Incidence of early tolerance to hemodynamic effects of continuous infusion of nitroglycerin in patients with coronary artery disease and heart failure.

Sustained therapy with nitroglycerin (NTG) has been reported to provoke the development of early tolerance. Because continuous intravenous NTG infusion is commonly used in patients with coronary artery disease and heart failure, we evaluated the incidence of early tolerance developed within the first 24 hr of therapy in 31 responders to NTG. After documentation of response to NTG, defined as a 10 mm Hg or greater or a 30% or greater reduction in mean pulmonary arterial wedge pressure (PAWP), 16 patients were blindly, randomly assigned to receive placebo and 15 patients were continued on same-dose NTG.

Effect of amino acid solutions on total nutrient admixture stability.

The stability of total nutrient admixture (TNA) systems containing a soybean oil emulsion (Soyacal) has been reported with only one amino acid (AA) solution. This study was conducted to compare the physical stability of 10 TNA systems varied only by the AA solution used. All systems contained electrolytes, vitamins, trace elements, and heparin.

Central and renal hemodynamic effects and hormonal response to diltiazem in severe congestive heart failure.

The central and renal hemodynamic effects and the hormonal response to single doses of 60 mg and 90 mg of diltiazem were evaluated in 10 patients with severe chronic left ventricular (LV) systolic dysfunction (ejection fraction 0.22 +/- 0.08).

Evidence for macrophage involvement in the enhancement of tumor growth delay with X-ray/Fluosol-DAR/O2 combination therapy.

The perfluorochemical emulsion, Fluosol-DAR, in combination with breathing a 95% oxygen atmosphere, has been shown to enhance the response of several solid tumors to radiation treatment. In this study, the number of macrophages present in two murine tumors was assessed in the absence of Fluosol-DA treatment and at various times post-Fluosol-DA treatment using a rosetting assay. The number of macrophages in the Lewis lung carcinoma and the FSaII fibrosarcoma, after an initial decrease, increased nearly 2-fold (at 14 days) after a single Fluosol-DA injection.

A comparison of two 20% lipid emulsions.

Two different soy oil emulsions (Intralipid and Soyacal) were studied over a 2-week period in a random crossover study to determine if there were clinical or biochemical differences between the two preparations when used in patients requiring total parenteral nutrition (TPN). Each fat emulsion was infused randomly over 1 week and then switched to the other. Eighteen adult patients requiring a minimum of 14 days TPN were studied.

Radiological rickets in extremely low birthweight infants.

Forty-eight infants of birthweight less than 1000 g who survived for more than 28 days, had wrist X-rays to prospectively determine the incidence of radiological rickets. Twelve infants (25%) had normal X-rays throughout, 10 infants (21%) showed osteopenia and 26 infants (54%) had classical changes of rickets of which 8 (17% of the total) had spontaneous fractures. There was poor correlation between peak values of serum alkaline phosphatase and the radiological changes.

Preterm blood counts vary with sampling site.

In preterm babies both haemoglobin and total neutrophil count values from capillary sites are significantly and variably higher than those from simultaneous arterial samples. Comparing simultaneous venous and arterial samples, the mean haemoglobin was slightly higher but the total neutrophil counts were similar.

A clinical trial of Fluosol DA 20% in advanced squamous cell carcinoma of the head and neck.

Fluosol DA 20% (Fluosol) enhances the response of several rodent tumors to radiation and oxygen. This is a Phase I/II study of Fluosol and oxygen breathing in the radiation treatment of advanced squamous cell carcinoma of the head and neck. Fifteen patients with Stage III/IV tumors entered and completed this trial.

Effects of intravenously infused Fluosol-DA 20% in rats.

Rats were injected with a fractionated 50 ml/kg dose of Fluosol-DA 20% with and without exposure to 100% oxygen. Animals were killed at 24, 43, 92, and 183 days post-treatment and samples taken for hematological, hepatic enzyme, histological, and perfluorochemical analyses. There were no significant differences in hemograms or hepatic enzyme findings between treatment and control groups.

Comparison of total nutrient admixture stability using two intravenous fat emulsions, Soyacal and Intralipid 20%.

The safe clinical use and physical stability of a total nutrient admixture (TNA) system containing a soybean oil emulsion (Intralipid) has been reported. A study was conducted to compare the physical stability of four admixtures which were divided into two groups based upon the ratios (1:1:1 and 2:1:1) of amino acids (8.5%), dextrose (70%), and fat emulsion (20%).

Outcome of neonatal intensive care: obstetric implications for a regional service.

Data from 634 newborn babies with birthweights less than or equal to 2000 g admitted to the South West Thames Regional Neonatal Unit in St George's Hospital since its opening in 1980 were analysed. Only 271 (43%) of the pregnancies were booked there; 200 (32%) of the babies were transferred in utero and 162 (26%) after delivery. Weight-specific neonatal survival rates, calculated after exclusion of lethal abnormalities showed that between 1001 and 1500 g, 79 (96%) of the 82 babies transferred in utero survived in 1981-1984, compared with only 57 (79%) of the 72 postnatal transfers (P less than 0.

Serial measurement of plasma arginine vasopressin in the newborn.

Plasma arginine vasopressin was measured serially in 11 preterm infants and one asphyxiated, term infant. The samples were taken through umbilical arterial catheters placed at birth for blood gas measurements because ventilatory support was required. Plasma samples of 200 to 300 microliter were taken 4 to 12 hourly for up to 100 hours after birth.

Incubator temperature control: effects on the very low birthweight infant.

We studied temperature stability in 22 infants of birthweight less than 1500 g in the first four days of life. Infants were nursed in incubators using either air mode control or skin temperature servo control. Data were collected continuously using a computer linked monitoring system.

Rectal aminophylline in the management of apnoea of prematurity.

Rectal suppositories as an alternative to intravenous aminophylline in the management of recurrent apnoea were studied in 41 preterm infants of mean gestation 28.3 weeks and mean birthweight 1176 g. Therapeutic blood concentrations were obtained two hours after a rectal loading dose of 10 mg/kg, with steady concentrations and maximum reduction in apnoeic episodes (from a mean of 0.

Birthweights of infants born before 30 weeks' gestation.

We give birthweight data with centiles on 222 singleton infants born between 24 and 30 weeks' gestation at St George's Hospital, London.

Calcium and phosphorus balance in extremely low birthweight infants in the first six weeks of life.

The absorption and retention of calcium and phosphorus in infants of 28 weeks' gestation, or less, who were fed either breast milk or a preterm formula, were determined in 22 balance studies. Breast milk contained significantly lower amounts of calcium and phosphorus than the formula milk. The percentage absorption of calcium was similar in the two groups, but the infants fed breast milk had greater urinary calcium losses and significantly lower calcium retention than the group fed formula milk.

Hypercalcaemia in extremely low birthweight infants.

We report 10 cases of hypercalcaemia associated with hypophosphataemia in the first two weeks of life in extremely low birthweight infants (birthweight less than 1000 g). At the time of diagnosis, the infants were fed mainly with expressed breast milk but they had also received intravenous nutrition. After treatment with additional phosphate plasma calcium concentrations returned to normal.