Changes in human drug metabolism after long-term exposure to hypnotics.

The influence of the newer, non-barbiturate hypnotics Mandrax (diphenhydramine-methaqualone) and nitrazepam on drug-metabolizing capacity was assessed and compared with the effect of amylobarbitone, a known inducer of drug-metabolizing enzymes. Plasma antipyrine and phenylbutazone half-lives and urinary output of 6beta-hydroxycortisol were used as indices. Volunteer subjects were exposed to therapeutic amounts of these agents and, in the case of Mandrax and barbiturates, further studies were carried out in dependent patients.

Recurrent thyrotoxicosis after subtotal thyroidectomy.

A study of patients with recurrent thyrotoxicosis after subtotal thyroidectomy has shown that the operation has a profound effect on the natural history of Graves's disease. It is followed by pronounced changes in the immunological features of the disease, with a fall in the prevalence of serum thyroid autoantibodies, including the long-acting thyroid stimulator. Thyroid suppression returns to normal in 70% of patients.

Effect of age and sex on human drug metabolism.

The capacity of inpatients in a geriatric hospital to metabolize drugs was measured. The mean plasma half-life values with antipyrine and with phenylbutazone were found to be 45% and 29% greater respectively in patients than in young controls. When women alone were considered the half-life of antipyrine was 78% longer in the elderly group.

Computer-assisted follow-up register for the north-east of Scotland.

An automated follow-up register for the detection of iatrogenic thyroid disease has been established as a joint venture between the general practitioners in the north-east of Scotland and the thyroid clinic of Aberdeen General Hospitals.The data-processing operations in the system are handled by an International Computers Limited 4/50 computer. Patients are followed up at predetermined intervals and the system has been designed to process, screen, and store clinical and biochemical follow-up data and report results to the patients, general practitioners, and the hospital records department.

Surgical treatment of thyrotoxicosis.

A retrospective study of thyrotoxic patients treated by subtotal thyroidectomy between 2 and 21 years ago in the north-east of Scotland showed that 20% of the patients could not be identified or traced at the time of the survey. The thyroid status of 40% of patients followed up was abnormal.It is now accepted that radioiodine treatment of thyrotoxicosis is followed by a significant incidence of late onset hypothyroidism, and life-long follow-up is regarded as obligatory.