Low-dose midazolam combined with propofol is an effective and economic alternative to benzodiazepine-based analgosedation. It is associated with a high degree of patient comfort and rapid recovery times, and has a potential cost benefit concerning nursing care and bed facilities.
Continuous infusion of dopexamine enhances mesenterial and portal perfusion in a dose-dependent manner without affecting the extent of physiological postprandial hyperaemia. Thus, dopexamine and enteral nutrition may interact with splanchnic haemodynamics by different pathways.
In juvenile patients with a severe and longstanding iron deficiency disease several abnormal features such as delayed growth, retarded development and maturation are displayed. The roentgenological examination of the sella turcica in 81 patients and the determination of the sellar size in 73 cases, including 40 men and 33 women, by employing the method of Haas with a slight modification and the following comparison of the results with the values obtained by this author in normal individuals of the same sex and age revealed that in the iron deficient patients the sellar area is considerably reduced. In addition, it could be shown that in the patients the normal augmentation of the size with the advancing age is likewise diminished and comes to an early standstill. It could be, moreover, demonstrated that in men the sellar size and growth are more reduced than in women and that the difference in the patients is much larger than the difference existing normally between both sexes. The reduced size of the sella turcica in the patients indicated that the pituitary gland placed in the sellar cavity is likewise diminished and that the activity of the gland, as far as the function is related to the volume, is equally decreased. This assumption is in good keeping with the clinical findings in the patients being attributed to a low and failing hormonal activity. The close relation between volume and function of the pituitary gland, is proved by the observation made in the patients after the administration of iron showing that the size of the sella is considerably augmented during a relatively short space of time and that at the same time a definite amelioration of clinical symptoms occurs. Thus the X-ray examination of the sella turcica and the determination of its area is a suitable method for a comparative investigation of the size and function of the pituitary gland. It offers a valuable tool for studying the disorders of growth, development and maturation in juvenile patients with a severe and longstanding iron deficiency disease and for investigating the relation of these clinical features to the pituitary function.
Lateral X-ray pictures of the skull in certain several and chronic disorders of the blood as thalassaemia, congenital haemolytic anaemia, sickle cell anaemia and iron deficiency disease show frequently changes of the outlines of the cranial bones. They consist of a double contour of the outer cranial border and on the interior side below the sagittal sutura of a band-like shadow or of multiple stripes and lines running parallel to the carnial vault. They concern the parietal bones and may extend from the bregma till to the lamda or occupy only a part of this distance. The roentgenological features are due to the enlargement of the crainal bones, the bulging out of both parietal bondes, the sometimes enlarged and deepened borders of the sulcus sagittalis superior and particularly to the furrow and depression on the skull above the sagittal suture caused by the protruding parietal bones on both sides. As these different abnormal structures must be passed by the picturing X-ray, effects of superposition and interference are produced. Longitudinal ridges or bony edges which could explain the roentgenological findings could not be established. Since the peculiar alterations of the cranial bones are mainly found in the mentioned blood disorders, where they are caused by the overgrowing red marrow, they also display the same roentgenological features. These features are, therefore, a characteristic sign of these diseases.
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