Managing acute cardiac patients in and out of the hospital setting

The National Service Framework (NSF) for Coronary Heart Disease (CHD) (Department of Health, 2003) sets the standard of treating eligible acute myocardial infarction (AMI) patients within 60minutes of a call for help in order to improve survival rates and long-term quality-of-life for heart-attack patients.

Transrectal electroejaculation in combination with in-vitro fertilization: an effective treatment of anejaculatory infertility after testicular cancer

Treatment of non-seminomatous testicular cancer often leads to infertility due to anejaculation/retrograde ejaculation and poor sperm quality. In these men spermatozoa may be obtained by transrectal electroejaculation (TE), but the optimal strategy for assisted procreation in these couples is not known. Our aim was to examine whether TE and conventional in-vitro fertilization (IVF) would be successful. A total of 10 couples, with long-standing infertility due to anejaculation or retrograde ejaculation after treatment for testicular cancer 5-14 years earlier, were referred to our unit. All men underwent diagnostic TE under general anaesthesia. Spermatozoa were recovered in nine cases. The antegrade fraction was prepared and used for IVF. Sperm quality was variable and conventional IVF was considered impossible in three cases. Altogether six IVF treatment cycles in six couples resulted in five pregnancies, of which four resulted in a delivery and one resulted in a spontaneous abortion. One additional pregnancy is ongoing after transfer of cryopreserved embryos. The fertilization rate was 54% (33/61) and the cleavage rate was 97% (32/33). No complications relating to the procedure have been encountered.

ABH isoantigens, histology and DNA ploidy in 36 consecutive patients with transitional cell bladder cancer. Status of tumor and biopsies taken from visually normal urothelium

Tumors and biopsies from visibly normal urothelium in 36 consecutive patients with transitional cell bladder carcinoma were analysed for histological pathology, DNA ploidy and ABH isoantigens. Tumor isoantigen deletion correlated strongly with malignant histology (p = 0.016) and aneuploidy (p = 0.005). In 4/12 patients with ABH isoantigens present on the tumor, and in 6/8 with isoantigens absent, isoantigen changes were found in normal looking urothelium, usually with normal histology and ploidy. It was concluded that the ABH isoantigen change was an early event in bladder carcinoma.

A holistic approach to stylalgia

A follow-up study was performed on 20 patients surgically treated because of stylalgia (Eagle's Syndrome). The aim of the study was to investigate why somatic treatment was often ineffective; furthermore, if there was a psychosomatic background to the complaints. The results of a psychiatric interview in which 11 patients took part clearly showed that most of them were suffering primarily from a psychiatric disorder. The question of stylalgia only as a form of atypical facial pain is discussed.

An analgesic study with repeated doses of phenazone, phenazone plus dextropropoxyphene, and paracetamol, using a visual analogue scale

A double blind randomized analgesic trial was carried out in patients suffering from pain after removal of an impacted lower wisdom tooth. In a repeated dose regimen, 120 patients received one of three different analgesics: phenazone, phenazone plus dextropropoxyphene, or paracetamol. The assessments of pain were made hourly on a visual analogue scale and the evaluation was carried out according to a method which considers repeated dose intake. The analgesic efficacy of 500 mg phenazone was similar to 500 mg of paracetamol. The pain reduction seemed adequate in most patients and no statistical differences were obtained between the treatment drugs. All analgesics were taken when needed, and the time interval from end of operation to first tablet intake, as well as the pain score at first tablet intake, were factors which significantly influenced the efficacy of the drugs. Therefore, these factors may be of significant importance in the evaluation of analgesics in small sample studies.