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The efficacy of tolamolol, a cardioselective beta adrenergic blocking agent, was evaluated in the treatment of cardiac arrhythmias in 27 patients. Nineteen patients had supraventricular arrhythmias and eight had ventricular arrhythmias. Evaluation was by doulbe-blind randomized trial in 23 patients. Tolamolol was effective in reducing ventricular rate in 17 (85 percent) of 19 patients with supraventricular arrhythmias and resulted in conversion to sinus rhythm in 2 of the 17. The mean ventricular rate in 17 patients decreased from 135 to 102/min 10 minutes after initiation of administration of tolamolol and gradually decreased further to 93/min after 60 minutes. Reduction in ventricular rate was sustained for 2 hours of monitoring undergone by all patients and for 4 and 6 hours monitoring in two subgroups. Among the eight patients with ventricular ectopic beats, tolamolol reduced their frequency in four patients and had no effect in four. Six patients had chronic obstructive pulmonary disease and experienced no adverse clinical effects on respiratory function in association with administration to tolamolol. Untoward effects occurred in 10 patients, including hypotension in 3, 1 of whom required vasopressor therapy. Other side effects were sedation, nausea, dyspnea and warmth in the chest, all of which were mild and transient, requiring no treatment. Cardioselective beta adrenergic blockade with tolamolol was highly effective in controlling ventricular rate in supraventricular arrhythmias and reduced the frequency of ventricular ectopic beats in half of the small group of patients with this arrhythmia. It is particularly applicable in patients with obstructive pulmonary disease in whom cardiac beta adrenergic blockade is indicated. Hypotension is an important potential side effect.
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PMID:Efficacy of cardioselective beta adrenergic blockade with intravenously administered tolamolol in the treatment of cardiac arrhythmias. 0 52

Twenty patients with pathologically proved non-resectable bronchogenic carcinoma were treated with 100 aerosolized BCG (Tice strain) doses in addition to conventional treatment. The procedure is based on findings that, generally BCG must be closely associated with neoplastic cells to be effective as an immunotherapeutic agent. Bronchogenic malignancy, usually of mucosal origin, is logically treated in this manner. We report here the findings and developments of 10 patients who were treated at least five times each (for a total of 81 treatments) and pertinent experience relating to these and another 10 patients treated a total of 19 times. Local and systemic reactions were frequent and consisted of fever, cough, dyspnea, nausea, vomiting, anorexia, and malaise. Four of the 20 patients (20%) had reactions with the first treatment; by the fourth treatment 6 of 6 (100%) were affected. Prednisone given prophylactically reduced the intensity and the frequency of reactions. There were no severe side effects, obvious BCG infections, or significant changes in pulmonary or liver functions or hematologic values. No patient acquired purified protein derivative sensitivity, although 3 persons converted other skin tests to positive. There was no improvement in actuarial survival time.
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PMID:Aerosolized BCG (Tice strain) treatment of bronchogenic carcinoma: phase I study. 16 70

Acute dapsone poisoning is rare and such cases are either accidental or suicidal. Though accidental DDS poisoning are reported in children, the same is fairly uncommon in adults. Only 2 such cases are reported in India literature. We here report 4 cases of fatal sucidial DDS poisoning in adults resulting death in 3 cases. The reported acute symptoms include nausea, vomiting, hyperexcitability followed by depression, Carpopedal spasm or convulsions. The most marked signs are dyspnoea and cyanosis. The symptoms are due to methaemoglobinaemia, and or sulphaemoglobinaemia. Normally dapsone induces red cell haemolysis and even with small therapeutic doses of 25-100 mg per day, and in toxic doses reduces the oxygen carrying capacity of blood and damages the red cells making them more vulnerable for haemolysis. The peculiarity of the presentation in this series are manifestation of severe haemorrhagic episode in one case and progressive jaundice in another besides cyanosis. None of the cases had carpopedal spasm or convulsion. Out of four cases three died inspite of intensive care, intravenous vitamin C, exchange transfusion (2 cases) and other supportive measures. Intravenous methylene blue could not be used in these cases due to non-availability.
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PMID:Acute fatal DDS poisoning. (Report of 4 cases). 48 Sep 16

Seven young men developed acute pulmonary hemorrhage and edema from the inhalation of powder or fumes of a bisphenol epoxy resin containing tri-mellitic anhydride (TMA) while working in a steel pipe-coating plant. The illness was characterized by cough, hemoptysis, dyspnea, fever, weakness and nausea or vomiting. Chest roentgenograms showed either a bilateral or unilateral pulmonary infiltrate. All patients had a normochromic type of anemia. Pulmonary function studies demonstrated a restrictive defect, hypoxemia, and increased A-a DO2 gradients. Light and electron microscopic studies of lung tissue revealed extensive bleeding into alveoli but no basement membrane deposits were seen and no antiglomerular basement membrane antibodies were detected. The patients improved quickly without treatment. Follow-up studies of six patients three weeks to one year after their illness revealed apparent recovery. A detailed medical survey carried out on all 29 workers currently employed in the plant revealed five additional men had experienced severe recurrent pulmonary problems.
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PMID:Pulmonary hemorrhage and edema due to inhalation of resins containing tri-mellitic anhydride. 49 27

Sulproston (SH B 286 AD), a PGE2-derivate, was used for termination of pregnancy in 40 patients during the IInd and IIIrd trimester. Mean abortion time was 12.7 hours (range:4 to 26 hours). Sulproston was given intravenously (150 to 1000 micrograms) or via an extraamnial catheter (200 to 400 micrograms). One single dose of 500 micrograms was sufficient in 26 patients. Five women required a dose of 150 to 400 micrograms, four patients a dose of 500 to 1000 micrograms. The rate of side effects was low and included freezing, nausea, vomiting or abdominal spasms and dyspnea in one case. An obligatory curettage followed the abortion without exception. There was no statistical significance for changes of blood pressure and heart rate during the perfusion of Sulproston and in the course of the abortion.
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PMID:[Termination of pregnancy during the IInd and IIIrd trimester with Sulproston (SH B 286 AD) (author's transl)]. 56 40

15-methyl-prostaglandin F2 alpha (PGF2a) was injected extraamniotically .92 mg in 5.5 ml Hyskon (dextran 70, 32%) in 660 women 10-20 weeks' pregnant for abortion. 72.6% aborted within 36 hours and 80.3% within 36 hours, but only 32.2% had complete abortions. Mean abortion intervals were 13.1 hours in multigravidae and 16.2 in primigravidae. Infrequent complaints included flushing, nausea, dyspnea, chest pain, headache, and shivering. 1 cervical laceration was reported. 6 woemn required readmission for bleeding or infection of the 53% attending for follow-up. It is concluded that this method is safe and effective for abortion.
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PMID:Prostaglandins and abortion. II. Single extra-amniotic administration of 0.92 mg. of 15-methyl prostaglandin F2alpha in Hyskon for termination of pregnancies in weeks 10 to 20 of gestation: an international multicenter study. World Health Organization Task Force on the Use of Prostaglandins for the Regulation of Fertility. 92 Jul 60

A clinical study was performed on 41 asthmatic patients. After complete physical and spirometric examinations, they received capsules containing 200 mg anhydrous theophylline per capsule t.i.d. for three weeks. All other antiasthmatic medications were omitted during this study. The results showed that these capsules (Elixophyllin Capsules) produced statistically significant improvement in wheezing, dyspnea, global clinical assessment, vital capacity, and forced expiratory volume at 1 second. Side effects, which were generally mild and transient, were those usually reported for theophylline and were observed in 11 of the 41 patients. One patient dropped out of the study because of extreme nausea. It was concluded that theophylline as a single entity can provide significant improvement in asthmatic patients at a total daily dose of 600 mg.
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PMID:Therapeutic efficacy of a new anhydrous theophylline dosage form. 94 70

A unique opportunity was presented to observe the potentially toxic effects of an acute exposure to the vapors of petroleum naphtha distillate on a relatively large number of individuals. The immediate manifestation in all was dyspnea. The action on motor vehicle combustion suggested that some of this could have been due to oxygen deprivation; however, all individuals were dyspneic for several minutes after exposure. A few were cyanotic for several minutes after exposure. All were excited. Tremulousness and mild nausea followed the initial symptoms but were of brief duration. One individual manifested numerous premature ventricular contractions. Since his exposure was brief and since none of the others showed similar findings, it is unlikely that the exposure was causal. The central nervous system depression described in acute exposure cases of the intact (not distillate) petroleum naphtha fumes was not observed in any of this series. There were no delayed manifestations or complications.
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PMID:Toxicology of petroleum naphtha distillate vapors. 99 75

An analysis of the reports on 16 patients who developed cardiac tamponade, complicating the use of central venous catheters, showed that 14 died. The two survivors were treated by removal of the catheter and needle aspiration of the pericardial fluid. Some patients complained of warning symptoms such as nausea, pain, and dyspnoea, and the combination of tachycardia, hypotension, and raised venous pressure was common. We suggest that awareness of the hazard, radiographic visualization of the catheter tip, and expeditious treatment would reduce the mortality.
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PMID:Cardiac tamponade and central venous catheters. 113 28

A 19-year-old man presented with dyspnea, cough and chest pains; he also complained of nausea, anorexia and postprandial vomiting and reported a 10-kg weight loss. Generalized lymphadenopathy and some rales over both lung bases were noted and a chest radiograph showed bilateral nodular lesions. Persistent leukocytosis, thrombocytosis, proteinuria and anergy to a series of natural antigens were found. The diagnosis of lymphoid interstitial pneumonia was made from material obtained at open lung biopsy. Rapid but incomplete clearing of the lung lesions resulted from steroid therapy; the other abnormalities were corrected gradually, except for the proteinuria, which persisted. The clinical improvement and the ability to work and play have been maintained for the past 20 months.
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PMID:Lymphoid interstitial pneumonia. 126 92


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