Prophylactic use of cefotaxime in elective biliary surgery

This paper describes a randomized trial of 66 patients undergoing elective biliary surgery, half of whom received 1 g of intravenous injection of cefotaxime at the time of induction of anaesthesia and half who had no treatment. A 12.5% wound infection rate in the untreated patients was observed compared to a complete absence of infection in the treated patients.

The use of cholecystokinin in diagnosing biliary pain

Some patients who present with a story of gallbladder disease may have a normal oral cholecystogram. In some such cases an intravenous injection of cholecystokinin may reproduce their symptoms and it is suggested that this is a positive indication for advising a cholecystectomy.

The solitary thyroid nodule

In a 4-year period the solitary thyroid nodule was the most common form of thyroid pathology seen in the surgical section of a thyroid clinic. The cold thyroid nodule was the most frequent type of solitary nodule and half of these were unilocular cysts which were treated by aspiration and sclerotherapy. Cytological examination of the aspirated fluid revealed no evidence of malignant cells. Emphasis is placed on recommending operation if aspiration fails to cause the mass to disappear.

The evaluation of cefuroxime in the prevention of postoperative infection

Patients undergoing biliary surgery received either 750 mg cefuroxime i.m. with the premedication and then 8 hourly for 3 days ((group A) or 1.5 g cefuroxime i.v. at the time of induction of anaesthesia (group B) or not treatment (group C). Wound infections occurred in 3 out of 35 patients in group A, 1 out of 40 patients in group B and 11 out of 39 patients in group C (group B significantly different than group C, P less than 0.05). Eight patients (23%) in group C had chest complications. Cefuroxime was effective in the reduction of wound sepsis following biliary surgery and 1.5 g i.v. administered during induction of anaesthesia is the dosage of choice. The incidence of chest infection tended to be lower in patients receiving cefuroxime but many more patients would have to be studied for a conclusive result.

Diagnosis of primary hyperparathyroidism

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Medroxyprogesterone acetate and reproductive processes in male dogs

The treatment of normal male dogs with a depot preparation of medroxyprogesterone acetate (4 mg/kg) for 7 weeks reduced peripheral testosterone levels by 58%. No effects on testicular size and consistency, semen quality or libido were found.

Comparison of the effects of chlorpromazine, dextroamphetamine and methylphenidate on the behaviour and intellectual functioning of hyperactive children

Chlorpromazine, dextroamphetamine and methylphenidate were significantly superior to placebo in producing overall improvement in the behaviour of hyperactive children. Chlorpromazine was effective for the majority of the children, but reduced only hyperactivity, having no demonstrable effect on distractibility, aggressivity or excitability. Both stimulants produced more goal-oriented behaviour and reduced distractibility. Methylphenidate was the most effective of the drugs in prpducing exceptional improvement. All three active drugs had to be discontinued in a few of the children because of side effects. Not all hyperactive children were benefited by the drugs.No background variables (with the exception of mother-child relationship) were found in the present studies to predict favourable response to the drugs.Methylphenidate became our drug of choice for this group of hyperactive children.

A case of obstructive jaundice due to a duodenal diverticulum

A case is reported of an obstructive jaundice caused by compression of the common bile-duct by a duodenal diverticulum. The obstruction was relieved by a cholecystojejunostomy and it is suggested that this is the treatment of choice for this rare condition occurring in the elderly.