No abstract

We describe here five cardiac patients with type II amiodarone-induced hyperthyroidism who were treated prospectively with a combination of an oral cholecystographic agent (sodium ipodate, Oragrafin, or sodium iopanoate, Telepaque) and a thionamide (propylthiouracil or methimazole); amiodarone was discontinued in all patients. All patients improved substantially clinically within a few days of treatment and became euthyroid or hypothyroid in 15-31 wk when treatment was discontinued. Four of the five became hypothyroid and required long-term treatment with L-T(4); the remaining patient was euthyroid, but died from cardiomyopathy and congestive heart failure at 29 wk, when he had been off oral cholecystographic agent and thionamide for 6 wk. We did not find any clinical or biochemical adverse effects of the treatment. Our study suggests that a combination of oral cholecystographic agent and thionamide is a safe and effective treatment of type II amiodarone-induced hyperthyroidism. Data also suggest that hypothyroidism is a common end result of type II amiodarone-induced hyperthyroidism.

Staphylococcal colonization and infection were studied prospectively in infants, mothers and households after childbirth at home and in hospital. Infants were treated prophylactically with frequent applications of ‘Ster-zac’ hexachlorophane dusting powder. Some were treated in addition with ‘Naseptin’ nasal disinfectant cream.The incidence of staphylococcal sepsis in infants was much less than before the adoption of hexachlorophane prophylaxis. The sepsis rate was further reduced when ‘Naseptin’ was used in addition to hexachlorophane. Of the two prophylactic agents, hexachlorophane was the more convenient and probably the more effective. ‘Naseptin’ was difficult to employ correctly and unsuitable for routine use.The treatment of infants with disinfectants reduced nasal carriage markedly in infants and to a smaller extent in mothers. Both agents contributed to the reductions which persisted for some weeks after treatment ceased.Breast abscesses were almost entirely confined to mothers of infants who became nasal carriers by the second week of life.Staphylococcal colonization of infant's skin was greater when they wore impervious garments, probably because skin moisture increased.