Treatment of ketoacidosis and diabetic coma by continuous intravenous administration of water, glucose, regular insulin and electrolytes.

The therapeutical scheme prescribed for the treatment of ketoacidosis and diabetic coma before the 1970s is quite stereotyped and inflexible in regard to the routes of administration and doses of insulin, as well as the management of dehydration and metabolic acidosis. This paper reports the experience of the Endocrinology Service of the General Hospital of the "La Raza" Medical Center for over 10 years. 35 patients with diabetic ketoacidosis were included in a treatment by continuous intravenous administration of glucose, water, insulin and potassium. These patients were programmed in a 12 hour study. The dose of insulin was estimated at a ratio of 1 IU per 1 gm of excess glucose over 2.0 gm/l. The amount of glucose administered was in ratio to the caloric requirements per kilo of bodyweight of the individual patient. The volume of water was administered on the basis of the degree of dehydration estimated. The potassium was prescribed at a ratio of 20 mEq/l of solution, or more if necessary. The patient's recovery was observed during a period of from 7 to 10 hours, with improvement of the hyperglycemia, dehydration and metabolic acidosis. The method has allowed us to observe the diabetic patient's rapid recovery when he has been in ketoacidosis or coma, without complications such as hypoglycemia. No mortality was observed.

Circulating gonadotropin pattern in anorchia syndrome. Response to treatment.

Two anorchidic brothers, 16 and 25 years of age were studied; three, 60 min interval samples were drawn on the day -1 followed by a daily sample for five days, and after every seven days. 25 mg of testosterone propionate were administered daily during 24 days and after, 100 mg of testosterone enanthate were administered every 14 days (prolonged action). Testosterone, F S H and L H were quantified by R I A. Testosterone concentrations were 0.75 and 0.52 ng/ml; F S H 22.0 and 24.0 ng/ml and L H, 18.0 and 25.0 ng/ml respectively in A. F. M. and A.F.J. With testosterone propinate, F S H basal levels were decreased in 53 and 55 per cent, and L H, 80 and 86 per cent in A.F.M. and A.F.J. respectively. With prolonged action testosterone, F S H and L H levels were within normal limits after a 7 day administration course. Due to the decrease in F S H and L H initial levels as a result of treatment we concluded that in the anorchia syndrome, receptors in the hypothalamus - pituitary axis maintain their normal ability of feedback mechanism response with testosterone administration and thus prolonged action testosterone is the best substitute.

[Administration of equally divided doses of propylthiouracil every two-eight hours in hyperthyroidism]. / Administración de igual dosis de propiltiouracilo fraccionada cada dos y cada ocho horas en el hipertiroidismo.

Serum propylthiouracil semi splitting occurs in 1.1 and 1.65 hours when administered in a single dose. In this work treatment for hyperthyroid patients is described; 350 mg were administered daily in divided doses, every two and eight hours. In group A fifteen patients received 50 mg every two hours from 8:00 to 20:00 hs. and in group B nine patients were administered 100, 100 and 150 mg at 8 hour intervals. The patients were hospitalized the first seven days and during this time circulating triiodothyronine and thyroxine concentrations were measured daily at 8:00 and 20:00 hrs. and then at 8:00 hrs. at days 8, 14, 21 and 28. After almost one week of treatment, in group "A", seven patients (46.6 per cent p 0.05) had normal concentration levels in both hormones. In group "B" only one patient reached normal levels in the first eight days. The administration of propylthiouracil every two hours is a useful procedure to attain the euthyroid state in less time than with other therapeutic patterns without undesirable side effects.