RESUMEN
In a large multicentered, collaborative randomized and blinded trial utilizing antenatal corticosteroids, the goals included determining the effectiveness of these agents in accelerating lung maturation, as well as monitoring any short-term or long-term adverse effects of this treatment on the parturient, fetus, and/or infant. More than 100 specific items, pertaining to diagnoses, complications, and outcomes were recorded for the 696 mothers enrolled in the study and their 745 infants. A significantly decreased incidence of necrotizing enterocolitis (P = .002) was found in the infants treated with steroids. The possibility of accelerated intestinal maturation induced by antenatal maternal steroid therapy exists. This treatment regimen is particularly attractive as adverse aspects of steroid therapy at the dosage utilized have not been demonstrated.
Asunto(s)
Enterocolitis Seudomembranosa/prevención & control , Glucocorticoides/administración & dosificación , Enfermedades del Prematuro/prevención & control , Ensayos Clínicos como Asunto , Enterocolitis Seudomembranosa/epidemiología , Femenino , Florida , Humanos , Recién Nacido , Enfermedades del Prematuro/epidemiología , Embarazo , Complicaciones del Embarazo/epidemiología , Atención Prenatal , Distribución Aleatoria , Síndrome de Dificultad Respiratoria del Recién Nacido/epidemiología , Síndrome de Dificultad Respiratoria del Recién Nacido/prevención & controlRESUMEN
The shelf life of succinylcholine chloride injection at several pH values when stored at room temperature was evaluated. Solutions containing 20 mg/ml of succinylcholine chloride were stored at 25 and 40 degrees C. The reaction was studied at pH values ranging from 3.0 to 4.5. At two-week intervals, the solutions were assayed by high-pressure liquid chromatography. The initial amount of succinylcholine chloride in all samples was 100.1 +/- 2.37% of label claim. Hydrolysis of succinylcholine chloride in unbuffered solutions followed apparent zero-order kinetics. The pH range of maximum stability was found to be from 3.75 to 4.50. Succinylcholine chloride decomposed at a considerably higher rate at 40 degrees C. Allowing for the effects of pH adjustment during manufacture and degradation during shipping, losses of 7.0% and 9.0% potency can be expected after storage at 25 degrees C for four and six weeks, respectively. Succinylcholine Chloride Injection, USP, should be stored in the refrigerator; if unbuffered succinylcholine chloride injection complying with USP pH limits must be stored at room temperature, it should not be kept for longer than four weeks.
Asunto(s)
Succinilcolina , Estabilidad de Medicamentos , Almacenaje de Medicamentos , Concentración de Iones de Hidrógeno , Inyecciones , TemperaturaAsunto(s)
Aminoácidos/uso terapéutico , Recién Nacido de Bajo Peso , Recien Nacido Prematuro , Nutrición Parenteral Total , Nutrición Parenteral , Aminoácidos/administración & dosificación , Aminoácidos/sangre , Estatura , Peso Corporal , Ensayos Clínicos como Asunto , Electrólitos , Ingestión de Energía , Femenino , Glucosa/uso terapéutico , Humanos , Recién Nacido , Masculino , Soluciones para Nutrición Parenteral , Estudios Prospectivos , SolucionesRESUMEN
The clinician considering administration of steroids to prevent respiratory distress syndrome (RDS) should attempt to identify patients who do not have criteria previously shown to increase the likelihood of benefit in the prevention of RDS. It is possible to accurately predict the interval to delivery in most cases. Four hundred thirty-nine patients at risk to deliver prior to 37 weeks have been screened for factors known to decrease the likelihood of benefit. Only 47 (10.7%) screened candidates have no exclusion criteria. Twenty-seven (6.9%) of 392 excluded neonates developed RDS; 20 of the 27 were predicted to and did deliver in less than 24 hours after initial screening. Only one case was inappropriately excluded. Fetal surfactant assessment is crucial; pulmonary maturity excludes 19% at 28 to 33 weeks and 35% at 34 to 37 weeks. Careful screening for exclusion factors known to decrease the likelihood of steroid derived benefit is essential when use of a drug with potential long-term consequences (risk) is considered.
Asunto(s)
Corticoesteroides/uso terapéutico , Intercambio Materno-Fetal , Síndrome de Dificultad Respiratoria del Recién Nacido/prevención & control , Corticoesteroides/administración & dosificación , Amniocentesis , Líquido Amniótico/análisis , Femenino , Edad Gestacional , Hospitalización , Humanos , Recién Nacido , Pulmón/embriología , Fosfatidilcolinas/análisis , Placebos , Embarazo , Estudios Prospectivos , Riesgo , Esfingomielinas/análisis , Factores de TiempoAsunto(s)
Líquido Amniótico/análisis , Péptido C/sangre , Sangre Fetal/análisis , Insulina/análisis , Islotes Pancreáticos/fisiología , Péptidos/sangre , Embarazo en Diabéticas/fisiopatología , Peso al Nacer , Diabetes Mellitus Tipo 1/fisiopatología , Femenino , Feto/fisiología , Humanos , Recién Nacido , Islotes Pancreáticos/fisiopatología , EmbarazoAsunto(s)
Síndrome de Dificultad Respiratoria del Recién Nacido/diagnóstico por imagen , Diagnóstico Diferencial , Edad Gestacional , Humanos , Enfermedad de la Membrana Hialina/diagnóstico por imagen , Recién Nacido , Radiografía , Síndrome de Dificultad Respiratoria del Recién Nacido/etiología , RiesgoRESUMEN
Pheniramine is efficiently adsorbed by Norit Medicinal Activated Charcoal in vitro. Administration of activated charcoal after pheniramine ingestion in dogs resulted in significantly lower blood levels. Norit or another proven effective activated charcoal would be of value in first-aid treatment of pheniramine poisoning.