Exercise tolerance in patients with angina pectoris after pentaerythritol trinitrate and alprenolol studied by two different methods

The Untimely Popping Phial: Poppers as an Unusual Cause of Skin Corrosion of the Thigh

Background

Alkyl nitrites or “poppers” are widely used as sex-drugs due to their aphrodisiac and muscle relaxant effects. We describe the rare case of a large-sized dermatitis after direct skin contact with the poppers-fluid in a poppers user. Case Presentation. A 52-year-old patient presented to the emergency department due to burning pain on his proximal right thigh and scrotum. Clinical examination showed an 8 × 5 cm measuring burning wound resembling lesion. During further history the patient mentioned that the day before presentation a “poppers” phial unintentionally opened in his pocket and the fluid leaked.

Conclusions

The present case shows severe skin defects after skin-contact with alkyl nitrates in a “poppers” user. Maculopathy and methemoglobinemia are prominent unwanted side effects of “poppers” use. However, our report demonstrates that attention should also be paid to potential harm for the skin.

Antianginal efficiency of nifedipine with and without a beta-blocker, studied with exercise test. A double-blind, randomized subacute study

Twenty-one patients, mean age 60.3 years, with stable angina pectoris earlier treated with beta-blockers, were investigated with standardized exercise tests to evaluate the action of nifedipine alone and in combination with a beta-blocker. The first exercise test was performed 3 weeks after treatment with the patient's usual beta-blocker. Following this, the patients were tested twice after a double-blind cross-over 3-week trial with nifedipine and placebo. The patients were subsequently treated for 3 weeks with nifedipine 10 mg 3 times daily or placebo and then performed an exercise test. During the 4th period of 3 weeks the patients took a combination of nifedipine, 10 mg 3 times daily, and their usual beta-blocker and then performed the final exercise test. Nifedipine alone raised the heart rate by 5 beats/min at rest and diminished the systolic blood pressure at rest by 17 mm Hg. During exercise at comparable load the heart rate did not change significantly, but the systolic blood pressure decreased with 22 mm Hg. The exercise tolerance expressed as total work increased on a average by 20%, range-14 - + 194%. Nifedipine in combination with a beta-blocker gave a further decrease in the systolic blood pressure, totally 37 mm Hg at comparable load. The exercise tolerance increased more, totally by an average of 41%. There was a significant correlation between basal values for systolic blood pressure registered during the placebo period at rest and the percentage change in total work. The atrioventricular conduction time did not change significantly compared to placebo during treatment with nifedipine or the combination nifedipine + beta-blocker. No serious side-effects were observed during the study.