PubMed · 9392930
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V Calandro, H R Shah, J D Talley. 1997. Acute aortic dissection.. https://pubmed.ncbi.nlm.nih.gov/9392930/
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To study the therapeutic effects of a single 40 mg intramuscular dose of piroxicam versus a single 75 mg intramuscular dose of diclofenac sodium for treatment of acute renal colic. - The study comprised 64 patients (52 men and 12 women, mean age 28 years, range 18 - 42) who presented with acute renal colic and were diagnosed by IVU, a general urine examination and ultrasonography. The patients were randomly assigned to receive either 40 mg of piroxicam i.m (34 patients) or 75 mg of diclofenac sodium i.m (330 patients). The severity of pain was assessed on Visual Analogue Scale. - Results showed that thirty-two patients (94.1%) markedly improved within 1h of receiving piroxicam and 26 patients (86.6%) improved within 1h of receiving diclofenac sodium (P <0.05). Within 30 min, 25 patients (73.5%) markedly improved after piroxicam and 15 patients (50%) markedly improved after diclofenac sodium (P <0.05). After piroxicam, none of the patients showed pain relapse over a period of 24 h while 9 patients had relapse within 24 h after their initial response to diclofenac sodium. No side effects were reported with use of either treatment. - We concluded that piroxicam can be used successfully to treat acute renal colic and it has earlier onset of action and prolong effect as compared with diclofenac sodium.
A model of acute carbon monoxide poisoning combined with spreading depression (SD) induced metabolic stress was used to examine the protective effects of cerebrolysin (CL) on the development of electrophysiological, behavioral and morphological signs of hypoxic damage. Capillary electrodes were implanted into the neocortex and hippocampus of anesthetized rats which were then exposed for 90 min to breathing of 0.8% to 0.5% CO, while 3 to 4 waves of cortical and hippocampal SD were elicited by microinjections of 5% KCl. Duration of SD-provoked depolarization of cerebral cortex and hippocampus was noted. Nine and 18 to 19 days later propagation of SD waves was recorded with the same electrodes and decrease of their amplitude was used as an index of brain damage which was significant in the hippocampus but not in the cortex. CL-treatment (2.5 ml/kg per day) started after CO administration and continued for 14 days significantly improved hippocampal recovery manifested by increased amplitude of SD waves. Behavioral tests performed 10 and 20 days after CO poisoning in the Morris water maze revealed better performance (escape latency 7 s) in the CL-treated than in untreated animals (14 s). Morphological analysis showed marked damage in the hippocampus consonant with electrophysiological and behavioral findings in the same animals. No apparent histological damage was found in rats exposed to CO inhalation alone without the additional SD-provoked depolarization. It is concluded that chronic CL-treatment enhances recovery of hippocampal tissue after hypoxic damage of intermediate severity.
OBJECTIVES: To determine clinical correlates and outcome of hypoxaemia in children admitted to hospital with an acute lower respiratory tract infection. DESIGN: Prospective cohort study. SETTING: Paediatric wards of the Royal Victoria Hospital and the hospital of the Medical Research Council's hospital in Banjul, the Gambia. SUBJECTS: 1072 of 42 848 children, aged 2 to 33 months, who were enrolled in a randomised trial of a Haemophilus influenzae type b vaccine in the western region of the Gambia, and who were admitted with an acute lower respiratory tract infection to two of three hospitals. MAIN OUTCOME MEASURES: Prevalence of hypoxaemia, defined as an arterial oxygen saturation <90% recorded by pulse oximetry, and the relation between hypoxaemia and aetiological agents. RESULTS: 1072 children aged 2-33 months were enrolled. Sixty three (5.9%) had an arterial oxygen saturation <90%. A logistic regression model showed that cyanosis, a rapid respiratory rate, grunting, head nodding, an absence of a history of fever, and no spontaneous movement during examination were the best independent predictors of hypoxaemia. The presence of an inability to cry, head nodding, or a respiratory rate >/= 90 breaths/min formed the best predictors of hypoxaemia (sensitivity 70%, specificity 79%). Hypoxaemic children were five times more likely to die than non-hypoxaemic children. The presence of malaria parasitaemia had no effect on the prevalence of hypoxaemia or on its association with respiratory rate. CONCLUSION: In children with an acute lower respiratory tract infection, simple physical signs that require minimal expertise to recognise can be used to determine oxygen therapy and to aid in screening for referral. The association between hypoxaemia and death highlights the need for early recognition of the condition and the potential benefit of treatment.