Eliminating errors with intravenous heparin.
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Biomedical subjects
Publications and source records attributed to V Vasanthakumar.
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Five hundred and fifteen patients aged 60 and over (mean age 74.7; 278 men and 237 women) underwent routine endoscopic procedures (gastroscopy, bronchoscopy and cystoscopy). Alternate patients were given antibiotics before the procedure, as currently recommended, and blood was taken for culture from all patients within five minutes of completion of the procedure. Of 74 patients who underwent bronchoscopy, only one culture, from one of 37 controls was positive. Of 262 who underwent gastroscopy, cultures were negative in the 130 who received antibiotics but positive in 13 of the 132 controls (9.8 per cent p less than 0.001). Cystoscopy was performed in 179; one culture was positive in the 88 given antibiotics (1.1 per cent) compared to 25 in the 91 controls (27.5 per cent; p less than 0.001). Bacteraemia rates appear to be low following bronchoscopy (less than 5 per cent) but higher with gastroscopy (10 per cent) and cystoscopy (28 per cent). Chemoprophylaxis was effective in reducing these rates in this patient group.
A case is presented in which florid hypertrophic osteoarthropathy regressed clinically and radiologically when a Celestin tube was removed.
A study was carried out in 18 patients with rheumatoid arthritis to compare the effects of two different preparations of indomethacin with placebo on night pain, sleep and duration of morning stiffness. Patients were treated for 1 night each, in random order, with identical capsules containing 75 mg indomethacin, either as 'Indomod' (all sustained-release form) or 'Indocid' R (25 mg normal, 50 mg sustained-release form), or placebo as a substitute for their usual night-time medication. The results of visual analogue scale scores and a standard sleep assessment questionnaire score indicated the same order of effectiveness for each of the three parameters, with 'Indomod' best, 'Indocid' R intermediate and placebo worst, but only the difference in sleep was statistically significant. 'Indomod', therefore, might offer a slight advantage over the same dose of indomethacin as 'Indocid' R given at night. Less side-effects were produced by active treatment than by placebo and none was severe.