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Biomedical subjects

A Baraka

Publications and source records attributed to A Baraka.

At least 289 records · Page 16Linked to original sources
PubMed1977

Irreversible curarization.

The reversal effect of neostigmine following different doses of tubocurarine was investigated in 20 anesthetized adults. After five minutes, neostigmine could rapidly and effectively reverse a blocking dose of tubocurarine. Doubling the dose of tubocurarine necessitated a much higher concentration of neostigmine to achieve reversal, while a triple dose could be reversed only after enough time had elapsed to allow for lowering its concentration. It is concluded that the degree of reversal by neostigmine is related inversely to the concentration of tubocurarine at the time of reversal. An overdose of tubocurarine predisposes to the so called "neostigmine-resistant curarization".

Clinical Trials as Topic↗
PubMed1975

Cardiac arrest related to anesthesia. Contributing factors in infants and children.

A collaborative retrospective study undertaken to investigate cardiac arrest related to pediatric anesthesia in seven institutions between 1960 and 1972 showed 73 instances in which anesthesia was thought to have been either directly responsible or had played an important contributing role. About two thirds of these patients were successfully resuscitated. Cases were found to fit into one of two major categories: cardiovascular and respiratory. Among cardiovascular factors, blood loss, preoperative anemia, inappropriate administration of succinylcholine, and accidental administration of potassium were important contributing causes. Respiratory factors included failure to maintain a patent airway and ventilatory problems. In retrospect, most of these accidents were preventable. Such information should indicate where research emphasis needs to be placed and that our current methods of teaching and training need to be reevaluated.

Adolescent↗
PubMed1975

Oesophageal foreign bodies.

Impaction of foreign bodies in the oesophagus was analysed in 54 patients, 45 of whom were children. Of the 45 children 28 were aged 2-4 years. Coins were the most common foreign body in children (27 cases) while in adults a bolus of meat was most common (nine cases). In 41 children there was no predisposing factor, but an underlying mechanism was detected in 88% of the adults. The mechanisms were of three types: oesophageal (stricture), neuromuscular (myasthenia gravis), and extrinsic and mechanical (ankylosing spondylitis). In children most of the foreign bodies were impacted in the upper oesophagus at the cricopharyngeal junction, which is the narrowest part of the oesophagus, while in adults the foreign body was usually impacted at the site of the predisposing lesion or in the lower oesophagus. In all patients oesophagoscopy was performed under general anaesthesia to remove the impacted foreign body. Complications were more frequent in adults, mainly owing to the underlying condition.

Adult↗
PubMed1975

Potentiation of suxamethonium blockade by neostigmine in patients with atypical cholinesterase.

This report describes the potentiation of a suxamethonium-induced (0.1 mg/kg) neuromuscular block in two children with atypical serum cholinesterase activity, and compares it with a control response demonstrated in a homozygote brother. In the atypical homozygote patients, suxamethonium produced a markedly prolonged neuromuscular block associaiated with partial desensitizatin as evidenced by tetanic fade and post-tetanic facilitation. The use of neostigmine 0.05 mg/kg for reversal was followed by a paradoxical potentiation of the block and a marked delay in recovery. It is suggested that in atypical homozygotes, the development of desensitization after suxamethonium does not necessarily imply that the block will be reversed with neostigmine.

Anesthesia, Inhalation↗
PubMed1975

Hexafluorenium-suxamethonium interaction in patients with normal versus atypical cholinesterase.

The effect of hexafluorenium 0.3 mg/kg on the neuromuscular block of suxamethonium 0.1 mg/kg in a child with homozygote atypical plasma cholinesterase activity and in one of his normal brothers has been compared. In the normal child, hexafluorenium produced a marked potentiation of suxamethonium block, while partially antagonizing the block in the atypical homozygote child. In both situations, the hexafluorenium-suxamethonium block appeared to be antidepolarizing in nature as indicated by tetanic fade and post-tetanic facilitation. It is concluded that, in man, hexafluorenium can modify the action of suxamethonium by two different mechanisms. In patients with normal plasma cholinesterase activity, the anti-esterase effect predominates and results in marked potentiation of suxamethonium block, while in atypical homozygotes a direct antidepolarizing action at the neuromuscular junction may result in a diminished response.

Child↗