RESUMO
Dos nuevos beta agonistas de efecto prolongado son actualmente usados clínicamente: salmeterol y formoterol. El primero no ha demostado efectividad en los casos de asma aguda mientras que el segundo, formoterol, comparable en su período de latencia al albuterol, no ha sido empleado en el manejo de las crisis de asma. En este estudio utilizamos mediciones de flujo espiratorio pico antes y después de la administración de 12 microgramos de fumarato de formoterol (ForadilR) en polvo seco vía nebulización, inmediatamente después de su dilución en solución salina estéril, a treinta pacientes con crisis de asma y grados variables de obstrucción bronquial. Los resultados muestran mejoría significativa a los 5 y 30 minutos después de su administración, sugiriendo estabilidad de este producto así como un novedoso enfoque costo efectivo por su menor dosificación y posible impacto sobre la frecuencia de readmisiones debido a una broncodilatación prolongada
Assuntos
Humanos , Masculino , Feminino , Antiasmáticos/antagonistas & inibidores , Antiasmáticos/farmacologia , Asma , Broncodilatadores , Nebulizadores e Vaporizadores , Medicina , VenezuelaRESUMO
Epidemiological data for drug reactions in pediatric medical literature as well as in specialized periodicals are scarce. A relationship between nonsteroidal antiinflammatory drugs (NSAIDs), facial angioedema and atopic status has been described in adults. A 10-year retrospective random review of 1,007 charts of atopic children (60.9% male) attending an allergy clinic for management of asthma and/or rhinitis was carried out. Careful attention was given to the written history of NSAID facial angioedema reactions (41 out of 1007, 4.07%) and atopy was confirmed if the patient had a family history and at least one positive skin prick test (>3 mm wheal compared to glycerosaline control) to aeroallergens. Telephone recall was performed when available. Patients were classified into four age groups as follows: a) 0-5 years old; b) 6-10 years old; c) 11-15 years old; and d) 16-21 years old. NSAID facial angioedema rates were as follows: group a 10/493 (2.0%), group b 14/361 (3.8%), group c 10/121 (8.2%), and group d 7/32 (21.8%). Aspirin was the most commonly reported NSAID, and less common were pyrazolones and ibuprofen. Of the 41 patient with chart-reported reactions, 27 (66%) could be contacted by telephone. Of these, 17 patients confirmed the facial angioedema NSAID reaction occurring once or more due to inadvertent exposure. No reactions were reported in the remaining 10 patients since no other NSAID, except acetaminophen, had been used for fever or pain. In conclusion, our data show the age dependency of these reactions and its rather frequent occurrence in such selected pediatric atopic populations. Since NSAIDs are used more frequently in younger children, exposure would not be a plausible explanation for these observations.
Assuntos
Angioedema/induzido quimicamente , Anti-Inflamatórios não Esteroides/efeitos adversos , Adolescente , Adulto , Criança , Pré-Escolar , Face , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos RetrospectivosRESUMO
Increasing attention has recently been paid to a group of patients who experience anaphylaxis after ingestion of foods prepared with mite-contaminated wheat flour. We present three cases of this syndrome, which occurs more often in young adults with allergic rhinitis and/or asthma. We have observed an increased frequency of sensitivity to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), manifested as urticaria or angioedema, in patients with this condition.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Aspirina/efeitos adversos , Hipersensibilidade a Drogas/etiologia , Contaminação de Alimentos , Hipersensibilidade/etiologia , Ácaros , Rinite/etiologia , Adolescente , Adulto , Animais , Anti-Inflamatórios não Esteroides/uso terapêutico , Aspirina/uso terapêutico , Hipersensibilidade a Drogas/diagnóstico , Feminino , Farinha , Humanos , Hipersensibilidade/tratamento farmacológico , Hipersensibilidade/fisiopatologia , Masculino , Pessoa de Meia-Idade , Rinite/tratamento farmacológico , Rinite/fisiopatologiaRESUMO
Dos métodos de profilaxia antimicrobiana en cirugía biliar abierta fueron evaluados y comparados en un estudio prospectivo aleatorio, utilizando dosis única de Cefuroxima sodical (1.5 gr.IV). A 20 pacientes que fueronsometidos a colecistectomía electiva se les administró cefuroxima sodica estéril inmediatamente después de la inducción de la anestesia (Grupo 1), mientras que al otro grupo de 20 pacientes solamente se les administró el antibiótico si la tinción de gram de bilis tomada al comienzo de la cirugía revelaba bacterias (Grupo 2). Las variables introducidas en el estudio fueron controlables, lo que hizoque los dos grupos de pacientes fueran semejantes. Un 20/100 de los pacientes del Grupo 2 desarrollaron infección de la herida operatoria, en comparación a los pacientes del grupo 1 donde no hubo infecciones (p=0.03). El gram de bilis transoperatorio es poco sensible pues sólo detectó a un 33.33/100 de las pacientes con bactebilia, sin embargo su especificidad es del 100/100. Pensamos que la profilaxia antimicrobiana rutinaria en colecistectomía abierta electiva está indicada
Assuntos
Humanos , Masculino , Feminino , Antibacterianos/uso terapêutico , Colecistectomia , Infecção da Ferida Cirúrgica/tratamento farmacológicoRESUMO
PIP: A prospective clinical study was conducted between January 1991 and June 1992 of 92 HIV seropositive patients attending the Adult Outpatient Clinic of the San Juan de Dios General Hospital in Guatemala City. 52 of the patients met the US Centers for Disease Control clinical criteria for AIDS. Limitations in the diagnostic and laboratory facilities of the hospital hampered identification of some opportunistic infections. 74 of the 92 patients were male. 3 of the 18 infected women gave birth during the study period; the status of their children is not yet known. 87% of the cases were in adults aged 18-40. 25 of the patients died during the 18-month study period and 9 were lost to follow-up. 57 of the 92 had lived in the US or Mexico. 43 of the 74 men reported homosexual relations. 6 reported use of intravenous drugs. 3 had received blood transfusions as the only known risk factor. 56 had histories of sexually transmitted diseases. 3 patients reported always using condoms, 57 never did so, and the rest did so occasionally. 52 of the patients had opportunistic infections. 18 had proven and 5 had presumptive extrapulmonary mycobacteria, probably tuberculosis. 2 had salmonella in the blood. 4 had presumptive cytomegalovirus, 6 had chronic mucocutaneous herpes, and 3 had presumptive HIV encephalopathy. 12 had esophageal candidiasis, 6 had extrapulmonary cryptococcosis, and 14 had pneumocystis carinii pneumonia. 13 had proven intestinal cryptosporidiosis, and 1 each had presumptive cerebral toxoplasmosis and extraintestinal strongyloidiasis. 3 had proven Kaposi's sarcoma and 1 had proven immunoblastic lymphoma. 10 had HIV-related weight loss.^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida , Infecções por HIV , Hospitais , Infecções , Estudos Prospectivos , América , América Central , Atenção à Saúde , Países em Desenvolvimento , Doença , Guatemala , Saúde , Instalações de Saúde , América Latina , América do Norte , Pesquisa , VirosesRESUMO
Concentrations in Gulf of Mexico slope sediment of material soluble in methanol and benzene as high as 4.5 percent are shown to be attributable to biodegraded petroleum. Associated carbonate deposits and organic sulfur are the products of the microbial oxidation of petroleum and sulfate reduction. The results of chemical and carbon isotope analyses indicate that high concentrations of hydrocarbon gases, from methane to pentane, are petroleum rather than microbiologically derived. These hydrocarbons, believed to have been produced thermally at depth, probably reached the surface through faults and fractures associated with salt diapirs.
RESUMO
A bluff on the eastern coast of Mexico reveals a cross section through an ancient beach deposit now lying 4 meters above sea level. Radio-carbon dates on the shells within the deposit reveal an age of 1940 years. The deposit appears to be valid evidence for submergence greater than that of the present, but whether that submergence was due to a higher eustatic stand of the sea or whether there has been an uplift of the land since that time cannot yet be determined.