RESUMO
OBJECTIVE: To compare and contrast the head injury advice give by various hospitals in England after minor head injury, and to draw attention to the need for a national set of head injury instructions. METHODS: 50 accident and emergency departments were contacted by post and asked to supply a copy of their head injury information card or leaflet; 41 hospitals replied (82%). RESULTS: Comparison of the cards showed inconsistencies and conflicting advice given by the departments contacted. CONCLUSIONS: There is a need for a national head injury card and a proposal for such a card is presented.
Assuntos
Assistência ao Convalescente/normas , Traumatismos Craniocerebrais/terapia , Serviço Hospitalar de Emergência/organização & administração , Cooperação do Paciente , Adulto , Criança , Inglaterra , HumanosRESUMO
A two-centre, double-blind, placebo controlled, randomized 3-way crossover study was undertaken to assess the efficacy, tolerability and safety of celiprolol in mild to moderate essential hypertension. A 4-week single-blind placebo run-in/screening period, during which no antihypertensive medication was given, was followed by 3 consecutive 4-week treatment periods with placebo or celiprolol (200 mg or 400 mg daily). At the end of the 4-week placebo run-in/screening period, 26 hospital out-patients with a seated mean blood pressure (systolic/diastolic) of 161.4/101.7 mmHg and a mean pulse rate of 75 beats/min entered the double-blind crossover phase of the study. Results showed that there was no significant difference in seated mean systolic or diastolic blood pressure between 200 mg celiprolol daily (149.2/92.3 mmHg) and 400 mg celiprolol daily (149.1/92.5 mmHg). However, mean seated systolic and diastolic blood pressures were significantly (p less than 0.05) lower on celiprolol than on placebo (157.1/98.2 mmHg). Neither dose of celiprolol had a significant effect on seated pulse rate. No patient was withdrawn due to an adverse event and no laboratory assessment outside the normal range was reported to be of any clinical significance. It is concluded that oral celiprolol, 200 mg or 400 mg daily, is effective and well tolerated for controlling mild to moderate essential hypertension. Since both doses had very similar effects on blood pressure there is no advantage in this group of patients for the 400 mg daily dose of celiprolol.
Assuntos
Anti-Hipertensivos/administração & dosagem , Hipertensão/tratamento farmacológico , Propanolaminas/administração & dosagem , Administração Oral , Adulto , Idoso , Anti-Hipertensivos/efeitos adversos , Anti-Hipertensivos/uso terapêutico , Celiprolol , Método Duplo-Cego , Feminino , Humanos , Hipertensão/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Propanolaminas/efeitos adversos , Propanolaminas/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Forty-six eyes with chronic open-angle glaucoma (COAG) and 24 eyes which had previously undergone trabeculectomy for COAG were studied and the postural response of the intraocular pressure compared with that of 70 normal eyes. In all three groups the greatest rise in intraocular pressure (IOP) occurred when the subject changed from the sitting to the lying position. In the control group this was never more than 2 mmHg in any subject. The rise was greater than 2 mmHg in 93% of the patients suffering from COAG who were treated medically and in 100% of the eyes of those on which trabeculectomy had been performed. The well recognised abnormal postural response of intraocular pressure in COAG appears both to be retained and to be unaffected in those eyes which have undergone trabeculectomy.