Since William Withering first described the use of digitalis, over 200 years ago (1), its popularity has waxed and waned. Digitalis preparations are widely prescribed for elderly patients. Surveys of hospital in-patients have shown a high prevalence of the use of digitalis preparations (2, 3), but also of digitalis toxicity; though not all studies have shown the latter to increase with age. A survey of people aged 70, living in Gothenberg, showed that 14% were taking digitalis preparations (4); other studies have shown similar figures. Now that powerful diuretics and vasodilators are available for the treatment of heart failure, and many antiarrhythmics are used for the control of atrial tachyarrhythmias, there is controversy about the value of cardiac glycosides in the treatment of elderly patients.
Second derivative ultraviolet spectrophotometric methods have been devised for the analysis of hospital-formulated oral liquid preparations. These rapid techniques are useful in the routine quality control of oral liquid formulations where direct spectrophotometric determination of the drug analyte is precluded by interference from formulation excipients and colouring agents. This report describes examples in which the active principles of a dipipanone mixture, a methadone mixture and an orphenadrine syrup were determined by derivative spectroscopy. In each case spectral interference from formulation excipients was abolished. The accuracy, precision and specificity of each method has been established.
This year we are celebrating the bicentenary of the publication, by William Withering, of An Account of the Foxglove and Some of its Medicinal Uses with Practical Remarks on Dropsy and Other Diseases (1). During these two hundred years digitalis has constantly been to the fore of medical thinking and it is appropriate that we should look back and examine the contributions which studies of this drug have made to medicine as we know it today. Some of the studies have been at the centre of fierce controversy and others have been of seminal importance in the development of new concepts.
Journal of Clinical Pharmacy and TherapeuticsVolume 11, Issue 1 p. 21-32 THERAPEUTIC PROGRESS—REVIEW XVIII J. A. Kohler, J. A. Kohler Paediatric Medical Unit, Southampton General Hospital, Southampton, U.K.Search for more papers by this authorC. J. Rolles, Corresponding Author C. J. Rolles Paediatric Medical Unit, Southampton General Hospital, Southampton, U.K.2 Consultant Paediatrician, Paediatric Medical Unit, Southampton General Hospital, Southampton, U.K.Search for more papers by this author J. A. Kohler, J. A. Kohler Paediatric Medical Unit, Southampton General Hospital, Southampton, U.K.Search for more papers by this authorC. J. Rolles, Corresponding Author C. J. Rolles Paediatric Medical Unit, Southampton General Hospital, Southampton, U.K.2 Consultant Paediatrician, Paediatric Medical Unit, Southampton General Hospital, Southampton, U.K.Search for more papers by this author First published: February 1986 https://doi.org/10.1111/j.1365-2710.1986.tb00825.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL REFERENCES 1 Shwachman, H., Kowalski, M. & Khaw, K. (1977) Cystic fibrosis: a new outlook, 70 patients above 25 years of age. Medicine, 56, 129– 149. 2 Knowles, M.R., Gatzy, J. & Boucher, R. (1981) Increased bio-electric potential difference across respiratory epithelia in cystic fibrosis. New England Journal of Medicine, 305, 1489– 1495. 3 di Sant'Agnese, P.A., Darling, R.C., Perera, G.A. & Shea, E. (1953) Abnormal electrolyte composition of sweat in cystic fibrosis. Pediatrics, 12, 549– 563. 4 Quinton, P.M. (1983) Chloride impermeability in cystic fibrosis. Nature, 301, 421– 422. 5 Reid, L. & de Haller, R. (1964) Lung changes in cystic fibrosis. In: Cystic Fibrosis: a symposium (ed. H.V. Hubble), Chest and Mean Association, London . 6 Roulet, M., Weber, A.M., Paradis, Y., Roy, C.C., Chartrand, L., Lasalle, R. & Morin, C.L. (1980) Gastric emptying and lingual lipase activity in cystic fibrosis. Pediatric Research, 14, 1360– 1362. 7 Watkins, J.B., Tercyak, A., Szczepanik, P. & Klein, P.D. (1977) Bile-salt kinetics in cystic fibrosis: influence of pancreatic emzyme replacement. Gastroenterology, 73, 1023– 1028. 8 Gaskin, K., Gurwitz, D., Durie, P., Corey M., Levison, H. & Forstner, G. (1982) Improved respiratory prognosis in patients with cystic fibrosis with normal fat absorption. Journal of Pediatrics, 100, 857– 862. 9 Gow, R., Bradbeer, R., Francis, P. & Shepherd, R. (1981) Comparative study of varying regimens to improve steatorrhoea and creatorrhoea in cystic fibrosis: effectiveness of an enteric coated preparation with and without antacids and cimetidine. Lancet, ii, 1071– 1074. 10 Zentler-Munro, P.L., Fine, D.R., Gannon, M. & Northfield, T.C. (1981) Effect of cimetidine on intraduodenal bile-acid precipitation, pancreatin inactivation and lipid solubilization in pancreatic steatorrhoea. Gut, 22, A431. 11 Chase, H.P., Long, M. & Lavin, M. (1979) Cystic fibrosis and malnutrition. Journal of Pediatrics, 95, 337– 347. 12 Lloyd-Still, J.D. & Ganther, H.E. (1980) Selenium and glutathione peroxidase in cystic fibrosis. Pediatrics, 65, 1010– 1012. 13 Berry, H.K., Kellogg, F.W., Hunt, M.M., Ingberg, R.L., Richter, L. & Gutjahr, C. (1975) Dietary supplement and nutrition in children with cystic fibrosis. American Journal of Diseases in Children, 129, 165– 171. 14 Dowd, P.S. & Heatley, R.V. (1984) The influence of under-nutrition on immunity. Clinical Science, 66, 241– 248. 15 Shepherd, R., Cooksley, W.G.F. & Cooke, W.D. (1980) Improved growth and clinical, nutritional and respiratory changes in response to nutritional therapy in cystic fibrosis. Journal of Pediatrics, 97, 351– 357. 16 O'Loughlin, E.V., Forbes, D., Parsons, H., Scott, B., Cooper, D. & Gall, D.G. (1984) Nutritional rehabilitation in malnourished patients with cystic fibrosis. Effects on the course of the disease. In: Cystic Fibrosis: Horizons (ed. D. Lawson), p. 97. Wiley, Chichester . 17 Park, R.W. & Grand, R.J. (1981) Gastrointestinal manifestations of cystic fibrosis: a review. Gastroenterology, 81, 1143– 1161. 18 Hodson, M., Mearns, M. & Batten, J. (1976) Meconium ileus equivalent in adults with cystic fibrosis of pancreas: a report of six cases. British Medical Journal, 2, 790– 791. 19 Langford, D.T. & Hiller, J. (1984) Prospective, controlled study of a polyvalent pseudomonas vaccine in cystic fibrosis—three year results. Archives of Diseases in Childhood, 59, 1131– 1134. 20 Høiby, N. (1982) Microbiology of lung infections in cystic fibrosis patients. Acta Paediatrica Scandinavica, Suppl. 301, 33– 54. 21 Staff, M., Høiby, N. & Flensborg, E.W. (1983) Frequent antibiotic therapy improves survival of cystic fibrosis patients with chronic Pseudomonas aeruginosa infection. Acta Paediatrica Scandinavica, 72, 651– 657. 22 Schuster, S.R., McLaughlin, F.J., Matthews, W.J., Strieder, D.J., Khaw, K.T. & Shwachman, H. (1983) Management of pneumothorax in cystic fibrosis. Journal of Pediatric Surgery, 18, 492– 497. 23 Danes, B.S. (1973) Association of cystic fibrosis factor to metachromasia of the cultured cystic fibrosis fibroblast. Lancet, ii, 765– 767. 24 Wilson, G.B., Jahn, T.L. & Fonseca, J.R. (1973) Demonstration of serum protein differences in cystic fibrosis by iso-electric focusing in thin-layer polyacrylamide gels. Clinical Chimica Acta, 49, 79– 91. 25 Manson, J.C. & Brock, D.J.H. (1980) Development of a quantitative immunoassay for the cystic fibrosis gene. Lancet, i, 330– 331. 26 Brock, D.J.H., Bedgood, D. & Hayward, C. (1984) Prenatal diagnosis of cystic fibrosis by assay of amniotic fluid microvillar enzymes. Human Genetics, 65, 248– 251. Volume11, Issue1February 1986Pages 21-32 ReferencesRelatedInformation
In this study Betnelan-V cream was diluted with Beeler's basis and Cold cream. Cold Cream reduced the skin-blanching activity of the original cream more than Beeler's base. The stability of betamethasone-17-valerate was better in a Beeler's basis dilution than in a Cold cream dilution.
Fifty doctors completed a questionnaire which assessed their knowledge of the basic National Health Service cost of 15 commonly prescribed medications. Nearly half the estimates exceeded twice the actual cost of the drug. As well as ignorance of absolute prices, the study demonstrated imperfect knowledge of the relative prices of drugs of the same type. Estimates of the costs of commonly prescribed medications were no more accurate than those for rarely prescribed drugs. Self perception of cost consciousness was not related to the accuracy of the responses.
The effects of fasting on the drug regimens of 81 Asian Moslem patients during the religious month of Ramadan have been examined. Twenty-two male and 15 female patients were found to change their drug dosage pattern while fasting: 35 missed doses; 8 took their tablets at different times and 4 patients took all their medication as one single daily dose after breaking fast in the evening. The consequences of these changes are discussed and ways in which the problems which arise may be overcome are examined.
The stability of methotrexate solutions, subject to a freeze-thaw procedure, has been investigated. According to our results these solutions can be produced in batches in the hospital pharmacy and thawed to room temperature immediately before use without any degradation of methotrexate within the time limits given.
The chemical stabilities of lignocaine hydrochloride (lidocaine hydrochloride) and phenylephrine hydrochloride in a combination aqueous solution have been determined using stability-indicating high-performance liquid chromatographic methods. The drugs did not interact and were stable for at least 66 days at room temperature. The pH value changed from 6.0 to 5.8 after 66 days but was still within the optimum pH range for the stabilities of lignocaine and phenylephrine.
Journal of Clinical Pharmacy and TherapeuticsVolume 11, Issue 4 p. 301-306 PATIENT CHARACTERISTICS AND PRESCRIBING PATTERNS AT THE PAEDIATRIC ASTHMA CLINIC OF A TEACHING HOSPITAL SERVING A DEVELOPING COMMUNITY S. Rawnsley, Corresponding Author S. Rawnsley School of Pharmacy, Medical University of Southern Africa, P.O. Medunsa, 0204, South AfricaCorrespondence and reprints: S. Rawnsley.Search for more papers by this authorR. S. Summers, R. S. Summers School of Pharmacy, Medical University of Southern Africa, P.O. Medunsa, 0204, South AfricaSearch for more papers by this authorI. T. Hay, I. T. Hay *Department of Paediatrics and Child Health, Medical University of Southern Africa, P.O. Medunsa, 0204, South AfricaSearch for more papers by this author S. Rawnsley, Corresponding Author S. Rawnsley School of Pharmacy, Medical University of Southern Africa, P.O. Medunsa, 0204, South AfricaCorrespondence and reprints: S. Rawnsley.Search for more papers by this authorR. S. Summers, R. S. Summers School of Pharmacy, Medical University of Southern Africa, P.O. Medunsa, 0204, South AfricaSearch for more papers by this authorI. T. Hay, I. T. Hay *Department of Paediatrics and Child Health, Medical University of Southern Africa, P.O. Medunsa, 0204, South AfricaSearch for more papers by this author First published: August 1986 https://doi.org/10.1111/j.1365-2710.1986.tb00856.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume11, Issue4August 1986Pages 301-306 RelatedInformation
At the request of the consultant, a pharmacist attended the paediatric out-patient neurology clinic held at Ga-Rankuwa Hospital, from June 1984. After 6 months of this 'team' approach, its effect on patient care was evaluated. The study consisted of a retrospective survey of approximately 100 patient-visits before and after the establishment of the specialist clinic. Patient medication details and frequency of fits were analysed by a microcomputer. There was an increase in the number of patients seen per session. The results also showed that polypharmacy, dosing frequency and average dose per day were reduced under the new arrangement, whilst disease control, i.e. fit frequency, was no worse. The overall result has been to rationalize and improve anticonvulsant drug therapy at this clinic.
A study was performed to compare the predictability of a reported Bayesian graphical method, the drug nomogram used in the Bayesian Computer Method and the Driessen Nomogram with that of a computerized Bayesian analysis method in the interpretation of serum phenytoin concentrations. It was found that the results generated by the graphical method were similar to those of the computer with a mean prediction error of 3.9 mg/day in the dose to achieve a concentration at steady-state of 20 ml/l. Overall the results of the graphical method were less biased and had more precision with a significant improvement in relative precision (P less than 0.01) than the initial estimate or Driessen methods.
The effect of added Aminoplex, Glucoplex, nutrient additives and calcium chloride on the stability of a fat emulsion (Intralipid) has been examined. The conclusions are as follows: Aminoplex and Glucoplex do not cause a decrease in the physical stability of mixed systems that contain fat droplets stored at room temperature for at least 7 days. The mixed systems are stable even in the presence of high electrolyte loads (greater than 600 mmol litre-1 expressed in terms of monovalent cation). The amino acids in Aminoplex could be having a stabilizing effect on the emulsion system by the adsorption of components to the oil/water interface.
The concept of histamine receptors is outlined and the rationale for the synthesis of H2-antagonists presented. Structure-activity relationships among these compounds are described and aspects of absorption, distribution and elimination discussed with particular reference to cimetidine and ranitidine. Oxmetidine, lupitidine and loxtidine are also considered. Methods for the analysis of these drugs in body fluids are presented followed by a discussion of their toxicology. Volunteer and patient studies are also surveyed.
A convenient rapid gas-chromatographic method is described for the quantitative determination of ethylene chlorohydrin. The method reported herein extracts the ethylene chlorohydrin with water. The method is simple and offers advantages since no elaborate and expensive gas extraction apparatus is required. The ethylene chlorohydrin levels in five different sterilized polyvinyl chloride samples were found to vary between 5 and 25 ppm. The effect of resterilization with ethylene oxide was investigated and was found to produce less ethylene chlorohydrin.
Journal of Clinical Pharmacy and TherapeuticsVolume 11, Issue 6 p. 381-388 Free Access THE THERAPY OF GENITAL WARTS W. W. Dinsmore, W. W. Dinsmore Department of Genitourinary Medicine, Royal Victoria Hospital, Belfast BT12 6BA, Northern IrelandSearch for more papers by this author W. W. Dinsmore, W. W. Dinsmore Department of Genitourinary Medicine, Royal Victoria Hospital, Belfast BT12 6BA, Northern IrelandSearch for more papers by this author First published: December 1986 https://doi.org/10.1111/j.1365-2710.1986.tb00867.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL REFERENCES 1 Straus, M.J., Shaw, E.W., Bunting, H. & Melnick, J.L. (1949) ‘Crystalline’ virus-like particles from skin papillomas characterized by intranuclear inclusion bodies. Proceedings of the Society for Experimental Biology and Medicine, 72, 46– 50. 2 Dunn, A.E.G. & Ogilvie, M.M. (1968) Intranuclear virus particles in human genital wart tissue: observations on the ultrastructure of the epidermal layer. Journal of Ultrastructural Research, 22, 282– 286. 3 Singer, A., Campion, M.J. & McCance, D.J. (1983) Human papillomavirus. British Journal of Hospital Medicine, 34 (2), 104– 108. 4 Oriel, J.D. (1984) Genital warts. In: Sexually Transmitted Diseases (eds K. K. Holmes, P. Mardh, P. P. Sparling & P.J. Wieswer), pp. 496– 505. McGraw-Hill Book Company, New York . 5 Gartman, E. (1956) Intraurethral verruca acuminata in men. Journal of Urology, 75, 717– 718. 6 Dretler, S.P. & Klein, L.A. (1975) The eradication of intraurethral condyloma acuminata with five per cent 5-fluorouracil cream. Journal of Urology, 113, 195– 198. 7 Durst, M., Gissman, L., Ikenberg, H. & Zur Hausen, H. (1983) A papillomavirus DNA from a cervical carcinoma and its prevalence in cancer biopsy samples from different geographic regions. Proceedings of the National Academy of Sciences, U.S.A., 80, 3812– 3815. 8 Boshart, M., Gissman, L., Ikenberg, M., Kleinheinz, A., Scheurlen, W. & Zur Hausen, M. (1984) A new type of papillomavirus DNA, its presence in genital cancer biopsies and in cell lines derived from cervical cancer. EMBO Journal, 3, 1151– 1157. 9 Gissman, L., Wolnik, L., Ikenberg, H., Koldovsky, U., Schnurch, M.G. & Zur Hausen, H. (1983) Human papilloma virus types 6 and 11 DNA sequences in genital and laryngeal papillomas and in some cervical cancers. Proceedings of the National Academy of Science, U.S.A., 80, 560– 563. 10 Zur Hausen, H. (1977) Human papilloma viruses and their possible role in squamous cell carcinoma. Current Topics in Microbiology and Immunology, 78, 1– 30. 11 Walker, P.G., Singer, A., Dyson, J.L. & Oriel, J.D. (1983) Natural history of cervical epithelial abnormalities in patients with vulval warts. A colposcopic study. British Journal of Venereal Disease, 59, 327– 329. 12 Franceschi, S., Doll, R., Gallway, J., La Vecchia, C., Peto, R. & Spriggs, A.I. (1983) Genital warts and cervical neoplasia: an epidemiological study. British Journal of Cancer, 48, 621– 628. 13 Reid, R., Stanhope, C.R., Herschman, B.R., Booth, E., Phibbs, G.D. & Smith, J.P. (1982) Genital warts and cervical cancer. Cancer, 50, 377– 387. 14 Singer, A., Walker, P.G. & McCance, D.J. (1984) Genital wart virus infections: nuisance or potentially lethal. British Medical Journal, 288, 735– 737. 15 Chief Medical Officer (1985) Sexually transmitted disease. Genitourinary Medicine, 61, 204– 207. 16 Von Krogh, G. (1978) Topical treatment of penile condylomata acuminata with podophyllin, podophyllotoxin and colchicine. Acta Dermato-Venerologica (Stockholm), 58, 163– 168. 17 Simmons, P.D. (1981) Podophyllin 10% and 25% in the treatment of anogenital warts. British Journal of Venereal Disease, 57, 208– 209. 18 Maiti, H. & Haye, K.R. (1985) Self treatment of condylomata acuminata with podophyllin resin. The Practitioner, 229, 37– 39. 19 Slater, G.E., Rumack, B.M. & Peteresen, R.G. (1978) Podophyllin poisoning. Obstetrics and Gynaecology, 52, 94– 96. 20 Ward, J.W., Clifford, W.S., Monaco, A.R. & Bickerstaff, H.J. (1954) Fatal systemic poisoning following podophyllin treatment of condyloma acuminatum. Southern Medical Journal, 47, 1204– 1206. 21 Chamberlain, M.J., Reynolds, A.L. & Yeoman, W.B. (1972) Toxic effect of podophyllin application in pregnancy. British Medical Journal, 3, 391– 392. 22 Sadhir, O., Leventhal, M.L. & Kline, T.S. (1959) Podophyllin-induced dysplasia of the cervix uteri. American Journal of Clinical Pathology, 32, 446– 456. 23 Kaminetzky, H.A. & Swerdlow, M. (1965) Podophyllin and the mouse cervix: assessment of carcinogenic potential. American Journal of Obstetrics and Gynecology, 93, 486– 490. 24 Gueson, E.T., Liu, C.T. & Emich, J.P. (1971) Dysplasia following podophyllin treatment of vulvar condyloma acuminata. Journal of Reproductive Medicine, 6, 33– 36. 25 Von Krogh, G. (1976) 5-Fluorouracil cream in the successful treatment of therapeutically refractory condylomata acuminata of the urinary meatus. Acta Dermato-Venerologica (Stockholm), 56, 297– 301. 26 Nel, W.S. & Fourie, E.D. (1973) Immunotherapy and 5% topical 5-fluorouracil ointment in the treatment of condylomata acuminata. South African Medical Journal, 47, 45– 49. 27 Von Krogh, G. (1978) The beneficial effect of 1% 5-fluorouracil in 70% ethanol on therapeutically refractory condylomas in the preputial cavity. Sexually Transmitted Diseases, 5, 137– 140. 28 Bunney, M.M., Nolan, M.W., Buxton, P.K., Going, S.M. & Prescott, R.J. (1984) The treatment of resistant wans with intralesional bleomycin: a controlled clinical trial. British Journal of Dermatology, 110, 197– 207. 29 Shumer, S.M. & O'Keefe, E.J. (1983) Bleomycin in the treatment of recalcitrant warts. Journal of the American Academy of Dermatology, 9 (1), 91– 96. 30 Figueroa, S. & Gennard, A.R. (1980) Intralesional bleomycin injection in treatment of condyloma acuminatum. American Society of Colon and Rectal Surgeons, 23 (8), 550– 551. 31 Mohanty, K.G. & Roy, R.B. (1984) Thymus derived lymphocytes (T cells) in patients with genital warts. British Journal of Venereal Disease, 60, 186– 188. 32 Bradshaw, L.J. & Summer, M.L. (1977) In vitro, studies on cell mediated immunity in patients treated with inosiplex for herpes virus infection. Annals of the New York Academy of Science, 284, 190– 196. 33 Mohanty, K.C. & Scott, C.S. (1985) Comparison of conventional treatment with immunotherapy (Imunovir) in patients with genital warts. In: Proceedings of the Medical Society for the Study of Venereal Diseases, Spring Meeting 1985, Uppsala, Sweden. 34 Malgouyat, J. (1983) New approach to the treatment of genital condyloma in women. Gynecologie, 34 (5), 415– 517. 35 Gabriel, G. & Thin, R.N.T. (1983) Treatment of anogenital warts—comparison of trichloracetic acid and podophyllin versus podophyllin alone. British Journal of Venereal Disease, 59, 124– 126. 36 Ghosh, A.K. (1977) Cryosurgery of genital warts in cases in which podophyllin treatment failed or was contraindicated. British Journal of Venereal Diseases, 53, 49– 53. 37 Dodi, G., Infantino, A., Moretti, R., Scalco, G. & Lise, M. (1982) Cryotherapy of anorectal warts and condylomata. Cryobiology, 19, 287– 288. 38 Simmons, P.D., Langlet, F. & Thin, R.N.T. (1981) Cryotherapy versus electrocautery in the treatment of genital warts. British Journal of Venereal Diseases, 57, 273– 274. 39 Balsdon, M.J. (1978) Cryosurgery of genital warts. British Journal of Venereal Diseases, 54, 352– 355. 40 Ong, T.K., Ng, C.S.A. & Ratnam, S.S. (1980) Treatment of genital warts by cryosurgery—a follow-up study. Annals of the Academy of Medicine, 9, 396– 398. 41 Zacarian, S.A. (1983) Neuropathy after cryosurgery. Journal of the American Academy of Dermatology, 8, 422. 42 Evans, A.S., Monaghan, J.M. & Beattie, A.B. (1984) Carbon dioxide laser treatment of cervical warty atypias. Gynecologic Oncology, 17, 296– 300. 43 Sadoul, G. & Beuret, T. (1984) Treatment of cervical and vulvar condylomata with CO2 laser combined with an immunostimulant. Revue Francaise de Gynecologie et Obstettrie. 79, 681– 684. 44 Young, R.L., Acosta, A.A. & Kaufman, R.H. (1973) The treatment of large condylomata acuminata complicating pregnancy. Obstetrics and Gynaecology, 41, 65– 73. 45 Powell, L.C. (1978) Condyloma acuminatum: recent advances in development, carcinogenesis, and treatment. Clinical Obstetrics and Gynaecology, 21, 1061– 1079. 46 Dreyfuss, W. & Neville, W.E. (1955) Buschke-Lowenstein tumours (giant condyloma accuminata). American Journal of Surgery, 90, 146– 150. 47 Bruns, T.N.C., Lauvetz, R.J., Kerr, E.S. & Ross, G. (1975) Buschke-Lowenstein giant condylomas — pitfalls in management. Urology, 5, 773– 776. 48 Netto, N.R., Chade, J. & Camargo, F.P. (1976) Giant condyloma or Buschke-Lowenstein lesion. International Surgery, 61, 105– 107. 49 Thomson, J.P.S. & Grace, R.H. (1978) The treatment of perianal and anal condylomata acuminata: a new operative technique. Journal of the Royal Society of Medicine, 71, 181– 185. 50 Gollock, J.M., Slatford, K. & Hunter, J.M. (1982) Scissor excision of anogenital warts. British Journal of Venereal Disease, 58, 400– 401. 51 Abcarian, H. & Sharon, N. (1977) The effectiveness of immunotherapy in the treatment of anal condyloma acuminatum. Journal of Surgical Research, 22, 231– 236. 52 Petterson, S., Hansson, G. & Biohme, I. (1976) Condyloma acuminatum of the biadder. Journal of Urology, 115, 535– 536. 53 Biberstein, H. (1944) Immunization therapy of warts. Archives of Dermatology and Syphilology, 50, 12– 22. 54 Powell, L.C., Pollard, M. & Jinkins, J.L. (1970) Treatment of condyloma acuminata by autogenous vaccine. Southern Medical Journal, 63, 202– 205. 55 Abcarian, H., Smith, D. & Sharon, N. (1976) The immunotherapy of anal condyloma acuminatum. Diseases of the Colon and Rectum, 19, 237– 244. 56 Sanders, B.B. & Smith, K.W. (1981) Dinitrochlorobenzene immunotherapy of human warts. Cutis, 27, 389– 392. 57 Bauer, D.T. (1982) Treatment of plantar warts with acyclovir. The American Journal of Medicine, 20, 73(1A), 313– 314. 58 Gibson, J.R., Harvey, S.G., Barth, J., Darley, C.R., Reshad, M. & Burke, C.A. (1984) A comparison of acyclovir cream versus placebo cream versus liquid nitrogen in the treatment of viral plantar warts. Dermatologica, 168, 178– 181. 59 Gibson, J.R. & Harvey, S.G. (1984) Interferon in the treatment of persistant viral warts. Dermatologica, 169, 47– 48. 60 Scott, G.M. & Csonka, G.W. (1979) Effect of injections of small doses of human fibroblast interferon into genital warts. British Journal of Venereal Disease, 55, 442– 445. 61 Saul, A., Sanz, R. & Gomez, M. (1980) Treatment of multiple viral warts with Levamisole. International Journal of Dermatology, 19, 242– 243. 62 Scott, K.W. (1982) Glutaraldehyde gel for warts. The Practitioner, 226, 1342– 1343. 63 Flindt-Hansen, H., Tikjob, G. & Brandrup, F. (1984) Wart treatment with Anthralin. Acta Dermato-Venerologica (Stockholm), 64, 177– 179. 64 Hughes, E., Marshall, M., Mehlmauer, M., Koch, M., Whitaker, K. & Weinstein, R. (1983) Human warts permanently removed by static electricity. Cutis, 31, 319– 325. 65 Cohen, S.B. (1978) Editorial: warts. American Journal of Clinical Hypnosis, 20, 157– 159. 66 Morris, B.A.P. (1985) Hypnotherapy of warts using the Simonton visualization technique: a case report. American Journal of Clinical Hypnosis, 27, 237– 240. 67 Malan, J.J. (1979) Home remedies. South African Medical Journal, 56, 205. Volume11, Issue6December 1986Pages 381-388 ReferencesRelatedInformation
A successful kinetic approach to the screening of preservation efficacy of benzylalcohol--a neutral-type preservative--is described. The D-value, activation energy (Ea), temperature coefficient (Q10) and concentration exponent (n) were used as parameters in determining the influence of different factors on the efficacy of benzylalcohol. Factors, such as the pH of the solution, temperature and concentration of the preservative were investigated. The study was carried out using five micro-organisms: Aspergillus niger, Candida albicans, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus.
Trichophyton mentagrophytes and Aspergillus niger conidia and Candida albicans blastospores were employed to assess the fungicidal activity of a range of antimicrobial agents used for hard-surface and skin disinfection in hospitals in the U.K. The antimicrobials were tested at in-use concentrations. The time taken to give greater than 99.99% kill was determined by estimating the number of survivors (cfu/ml) at a variety of time intervals after exposure of washed suspensions of spores to the disinfectants. At equivalent times the recovery in the broth was investigated. An alcoholic solution of chlorhexidine gluconate (0.02%) (Hibitane), iodine in Industrial Methylated Spirit (IMS) and a phenolic (0.36% phenols, Stericol) produced a 99.99% kill of all species within 2 min, alcoholic and aqueous solutions (10%) of povidone-iodine (Betadine) and hypochlorite (0.2%) required 10 min to give a 99.99% kill of all species tested. The preparations which contained cetrimide (Cetavlon), aqueous solutions of chlorhexidine gluconate (Hibitane) and combinations of these (Savloclens and Savlodil) were only slowly fungicidal, particularly against T. mentagrophytes spores, which was the most resistant of the three fungal species to disinfection.
Pain as a problem in terminal care is considered in this review with particular emphasis on the use of opiates. The choice of routes of administration is discussed in detail and the role of combination of opiates with anti-emetics and steroids is considered.
Since William Withering first described the use of digitalis, over 200 years ago (1), its popularity has waxed and waned. Digitalis preparations are widely prescribed for elderly patients. Surveys of hospital in-patients have shown a high prevalence of the use of digitalis preparations (2, 3), but also of digitalis toxicity; though not all studies have shown the latter to increase with age. A survey of people aged 70, living in Gothenberg, showed that 14% were taking digitalis preparations (4); other studies have shown similar figures. Now that powerful diuretics and vasodilators are available for the treatment of heart failure, and many antiarrhythmics are used for the control of atrial tachyarrhythmias, there is controversy about the value of cardiac glycosides in the treatment of elderly patients.
