RESUMEN
Traumatic brain injury (TBI) is associated with a variety of cognitive and behavioural disorders. A few reports have suggested that pharmacotherapy might be useful in the management of these disorders. We present a case of a patient who suffered a left subdural hematoma and herniated. Several months after the injury, his function was severely limited. Nevertheless, he demonstrated a clear improvement in response to oral methylphenidate and parenteral physostigmine. We conclude that specific pharmacotherapy may result in major cognitive and functional improvements in severely impaired patients.
Asunto(s)
Lesiones Encefálicas/complicaciones , Trastornos del Conocimiento/tratamiento farmacológico , Metilfenidato/uso terapéutico , Fosfatidilcolinas/uso terapéutico , Fisostigmina/uso terapéutico , Adulto , Trastornos del Conocimiento/etiología , Quimioterapia Combinada , Humanos , MasculinoRESUMEN
The performance of a nurse practitioner, under the supervision of an internist, in managing inpatients in a rehabilitation hospital was assessed by comparison with three similar groups managed by internists. Criteria were chosen to reflect both quality of care and cost-effectiveness. The medical records of 25 patients discharged consecutively on each service were examined to determine length of stay, laboratory and x-ray costs per day, number of consultations, and mean score on six index conditions. The index conditions score was designed to reflect proper recognition and management of the following common medical problems: urinary tract infection, congestive heart failure, anemia, diabetes, hypertension, and hypokalemia. No statistically significant differences were found between the patient groups managed by the supervised nurse practitioner and the independent internists.
Asunto(s)
Trastornos Cerebrovasculares/rehabilitación , Enfermeras Practicantes , Adulto , Anciano , Análisis Costo-Beneficio , Femenino , Humanos , Medicina Interna , Tiempo de Internación , Masculino , Persona de Mediana Edad , Enfermeras Practicantes/economía , Enfermeras Practicantes/normas , Calidad de la Atención de Salud , Derivación y ConsultaRESUMEN
Two boys are presented who fulfilled criteria for a diagnosis of idiopathic pulmonary hemosiderosis. A lung biopsy specimen from the first patient showed alveolar-capillary basement membrane abnormalities, together with abnormalities of capillary endothelial cells and hemosiderin-laden macrophages. A lung biopsy specimen from the second patient showed mainly capillary endothelial abnnormalities and interestitial fibrosis. Both patients had a noticeable improvement in symptoms and relative stabilization of their roentgenographic and pulmonary function abnormalities following azathioprine therapy.
Asunto(s)
Azatioprina/uso terapéutico , Hemosiderosis/patología , Pulmón/ultraestructura , Anemia Hipocrómica/patología , Azatioprina/administración & dosificación , Niño , Relación Dosis-Respuesta a Droga , Hemosiderosis/diagnóstico por imagen , Hemosiderosis/tratamiento farmacológico , Humanos , Mediciones del Volumen Pulmonar , Macrófagos/ultraestructura , Masculino , Alveolos Pulmonares/ultraestructura , RadiografíaAsunto(s)
Coagulación Intravascular Diseminada/sangre , Hiperlipidemias/sangre , Hiperlipidemias/genética , Lipoproteínas LDL/sangre , Lipoproteínas VLDL/sangre , Antitrombinas/análisis , Coagulación Sanguínea , Colesterol/sangre , Cromatografía en Agarosa , Cromatografía en Gel , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Fibrinógeno/análisis , Fibrinógeno/metabolismo , Humanos , Masculino , Peso Molecular , Triglicéridos/sangre , UltracentrifugaciónRESUMEN
The effect of ipratropium bromide administered at two dosage levels, 40 and 80 mug, isoproterenol, 150 mug, and placebo using a metered dose inhaler was evaluated in ten adult patients with asthma in a double-blind, crossover study. The new atropine-like drug proved to be as effective a bronchodilator as isoproterenol in this study, although it had a later peak effect. Ipratropium bromide had a longer course of action than isoproterenol (4 hours compared to 1-2 hours) and was free of significant side effects. The larger dose of the new drug produced a slightly greater and longer-acting effect than the smaller dose. Ipratropium bromide seems to have had bronchodilator effects on both large and small airways.
Asunto(s)
Asma/tratamiento farmacológico , Derivados de Atropina , Ipratropio/uso terapéutico , Isoproterenol/uso terapéutico , Adulto , Resistencia de las Vías Respiratorias , Asma/fisiopatología , Ensayos Clínicos como Asunto , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Curvas de Flujo-Volumen Espiratorio Máximo , Flujo Espiratorio Medio Máximo , Persona de Mediana Edad , Factores de TiempoRESUMEN
Native bovine factor V exhibits a molecular weight of 300000 as determined by gel filtration of untreated plasma. Highly purified factor V exhibits multiple molecular weight forms which range from small active fragments to aggregates of several million which are generated during the purification on cellulose phosphate. Isoelectric focusing on a single high-molecular-weight species produced a single protein and activity peak at pH 4.65. Factor V activity is associated with each protein band observed following polyacrylamide gel electrophoresis. Antisera to factor V prepared in rabbits produces a time-dependent and concentration-dependent inhibition of factor V activity in plasma and purified factor V. The multiple molecular weight forms of factor V appear equivalent upon immunodiffusion and on immunoelectrophoresis migrate as an alpha globulin between albumin and fibrinogen. Immunoprecipitation arcs are equivalent in plasma and serum. Factor V consists of two major types of subunits, a light chain (73000), aggregates of which form the high-molecular-weight species, and a heavy chain (125 000). Using preparations containing one or both chains isolated by disc gel electrophoresis, antiserum was shown to contain two families of antibodies, one against each subunit. Cross reactivity with both light and heavy chain antigens is observed in sheep and goat but not monkey or human plasma. The antisera also neutralized goat and sheep factor V activity.