Results show that, although the diagnosis of hypochondriasis is rarely made, physician recognition is high. They also show that several indicators of internal and external validity of this diagnostic category exist. Findings suggest that if physicians are to reduce the functional impairment and nonproductive health care utilization of these patients, they will need to make the diagnosis of hypochondriasis and intervene appropriately. However, for this to occur, research demonstrating predictive validity and treatment responsiveness of the disorder will be required.
The ampicillin levels in sputum, serum, and saliva from 40 patients receiving a dose of 250 mg., 26 patients receiving a dose of 500 mg., and 11 patients receiving a dose of I g. were estimated. The ampicillin was given orally four times daily.The 1-2 hour and 2-3 hour sputum levels were similar in individual patients. There was no difference in the range or mean sputum or saliva levels between specimens from patients receiving 250 mg. and 500 mg., but the levels were significantly higher after the 1 g. dose. The mean serum level sihowed a small increase after 500 mg. ampicillin as compared with the 250 mg. dose and a big increase after the 1 g. dose: only the latter difference was significant. The sputum levels were approximately 30 to 40 times lower than the corrzsponding serum levels. There was considerable scatter in the sputum level for any level of ampicillin in the serum: in only two of the 1-2 hour sputum specimens was there no detectable ampicillin.There was no correlation between the sputum levels and either the body weight or the dose in milligrams per kilogram. There was no evidence that corticosteroids or diuretics affected the sputum level.It was not possible to demonstrate any relationship between the purulence of the sputum and the level of ampicillin after doses of 250 mg. or 500 mg., but higher levels were found in the more purulent specimens after 1 g. doses.Previous work (Hafez, Stewart, and Burnet, 1965) showed that there was considerable variation between patients in the level of penicillin in the sputum after intramuscular injection and that the sputum levels were appreciably lower than the serum levels. May and Delves (1965) reported the serum, saliva, and sputum levels in a small group of patients with chronic bronchitis treated orally with ampicillin. They found considerable variation between patients.The present investigation was carried out to determine the range of ampicillin sputum levels in a larger series of patients with respiratory disease after treatment with doses of 250 mg., 500 mg. or 1 g. orally four times daily. Serum levels were also assayed since these are the levels frequently quoted when assessing the adequacy of the dosage of a drug. Saliva levels were estimated because contaminatilon of sputum with saliva containing ap-
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