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By Professor J. R. Trounce (auth.), Professor J. R. Trounce (eds.)

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Each time the guts is challenged with an elevated paintings load for a protracted interval, it responds through expanding its muscle mass--a phenomenon often called cardiac hypertrophy. even supposing cardiac hypertrophy is often noticeable less than physiological stipulations akin to improvement and workout, a wide selection of pathological situa­ tions resembling high blood pressure (pressure overload), valvular defects (volume overload), myocardial infarction (muscle loss), and cardiomyopathy (muscle affliction) also are recognized to bring about cardiac hypertrophy.

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References 1. Boulter, P. , Brit. J. Surg. (1961), 49, 17. 2. Scott, M. , Lancet (1969), i, 1065-1067. 3. , and Syme, C. , Brit. J. (1969), 3,596. 4. Rees, H. , Muir, A. , Macdonald, H. , Lawrie, D. , Burton,]. , and Donald, K. , ibid. (1967), ii, 863-866. 5. , Snijder, J. A. , and Nieweg, H. , Lancet (1966), ii, 768. 6. , Kerr, D. N. , Swinney, J. and Yeates, W. , Brit. med. J. (1969), 3, 378-3 82. 7. Editorial, Lancet (1969), ii, 1233. 8. Aggeler, P. , O'Reilly, R. , and Kowitz, P. , New Eng.

As for chlorpromaiine. Pericyazine Pharmacological action. Analogous to chlorpromazine but more potent with substituted cyanide radical. Therapeutic use. Thought to be useful in adolescent behaviour disorders and psychotic states. s. Well tolerated intramuscularly, 10-20 mg dose. Fluphenazine [21] Replacement of the methyl group with an alcohol greatly strengthens its action. As effective clinically as chlorpromazine in schizophrenia. Useful in unreliable patients in form of depot injection 12'5-25 mg (fluphenazine enanthate) which lasts 2-4 weeks.

Although injections may be continued indefinitely, preferably at a reduced dose. The dosage required with aurothioglycanide may be a little higher. Contraindications and side effects. Toxic effects occur in at least 30 per cent of cases and include pruritus, urticaria, purpura, dermatitis which may exfoliate, stomatitis which may ulcerate and less commonly thrombocytopenia, aplastic anaemia, hepatic and renal damage, peripheral neuropathy and an encephalopathy may develop. The urine should be examined for protein before each injection and blood counts made every 2-3 weeks.

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