Subject(s)
Adolescent , Adolescent Health Services , Ambulatory Care , Project Formulation , HandbookABSTRACT
Objetivo - Comparar o tempo e o índice de sucesso para reversäo da fibrilaçäo atrial (FA) aguda, com o uso de amiodarona, procainamida ou quinidina. Métodos - Aleatoriamente, 60 pacientes com FA aguda foram divididos em três grupos, recebendo o grupo quinidina (GQ), constituído de 21 pacientes, digital EV + quinidina até 600mg VO; o grupo procainamida (GP) com 23 pacientes, digital EV + 10mg/kg de procainamida EV e o grupo amiodarona (GA), com 16 pacientes 5mg/kg de amiodarona EV. O período de observaçäo foi de no máximo 4h, através de Holter. Na análise estatíca foi utilizado o teste de x2 com o método de Kruskall-Wallis, considerando-se significativo p<0,05. Resultados - Os três grupos foram similares quanto a idade, sexo e tempo de instalaçäo da FA. A reversäo ocorreu em 71,4 por cento dos casos no GQ, em 47,8 por cento no GP e em 50 por cento no GA, (p>0,05). O tempo para reversäo em minutos foi de 112 + ou - 43 no G!, de 44,1 + ou - 28 no GP, de 20 + ou - 13 no GA, sendo menor e estatisticamente significante no GP e, principalmente, no GA (p= 0,001) em relaçäo ao GQ. Os efeitos colaterais foram mais freqüentes no GP, embora sem significância estatística. Conclusäo - A amiodarona, especialmente na ausência de cardiopatia de base, é uma boa opçäo para maior rapidez na reversäo da FA, enquanto a quinidina propicia maior taxa de reversäo, com menos efeitos colaterais
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Procainamide/therapeutic use , Quinidine , Amiodarone/therapeutic use , Atrial Fibrillation/drug therapy , Time Factors , Emergencies , Acute Disease , Atrial Fibrillation/physiopathology , Sinoatrial Node , Sinoatrial Node/physiopathologyABSTRACT
PurposeTo evaluate the efficacy and safety of intravenous hidralazine in arterial hypertension. Patients and Methods12 patients, meanage 45,33 15,82,8 men and 4 women all of them with systolic (S) arterialpressure (AP) 180 and or diastolic (D) 126 mmHg with symptoms like headache, incaracteristic toraxic pain and others but without an hypertensive emergency neither acute manifestation of hypertensive encephalopathy through fundi examination were studied. The AP was taked 10 minutes after rest (inicial) and 5, 15, 30 and 60 min (final) after intravenous administration of hidralazine-HCL (5mg) which was repeated when at least 20% AP reduction was not achieved. Results The inicial and final SAP, DAPand heart rate (HR) wre 208 ± 19,4 and 176 ± 17,2 (p < 0.0001), 133 ± 11,3 and 112 ± 11,5 (p< 0.001) and 72 ± 12,9 and 80 ± 15,5 (NS), respectively. Side effects related to the drug were observed in 3 (25%) patients. One had symptomatic ortostatic hypotension, the second had precordial pain with ST-T changes compatible with myocardial ischemia and the third presented a torax and abdominal cutaneous erithema, but all of them reversible. Conclusion Intravenous hydralazineHC1 is an alternative when rapid arterial pressurereduction is needed
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Emergencies , Hydralazine/therapeutic use , Hypertension/drug therapy , Hydralazine/administration & dosage , Hydralazine/pharmacology , Injections, Intravenous , Drug Evaluation , Heart Rate , Arterial PressureABSTRACT
The purpose of this document is not only to present the markedly different patterns of distributions of birthweights and their relationship to infant mortality, but also to stress the importance of promoting favorable birthweights by improvements of the health and nutrition of mothers, families, communities, and therefore countries. Several examples of experiences in specific countries illustrate the success that multiple interventions have had in achieving patterns of birthweights and rapid reductions of infant mortality. The distributions of birthweights are given for 22 distinct experiences in 15 countries of four regions of the world. As illustrated by the experiences in several countries, positive changes in distributions of birthweights- and therefore in the health and survival of infants- can be effected in spite of difficult economic, political, social, and environmental conditions. These changes require proper recognition of vulnerable population groups and the introduction of solutions to problems such as unfavorable birthweights and preterm births. This públication is intended primarily for policy makers at the national level. Project planners and managers at all levels will also find the examples useful as models for future activities