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2689. Effect of ingestion of meat on plasma cholesterol of vegetarians.
作者: F M Sacks.;A Donner.;W P Castelli.;J Gronemeyer.;P Pletka.;H S Margolius.;L Landsberg.;E H Kass.
来源: JAMA. 1981年246卷6期640-4页
In a controlled trial, 21 strict vegetarians were studied prospectively for eight weeks: a two-week control period of the usual vegetarian diet was followed by four weeks, during which 250 g of beef was added isocalorically to the daily vegetarian diet and then by two weeks of the control diet. Plasma high-density lipoprotein-cholesterol did not change during the study, whereas plasma total cholesterol rose significantly by 19% at the end of the meat-eating period. Systolic blood pressure (BP) increased significantly during the meat eating by 3% over control values, whereas diastolic BP showed no major changes. Plasma renin activity, prostaglandin A and E levels, and urinary kallikrein, norepinephrine, and epinephrine excretions were within normal limits and did not change notably throughout the trial. The study suggests an adverse effect of consumption of beef on plasma lipid and BP levels.
2690. Dissemination of relevant information on hypertension.
The timely dissemination of new medical information to the practicing physician has been identified as a problem. To examine the magnitude of this problem and useful strategies for correction, we surveyed primary care physicians to determine their knowledge of the Hypertension Detection and Follow-up Program, a recent clinical trial with important treatment implications. Forty percent of family physicians (44/110) were aware of the study within two months of publication, and 63% of internists (114/182) learned of it within six months. Eighty percent of the family physicians and 50% of the internists listed medicine journals as the source of their knowledge, while 40% of the internists learned of it from continuing medical education (CME) courses. These findings indicate that rapid dissemination of new information can occur when relevant journals are used and that CME courses also provide a timely and effective means of dissemination.
2693. Administration of levodopa for relief of herpes zoster pain.
Forty-seven outpatients with herpes zoster, seen within five days of onset of the eruption, received ten days' administration of oral levodopa and benserazide or placebo in a double-blind controlled study. Both the total patient group and high-risk group, eg, those with either ophthalmic zoster or those older than 65 years, were analyzed. Both groups were comparable in terms of demographic and pathological criteria. Vomiting was the only side effect observed in both groups. A significant decrease in intensity of pain was seen in the group receiving levodopa from the third day, and complete cessation of both pain and sleep disturbances was more frequent in the patients. Two months later, postherpetic neuralgia was also less frequent in the group that received levodopa.
2696. Selection of patients with chronic obstructive pulmonary disease for long-term oxygen therapy.
作者: R M Timms.;P A Kvale.;N R Anthonisen.;C T Boylen.;D W Cugell.;T L Petty.;G W Williams.
来源: JAMA. 1981年245卷24期2514-5页
The Nocturnal Oxygen Therapy Trial, a study of oxygen therapy in patients with chronic obstructive pulmonary disease, has combined the experience of six centers concerning the selection of patients for oxygen treatment. Forty-five percent of hypoxic patients initially selected for the study improved enough during the one month of outpatient observation to allow suspension of plans to treat them with oxygen. Therefore, long-term oxygen therapy plans should only be made without a month of careful observation. Resting PaO2 values less than 40 mm Hg suggest instability or that chronic obstructive pulmonary disease is not the only cause of the hypoxemia. Nasal prong oxygen flow of 1 to 3 L/min reversed hypoxemia in 95% of stable patients with chronic obstructive pulmonary disease.
2700. delta 9-tetrahydrocannabinol in clinical oncology.
After anecdotal reports of marijuana's providing antiemetic activity in cancer chemotherapy patients refractory to standard agents, orally administered delta 9-tetrahydrocannabinol (THC) was formally studied by a number of investigators. In six of seven well-controlled studies, orally administered THC was a superior antiemetic agent compared with control agents. The THC toxic effects are notable but manageable. Patients rarely require hospitalization after the development of THC-induced dysphorias. However, serious toxic effects are uncommon and the most frequently noted effects are somnolence, conjunctivitis, and tachycardias. Because certain subgroups of patients are more prone to have toxicities develop, careful selection of the candidates to receive this agent is mandatory. Overall, the benefits of orally administered THC use represent a major advance in antiemetic therapy.
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