RESUMO
We examined for myocardial ischemia induced by continuous inhalation of fenoterol in children with severe acute asthma. Thirty children with severe acute asthma were evaluated for signs of myocardial ischemia when treated with 0.5 mg kg dose (maximum 15 mg) of inhaled fenoterol for one hour. The heart rate was measured before and after inhalation. Cardiac enzymes (creatine kinase, creatine kinase MB fraction and troponin levels) were measured at admission and 12 hours later. An EKG was recorded before inhalation was started and immediately after its completion to detect the presence of any evidence of myocardial ischemia. All patients developed significant increase in heart rate. Six patients showed EKG changes compatible with myocardial ischemia, despite normal enzyme levels. Patients with severe acute asthma show tachycardia and may show EKG changes of myocardial ischemia.
Assuntos
Asma/tratamento farmacológico , Broncodilatadores/efeitos adversos , Fenoterol/efeitos adversos , Isquemia Miocárdica/induzido quimicamente , Administração por Inalação , Broncodilatadores/administração & dosagem , Criança , Pré-Escolar , Feminino , Fenoterol/administração & dosagem , Humanos , Masculino , Estatísticas não ParamétricasRESUMO
OBJECTIVE: To report four cases of myositis ossificans progressiva, its form of presentation, in addition to new control and treatment options. DESCRIPTION: The authors describe four cases of myositis ossificans progressiva, presenting its clinical manifestations, evolution, and available forms of control and treatment. The main congenital anomalies associated with myosistis ossificans progressiva are described, namely: hallux valgus, clinodactyly, short thumbs, exostosis, and syndactyly. The evolution and therapeutic responses of clinical improvement to oral ascorbic acid and biphosphonate in patients 1 and 4 are also described; patient 1 had a better response after receiving intravenous biphosphonate, while patients 2 and 3 showed clinical improvement after the administration of oral ascorbic acid. COMMENTS: Ascorbic acid relieves the pain and improves psychism in patients with myositis ossificans progressiva. Intravenous biphosphonate is an alternative to patients with significant worsening of the disease, especially those with ambulatory restrictions. The orientation towards avoiding recurrent trauma in myositis ossificans progressiva patients is important.
RESUMO
This study examined the response of 10 newborns admitted to the Neonatal Intensive Care Unit of Hospital Universitário, UFMS, Campo Grande, MS, Brazil, submitted to mechanical ventilation under the following ventilator parameters: FiO2 = 100%, PIP (24 mmHg, rate > 30 mpm. All had severe hypoxia and were treated with a solution of sodium nitroprusside (SNP) administered through a special adapter for continuous endotracheal inhalation. Significant increases in PaO2, SaO2 and in PaO2/FiO2 ratio were observed at 1 h and at 6-8 h of treatment, whereas blood pressure did not change significantly while treatment was being delivered. No side effects such as methemoglobinemia or cyanogen accumulation were observed. Although appropriate studies using animal models have still to be conducted, present results suggest that endotracheal inhalation of SNP could constitute a valid form of treatment for newborns with persistent pulmonary hypertension or severe hypoxia of difficult management.