Search PubMed⌕ Search

Biomedical subjects

P Biro

Publications and source records attributed to P Biro.

41 records · Page 3Linked to original sources
PubMed1992

[Intravenous postoperative pain management using nalbuphine and tramadol. A combination of continuous infusion and patient-controlled administration].

UNLABELLED: The aim of the study was to examine the analgesic efficacy and applicability of the two analgesic drugs nalbuphine and tramadol, administered by continuous i.v. infusion combined with a patient-controlled analgesia device (PCA). METHODS: With informed consent and approval of the ethical committee, 40 patients were studied after abdominal hysterectomy in a randomized, double-blind order. Twenty received an initial postoperative dose of 10 mg nalbuphine followed by a continuous infusion of 5 mg/h and the possibility of an additional 5 mg every 30 min. The other 20 received equipotent analgesia consisting of an initial bolus of 50 mg tramadol i.v. followed by a continuous infusion of 25 mg/h and the possibility of an additional 25 mg every 30 min. Analgesia, sedation, general well-being, and acceptance of the patients as well as blood pressure, heart rate, respiratory rate, and pulse-oximetric O2 saturation were measured regularly during a 5-h postoperative period. Data were analyzed using the Mann-Whitney test, with P less than 0.05 considered significant; results were expressed as mean +/- standard deviation. RESULTS: The postoperative pain score on the visual analogue scale (0 to 10) fell with nalbuphine from 7.14 +/- 3.45 to 2.03 +/- 1.25 and with tramadol from 7.81 +/- 2.85 to 1.57 +/- 1.40. There were no significant differences between the two groups. PCA supplements were requested 21.7 times in the nalbuphine group and 27.3 times in the tramadol group. General well-being of the patients on a 4-point scale (0 to 3) improved for the nalbuphine group from 0.70 +/- 0.92 to 2.11 +/- 0.49 and for the tramadol group from 0.62 +/- 0.67 to 2.33 +/- 0.50, which was significantly better in the nalbuphine group after 45, 60, and 90 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[A life-threatening anaphylactic reaction following mannitol].

CASE REPORT: After uneventful induction of general anesthesia, severe hypotension and cardiac arrest developed in a 39-year-old, non-atopic man following infusion of 20% mannitol 80 min after the beginning of anesthesia. It caused a systolic blood pressure of 40 mmHg during a period of 10 min and tachycardia followed by ventricular fibrillation. Immediate resuscitation measures, i.e., external cardiac compression, rapid infusion of 3,000 ml crystalloid and 1,000 ml colloid, central-venous application of suprarenin (2.4 mg total), lidocaine (100 mg), sodium bicarbonate (100 mmol), and two defibrillations, could alleviate the life-threatening reaction. The patient recovered a few hours later without any further sequelae. ALLERGOLOGIC INVESTIGATIONS: Allergologic studies with all drugs involved revealed a positive and specific reaction in an intradermal skin test to 1:100 diluted mannitol, as did in-vitro leucocyte histamine release to 20% and 2% mannitol. For all the other drugs, skin tests and leucocyte histamine release were negative or unspecific. Available RAST determinations to thiopental and suxamethonium were also negative. The total IgE level was normal. CONCLUSIONS: Reflecting the hypotension induced by histamine, the hematocrit rose from 0.4 to 0.5 even though the patient received a large amount of fluid before and during resuscitation. This can be explained by marked sequestration of plasma in the interstitial compartment, leading to hypovolemia. The clinical course and test results suggest that mannitol was the agent responsible for the anaphylactoid reaction.

Adult↗
PubMed1988

Human heme oxygenase cDNA and induction of its mRNA by hemin.

Hemin treatment increased both activity and mRNA level of heme oxygenase in human macrophages. Using poly(A)-rich RNA prepared from human macrophages treated with hemin, we have constructed a cDNA library in the Okayama-Berg vector. The human heme oxygenase cDNA was isolated by screening this library with a rat cDNA and was subjected to nucleotide sequence analysis. The deduced human heme oxygenase is composed of 288 amino acids with a molecular mass of 32,800 Da. The homology in amino acid sequences between rat and human heme oxygenase is 80%. Like rat heme oxygenase, human enzyme has a putative membrane segment at its carboxyl terminus, which is probably essential for the insertion of heme oxygenase into endoplasmic reticulum. Both rat and human heme oxygenase have no cysteine residues. Recently we have shown that rat heme oxygenase is a heat-shock protein [J. Biol. Chem. 262, 12889-12892 (1987)], and therefore we examined the effects of heat treatment on the induction of heme oxygenase in human macrophages and glioma cells. In contrast to hemin treatment, heat treatment had no apparent effects in either human cell line on the activity of heme oxygenase and its mRNA levels. These results suggest that human heme oxygenase may not be a heat-shock protein.

Amino Acid Sequence↗
PubMedDate not supplied

Anesthesia in a patient with acute respiratory insufficiency due to relapsing polychondritis.

We report on a male patient with advanced relapsing polychondritis (RP), who was hospitalized for an ophthalmologic intervention. He had to undergo a tracheostomy with general anesthesia due to respiratory decompensation. RP is a rare systemic, inflammatory, and destructive disease of the cartilaginous structures leading to multiple functional disorders in the affected organs. Involvement of the tracheobronchial tract may cause severe respiratory problems and even life-threatening respiratory insufficiency. Treatment consists of corticoids, chemotherapy, antirheumatics, and surgical intervention. Anesthesiologic management requires careful preoperative evaluation of vital organ functions, in particular respiration, so that the anesthetic approach can be tailored to the individual needs of each patient.

Acute Disease↗