Lyme disease: ocular manifestations

We present three cases of Lyme disease, complicated by ocular manifestations. These included optic nerve abnormalities and corneal opacities.     

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.     

Prostaglandin E1 in decreased arterial perfusion

Prostaglandin E 1 has been used for the past 15 years in decreased peripheral arterial perfusion with differing degrees of success. The exact mechanism of action has not been clarified so far. Vasodilatation, increased fibrinolytic activity and an improved cellular metabolism were observed in response to PGE 1 in animal experiments both in vivo and in vitro. In the clinical studies performed so far PGE 1 has been used in cases of decreased peripheral arterial perfusion after functional, inflammatory, degenerative or diabetic arteriopathy (stages IIb-IV). Reduction or alleviation of ischaemic rest pain, as well as a faster healing of tissue necrosis was reported after intaarterial administration, especially in non-controlled, but also in controlled studies. Intravenous administration of PGE 1 had a positive influence on clinical symptoms in non-placebo-randomized patients; in the controlled studies, however, the results were not significant. The greatest therapeutic success can be achieved using intermittent intraarterial administration in decreased peripheral arterial perfusion due to functional or inflammatory arteriopathies.