Deaths as a result of a combination of codeine and glutethimide

Toxicological findings are described in 16 medical examiner cases directly related to the combination of codeine and glutethimide. The cases described represent a six-month period, July through December 1982, showing the epidemic rate of abuse of this drug combination, most prominent in the Newark, NJ area since the late 1970s. Concentrations of codeine and glutethimide, measured by gas liquid chromatography (GLC), in the blood averaged 0.62 and 4.07 mg/L, respectively. Similarly determined urine concentrations averaged 38.06 and 12.68 mg/L, respectively. Specific concentrations of each drug in most cases were in the high therapeutic range, suggesting a possible toxic synergistic effect.

Effects of antibiotics on polymorphonuclear leukocyte chemiluminescence and chemotaxis

Polymorphonuclear leukocyte chemiluminescence and chemotaxis assays were performed on cells obtained from normal individuals and patients with defined defects in chemotaxis or chemiluminescence. After in-vitro pre-incubation with trimethoprim/sulphamethoxazole, its separate components, clindamycin and cefotaxime, normal cells showed some enhancement in chemotaxis and significant increase in chemiluminescence. There was an even more marked increase in chemotaxis when these antibiotics were incubated with cells from patients with leukocyte chemotaxic defects. When the cells from patients with chemiluminescence defects were pre-incubated with these antibiotics, there was also substantial enhancement in chemiluminescence.

Histo-mechanical aspects of carpal tunnel syndrome

Carpal tunnel syndrome is a result of median nerve compression within the carpal canal. Factors associated with the appearance of carpal tunnel syndrome can be related to the bony architecture of the carpal canal, to its contents and to systemic disease. The purpose of this work is to see if changes in the elasticity of the transverse carpal ligament may cause carpal tunnel syndrome.

Value of concomitant sympathectomy in aortoiliac reconstruction. Results of a prospective, randomized study

The efficacy of concomitant lumbar sympathectomy in improving results of aortoiliac reconstruction was assessed by a prospective, randomized study of 51 patients undergoing operation for occlusive or aneurysmal disease. Sympathectomy was performed on 50 limbs, while 52 extremities served as controls. Sympathectomy resulted in a significant reduction in foot vascular resistance determined by plethysmography. However, the procedure had no effect on leg circulation, assessed by ankle/arm pressure indices determined by Doppler ultrasound. In the sympathectomy group, there were three early postoperative amputations for ischemia, despite patent grafts. In the control group, there was one late graft occlusion, caused by progressive atherosclerotic disease. Although sympathectomy may improve pedal circulation, the procedure does not appear to improve the results of aortoiliac reconstruction.