RESUMEN
The Greenfield filter has become the most popular device for interruption of the inferior vena cava; however, a potential for lethal complications exists. We report two cases in which this filter was accidentally released in the heart. To avoid this problem, it is recommended that the guide wire be positioned in the inferior vena cava before the introducer is inserted into the venous system.
Asunto(s)
Filtración/instrumentación , Cuerpos Extraños , Corazón , Vena Cava Inferior , Femenino , Humanos , Complicaciones Intraoperatorias , Masculino , Persona de Mediana Edad , Embolia Pulmonar/prevención & controlAsunto(s)
Apendicitis/cirugía , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Recién Nacido , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
1. A randomized, placebo controlled, double-blind cross-over study was conducted to evaluate the clinical efficacy of the anticholinergic agent, benztropine mesylate (CogentinR) in 29 patients with mild to moderate, idiopathic Parkinson disease. 2. Patients were maintained on a stable, therapeutically optimal dosage and schedule of levadopa-carbidopa (Sinemet) throughout the study. 3. Both the neurologist's and the patient's global assessments of treatment efficacy indicated that Sinemet plus benztropine mesylate resulted in significantly greater improvement than Sinemet plus placebo. 4. Qualitative and quantitative evaluations of relevant neurologic functions showed small, but statistically significant improvements for rigidity, finger tapping speed and activities of daily living in patients during the Sinemet plus benztropine mesylate treatment period. 5. At the completion of the study 16 patients chose to continue taking benztropine mesylate as an adjuvant to Sinemet. 6. No important adverse side effects occurred during the study.
Asunto(s)
Antiparkinsonianos/uso terapéutico , Benzotropina/uso terapéutico , Carbidopa/uso terapéutico , Levodopa/uso terapéutico , Enfermedad de Parkinson/tratamiento farmacológico , Tropanos/uso terapéutico , Anciano , Benzotropina/análogos & derivados , Método Doble Ciego , Combinación de Medicamentos/uso terapéutico , Quimioterapia Combinada , Humanos , Persona de Mediana EdadRESUMEN
A randomized, double-blind clinical trial was designed to compare two ratios of carbidopa to levodopa (10 mg of carbidopa to 100 mg of levodopa [Sinemet 10/100] and 20 mg of carbidopa to 100 mg of levodopa [Sinemet 20/100]) with levodopa (100 mg) alone. Twenty-nine male patients (46 to 78 years of age) with clinically definite idiopathic Parkinson's disease of mild to moderate severity were selected and hospitalized for the three-week period of the study. Medications being taken at time of entry were phased out during week 1. Fixed daily increments of medications were given during week 2, and adjusted during week 3 to achieve best clinical response with fewest side effects. Qualitative and quantitative examinations of neurologic function showed that upper extremity measurements of resting tremor, rigidity, and finger-tapping speed, and lower extremity measurements of foot coordination and tandem gait (both types of speed tests) showed significantly more improvement in patients receiving the 20:100 combination than in those receiving the 10:100 combination or levodopa alone. Adverse effects were similar and minimal in each of the three groups. Results indicate that increasing the amount of carbidopa from 10 to 20 mg per 100-mg dose of levodopa gives a greater therapeutic response in Parkinson's disease than does a 10:100 carbidopa-levodopa ratio or levodopa alone.