Approximately equianalgesic oral doses of codeine, an oxycodone compound resembling Percodan, and pentazocine were compared for adverse effects in a double-blind, randomized study of four doses of each drug given over two days to 247 postsurgical patients with pain. Placebo and parenteral morphine were also treated as negative and positive controls, respectively. Approximately 50 patients each received one of the five drugs. Codeine, pentazocine, and morphine had the same incidence of adverse effects (22 to 28 per cent). One capsule of oxycodone compound was the analgesic equivalent of 12.5 mg morphine with an adverse effect incidence of 4 per cent (placebo 8 per cent). Smoking made no difference in analgesic effect or adverse effects. Analgesics given in the evening intervening between the two days may have affected the analgesic performance of placebo.
gous diseases encountered were concerned, no variation from the findings in civilian life was noted. However, on the basis of possibility of spread, some uncommon diseases of limited distribution, such as Paracoccidioides, mycetoma and tinea imbricata, received considerable attention. To date no reports have shown any spread of these or of other unusual fungous diseases in this country. It is apparent that in medical mycology much important work remains to be done. CHAPTER IIClassification of Fungi FUNGI are microscopic members of the plant kingdom. They are included in the phylum of Thallophyta, in which there is no differentiation into roots, stem and leaves. There is further division into the orders of Algae and Fungaceae. Since the latter do not contain chlorophyll, they are unable to carry on photosynthesis. Fungaceae are divided into Bacteria, true fungi and Myxomycetes. The true fungi are divided into four subclasses; the most important subclass consists of Hyphomycetes, or fungi imperfecta which include practically all the fungi pathogenic to human beings.There have been many attempts further to classify and arrange the fungi which cause ringworm. Most of those who have studied the subject are dissatisfied with the existing subdivisions but realize that a botanic solution of the problem is at present impossible. It is usual to classify the fungi imperfecti which cause ringworm as dermatophytes. Sabouraud pointed the way to a purely clinical approach, and his classification of the superficial dermatophytes has been widely used. We believe that a modification of Sabouraud's arrangement (to suit the flora in this country) is sufficient for all who are not essentially botanists.In Sabouraud's classification, fungi having small spores in which the elements are found in mosaic arrangement and in profusion on the surface of the hair are known as Microspora. The next group comprises Trichophyta, divided into endothrix, which invades the hair shaft with the formation of large spores in linear arrangement, and ectothrix, which forms chains of spores external to the hair. The endothrix micro-organisms are usually not inoculable into laboratory animals, whereas the ectothrix fungi are often pathogenic for them. The genus Achorion includes only one common pathogen, the cause of favus. It may be well to drop this term and include Achorion with the endothrix Trichophyta. The term "Epidermophyton" denotes lack of invasion of a hair follicle. CHAPTER IIIStructure of Fungi STRUCTURALLY, fungi consist of vegetative elements and of fructification, or spore, forms. With few exceptions, in which the vegetative form consists solely of budding cells, the pathogenic fungi all form hyphae. These vegetative, filamentous structures are irregularly segmented and show some variation in form, according to the species. This is the form in which fungi are chiefly present in the human bodv. The structures connected with fructification are more specific, forming the basis for the identification of species. They are rarely present except in...
A total of 152 patients were treated at a single center in a single-dose, double-blind parallel study designed to compare the safety and efficacy of 25, 50, and 100 mg ketoprofen to 90 mg codeine and placebo in patients with moderate to severe postpartum pain (i.e., postepisiotomy, uterine cramping, or cesarean section pain). The analgesic responses to all three doses of ketoprofen and 90 mg codeine were superior to placebo and were not significantly different from each other. No dose-related response was observed with ketoprofen. The number of side effects was significantly greater (P = 0.001) among patients receiving codeine (six patients) than among those receiving ketoprofen (three patients).
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