[Role of colonoscopy in the diagnosis of ischemic colitis as a complication of surgery of aneurysms of the abdominal aorta]

Ischaemic colitis is one of the complications following aortic reconstruction for abdominal aortic aneurysm. The diagnosis and monitoring of this complication can be helped by a left colonoscopy. Through an endoscopic valuation of 18 patients, the Authors value the incidence of colonic mucosal or mucosal and muscularis ischaemia following aortic aneurysmectomy with inferior mesenteric arterial ligation.

[Spontaneous hematoma of the abdominal wall. Review of a clinical case load]

The treatment of several cases of spontaneous haematomas of the abdominal wall triggers some remarks on clinical aspects of the condition.

Acid-base balance and respiratory response during biofiltration with polyacrylonitrile membrane

To further elucidate the mechanisms responsible for the hypoxemia we studied ventilation, pulmonary gas exchanges, blood gas pressures and exchanges of CO2-T, CO2-D and HCO-3 in six patients during AD and BD on 1 m2 cuprophan filter and during BF on 1.2 m2 polyacrylonitrile filter. Blood passing through the dialyzer lost 172.8 mM/h of CO2-T in AD, 149.2 mM/h in BF and gained 25.6 mM/h in BD. In AD VE, VA and PaO2 decreased significantly after 30 and 60 min., in BF for the whole duration of dialysis. PoO2 showed a significant decrease both in AD and BF after 60 min. In AD PaCO2 was significantly reduced after 120 and 180 min. All the above parameters remained unchanged in BD. VCO2 remained unchanged in all. VCO2 and R decreased both in AD and BF. However, when VCO2 was corrected for CO2 loss across the dialyzer, overall CO2 loss (ventilated plus filtered) and R returned to basal values. In AD, HCO-3 and pH fell in the first 120 min., while in BD and BF they increased from the beginning of dialysis. In AD hypoventilation, hypoxemia and inadequate correction of acid-base balance were due to the loss of HCO-3 across the filter. In BF also hypoventilation and hypoxemia were due to the loss of HCO-3 across the filter but the acid-base balance was adequately corrected by HCO-3 reinfusion. In BD, there was HCO-3 gain across the filter which induced a gradual correction of acid-base balance without impairment of ventilation.

A crossover trial of oxdralazine in hypertension

Twenty-nine moderate and severe essential hypertensive patients completed a crossover study aimed at evaluating efficacy and tolerability of a double combination (chlorthalidone plus propranolol) and of a triple combination (chlorthalidone plus oxdralazine plus propranolol). After one month on 25 mg/day chlorthalidone, which caused nonsignificant reduction in blood pressure of 7/4 mm Hg, patients were randomized to receive either the double or triple regimen for a three-month period. Then, after another month on chlorthalidone alone at the same dose of 25 mg/day, treatments were crossed over and the study continued for another three-month period. The double regimen caused a drop in pressure of 16/11 mm Hg after one month (daily doses 25 mg chlorthalidone, 103 +/- 25 mg propranolol), and this reduction did not change at the third month in spite of dosage increases (daily doses 25 mg chlorthalidone, 222 +/- 77 mg propranolol). The triple regimen reduced blood pressure 35/15 mm Hg after one month (daily doses 25 mg chlorthalidone, 20 mg oxdralazine, 40 mg propranolol), and further increase in dosages caused a reduction of 45/24 mm Hg at the third month (daily doses 25 mg chlorthalidone, 56 +/- 20 mg oxdralazine, 112 +/- 40 mg propranolol). Both treatments were well tolerated; in particular, at the end of the third month of each treatment period, 25 patients on the triple regimen achieved a stable diastolic blood pressure of 90 mm Hg or less, as compared to 10 patients on the double regimen (P less than 0.01).

A comparative trial of timolol and flutonidin as antihypertensive agents

In a double-blind cross-over clinical trial, flutonidin (2-4 mg daily) was compared with timolol (20-40 mg daily) in the treatment of mildly or moderately hypertensive patients who concomitantly received fixed diuretic treatment. Each drug was administered for 1 month, with an interval of 2 weeks between the two monthly periods. During administration of flutonidin, blood pressure initially fell but returned to baseline values at the end of treatment. Heart rate was not affected by the drug. Timolol significantly reduced both blood pressure and heart rate. Its effect becomes evident during the 1st week and increases throughout the treatment period. Side effects were more frequent during flutonidin administration than during timolol administration. No significant modifications of the laboratory findings were observed during either flutonidin or timolol treatment.