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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To assess the safety of inhaled beta-agonist bronchodilators during pregnancy, perinatal outcomes in 259 prospectively managed women with asthma using these medications during pregnancy were compared to perinatal outcomes in 101 concurrently followed pregnant subjects with asthma not using inhaled bronchodilators and to perinatal outcomes in 295 concurrently followed pregnant control subjects without asthma. No significant differences between women with asthma using inhaled bronchodilators and subjects not receiving inhaled bronchodilators were found in the following parameters: perinatal mortality, congenital malformations, preterm births, low birth weight infants, mean birth weight, small for gestational age or low ponderal index infants, Apgar scores, labor/delivery complications, or postpartum bleeding. Increased incidences of maternal chronic and pregnancy-induced hypertension and transient tachypnea of the neonate were observed in the pregnancies of subjects with asthma using regular inhaled bronchodilators compared to control subjects, but a logistic regression analysis within the sample of subjects with asthma did not significantly associate the use of inhaled bronchodilators with these outcomes. In the light of the known substantial perinatal risks of severe, uncontrolled asthma and the relatively sparse evidence of human gestational safety for alternative asthma medications, these data support the use of inhaled beta-agonist bronchodilators as part of the management of asthma during pregnancy.
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PMID:The safety of inhaled beta-agonist bronchodilators during pregnancy. 317 Oct 9

Isotretinoin (13-cis-retinoic acid) is an oral synthetic vitamin A derivative used for control of acne and a variety of other dermatologic conditions. The case of a 21 month old child who accidentally ingested an estimated 1120 mg (63.3 mg/kg) of isotretinoin is presented. The patient demonstrated only minor immediate effects, consisting of facial flushing, and mild tachycardia, tachypnea, and hypertension, all of which resolved over 24 hours. The patient had no subsequent adverse long-term effects from the ingestion. This is the first reported ingestion of isotretinoin in a child. Short term sequelae have not been reported; long-term administration of isotretinoin may cause multiple and potentially severe reactions.
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PMID:Isotretinoin ingestion in a pediatric patient. 322 29

A 65-year-old woman with a two-day history of progressive back pain presented with acute dyspnea, tachypnea, hypotension, and tachycardia. The patient was being treated for chronic obstructive lung disease and long-standing hypertension. She evidenced unilateral diminished breath sounds and wheezing. A portable chest radiograph in the emergency department revealed a large left pleural effusion. A hemothorax was confirmed by thoracentesis, and a 7-cm descending thoracic aortic aneurysm was demonstrated by angiography. The patient underwent successful surgical resection and Dacron graft repair of the aneurysm. This case emphasizes the need for maintaining a high index of suspicion for atypical presentations of ruptured thoracic aneurysms and for using diagnostic thoracentesis in pleural effusions of unknown etiology.
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PMID:Ruptured thoracic aneurysm presenting as dyspnea and hypotension. 338 74

Hypersensitivity reactions to heparin preparations with a wide spectrum of clinical manifestations have been reported frequently in the past, but are a rarity now. A 88 year old man was admitted for physical therapy of a collum femoris fracture. Treatment with a diuretic, Reserpine and Verapamil was continued. Chest x-ray revealed a large thoracic aortic aneurysm. From the 12th to the 18th day of low dose heparin prophylaxis with calcium heparin, 7500 U twice daily, at least eight attacks of asthma or cyanosis were observed, starting about two hours after heparin injection. The last attack began suddenly with wheezing, tachypnoea and cough and was associated with apprehension, a sudden blood pressure increase and severe cyanosis. Ventilation improved with oxygen and a beta 2-stimulator, but hypertension and cyanosis lasted for three hours. After discontinuation of heparin no further attacks occurred. Causes other then heparin could not be found. Despite the use of porcine mucosa heparin, avoidance of preservatives and use of low doses a hypersensitivity reaction occurred in our case. The delayed onset after preceding subcutaneous application as well as difficulties in separating the reaction from complications of underlying disease may delay heparin discontinuation.
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PMID:[Asthma attacks in low-dose preventive use of heparin in a male with femoral neck fracture and aortic aneurysm]. 366 60

A pulmonary depressor reflex has been shown to be elicited in anesthetized cats, dogs, and rats by intravenous injection of capsaicin. The effects observed include apnea, hypotension, and bradycardia with some investigators reporting tachypnea following the apneic period. We investigated the response to a bolus injection of capsaicin (20 micrograms/kg) into the cephalic vein in 11 conscious beagle dogs. Five control dogs underwent sham thoracotomies, and six dogs underwent selective denervation of the lungs. A low dead-space latex rubber mask was used to monitor ventilation, and arterial blood pressure was obtained by catheterizing an exteriorized carotid artery. In four of the five control dogs the observed response was apnea concomitant with hypotension and bradycardia, followed by tachypnea. In five of the six lung-denervated dogs there was a slight tachypnea along with hypertension. It is concluded that the pulmonary depressor reflex can be elicited in conscious dogs by intravenous injection of capsaicin but is absent in lung-denervated dogs.
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PMID:Pulmonary depressor reflex elicited by capsaicin in conscious intact and lung-denervated dogs. 381 75

Following the ingestion of an alleged aphrodisiac known as "yo-yo," a 16-year-old girl experienced an acute dissociative reaction accompanied by weakness, paresthesias, and incoordination. Subsequent symptoms included anxiety, headache, nausea, palpitations, and chest pain. Hypertension, tachycardia, tachypnea, diaphoresis, pallor, tremors, and an erythematous rash were noted on physical examination. Serum epinephrine and norepinephrine levels were found to be elevated. Symptoms resolved spontaneously but lasted approximately 36 hours. The ingested substance was identified as yohimbine. The pharmacology of yohimbine and the treatment of yohimbine poisoning are discussed.
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PMID:Yohimbine: a new street drug. 403 64

1. The effects of bradykinin (1-5 mug) injected into the cannulated lateral cerebral ventricles were studied in unanaesthetized rabbits before and after intravenous atropine, diphemanil and morphine.2. The intraventricular injections of bradykinin produced a short-lasting phase of behavioural excitation with vocalization followed by sedation. The behavioural excitation was associated with desynchronization in the electrocorticogram (e.co.g.), bradycardia and hypotension followed by tachycardia and hypertension. Tachypnoea was also observed. The subsequent phase of sedation was more prolonged and associated with synchronization of the e.co.g. and signs of catalepsy. Intense miosis was present during both phases.3. With repeated intraventricular injections of bradykinin, excitation, miosis, cardiovascular responses and tachypnoea diminished and eventually disappeared but the sedation did not exhibit tachyphylaxis.4. Atropine abolished the e.co.g. desynchronization, vocalization and bradycardia, reduced the duration of the excitatory and sedatory phase, diminished the tachycardia and hypotension, enhanced the hypertension, but did not affect the miosis and tachypnoea.5. Diphemanil affected only the cardiovascular effects produced by intraventricular bradykinin. They were affected in the same way as by atropine.6. Morphine did not affect the excitatory phase, but enhanced the cardiovascular effects produced by intraventricular bradykinin.7. The intraventricular injection of bradykinin (50 mug) caused a reduction in the amount of noradrenaline but not of 5-hydroxytryptamine (5-HT) in the brain stem; the amount of dopamine in the caudate nuclei was not affected.8. It is suggested that central cholinergic and adrenergic systems are activated by intraventricular bradykinin.
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PMID:Behavioural and somatic effects of bradykinin injected into the cerebral ventricles of unanaesthetized rabbits. 538 83

Earlier behavioral results led to the suggestion that GABA exerts a tonic inhibitory influence in the dorsal periaqueductal gray (DPAG) matter of the rat integrating defensive behavior. In the present experiments, the role of GABAergic mechanisms in the modulation of the autonomic component of the defense reaction was studied. Thus, the effects of intravenous (IV) injections of chlordiazepoxide as well as of intracerebral (IC) injections of midazolam in the dorsal midbrain, on the blood pressure (BP), heart rate (HR) and respiratory increases induced by electrical stimulation of the DPAG were measured in rats anesthetized with urethane. Chlordiazepoxide (10 mg/kg, IV) as well as midazolam (40 and 160 nmol, IC) attenuated the centrally-induced hypertension, without affecting basal BP. The tachycardia induced by aversive brain stimulation was similarly decreased by the benzodiazepines. In addition, the HR baseline was significantly raised by chlordiazepoxide and by the highest dose of midazolam. The tachypnea induced by brain electrical stimulation was also reduced by both benzodiazepines. Basal respiratory rate was slightly, but significantly decreased by chlordiazepoxide as well as by the two doses of midazolam used and to a lesser extent by the vehicle alone. Chlordiazepoxide attenuated the increase in respiratory depth caused by brain stimulation, while basal respiratory amplitude was not affected. The effects of midazolam on this parameter were unclear. Microinjection of bicuculline (5 and 10 nmol) or picrotoxin (0.3 and 1 nmol) into the DPAG increased the BP, HR and respiration, like the electrical stimulation. The latency and duration of bucuculline effects were shorter than those of picrotoxin.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:GABA modulation of the defense reaction induced by brain electrical stimulation. 631 41

A 48-year-old woman with a known history of hypothyroidism was admitted to the intensive care unit with a diagnosis of thyroid storm secondary to acute thyroid hormone poisoning and the possible hyperfunction of a singular thyroid nodule. Her clinical manifestations included pyrexia, tachycardia, tachypnea, hypertension, RUQ abdominal pain, psychotic behavior, and pharyngitis. She was successfully treated with sodium iodide, PTU, propranolol, antibiotics, and a hypothermia mattress, with her serum T4 level returning to normal range prior to discharge. The patient was discharged 9 days after admission in good medical health with no medication. This article clearly shows that the functions of the endocrine system remain a frontier in today's medicine. With research, perhaps one day we might fully understand the intricate pathophysiology that results in thyroid storm. The potential problem format has been utilized in the development of the nursing care plan to assist the nurse with identifying and defining her patient's problems, as well as directing her assessment and nursing intervention. As more is learned about thyroid storm, nurses should update their knowledge so that they will be prepared to care for the patient with these difficult nursing problems.
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PMID:Thyroid storm--a nursing crisis. 655 51

We examined the influence of whole and lower body hypoxia and lower body ischemia on breathing in White Pekin ducks, Anas platyrhynchos, excluding pathways involving the carotid bodies. Carotid body denervated birds breathing 10 or 5% O2 developed a tachypnea after a latency of 30-100 s. The tachypnea was more pronounced with the more severe hypoxia, resulting in almost a doubling of minute ventilation (VE). Occlusion of the abdominal aorta in unanesthetized ducks produced immediate development of hypertension. Ventilation was unaffected for the 1st min; a tachypnea then developed rapidly and persisted for the duration of the occlusion resulting in a 25% increase in VE. After thoracic spinal section, all ventilatory responses to occlusion were eliminated. Experimental perfusion of the brain and single intact carotid body in unanesthetized ducks with hyperoxic blood during low O2 breathing (6-9% O2) resulted in tachypnea, also after a considerable latency. These results suggest that severe hypoxia can affect breathing in birds via pathways other than those involving the carotid bodies.
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PMID:Influence of ischemia and hypoxia on breathing in ducks. 661 32


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