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1.
Naunyn Schmiedebergs Arch Pharmacol ; 330(3): 175-8, 1985 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-2414673

RESUMO

Cystometric recordings were performed in pentobarbitone anaesthetized rats and the effects of baclofen on urinary bladder function were evaluated as their influence on bladder hyperactivity induced by 1-dihydroxyphenylalanine (L-dopa) after peripheral decarboxylase inhibition. The bladder response was inhibited by intracerebroventricularly (i.c.v., 4th ventricle, 0.1 microgram) as well as by systemically administered (10 mg/kg i.v.) baclofen. Intravenous naloxone but not i.v. bicuculline i.c.v. substance P or i.c.v. glutamate antagonized the inhibitory actions of i.c.v. or/and i.v. baclofen. It is suggested that baclofen depresses the hyperactive bladder by a central action that is unrelated to bicuculline sensitive gamma aminobutyric acid mechanisms, substance P or glutamate neurotransmission but that is possibly related to interference with opioid mechanisms.


Assuntos
Baclofeno/farmacologia , Levodopa/farmacologia , Bexiga Urinária/efeitos dos fármacos , Animais , Inibidores das Descarboxilases de Aminoácidos Aromáticos , Baclofeno/administração & dosagem , Bicuculina/farmacologia , Glutamatos/farmacologia , Ácido Glutâmico , Injeções Intraventriculares , Masculino , Naloxona/farmacologia , Ratos , Ratos Endogâmicos , Substância P/farmacologia , Ácido gama-Aminobutírico/fisiologia
2.
Naunyn Schmiedebergs Arch Pharmacol ; 314(2): 195-200, 1980 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-6256670

RESUMO

Cystometric recordings were performed in pentobarbitone anaesthetized rats and the effects of gammaaminobutyric acid (GABA) mechanisms on urinary bladder function were evaluated as their influence on a bladder hyperactivity induced by 1-dihydroxyphenylalanine (L-DOPA) after peripheral decarboxylase inhibition. The bladder response was inhibited by intracerebroventricular (i.c.v., 4th ventricle) injections of GABA (250 microgram), muscimol (0.2 microgram) and glycine (1,000 microgram) as well as by systemically administered muscimol (4 mg/kg) and diazepam (2 mg/kg). Intravenous (i.v.) bicuculline, but not i.v. strychnine, antagonized the inhibitory actions of intraperitoneal (i.p.) and i.c.v. muscimol and i.v. diazepam while the opposite was true for the inhibitory action of i.c.v. glycine. In rats not pretreated with L-DOPA, i.p. administration of bicuculline (4 mg/kg) after 15 min caused prominent detrusor contractions that were prevented by an infracollicular brain transection. It is suggested that GABA synapses in the pontinemesencephalic brain region may be involved in the modulation of urinary bladder function.


Assuntos
Receptores de Superfície Celular/fisiologia , Bexiga Urinária/fisiologia , Ácido gama-Aminobutírico/fisiologia , Animais , Bicuculina/farmacologia , Diazepam/farmacologia , Glicina/farmacologia , Levodopa/farmacologia , Masculino , Muscimol/farmacologia , Contração Muscular/efeitos dos fármacos , Ratos , Bexiga Urinária/efeitos dos fármacos , Ácido gama-Aminobutírico/farmacologia
3.
J Pediatr Surg ; 14(2): 154-7, 1979 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-458539

RESUMO

Fourteen cases of thromboembolic complications appeared in 267 consecutive angiographies during a 7-yr period. The arterial circulation has been evaluated both clinically and with oscillometry. The complication rate was substantially higher after cut down then after percutaneous approach (56% vs. 2.7%). Seven patients with signs of total vascular obstruction were subjected to acute thromboectomy whereas three patients with milder clinical symptoms were treated nonoperatively with anticoagulants. Four patients have died during the examination period, the remaining ten patients have been subjected to long term follow-up (mean follow-up period 3 yr). Seven demonstrated normal findings clinically, as well as oscillographically, whereas three patients subjected ot thromboectomy after cut down were clinically normal but decreased oscillographic pulsations could be demonstrated.


Assuntos
Angiografia/efeitos adversos , Tromboembolia/etiologia , Adolescente , Angiografia/métodos , Anticoagulantes/uso terapêutico , Cateterismo , Criança , Pré-Escolar , Seguimentos , Humanos , Lactente , Recém-Nascido , Perna (Membro)/irrigação sanguínea , Oscilometria , Tromboembolia/diagnóstico , Tromboembolia/cirurgia
4.
J Pediatr Surg ; 23(9): 805-9, 1988 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-3183892

RESUMO

This report reviews 16 years' experience in the management of patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF), with special emphasis on long-term results and early complications in relation to the magnitude of the gap between the esophageal segments. In 94 infants with no or moderate distance between the esophageal ends (less than 2 cm), an end-to-end anastomosis was performed in 90 cases after closing the TEF. In 51 of the 90 patients, no complications were seen (57%), whereas in the remaining 39, postoperative complications were noted with anastomotic leakage (24 patients, 26%), anastomotic stricture (16 patients, 18%) and gastroesophageal reflux (5 patients, 5%). Sixteen patients (9 with and 7 without TEF) had a "long gap" between the esophageal segments (greater than 2 cm). Thirteen (9 with and 4 without TEF) of these 16 patients were subjected to an end-to-end anastomosis, 11 primarily and two secondarily after 3 and 12 weeks, respectively. All 13 patients with an end-to-end anastomosis had anastomotic leakage (100%)--nine had stricture (75%) and 5 had gastroesophageal reflux (50%). The remaining three patients in this long-gap group were subjected to colon transposition, two primarily and one secondarily. The total mortality rate decreased from 19/57 patients (33%) from 1969 to 1977, to 5/53 (9%) from 1978 to 1984. The main cause of death in both periods was associated anomalies (18% and 7%, respectively), whereas deaths related to the EA malformation as such had almost disappeared during the latter period (15% and 2%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Atresia Esofágica/cirurgia , Feminino , Humanos , Recém-Nascido , Masculino , Complicações Pós-Operatórias , Fístula Traqueoesofágica/cirurgia
5.
J Pediatr Surg ; 27(11): 1447-50, 1992 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-1282543

RESUMO

Thirty-two children with sacrococcygeal teratoma have been treated during the last 10 years (1980 to 1989) in Sweden. A retrospective study was performed in four departments of pediatric surgery that treat sacrococcygeal teratomas in children from the whole of Sweden. Prenatal and perinatal histories were reviewed together with interval to diagnosis, Altman classification, histology, and serum alpha-fetoprotein. Details of surgical management +/- adjuvant chemotherapy and outcome of patients were also documented. In 8 patients the teratoma was diagnosed prenatally by ultrasonography and there was one postoperative death in this group. Multiagent chemotherapy was used in all but one of 11 patients with malignant teratomas (in 8 of them a cisplatin, bleomycin, vinblastine combination). Only one patient with a malignant tumor treated by single-agent chemotherapy died, 8 others were still alive and tumor-free after 1 to 9 years (mean time, 5.4 years). Two patients developed late relapses and were treated by surgical resection. Metastases occurred in five of the 11 malignant tumors, one at presentation and in four patients 10 to 29 months following surgery. All relapses had distant metastases as well as local disease. Serum alpha-fetoprotein was used in monitoring some of these patients.


Assuntos
Região Sacrococcígea , Teratoma , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bleomicina/administração & dosagem , Quimioterapia Adjuvante , Cisplatino/administração & dosagem , Dactinomicina/uso terapêutico , Feminino , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Suécia , Teratoma/diagnóstico , Teratoma/tratamento farmacológico , Teratoma/cirurgia , Vindesina/administração & dosagem , alfa-Fetoproteínas/análise
6.
J Pediatr Surg ; 27(7): 916-8, 1992 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-1640343

RESUMO

Thirty-four patients operated with sacrococcygeal teratoma in Sweden between 1978 and 1989 were reviewed. Twenty-five children were available for functional follow-up. The patients and their parents were interviewed for bowel and micturition habits. Fourteen patients from this number were subjected to anorectal manometry (56%). Fifteen children reported normal bowel habits (60%). In 10 patients (40%) soiling was observed. However, four of them were under 3 years of age and wearing diapers, which made the functional evaluation difficult. The manometries showed normal and resting tone and squeezing pressures in 10 patients and subnormal values in four patients who also had soiling problems. All investigated children showed normal rectoanal inhibition reflex. Twenty-one patients reported normal micturition, in four (16%) urinary incontinence was recorded. Two of the latter children required intermittent clean catheterization, one was on medication and the last one lives without any treatment. No difference in functional outcome was noted between patients with intrapelvic or extrapelvic tumor location. Retrospectively, it is not possible to know whether the observed functional outcome is due to tumor growth or the result of surgery. Preoperative clinical investigation and in some cases anorectal manometry and cystometry could theoretically resolve this problem.


Assuntos
Defecação , Teratoma/cirurgia , Micção , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Manometria , Região Sacrococcígea , Suécia , Fatores de Tempo , Resultado do Tratamento
19.
Acta Physiol Scand ; 126(2): 181-7, 1986 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-2422879

RESUMO

Intravesical pressure recordings were performed in anaesthetized rats, and the effect of morphine on urinary bladder function was studied. The action of morphine was registered as its influence on bladder hyperactivity induced by central catecholaminergic stimulation with 1-dihydroxyphenylalanine (L-DOPA) after peripheral decarboxylase inhibition, and as its action on the response to regional injection of receptor agonists (acetylcholine (ACh), substance P (SP)) and peripheral motor nerve stimulation (PNS). The bladder response to L-DOPA was inhibited by intracerebroventricularly (i.c.v., fourth ventricle, 10 micrograms), as well as by systemically administered (1-5 mg kg-1 i.p.), morphine. Intravenous and i.c.v. naloxone antagonised the inhibitory actions of i.v. and i.c.v. morphine, respectively. Regional intra-arterial administration of morphine (0.01-5 mg) induced a weak bladder contraction per se, with a subsequent slight depression of bladder reactivity to ACh, SP and PNS. It is suggested that the inhibitory effect of morphine on bladder motility in the rat, is mainly mediated by central opioid-receptors. The direct peripheral effects on the detrusor muscle are weak, with an initial contraction followed by slight depression of the reactivity.


Assuntos
Morfina/farmacologia , Contração Muscular/efeitos dos fármacos , Bexiga Urinária/efeitos dos fármacos , Acetilcolina/antagonistas & inibidores , Animais , Carbidopa/farmacologia , Relação Dose-Resposta a Droga , Estimulação Elétrica , Injeções Intra-Arteriais , Injeções Intraventriculares , Levodopa/antagonistas & inibidores , Masculino , Morfina/antagonistas & inibidores , Músculo Liso/efeitos dos fármacos , Naloxona/farmacologia , Pelve/inervação , Ratos , Ratos Endogâmicos , Substância P/antagonistas & inibidores
20.
Eur J Clin Pharmacol ; 29(5): 625-8, 1986.
Artigo em Inglês | MEDLINE | ID: mdl-3956567

RESUMO

Plasma metronidazole was measured following a single intravenous dose of 20 mg/kg (Flagyl 5 mg/ml) in 12 infants less than 1 year of age undergoing abdominal surgery. In all patients sufficient plasma concentrations, well above the MIC values for anaerobic bacteria, were found for at least 16 h. A prolonged half-life was demonstrated in the group less than 8 weeks of age (t1/2/18.4 h). The group over 8 weeks of age demonstrated a t1/2 comparable to that seen in adults (t1/2 7 h).


Assuntos
Abdome/cirurgia , Metronidazol/uso terapêutico , Pré-Medicação , Infecção da Ferida Cirúrgica/prevenção & controle , Meia-Vida , Humanos , Lactente , Recém-Nascido , Cinética , Metronidazol/efeitos adversos
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