The collapse of toilets in Glasgow.

Three cases are presented of porcelain lavatory pans collapsing under body weight, producing wounds which required hospital treatment. Excessive age of the toilets was implicated as a causative factor. As many toilets get older episodes of collapse may become more common, resulting in further injuries.

Adder (Vipera berus) bites: a case report and review of the management for emergency medical personnel.

Few doctors working in the accident and emergency (A&E) department will have had experience in the management of adder (Vipera Berus) bites. While such events are uncommon, and rarely fatal, prompt correct management undoubtedly helps in reducing mortality and morbidity. Various isolated case reports (Watson & Harland, 1977; Gerard & Pugh, 1982; Jones & Clegg, 1985) and larger reviews (Reid, 1976; Pesson & Irestedt 1981; Hawley, 1988, 1990) have appeared in non A&E related journals.

Drug-induced hyperthermia.

Drugs with antidopaminergic properties and those capable of stimulating serotonin release can be responsible for hyperthermia syndromes such as neuroleptic malignant syndrome and serotonin syndrome. Dopamine and serotonin are important neurotransmitters in temperature regulation and it is likely that these reactions result from drug-induced changes in neurotransmitter levels. We describe three cases of drug-induced hyperthermia, discuss their aetiology and management, with both general measures and therapies designed to redress neurotransmitter imbalance.

Sports injuries as seen at an accident and emergency department.

We present certain characteristics of 1,000 consecutive patients who attended an Accident and Emergency Department (A&E) with an injury sustained as a result of sport. The majority of injuries occurred as a result of football. Sports injuries had a higher requirement of X-ray than general trauma patients.

Sports injuries' postal survey: difficulties encountered in assessment of outcome.

We present the results of a postal survey on the outcome of sports injuries treated in an Accident and Emergency Department which shows that this is unsuitable for assessing their outcome. There are, however, some points of interest relating to associated morbidity and satisfaction with treatment in the Accident and Emergency Department.

Bowel adenocarcinoma in a patient with cystic fibrosis.

Cystic fibrosis (CF) is an autosomal recessive condition affecting one in 2,000 live births in the UK. There are few reports of malignant tumours in this condition probably because, until recently, the majority died before the age of 30 years as a result of recurrent and chronic bronchopulmonary infection with impaired growth and development and resistance to infection due to pancreatic malabsorption. We describe an adult male with CF who died from an adenocarcinoma affecting the ileocaecal region of the bowel.

Plasma concentrations of sodium cromoglycate given by nebulisation and metered dose inhalers in patients with exercise-induced asthma: relationship to protective effect.

Plasma sodium cromoglycate (SCG) concentrations were measured in 11 patients at regular intervals before and after exercise in a double-blind study to assess the protective effect in exercise-induced asthma (EIA) of 2, 10 and 20 mg SCG aerosol and placebo, and (on an open basis) nebulised SCG (10 g l-1). There was a dose related increase in plasma concentration and AUC (0-1 h) with the aerosol formulations; values with nebulised SCG were significantly higher than with any aerosol dose. Protection from EIA increased to a maximum of 66% at plasma concentrations of 4 ng ml-1 and above.

Comparison of two calcium antagonists, verapamil and gallopamil (D-600), in exercise-induced asthma.

The effect of inhaled verapamil and gallopamil (estimated dose 3 mg) was studied in 10 patients with exercise-induced asthma. Saline was used as a control. Verapamil and gallopamil modified exercise-induced asthma in 8 of the 10 patients and the degree of inhibition with both the drugs was comparable.

Bronchioloalveolar cell carcinoma: a 21-year retrospective study of cases at the Western Infirmary, Glasgow.

A 21-year retrospective autopsy study of bronchioloalveolar cell carcinoma in the Western District of Glasgow is presented which includes a detailed review of the case notes and post-mortem pathology of 18 patients. Aspects of the histogenesis of the tumour and its prognosis are included in the discussion. It is concluded that bronchioloalveolar cell carcinoma is a valid term which describes a disease entity that is amenable to successful surgical resection when at a limited stage but that in pathological terms it represents a heterogeneous population of tumours.

Dose-response effect of sodium cromoglycate pressurised aerosol in exercise induced asthma.

The effects of 2, 10, and 20 mg of sodium cromoglycate delivered by aerosol were compared with those of placebo in a double blind study in 11 patients with extrinsic and exercise induced asthma. The effect of nebulised sodium cromoglycate delivered through a Wright nebuliser (estimated dose 12 mg) was also studied. Patients exercised on a treadmill for six to eight minutes at submaximal work loads on five days, 30 minutes after inhaling placebo or sodium cromoglycate.

Effect of lignocaine, sodium cromoglycate, and ipratropium bromide in exercise-induced asthma.

Eight patients with exercise-induced asthma participated in a single-blind trial comparing the protective effects of inhaled lignocaine (estimated dose 48 mg), sodium cromoglycate (estimated dose 12 mg), and ipratropium bromide (estimated dose 120 μg). Saline was used as control. Effects were assessed from the mean maximal percentage fall in forced expiratory volume in one second (FEV) and maximal mid-expiratory flow rates (MMFR) after they had run on a treadmill for eight minutes.