In the anesthetized rats, both naloxone hydrochloride and methiodide produced transient hypotension and bradycardia. The hydrochloride salt was able to revert (during 1 hr for the dose of 10 mg/kg I.V.) the hypotension produced by the endotoxin of Escherichia coli, the methiodide salt was ineffective. Further naloxone hydrochloride, produced tachycardia and some awaking of the animals which were not observed after the quaternary ammonium salt. These observations strengthen the view that the effects of naloxone observed in the shocked rat are of central origin and that the antihypotensive action results--partly at least--from the antagonism of beta endorphin released by the toxin.

Animals↗

PubMedDate not supplied

Prevalence of alcohol and illicit drug use by expectant mothers.

BACKGROUND: Prevalence data of illicit drug and alcohol use during pregnancy in Alaska is limited. This study demonstrates the prevalence of perinatal drug and alcohol use at a single community hospital in Anchorage, Alaska. METHODS: A convenience sample was used during a six month period. 351 anonymous urine samples were obtained from imminently delivering women. Screening toxicology tests were run and results were linked to demographic variables using a common random reference number. RESULTS: 16.2% (n = 57) of the samples were positive for drugs or alcohol. Cannabinoids and alcohol were found most frequently. Polydrug use was found in 22.8% of the positive samples. Medicaid recipients represented the highest users of illicit drugs and alcohol. CONCLUSIONS: The prevalence of positive drug screens and polydrug use in our sample is amongst the highest reported in the literature. The high prevalence of drug and alcohol use indicates that present prevention strategies are not working in Alaska. New and innovative outcome based strategies to decrease drug and alcohol use in pregnancy are needed.

Adolescent↗

PubMedDate not supplied

What determines survival and morbidity at very early gestation? Alaska's experience.

The charts of all infants (N = 46) 22-25 weeks gestation admitted to the Newborn Intensive Care Unit at Providence Alaska Medical Center from 1991-1994 were reviewed to determine factors associated with mortality and severe morbidity. Survival rates at 22 & 23 weeks gestation was poor (25% and 14% respectively). Survival rates of 24 and 25 week gestation infants were similar (53% and 62% respectively). Infants with "poor" outcomes (death or survival with Grade 3 or Grade 4 intraventricular hemorrhage or periventricular leukomalacia) were more likely to have suboptimal intrapartum care which primarily involved delayed intervention on behalf of the fetus. This was manifested as perinatal asphyxia needing vigorous resuscitation at birth with cardiac compression and epinephrine use, and the development of persistent pulmonary hypertension of the newborn in the first 24 hours of life. Ten of the fifteen deaths were primarily due to intractable respiratory failure complicated by barotrauma from ventilator therapy. The fetus at 24 and 25 weeks should be considered viable. Improving the survival and morbidity of these extremely low birthweight babies will require us to optimize fetal care in complicated pregnancies at previable and very early viable gestations (20-25 weeks).

Alaska↗

PubMedDate not supplied

The next challenge for newborn intensive care in Alaska: improving the survival of the larger neonate.

Using information from our database, a review of mortality for the Newborn Intensive Care Unit at Providence Alaska Medical Center was conducted for 1987-1996. There has been a significant decline in mortality over the last decade (p = 0.003). An analysis of mortality by birthweight and gestational age groups demonstrated a decline in mortality (p = 0.005) for infants with birthweight < 2 kg and infants < or = 34 weeks gestation, but no change for infants > or = 2 kg and > or = 35 weeks gestation. As a result, larger and more mature babies now account for an increasing proportion of NICU deaths. For 1995 and 1996 the major contributors to mortality for the smaller neonates were respiratory distress syndrome and congenital and nosocomial sepsis/pneumonia. The major contributors to mortality for larger neonates were persistent pulmonary hypertension of the newborn, congenital heart disease, congenital diaphragmatic hernia, and primary birth asphyxia. A majority of deaths in the larger neonates were due to non-lethal causes. We contend that improved survival in the larger neonate is an important and achievable goal. The introduction of ECMO (Extracorporeal Membrane Oxygenation) for the NICU and a focused review of the neonatal cardiac program offers the best possible potential for achieving this goal.

Alaska↗

PubMedDate not supplied

Oral cancer examination guide. Hines Tumor Registry, Hines VA Medical Center.

Explore the source record for details and available documents.

Humans↗

PubMedDate not supplied

[Immunopathologic aspects of recurrent phlebitis and nodular vascularitis. Therapeutic applications].

Recurrence of vasculitis is conditioned by 2 factors : a) one is extrinsic (bacteria, mycobacteria, viruses, chemicals) ; b) the other comes from the host. From host-extrinsic factors inter-relationships, depend recurrences of the disease. The role of streptococcosis is of primordial importance : 1) by its exotoxins (Streptolysin O) ;2) by its total exoproteins (highly sensitizing for human beings) ; 3) by an antigenic community with some tissular antigens. Immunotherapy when successful may act by an inhibiting effect on allergy (probably exerted by means of a stimulation of the reticuloendothelial system).

Bacterial Infections↗