedtime dosing, 102 duodenal ulcer patients randomly received either ranitidine 300 mg or enprostil 70 micrograms. More ulcers healed after 4 and 8 weeks treatment with ranitidine than with enprostil (76% ranitidine vs 52% enprostil, at 4 weeks p = 0.0065 and 94% vs 68%, respectively at 8 weeks, P = 0.0007). However, 6 months after cessation of treatment there was no material difference in overall outcome. Despite combining mucosal protection with acid inhibition enprostil treatment conferred no advantage over simple acid inhibition.     

Tinea imbricata in a British nurse

We describe a case of localized Tinea imbricata in a 23–year-old, British nurse. The infection was contractd in Papua New Guinea where it is endemic. Topical antifungals were of temporary benefit, but the infection relapsed on stopping treatment. Cure was achieved after a four week course of griseofulvin I g day⁻¹.     

STEREOPHOTOGRAMMETRIC ANALYSIS OF CHANGES IN BODY VOLUME ASSOCIATED WITH THE INDUCTION OF ANAESTHESIA

Changes in the volume of the trunk were measured in seven supinepatients, when anaesthesia was induced with thiopentone i.v.Stereophotograms were taken before and after induction and measurementsof volume calculated from contour plots of a reconstructed stereoimage. The changes in volume of the visible part of the trunkwere between –846 and + 505 ml. No systematic change intotal or lower trunk ("abdominal") volume was evident, but therewas a significant negative linear relationship (r = –0.87)between upper trunk ("ribcage") volume change and obesity (expressedas actual weight/expected weight). Changes in volume were moreevident in the upper parts of the supine subject, in both ribcageand abdomen (P < 0.05).     

Review of 59 patients with hypergonadotrophic amenorrhoea

Summary. Fifty-nine patients presented with elevated concentrations of gonadotrophins and secondary amenorrhoea before the age of 35 years. Fifty-three underwent laparoscopic examination and primordial follicles were observed in 16. Two others had follicles as they later became pregnant and a third showed biochemical evidence of spontaneous ovulation. There were streak ovaries in 12, two with follicles and three others with chromosomal abnormalities, two being 47XXX and one XO/XX. Two other patients had only one ovary each but no follicles. Chromosomal abnormalities were detected in two further patients one being XO/XX and the other a recombinant. Six patients became pregnant, two of them twice, resulting in four term deliveries and four spontaneous abortions. Three other patients showed biochemical evidence of ovulation; one spontaneously, one after oestrogen therapy and the third after treatment with gonadotrophin releasing hormone analogue.     

A clinical trial using danazol for the treatment of premenstrual tension

Summary. Forty women with premenstrual tension received either placebo, 100, 200 or 400 mg danazol daily for 3 months in a pilot study arranged as a double-blind trial. Thirteen patients withdrew by the third month usually because they complained of no improvement. They had significantly higher pretrial symptom scores than those who continued. In patients treated with danazol, symptom scores for breast pain during the second and third months and for irritability, anxiety and lethargy during the third month were significantly ( P <0.05) lower than scores in those given placebo. Most symptoms improved on placebo in the first month but by the third month only three remained improved. In contrast eight symptoms were improved on 200 mg danazol by the third month. By the end of the trial more than 75% of patients who were still taking danazol were essentially free of breast pain, lethargy, anxiety and increased appetite, but results for other common symptoms were no better than with placebo.