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1.
Mol Cell Biol ; 11(4): 1901-11, 1991 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-1706473

RESUMO

The control of expression of the Drosophila melanogaster tropomyosin I (TmI) gene has been investigated by P-element transformation and rescue of the flightless and jumpless TmI mutant strain, Ifm(3)3. To localize cis-acting DNA sequences that control TmI gene expression, Ifm(3)3 flies were transformed with P-element plasmids containing various deletions and rearrangements of the TmI gene. The effects of these mutations on TmI gene expression were studied by analyzing both the extent of rescue of the Ifm(3)3 mutant phenotypes and determining TmI RNA levels in the transformed flies by primer extension analysis. The results of our analysis indicate that a region located within intron 1 of the gene is necessary and sufficient for directing muscle-specific TmI expression in the adult fly. This intron region has characteristics of a muscle regulatory enhancer element that can function in conjunction with the heterologous nonmuscle hsp70 promoter to promote rescue of the mutant phenotypes and to direct expression of an hsp70-Escherichia coli lacZ reporter gene in adult muscle. The enhancer can be subdivided further into two domains of activity based on primer extension analysis of TmI mRNA levels and on the rescue of mutant phenotypes. One of the intron domains is required for expression in the indirect flight muscle of the adult. The function of the second domain is unknown, but it could regulate the level of expression or be required for expression in other muscle.


Assuntos
Drosophila melanogaster/genética , Elementos Facilitadores Genéticos , Íntrons , Músculos/metabolismo , Tropomiosina/genética , Animais , Elementos de DNA Transponíveis , Drosophila melanogaster/fisiologia , Regulação da Expressão Gênica , Mutação , Fenótipo , RNA/análise , RNA/genética , Mapeamento por Restrição , Transformação Genética
2.
Mol Cell Biol ; 11(12): 6337-42, 1991 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-1719381

RESUMO

The effects of promoter deletions on Drosophila tropomyosin I (TmI) gene expression have been determined by measuring TmI RNA levels in transformed flies. Decreases in RNA levels have been correlated with rescue of flightless and jumpless mutant phenotypes in Ifm(3)3 mutant transformed flies and changes in muscle ultrastructure. The results of this analysis have allowed us to identify a region responsible for 20% of maximal TmI expression, estimate threshold levels of TmI RNA required for indirect flight and jump muscle function, and obtain evidence suggesting that sarcomere length may be an important determinant of flight muscle function.


Assuntos
Músculos/fisiologia , Regiões Promotoras Genéticas , Tropomiosina/genética , Animais , Drosophila/genética , Feminino , Músculos/ultraestrutura , Mutação , Fenótipo , RNA/metabolismo , Transformação Genética , Tropomiosina/biossíntese
3.
J Neurosci ; 20(2): 709-21, 2000 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-10632600

RESUMO

Four Dlx homeobox genes, Dlx1, Dlx2, Dlx5, and Dlx6 are expressed in the same primordia of the mouse forebrain with temporally overlapping patterns. The four genes are organized as two tail-to-tail pairs, Dlx1/Dlx2 and Dlx5/Dlx6, a genomic arrangement conserved in distantly related vertebrates like zebrafish. The Dlx5/Dlx6 intergenic region contains two sequences of a few hundred base pairs, remarkably well conserved between mouse and zebrafish. Reporter transgenes containing these two sequences are expressed in the forebrain of transgenic mice and zebrafish with patterns highly similar to endogenous Dlx5 and Dlx6 expression. The activity of the transgene is drastically reduced in mouse mutants lacking both Dlx1 and Dlx2, consistent with the decrease in endogenous Dlx5 and Dlx6 expression. These results suggest that cross-regulation by Dlx proteins, mediated by the intergenic sequences, is essential for Dlx5 and Dlx6 expression in the forebrain. This hypothesis is supported by cotransfection and DNA-protein binding experiments. We propose that the Dlx genes are part of a highly conserved developmental pathway that regulates forebrain development.


Assuntos
Elementos Facilitadores Genéticos , Genes Homeobox , Proteínas de Homeodomínio/genética , Prosencéfalo/metabolismo , Fatores de Transcrição , Proteínas de Peixe-Zebra , Animais , Sequência de Bases , Sequência Conservada , Ectoderma/metabolismo , Humanos , Íntrons , Camundongos , Dados de Sequência Molecular , Neurônios/metabolismo , Bulbo Olfatório/metabolismo , Prosencéfalo/embriologia , Alinhamento de Sequência , Homologia de Sequência do Ácido Nucleico , Peixe-Zebra
4.
Biochim Biophys Acta ; 1392(2-3): 276-90, 1998 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-9630674

RESUMO

Transgenic mice were created overproducing a range of human HL (hHL) activities (4-23-fold increase) to further examine the role of hepatic lipase (HL) in lipoprotein metabolism. A 5-fold increase in heparin releasable HL activity was accompanied by moderate (approx. 20%) decreases in plasma total and high density lipoprotein (HDL) cholesterol and phospholipid (PL) but no significant change in triglyceride (TG). A 23-fold increase in HL activity caused a more significant decrease in plasma total and HDL cholesterol, PL and TG (77%, 64%, 60%, and 24% respectively), and a substantial decrease in lipoprotein lipids amongst IDL, LDL and HDL fractions. High levels of HL activity diminished the plasma concentration of apoA-I, A-II and apoE (76%, 48% and 75%, respectively). In contrast, the levels of apoA-IV-containing lipoproteins appear relatively resistant to increased titers of hHL activity. Increased hHL activity was associated with a progressive decrease in the levels and an increase in the density of LpAI and LpB48 particles. The increased rate of disappearance of 125I-labeled human HDL from the plasma of hHL transgenic mice suggests increased clearance of HDL apoproteins in the transgenic mice. The effect of increased HL activity on apoB100-containing lipoproteins was more complex. HL-deficient mice have substantially decreased apoB100-containing low density lipoproteins (LDL) compared to controls. Increased HL activity is associated with a transformation of the lipoprotein density profile from predominantly buoyant (VLDL/IDL) lipoproteins to more dense (LDL) fractions. Increased HL activity from moderate (4-fold) to higher (5-fold) levels decreased the levels of apoB100-containing particles. Thus, at normal to moderately high levels in the mouse, HL promotes the metabolism of both HDL and apoB-containing lipoproteins and thereby acts as a key determinant of plasma levels of both HDL and LDL.


Assuntos
Apolipoproteínas B/sangue , Lipase/metabolismo , Lipoproteínas HDL/sangue , Lipoproteínas/sangue , Animais , HDL-Colesterol/sangue , Eletroforese em Gel de Poliacrilamida , Heparina/farmacologia , Humanos , Lipase/genética , Lipoproteínas LDL/sangue , Fígado/enzimologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Fosfolipídeos/sangue , RNA Mensageiro/análise , Especificidade da Espécie , Distribuição Tecidual
5.
Am J Psychiatry ; 138(8): 1078-81, 1981 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-7258385

RESUMO

Conflicting reports concerning cholinomimetic-induced reduction of schizophrenic symptoms prompted the authors to study such changes in schizophrenic symptoms following physostigmine infusions in subgroups of patients with schizophrenic-like illness. These subgroups were defined by the presence or absence of antipsychotic response during a 2-week trial of lithium alone after physostigmine infusion. Patients who showed significant but temporary improvement in their thinking disturbance on serial Brief Psychiatric Rating Scale scores following physostigmine infusion subsequently responded to lithium; patients who failed to improve following physostigmine also failed to respond to lithium. The authors suggest that some schizophrenic-like illnesses may be biologically similar to mania both with respect to physostigmine and lithium-induced changes in symptomatology.


Assuntos
Lítio/uso terapêutico , Fisostigmina/uso terapêutico , Esquizofrenia/tratamento farmacológico , Adulto , Método Duplo-Cego , Feminino , Humanos , Infusões Parenterais , Masculino , Pré-Medicação , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/tratamento farmacológico , Psicologia do Esquizofrênico
6.
Transplantation ; 28(4): 294-302, 1979 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-388762

RESUMO

Antithymocyte globulin (ATG, ATGAM; The Upjohn Company) was tested for efficacy and safety in controlled studies in 358 renal allograft recipients. A total of 183 patients were treated according to protocols prescribing 14 daily doses of ATG in addition to standard immunosuppressive therapy with azathioprine and prednisone, while 175 controls received no ATG. Four ATG lots were tested; results with each lot were analyzed separately, and the data were also pooled to obtain an overall impression. ATG delayed the onset of the first rejection episode during the prescribed treatment period (2 weeks). Concurrently, less i.v. steroid was required, but the steroid dosage requirement then rebounded in the 2 weeks after the end of the prescribed treatment period. ATG did not significantly improve the proportion of patients alive with functioning grafts 6 months after transplant, except with one of the four lots.


Assuntos
Soro Antilinfocitário/uso terapêutico , Transplante de Rim , Linfócitos T/imunologia , Adulto , Soro Antilinfocitário/efeitos adversos , Azatioprina/uso terapêutico , Cadáver , Ensaios Clínicos como Assunto , Feminino , Rejeição de Enxerto , Humanos , Masculino , Prednisona/uso terapêutico , Transplante Homólogo
7.
Transplantation ; 28(5): 365-7, 1979 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-392832

RESUMO

Twenty renal allograft recipients were treated with antithymocyte globulin (ATGAM; ATG) for up to 16 weeks in addition to azathioprine and prednisone, while 20 controls received no ATG. The ATG group showed a lower incidence of first rejection episodes during the first month after transplantation, and also a better functional graft survival rate up to 2 years after transplantation. The results in this early ATG trial were better than those in subsequent trials which used 14-day treatment regimens. Longer treatment deserves another look.


Assuntos
Soro Antilinfocitário/uso terapêutico , Sobrevivência de Enxerto , Transplante de Rim , Linfócitos T/imunologia , Azatioprina/uso terapêutico , Ensaios Clínicos como Assunto , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Prednisona/uso terapêutico , Fatores de Tempo
8.
Pediatrics ; 71(3): 342-51, 1983 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-6828341

RESUMO

Psychological concerns for the timing of medical procedures on children result from the longstanding realization that events and behavioral patterns of childhood have wide-ranging effects on the later behavior of the adult. A review of the literature regarding the effects of surgery on psychological development is presented. Particular reference is made to the impact of genitourinary surgery with specific emphasis on the repair of hypospadias, a congenital anomaly affecting 1:250 to 1:400 live male births. Studies of adults who underwent hypospadias repair as children suggest that they are psychologically different from their peers who did not have this surgery. Specifically, as adults they frequently have sexual difficulty despite erectile competence and they generally occupy less responsible, less competitive, and less independent professions than similarly intelligent cohorts. These findings imply that the experience of hypospadias or its surgical repair may in some way affect psychological development. By examining these experiences in light of emotional and cognitive development and the emergence of body image and sexual identity, predictions for psychologically optimal timing of surgery are made. Importance of the role of the family in the psychological outcome and a discussion of surgical considerations are also provided.


Assuntos
Hipospadia/psicologia , Desenvolvimento Psicossexual , Procedimentos Cirúrgicos Operatórios/psicologia , Fatores Etários , Angústia de Castração , Imagem Corporal , Criança , Pré-Escolar , Cognição , Identidade de Gênero , Humanos , Hipospadia/cirurgia , Lactente , Masculino , Fatores de Tempo
9.
Pediatrics ; 96(3 Pt 1): 459-63, 1995 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-7651778

RESUMO

OBJECTIVE: It is estimated that 70% of individuals with factor VIII deficiency hemophilia who received blood products before 1985 are infected with human immunodeficiency virus (HIV). The goal of the current study was to assess how adolescents with hemophilia cope with reminders of their HIV status, because adaptation is likely to have implications for these individuals' quality of life and adherence to safer sex recommendations. METHODS: Participants included 297 HIV-positive adolescents with hemophilia who were recruited from 11 sites across the United States. Adolescents reported on the use and effectiveness of strategies for coping with reminders of their HIV status. RESULTS: A significant degree of distress was reported in response to such reminders, with anger being the most commonly reported emotion. Although a wide variety of coping strategies had been tried, participants reported using resignation (80.9%), self-calming (78.8%), and distraction (76.4%) most frequently in their attempts to cope with reminders of HIV. Self-blame (3.6%), engaging in risky behaviors (22.2%), thinking about sex (25.4%), and drug/alcohol use (29.1%) were used least. These adolescents tended to rate more active cognitive and behavioral coping strategies (eg, cognitive restructuring, seeking social support, physical activity) as most effective, whereas passive strategies (eg, wishful thinking, blaming others) were reported to be least helpful. Those individuals who reported being distressed by reminders of HIV endorsed most of the coping strategies significantly more often than the nondistressed group, although ineffective strategies were commonly chosen. Sexually active adolescents were more likely than their abstinent peers to cope by thinking about sex, engaging in risky behaviors, or using alcohol and drugs. CONCLUSION: In this population of adolescents who have known their serostatus for several years, distress about everyday reminders of HIV appears to be associated with ineffective coping strategies.


Assuntos
Adaptação Psicológica , Comportamento do Adolescente , Infecções por HIV/psicologia , Hemofilia A/complicações , Adolescente , Adulto , Análise de Variância , Criança , Infecções por HIV/complicações , Infecções por HIV/transmissão , Hemofilia A/psicologia , Humanos , Estudos Longitudinais , Masculino , Psicologia do Adolescente , Assunção de Riscos
10.
J Neurosurg ; 89(3): 405-11, 1998 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9724114

RESUMO

OBJECT: Cigarette smoking is associated with aneurysmal subarachnoid hemorrhage (SAH) and subsequent vasospasm. The purpose of this study was to quantify this association. METHODS: Nearly 3500 patients with SAH from North America and Europe have been enrolled in five different multicenter, controlled studies coordinated at the Neuroclinical Trials Center of the Virginia Neurological Institute at the University of Virginia. Among the prospective data gathered were whether the patient smoked at the time of their most recent SAH and the evolution of angiographic vasospasm. The rate of smoking in the patients enrolled in the studies was compared with the expected rate by using a chi-square statistic adjusted for age and gender, in the general population in the United States (U.S.) and Europe. In virtually all age and gender subgroups, and for the combined populations in the five clinical trials, patients with SAH reported current smoking rates 2.5 times higher than expected based on U.S. and European national surveys (p < 0.0001). Cigarette smoking was also associated with younger age at onset of SAH (5-10 years, p < 0.0001) and increased incidence of clinically confirmed vasospasm (p < 0.005). CONCLUSIONS: The findings of a significantly increased representation of current cigarette smokers in the study populations and significant association with younger age at the time of SAH and increased incidence of vasospasm concur with recent reports of smoking as a significant risk factor for ruptured aneurysms and subsequent vasospasm.


Assuntos
Aneurisma Intracraniano/complicações , Ataque Isquêmico Transitório/etiologia , Fumar/efeitos adversos , Hemorragia Subaracnóidea/etiologia , Adolescente , Adulto , Fatores Etários , Aneurisma Roto/etiologia , Canadá , Angiografia Cerebral , Distribuição de Qui-Quadrado , Europa (Continente) , Feminino , Humanos , Incidência , Ataque Isquêmico Transitório/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Estados Unidos
11.
J Chromatogr A ; 804(1-2): 295-304, 1998 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-9615408

RESUMO

Drinking water and condensate samples collected from the US Space Shuttle and the Russian Mir Space Station are analyzed routinely at the NASA-Johnson Space Center as part of an ongoing effort to verify water quality and monitor the environment of the spacecraft. Water quality monitoring is particularly important for the Mir water supply because approximately half of the water consumed is recovered from humidity condensate. Drinking water on Shuttle is derived from the fuel cells. Because there is little equipment on board the spacecraft for monitoring the water quality, samples collected by the crew are transported to Earth on Shuttle or Soyuz vehicles, and analyzed exhaustively. As part of the test battery, anions and cations are measured by ion chromatography, and carboxylates and amines by capillary electrophoresis. Analytical data from Shuttle water samples collected before and after several missions, and Mir condensate and potable recovered water samples representing several recent missions are presented and discussed. Results show that Shuttle water is of distilled quality, and Mir recovered water contains various levels of minerals imparted during the recovery processes as designed. Organic ions are rarely detected in potable water samples, but were present in humidity condensate samples.


Assuntos
Cromatografia por Troca Iônica/métodos , Eletroforese Capilar/métodos , Voo Espacial/normas , Poluentes da Água/análise , Abastecimento de Água/análise , Federação Russa , Estados Unidos , Abastecimento de Água/normas
12.
J Pharm Sci ; 65(9): 1285-91, 1976 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-966139

RESUMO

The effects of colestipol hydrochloride, a hypocholesterolemic bile acid-binding anion-exchange polymer, on the GI absorption of drugs commonly used in humans were studied in the rat. Colestipol hydrochloride was given by gavage in single doses of 71.5 or 214.5 mg/kg, equivalent to 5 or 15 g, respectively, in a 70-kg human; controls received equivalent amounts of microcrystalline cellulose. Single oral doses of labeled drugs were given concurrently with colestipol hydrochloride or microcrystalline cellulose at the human therapeutic dose range on a milligrams per kilogram basis. Subsequent changes in serum drug levels were measured at several time periods, and absorption was evaluated as the total area under the time-concentration curve. Colestipol hydrochloride at either dose did not significantly alter the absorption of 6-14C-nicotinic acid, 7-3H-tetracycline, 35S-chlorpromazine, 12alpha-3H-digoxin, warfarin (alpha-14C-benzyl), or clofibrate (14C-carboxyl). In addition, the effects of 214.5 mg/kg of colestipol hydrochloride were compared with the same dose of cholestyramine with respect to the absorption of 3-14C-hydrochlorothiazide, 2-14C-phenobarbital, and 3H-digitoxin. Cholestyramine reduced absorption of hydrochlorothiazide by 42%, but colestipol hydrochloride had no significant effect. Neither resin altered phenobarbital or digitoxin absorption when compared with the the control, but a significant difference occurred between the two resins with digitoxin; areas under the time-concentration curve [in (dpm/0.1 ml serum) x hr] were: colestipol hydrochloride, 2001; cholestyramine, 16,300; and cellulose, 17, 067. These results indicate that colestipol hydrochloride and cholestyramine can differ in their effects on the absorption of certain drugs from the GI tract of the rat.


Assuntos
Colestipol/farmacologia , Absorção Intestinal/efeitos dos fármacos , Preparações Farmacêuticas/metabolismo , Poliaminas/farmacologia , Animais , Celulose/farmacologia , Clorpromazina/sangue , Resina de Colestiramina/farmacologia , Clofibrato/sangue , Digitoxina/sangue , Digoxina/sangue , Hidroclorotiazida/sangue , Masculino , Ácidos Nicotínicos/sangue , Fenobarbital/sangue , Ratos , Tetraciclina/sangue , Varfarina/sangue
13.
J Adolesc Health ; 21(4): 232-7, 1997 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9304454

RESUMO

PURPOSE: To describe the self-reported sexual behaviors of human immunodeficiency virus (HIV)-seropositive youths with congenital coagulopathies in order to guide the development of interventions to prevent secondary transmission. SUBJECTS: A total of 297 HIV-seropositive males, 12-24 years of age, were sampled from 11 hemophilia treatment centers and 28 affiliated subsites. METHODS: Review of clinical records and self-administered survey of HIV-related knowledge, attitudes and behaviors. Subjects were classified and compared by self-reported sexual behavior over the lifetime and the prior 6 months into five mutually exclusive groups (G1-5). RESULTS: A total of 42% of subjects were virgins who never had oral, vaginal, or rectal sex (G1); 10% were nonvirgins who had abstained (G2); 13% were virgins and nonvirgins who had intimate touch only (G3); 21% had intercourse and always used condoms (G4); and 13% had had unsafe intercourse (G5). Among the groups, G5 was the oldest, least likely to forego sex, most angry and anxious when reminded of HIV, and most reluctant to disclose serostatus to friends. CONCLUSIONS: Most subjects (87%) had safer sex or abstained in the last 6 months. A relatively small group of HIV-seropositive youth with bleeding disorders were engaged in unprotected intercourse and in need of intensive help with HIV risk reduction.


Assuntos
Infecções por HIV/psicologia , Soropositividade para HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Hemofilia A/psicologia , Comportamento Sexual/psicologia , Adolescente , Adulto , Infecções por HIV/prevenção & controle , Humanos , Masculino , Assunção de Riscos
14.
Adv Exp Med Biol ; 67(00): 215-229, 1976.
Artigo em Inglês | MEDLINE | ID: mdl-179295

RESUMO

We describe high volume screening tests for hypobetalipoproteinemic agents in which compounds are administered orally to cholesterol-cholic acid fed (hypercholesterolemic( or normally fed weanling rats for 4 days. In these tests total serum cholesterol levels and heparin precipitating lipoproteins (HPL) are determined by automated analyses interfaced with a computer which eliminates all manual data reduction and provides necessary reports. The hypercholesterolemic rat test detects compounds which specifically reduce HPL (beta and pre beta lipoproteins) causing a decrease in the HPL: cholesterol ratio. Such activity is called hypobetalipoproteinemia. This activity is exhibited by bicyclo (2.2.2)-octyloxyaniline (U-26328) but not by any of the familiar hypocholesterolemic agents including clofibrats, lifibrats, nicotinic acid, probucol, triparanol, lentysine, D-throxine or the estrogens estrone and diethylstilbestrol.


Assuntos
Colesterol/sangue , Hipercolesterolemia/sangue , Lipoproteínas LDL/sangue , Farmacologia , Projetos de Pesquisa , Conversão Análogo-Digital , Animais , Colesterol na Dieta , Ácidos Cólicos/farmacologia , Dieta Aterogênica , Feminino , Lipoproteínas LDL/antagonistas & inibidores , Masculino , Ratos , Fatores Sexuais
15.
Biofactors ; 9(2-4): 121-9, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10416023

RESUMO

Ubiquinol (QH2) is a lipid-soluble molecule that participates in cellular redox reactions. Previous studies have shown that yeast mutants lacking QH2 are hypersensitive to treatment with polyunsaturated fatty acids (PUFAs) indicating that QH2 can function as an antioxidant in vivo. In this study the effect of 1 mM linolenic acid on levels of Q6 and Q6H2 is assessed in both wild-type and respiration-deficient (atp2 delta) strains. The response of Q-deficient mutants to other forms of oxidative stress is further characterized to define those conditions where QH2 acts as an antioxidant. Endogenous antioxidant defense systems were also assessed in wild-type, Q-deficient, and atp2 delta strains. Superoxide dismutase (SOD) activity decreased and catalase activity increased in both Q-deficient and atp2 delta mutants compared to wild-type cells, suggesting that such changes result from the loss of respiration rather than the lack of Q.


Assuntos
Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/fisiologia , Ubiquinona/genética , Canavanina/farmacologia , Catalase/metabolismo , Sulfato de Cobre/farmacologia , Genótipo , Glutationa/metabolismo , Dissulfeto de Glutationa/metabolismo , Peróxido de Hidrogênio/farmacologia , Oxirredução , Estresse Oxidativo , Oxigênio/farmacologia , Paraquat/farmacologia , Saccharomyces cerevisiae/efeitos dos fármacos , Superóxido Dismutase/metabolismo , Ubiquinona/metabolismo , Ácido alfa-Linolênico/farmacologia , terc-Butil Hidroperóxido/farmacologia
16.
Clin Pediatr (Phila) ; 40(10): 555-62, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11681822

RESUMO

Parents from urban (n=67) and suburban (n=76) primary care settings responded to a survey determining the extent to which 9 common psychosocial concerns have affected their children. Parents also reported their expectations of their pediatrician to discuss such topics during a health care visit. Within both settings, discipline was the most frequently experienced (41%), commonly discussed (34.3%), and frequently expected (75.4%) topic to be discussed. The frequency of discussions on psychosocial topics was less than half that of the actual reported occurrence of the psychosocial concern. When discussions on psychosocial topics did occur, however, most parents (87.3%) perceived pediatricians as helpful.


Assuntos
Educação Infantil , Pais , Pediatria , Relações Profissional-Família , Adulto , Atitude , Criança , Cuidado da Criança , Pré-Escolar , Relações Familiares , Feminino , Humanos , Lactente , Masculino , Visita a Consultório Médico , Fatores Socioeconômicos , População Suburbana , Inquéritos e Questionários , Televisão , População Urbana , Violência
17.
Clin Pediatr (Phila) ; 35(6): 295-301, 1996 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8782953

RESUMO

We prospectively evaluated the neurodevelopmental outcome of infants with documented viral meningitis to determine (1) whether deficits in physical growth, development, speech and language, hearing, or intelligence occur; and (2) if so, at what age these deficits can be detected. Sixteen infants with documented enteroviral meningitis under the age of 90 days and a control group of 13 patients matched for age, race, sex, and socioeconomic status were followed up prospectively for 3 years with annual evaluations, which included a developmental evaluation by a pediatric developmentalist, articulation and language tests by a speech-language pathologist (Sequenced Inventory of Communication Development, Receptive-Expressive Emergent Language Scale (REEL), Preschool Language Scale (PLS), Revised Peabody Picture Vocabulary Test (PPVT-R), Photo Articulation Test, audiometric screening), and intelligence tests by a psychometrist (Bayley Scales of Infant Development [BSID] and Stanford-Binet). No deficits were demonstrated in growth, development, hearing, BSID, articulation, and expressive language. Subtle but significant (P < 0.05) deficits were documented in the study group compared with the control group in the receptive component of the REEL, all subsections of the PLS, the PPVT-R, and the verbal comprehension/language-processing section (Factor II) of the Stanford-Binet. These differences could be reliably detected by 3 years of age. We conclude that viral meningitis in young infants may cause subtle deficits in language skills, particularly receptive language. We recommend that children who have had enteroviral meningitis during early infancy be monitored carefully for language development and, perhaps, receive increased language stimulation in the home prior to school entry in order to optimize their learning potential.


Assuntos
Transtornos do Desenvolvimento da Linguagem/etiologia , Meningite Viral/complicações , Análise de Variância , Distribuição de Qui-Quadrado , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Testes de Linguagem , Masculino , Testes Neuropsicológicos , Estudos Prospectivos , Psicologia da Criança/métodos , Psicometria/métodos , Sensibilidade e Especificidade , Teste de Stanford-Binet
18.
Int J Obstet Anesth ; 19(4): 390-4, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20832280

RESUMO

BACKGROUND: Ropivacaine may be the ideal spinal anesthetic for postpartum tubal ligation due to its medium duration of action, low incidence of side effects and possibly reduced post-anesthetic care unit (PACU) stay. METHODS: Two prospective up-down sequential allocation studies were performed using hyperbaric spinal ropivacaine via a combined spinal-epidural anesthetic technique for patients undergoing postpartum tubal ligation. The first study was performed using an initial dose of 12.5 mg hyperbaric ropivacaine, which was adjusted in testing intervals of 0.5 mg. The second study used an initial dose of 16 mg hyperbaric ropivacaine, a testing interval of 1.0mg, and a fixed dose of fentanyl 10 µg. The need to supplement the block with intravenous or epidural agents was defined as a failure. Failures were treated with epidural lidocaine. RESULTS: The first and second studies recruited 24 and 17 patients, respectively. The median effective dose (ED50) for hyperbaric spinal ropivacaine was 16.4 mg (95% CI 13.7-19) with an ED95 estimate of 21.9 mg. The median effective dose of spinal ropivacaine with fentanyl 10 µg was 17.0 mg (95% CI 15.4-18.7) with an ED95 estimate of 21.3 mg. When data were combined, the overall ED50 for ropivacaine was 16.7 mg (95% CI 15.1-18.4) with an ED95 estimate of 22.5 mg (95% CI 16.3-28.8). A T8 block was not achieved in 4 patients receiving spinal ropivacaine alone, and 1 patient receiving spinal ropivacaine with fentanyl. The majority (82%) of patients who did not receive epidural local anesthetic supplementation had recovery of motor block within 60 min following PACU admission. CONCLUSION: Spinal hyperbaric ropivacaine 22 mg with or without fentanyl 10 µg could be used for postpartum tubal ligation surgery.


Assuntos
Amidas/administração & dosagem , Analgésicos Opioides/administração & dosagem , Raquianestesia , Anestésicos Locais/administração & dosagem , Fentanila/administração & dosagem , Esterilização Tubária , Adulto , Relação Dose-Resposta a Droga , Feminino , Humanos , Bloqueio Nervoso , Medição da Dor , Período Pós-Parto , Ropivacaina
20.
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