Acute neuropathy in perazine-treated patients after sun exposure.
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Biomedical subjects
Publications and source records attributed to E Hund.
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The need for temporary cardiac pacing is not unusual in neurocritical patients, due either to disorders of the autonomic nervous system or to concomitant cardiac disease. Mostly, intravenous devices are used. However, intravenous pacing is not without risks, and requires skill and experience when done in emergency cases. We therefore tried a technique of non-invasive, transcutaneous cardiac stimulation on eight patients, for all of whom it proved safe and effective. The only observed side-effect was minor discomfort in conscious patients.
Twelve commercially available sets for drainage of cerebrospinal fluid were tested for handling, design, features for fixation of the ventricular catheter, reliability of the anti-reflux valve, obstruction, efficiency of the air ventilation filter caps, accuracy of flow measurement and adjustment of flow, quality of material, adjustment, and cost. All systems showed considerable deficiencies in their reliability and handling. None of them can be recommended without certain restrictions and they should all be revised.
Nimodipine, now widely used for treatment and prevention of cerebrovascular spasm, is regarded as a safe drug. Despite a preferential action on cerebral vessels, there is clinical and experimental evidence of effects on systemic vascular and intestinal smooth muscle cells. Gastro-intestinal side-effects, however, have not been reported in clinical studies dealing with treatment of vasospasm following subarachnoid haemorrhage. We report on a patient with subarachnoid haemorrhage who developed an acute life-threatening pseudo-obstruction of the colon, a variant of adynamic ileus, while being treated with intravenous nimodipine. The relationship between this complication and calcium antagonist therapy is discussed and therapeutic strategies are presented. We conclude that neurosurgeons and neurologists should be aware of calcium antagonist--related ileus in patients treated with nimodipine.
In 1960 Robinson inaugurated the method of placing atrial shunt catheters with the help of intracardiac ECG monitoring. Vulnerability to artifacts and problems with electrical safety (which have since been solved) led to its disuse. A newly developed ECG adapter proved free from artifacts and was practicable in 33 patients. 31 shunts were correctly placed without requiring time-consuming radiography. 2 extracardiac false positions were clearly identifiable by means of true negative results, which after correction showed a typical atrial ECG. The ECG method is compared with 9 other positioning methods. It seems to be superior to the conventional chest x-ray and equal to fluoroscopy. However, the method is not on a par with sophisticated measuring techniques such as intracardiac pressure monitoring or intravasal sonography.
Plasma renin activity (PRA), aldosterone, vasopressin and catecholamines were measured in 15 children (ages 7.3 to 16.2 years) with chronic renal failure (CRF) before and after one session of hemodialysis and in 15 control children. Basal levels of PRA and aldosterone in children with CRF did not differ significantly from control values, but showed a wider range. Uremic patients with nephronophthisis showed the highest basal PRA and aldosterone levels. In children with CRF, basal vasopressin levels were significantly higher (9.7 +/- [SEM] 2.0 ng/liter) than control values (3.2 +/- 0.8 ng/liter). Plasma noradrenalin and adrenalin concentrations were similar in children with CRF and controls. During hemodialysis, a fall in blood pressure and a rise in heart rate was observed in all children. PRA and catecholamines increased twofold to fivefold during dialysis while aldosterone and vasopressin showed a variable response. In contrast to reports in adults, there is no evidence for an insufficiency of vasoactive hormones or of the sympathetic nervous system in children on hemodialysis.