RESUMO
Glycerol kinetics and adverse affects were studied in nine patients with Reye's syndrome. Glycerol was given by continuous infusion over 2 hr, half over the first 0.5 hr and the remainder over the next 1.5 hr. The dose was adjusted to keep intracranial pressure less than or equal to 15 mmHg. At steady state, serial blood samples were collected during glycerol infusion and analyzed by an enzymatic assay specific for glycerol. At 0.75 to 1.75 gm/kg/2 hr glycerol doses, the serum levels ranged from 1.48 to 5.83 mg/ml. Total body clearance ranged from 1.99 to 5.1 ml/kg/min. Glycerol clearance was not related to serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), or serum ammonia levels. Glycerol provided effective control of intracranial pressure in all patients. Temporary elevation of serum creatinine and blood urea nitrogen (BUN) and presence of hemolysis in two patients, appeared to be related to glycerol.
Assuntos
Glicerol/metabolismo , Síndrome de Reye/metabolismo , Adolescente , Criança , Feminino , Glicerol/efeitos adversos , Hemólise/efeitos dos fármacos , Humanos , Pressão Intracraniana/efeitos dos fármacos , Rim/efeitos dos fármacos , Cinética , Fígado/metabolismo , Masculino , Taxa de Depuração MetabólicaRESUMO
We evaluated valproic acid (VPA) for 6 months as therapy for uncontrolled seizures in 100 children, 38 with partial and 62 with generalized epilepsy. Sixty-one patients experienced more than a 75% decrease in seizures. The improvement in generalized epilepsy paralleled adult VPA studies, but partial epilepsy improved more than expected, even though acceptable seizure control was often achieved only after 6 months of VP therapy. The most significant side effect was gastrointestinal distress, which was alleviated by dietary changes. Limited experience suggested that enteric-coated capsules eliminated gastrointestinal symptoms. Hematologic, hepatic, and behavioral sequelae were minimal.
Assuntos
Epilepsia/tratamento farmacológico , Ácido Valproico/uso terapêutico , Adolescente , Adulto , Anticonvulsivantes/uso terapêutico , Criança , Pré-Escolar , Ensaios Clínicos como Assunto , Feminino , Humanos , Lactente , Masculino , Ácido Valproico/efeitos adversosRESUMO
Reye syndrome in siblings was seen in three of 85 families; the incidence of RS in these family groups appears to exceed that of the general population. The interval between development of RS in the first and second siblings was two to 11 days and related to the incubation period of the initial viral infection. In five of the children this infection was chickenpox and in two, an unspecified upper respiratory illness. To assess the role of genetic factors, HLA typing was performed on these siblings; a common genetic marker indicating susceptibility to RS was not identified. All families resided in rural and suburban areas; exposure to a common environmental toxin was not identified.
