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101.
A D Timmis G Bergman L Walker M J Monaghan D E Jewitt 《International journal of cardiology》1984,5(3):327-338
This study was designed to investigate and compare the haemodynamic and metabolic responses to pirbuterol and salbutamol in patients with congestive heart failure and coronary artery disease. Attention was directed towards the effects these beta 2-adrenoceptor agonists have on left ventricular systolic function, systemic and coronary haemodynamics and myocardial substrate metabolism. Sixteen patients were randomly allocated to treatment with either pirbuterol 20 mg or salbutamol 6 mg. Since no statistically significant differences between the responses to these drugs were observed, combined data for both agents are presented. Ninety minutes after the drug intervention cardiac index increased from 2.2 +/- 0.1 to 2.9 +/- 0.2 1/min per m2 (P less than 0.001) in association with marked reductions in systemic vascular resistance (from 22 +/- 1 to 15 +/- 1 units, P less than 0.001) and increments in left ventricular dp/dtmax (from 1074 +/- 85 to 1422 +/- 133 mm Hg/sec, P less than 0.05). Modest reductions in left ventricular end-diastolic pressure (from 21 +/- 1 to 15 +/- 1 mm Hg, P less than 0.01) were observed. Heart rate increased from 82 +/- 5 to 91 +/- 4 beats/min (P less than 0.01) but the small fall in mean arterial pressure (from 86 +/- 3 to 78 +/- 3 mm Hg) was not significant. Drug-induced coronary vasodilatation reduced coronary coronary vascular resistance from 0.65 +/- 0.06 to 0.47 +/- 0.04 units (P less than 0.01) and led to a marked increase in coronary sinus blood flow (from 124 +/- 9 to 155 +/- 9 ml/min, P less than 0.05). Arterial levels of free fatty acids increased from 0.78 +/- 0.13 to 1.05 +/- 0.18 mmol/l (P less than 0.05) resulting in the preferential utilization of this substrate as a myocardial energy source. Despite the substantial haemodynamic improvement, however, no significant increase in myocardial oxygen uptake or lactate production was observed. Thus, in patients with coronary artery disease and congestive heart failure pirbuterol and salbutamol improve left ventricular function by a combination of afterload reduction and positive inotropism such that no appreciable deterioration in myocardial energetics occurs. 相似文献
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Maria Cristina Gonzalez Renata M. Bielemann Paula P. Kruschardt Silvana P. Orlandi 《Clinical nutrition (Edinburgh, Scotland)》2019,38(6):2846-2850
AimsTo compare the prognostic power of nutritional screening (NUTRIC score) and Subjective Global Assessment (SGA), executed alone or their complementarity, for predicting 28-day mortality risk in ICU patients. We also aimed to identify the cut-off point obtained in the NUTRIC that presented the best validity parameters for predicting mortality in this population.MethodsA sample of 159 patients was evaluated in the first 24 hours of ICU admission. Modified NUTRIC score was performed (without interleucina-6). ROC curve and Youden criterion were used to identify the best cut-off point. Poisson regression and the number needed to screen (NNS) were used to test the complementarity between the tools and their ability to predict 28-day mortality.ResultsA sample of 159 patients was evaluated (51% male, 56.6 ± 20 years) and the APACHE II, SOFA and NUTRIC score medians were 22 (IQR:15;26), 6 (IQR:2;9) and 3 (IQR: 2;5), respectively. Almost 60% of the patients were malnourished (SGA B or C) and 32.7% died during 28-day follow-up. The area under ROC curve for NUTRIC score was 0.79. Using a new cutoff (NUTRIC score ≥ 4), patients with nutritional risk have a 28-day mortality risk almost 6 times higher than subjects without nutritional risk. Patients classified as SGA C showed a 28-day mortality risk 2.19 times higher compared to nourished ones. Evaluating the complementarity of the tools, patients classified as nutritional risk (NUTRIC score ≥ 4) and SGA C showed a 28-day mortality risk 7 times higher and a lower NNS when compared to those patients with a NUTRIC < 4 and any SGA category.ConclusionsA new cutoff value was identified for this population. Simultaneous SGA assessment in patients with nutritional risk may enhance the predictive power of 28-day mortality, providing better identification of higher risk patients who may benefit from a more aggressive nutritional therapy. 相似文献
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目的了解缓和性血清阴性对称性滑膜炎伴凹陷性水肿综合征的临床和实验室特点。方法回顾性分析7例RS3PE综合征患者的临床资料。结果 7例患者中男5例,女2例,年龄45-69岁,平均61岁。均表现为突发双手、足背凹陷性水肿及多关节炎。血沉平均85mm/h,C反应蛋白平均65.9mg/L。3例患者手足关节X线表现为骨质疏松、关节间隙变窄。小剂量醋酸泼尼松和慢作用抗风湿药物治疗后临床症状缓解,1例3个月后合并过敏性紫癜。结论 RS3PE综合征是异质性临床症候群,小剂量醋酸泼尼松和慢作用抗风湿药物治疗有效,但该病与风湿性、肿瘤性、感染性疾病密切相关,积极治疗合并症可减少复发。 相似文献
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Summary The RS3PE syndrome (Remitting Seronegative Symmetrical Synovitis with Pitting Edema) is a manifestation of rheumatoid arthritis in
the elderly with a good prognosis. It usually presents as an acute, symmetric polysynovitis with edema of the dorsum of the
hands and feet. Anti-inflammatory treatment with corticosteroids leads to prompt improvement. We describe the case of an 81
year old man with a primarily unilateral manifestation involving the right hand. A thrombosis of the axillary vein was suspected.
Within a few days he developed a pitting edema of the dorsum of the other hand. Movement of both shoulders and wrists was
painful. Low-dose corticosteroid therapy resulted in a rapid improvement of the edema and the inflammatory symptoms.
Eingegangen: 3. August 1998 Akzeptiert: 9. Oktober 1998 相似文献
109.
Mathis C Ungerer A 《Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale》1999,129(1):147-155
The effects of immediate post-training administration of drugs interacting with group I and/or group II glutamate metabotropic
receptors (mGluRs) were determined on the retention performance of a partially acquired lever-press learning task in mice.
The antagonist (RS)-α-methyl-4-carboxyphenylglycine (MCPG) dose-dependently (0.1–100 nmol/mouse, i.c.v.) impairs the retention performance evaluated
24 h post-training. The retention deficit induced by 100 nmol MCPG is related to the selective suppression of a time-dependent
spontaneous improvement of performance between the two sessions. This phenomenon appears progressively within 24 h post-training
in control mice and is thought to reflect post-training processing of memory traces. The coadministration of either (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid (ACPD), the group I mGluR agonist (R,S)3,5-dihydroxyphenylglycine (DHPG), or the group II mGluR agonist LY354740, completely blocked MCPG-induced deficits at a
dose of 0.1 nmol for each agonist. These results suggest that selective activation of either group I or group II mGluRs is
able to prevent the memory retention deficits induced by MCPG.
Received: 27 January 1999 / Accepted: 27 May 1999 相似文献
110.