Oral beta2-agonist use by preschool children with asthma in East and Central Harlem, New York.

Although studies have documented underuse of controller medications and overuse of short-acting inhaled ss(2)-agonist among children with persistent asthma in disadvantaged communities, the persistence of oral ss(2)-agonist use in pediatric practice has not been studied since inhaled short-acting ss(2)-agonists became widespread. We describe medications used to treat asthma among children 3 to 5 years of age at 10 Head Start and other subsidized preschool centers in East and Central Harlem, New York City. We interviewed 149 parents/guardians of children who were identified as having probable asthma based on physician's diagnosis, persistent symptoms, hospitalization, and medication use. We classified 86 of the 149 children (58%) as having current persistent asthma. Only 15 of them (17%) were reported to have used controller medications at least 5 days/week in the last 4 weeks-only 2 of whom used inhaled corticosteroids. By contrast, 53 children (62%) used oral ss(2)-agonist in the last 4 weeks, often (72%) in conjunction with nebulized or inhaled short-acting ss(2)-agonist. Use of oral ss(2)-agonist was associated with more severe symptoms. This study documents the continued widespread use of oral ss(2)-agonist for treatment of children in a low-income community with high prevalence of asthma.     

多巴胺或多巴胺复合去甲肾上腺素对肝移植术中患者血液动力学、氧代谢及肾功能的影响

目的评价原位肝脏移植术(OLT)中持续输注多巴胺或多巴胺复合去甲肾上腺素对血液动力学、组织氧代谢和肾功能的影响。方法拟行OLT的患者30例,ASAⅢ或Ⅳ级,随机分为2组 (n=15)。A组:术中持续输注多巴胺,初始输注速率为1-3μg·kg-1·min-1;B组:术中持续输注多巴胺复合去甲肾上腺素,初始输注速率分别为1-3μg·kg-1·min-1和0．03μg·kg-1·min-1,多巴胺输注速率不超过5μg·kg-1·min-1;术中两组均调节输注速率维持MAP 60-80 mm Hg。分别于切皮前即刻、切肝期1 h、无肝期1 h、新肝期1h和术毕测定血液动力学、组织代谢和肾功能指标。结果两组HR、 MAP均维持较平稳。无肝期两组CVP、MPAP、PAWP、CO、CI、DO2、VO2降低(P<0．05);SVR和SVRI升高(P<0．05),但均在正常范围内。术中PVR、PVRI、pH及SvO2均较平稳。乳酸浓度增高并持续到术毕。两组术中Cr和BUN均在正常范围,B组总尿量高于A组(P相似文献   

A case of acute heart failure associated with Guillain-Barré syndrome

Abstract Guillain-Barré syndrome (GBS) is a disease of the peripheral nervous system, which is caused by aberrant immune responses directed against some components of peripheral nerves. GBS is rarely accompanied by cardiovascular involvement. We describe a case of acute neuropathy complicated by sudden heart failure and left ventricular dysfunction which had a presumably neurogenic origin. Pathogenesis of acute heart failure is probably due to transitorial stunned myocardium and neurogenic cardiac injury. We show a rare case of transitorial and acute cardiac dysfunction by echocardiography and laboratory markers of heart failure.     

A Seminoma in a Monorchid Guinea Fowl (Numida meleagris)

A case of seminoma in a monorchid adult guinea fowl (Numida meleagris) is described. Grossly, a right enlarged testis, which was soft in consistency, and white to pale in colour with few spots of haemorrhages was observed. Histologically, the testicle revealed diffusely spread sheets of tumour cells. The cells were large pleomorphic with eccentrically placed hyperchromic nuclei. Mitotic figures were evident. A scanty fibrous stroma, containing lymphocytes and histiocytes, separating the groups of tumour cells, along with few areas of haemorrhages were observed. Occurrence of seminoma in guinea fowl is unusual and hence reported.