The main objective of this study was to evaluate the effect of fenoterol alone or associated with ipratropium bromide or steroid on the heart rate in young children. Ninety-four infants less than 1 year of age were randomly allocated to receive nebulized fenoterol alone, fenoterol plus ipratropium bromide, fenoterol plus corticosteroids, or normal saline solution. An increase in heart rate was observed in all four groups. The increases were statistically significant (P less than 0.001) in all three treatment groups, and no difference between them was observed (F = 0.65, NS). However, the heart rate remained within clinically acceptance limits. We conclude that nebulized fenoterol alone or combined with ipratropium or steroids can be safely used in the treatment of wheezy infants.

Acute Disease↗

PubMedDate not supplied

Use of nebulized bronchodilators in infants under 1 year of age: analysis of four forms of therapy.

The main purpose of this study was to evaluate four different forms of treatment in young infants admitted for acute wheezing (AW). Seventy-nine infants less than one year of age were randomly assigned to one of five groups. Group 1 received nebulized fenoterol plus ipratropium bromide, group 2 fenoterol, group 3 fenoterol plus steroids, and group 4 aminophylline, IV, plus steroids and oral fenoterol; the control group, or group 5, received nebulized normal saline solution. Clinical evaluation was done by means of a scoring system. The effectiveness of treatments was estimated by a score decrease in the first 24 hours, by the percentage of patients whose scores did not decrease during the same period, and by the number of days in the hospital. All infants had significantly decreased scores, except those in the control group; the aminophylline group included a greater percentage of patients who did not abate their scores, and they stayed in the hospital for more days than those in the other groups. The fenoterol group had the shortest hospital stay. All four treatments produced objective clinical improvement in bronchial obstruction. However, the nebulized bronchodilator treatments were more effective than aminophylline IV in decreasing scores on the first day, and they resulted in shorter hospitalization.

Aminophylline↗

PubMedDate not supplied

Bronchodilator effect of fenoterol and ipratropium bromide in infants with acute wheezing: use of MDI with a spacer device.

Twenty-eight infants admitted to Exequiel González Cortes Children's Hospital because of acute wheezing (AW) were randomly assigned to three study groups. Fenoterol (FNT), ipratropium bromide (IB), and placebo were administered respectively to children in the different groups by means of metered dose inhalers (MDI) with spacers, using doses of 3 puffs every hour, for 4 hours. The degree of bronchial obstruction was assessed clinically and scored with the single-blind method every hour prior to each treatment. The criterion of a bronchodilator effect was a significant decrease in the degree of bronchial obstruction at subsequent scorings. The scores of the three groups were compared using the Student's t test for matched samples. The same test was also applied to the independent samples for determining the superiority of one treatment, FNT or IB, over the other. The results indicated a significant decrease in the scores of the groups receiving FNT and IB (P less than 0.05); this did not occur in the group in which placebo was used. FNT produced a more rapid and sustained effect than IB (P less than 0.05). Significant bronchodilator effect was obtained in infants with AW when repeated doses of FNT or IB were administered with MDI and spacers. This effect was significantly greater in the group treated with FNT.

Acute Disease↗

PubMedDate not supplied

[Emergence and postoperative course after anesthesia with sevoflurane versus propofol].

BACKGROUND: To compare the postoperative period, with particular regard to occurrence of adverse effects at the time of emergence from anaesthesia, recovery parameters, any post-surgical analgesia requirements and laboratory tests changes in 80 ASA I and II patients undergoing sevoflurane or propofol anaesthesia for elective extracavity surgery. DESIGN: A prospective randomized clinical trial. METHODS: Patients were randomly allocated into two groups: in the first group, thiopentone was administered for induction of anaesthesia and sevoflurane for maintenance; the second group received propofol either for induction of anaesthesia and maintenance. All patients received vecuronium for neuromuscular blockade and fentanyl as needed. At the end of surgery, the occurrence of adverse effects, recovery parameters, time of discharge from recovery area, any post-surgical analgesia requirements, time of walking resumption and any laboratory tests changes were recorded. RESULTS: In the sevoflurane group times of discharges from recovery area were significantly faster. In both groups total bilirubin increase was recorded until 72 hours after the end of anaesthesia. CONCLUSIONS: Significant differences of postoperative adverse effects and laboratory tests changes were not recorded in both groups of anaesthetics.

Adolescent↗

PubMedDate not supplied

[Tuberculin reaction in healthy infants vaccinated with BCG at birth].

Tuberculin test with PPD RT-23 with Tween 80 (2 TU strength), was performed to 228 infants under two years of age. None of them had any history of contact with tuberculosis. All were healthy, well-nourished infants, and had been vaccinated with BCG at birth. A positive PPD reaction (greater than 6 mm), was found only in 8.8%, of them and 16.2% had no BCG scar on examination; 14.9% of the studied infants had negative PPD (0-5 mm) reactions together with absent BCG scars. These findings are significantly different from those previously reported by chilean authors, which showed higher proportion of positive (greater than = 6 mm) reaction to 2 TU PPD in infants from similar populations that had been vaccinated with different BCG preparations than our patients. These results suggest the need to evaluate the efficacy of the BCG vaccines that are currently being used in our country to determine the factors that may affect it and the protection that they afford.

BCG Vaccine↗

PubMedDate not supplied

[Effects of extracorporeal circulation and hypothermia on cellular immune activity in patients undergoing heart surgery].

Aspecific cellular reactivity was assessed in patients who underwent open heart surgery. The authors conclude that depressed PMN activity measured as O2- production is not linked to anaesthesiological procedures, hemodilution and hypothermia. No conclusive reports are possible on the role of pulmonary reinfusion or plasmatic and cellular mechanism of depression.

Adolescent↗

PubMedDate not supplied