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PubMedDate not supplied

Possible role of drug interactions in bupivacaine-induced problems related to intraventricular conduction disorders.

Clinically, bupivacaine has depressant effects on intraventricular conduction that may lead to serious atrioventricular blocks or reentrant arrhythmias at plasma levels below those required to produce these effects experimentally (2-3 micrograms/ml instead of 8-10 micrograms/ml). The difference could be due to drugs present in the blood at the time of regional anesthesia that similarly inhibit conduction. This hypothesis was examined in 30 anesthesized, closed-chest dogs by measuring conduction time in the ventricular contractile fibers as well as effective refractory period under pacing at a constant, relatively high (180 beats/minute) rate. Changes in sinus rate were limited, as well as changes in ventricular effective refractory period and blood pressure regardless of the drug tested. In contrast, cibenzoline, disopyramide, and propranolol increased conduction time and lengthened QRS duration. Clomipramine appeared to prolong conduction time and widen QRS only moderately in therapeutic doses, whereas verapamil did not manifest noticeable effects on conduction. Caution is therefore recommended in regional anesthesia with bupivacaine in subjects being treated with cardiovascular drugs, such as cibenzoline, disopyramide, and propranolol and their congeners, or even by tricyclic antidepressants.

Animals↗
PubMed1993

In-patient treatment of 165 adolescents with emotional and conduct disorders. A study of outcome.

A two-year follow-up study of 165 teenagers with conduct and emotional disorders treated as in-patients on a regional adolescent unit (YPU) is described. The target types of behaviour for each subject were scored independently by the teenager, the parent or guardian, and the professional referrer before admission and at one month, one year and two years after discharge. The significant overall improvement in behaviour observed at one month after discharge was sustained at one and two years. Thirty-three subjects who abandoned treatment within six weeks of admission had made significantly less progress than the fully treated group at one month after discharge, but there were no significant differences at the one- and two-year evaluations. Two years after treatment, between 69% and 79% of the 132 subjects who completed treatment were regarded as improved, depending on which respondent made the assessment. Adolescents who completed treatment had different characteristics from those who terminated treatment prematurely and were more likely to be girls in care referred by social services.

Adolescent↗
PubMed2000

[Biventricular pacing as a new therapeutic method in heart failure. An alternative for patients with intraventricular conduction disorders].

Patients with severe heart failure often have interventricular conduction disturbances indicated by wide QRS complexes. The resulting uncoordinated contraction pattern leads to impaired systolic and diastolic function which might be overcome by a new technique, biventricular pacing. The first Swedish clinical trial is reported, an open study where 13 out of 16 patients improved in terms of functional class, walking test and quality of life after six months of treatment. The number of hospital days was markedly reduced after pacemaker implantation.

Adult↗
PubMed1975

[Rhythmic and conductive disorders in the acute stage of cardiac infarct].

Rhythm and conductive disturbances were established in 170 (63,8%) out of 266 patients with fresh cardiac infarction, in the greatest part with prophylactically applied lidocain i.m. With age advancing a growth in their incidence is established but no statistical difference between the age groups 20-59 and 60-90 was found. Rhythm disturbances are found more frequently in women (81,6%) as compared with the men 58,7%) while the incidence in patients with posterior (62, 5%) and anterior (65, 7%) infarction is the same. Th-disturbances due to electrical instability and failure are more frequent in anterior infarction. Statistical difference (P less than 0,001) was established concerning the rhythm disturbances in patients with heart failure and without it, with a prevalence of sinus tachycardia, auricular fibrillation, ventricular extrasystoles, ventricular tachycardia and bundle branch block. The timely diagnosis and the treatment with medicaments led to the restoration of sinus rhythml in 79 out of 94 disturbances and with electrical shock in 12 out of 16. Parallelly with the classica netirhythm medicines (chinidine and procainamid), newer ones are used as tachmalin, lidocaine, abta-blockers, sympaticomimetics and temporary intracardial electric stimulation.

Acute Disease↗
PubMed2003

[Relationship between polymorphism of non-coding regions of human mitochondrial genome and primary cardiac conduction disorders].

AIM: Analysis of associations between idiopathic disturbances of cardiac conduction (DCC) and polymorphism of mitochondrial genome. MATERIAL AND METHODS: A family examination was performed in 431 probands with various DCC and 1347 relatives of the first, second and third degree of kinship (the study group). All the examinees were divided into four subgroups. These included 158 probands with atrioventricular block (AVB) of various degree and their 518 relatives (subgroup 1); 50 probands with a complete right bundle-branch block (BBB) and their 161 relatives (subgroup 2); 108 probands with a complete left BBB and left anterior branch of the His bundle and their 152 relatives (subgroup 3); 115 probands with sick sinus syndrome (SSS) and their 327 relatives (subgroup 4). The control group consisted of 104 probands without clinical ECG manifestations of cardiac diseases and their 321 relatives. All the examinees have undergone ECG, atropin test, echocardioscopy, electrophysiological examination of the heart and mitochondrial DNA (mDNA). RESULTS: Comparison of the incidence of mDNA D-loop restriction sites in the group of patients with idiopathic DCC and controls has found higher frequency of the Hae III 16517 site in the group of the patients (p = 0.0480). By location of the blocks (atrioventricular and intraventricular), the site occurred more frequently in patients with AVB (86.36%). The variant "+" by the site of Hae III 16517 mDNA was found to associate with disturbances of cardiac conduction, more closely in AVB. CONCLUSION: Variability of mDNA may be an etiological factor of idiopathic DCC pathogenesis.

DNA, Mitochondrial↗
PubMed2001

Satisfaction of parents with their conduct-disordered and substance-abusing youth.

This study examined parental satisfaction (using the Parent Satisfaction With Youth Scale) in 132 parents of adolescents who were dually diagnosed with conduct disorder/oppositional defiant disorder and drug abuse/dependence. Results indicated parental satisfaction did not vary as a function of age, ethnic minority status, or gender. Parents of younger youth were generally more dissatisfied than parents of older adolescents although younger youth were no more delinquent than older youth. These results suggest that parents of delinquent youth become tolerant of their children's behavior problems with time. As expected, parents were most dissatisfied with their youth's use of drugs, illicit behavior, school performance, and response to discipline. Parents who endorsed lower levels of satisfaction reported their youth engaged in more pronounced levels of problem behavior and more drug use than did parents who were relatively more satisfied with their youth. Study implications and future directions are discussed.

Adolescent↗
PubMed1999

Barriers to treatment participation and therapeutic change among children referred for conduct disorder.

Examined predictors of therapeutic change among children seen in outpatient therapy. Children (N = 200) referred for oppositional, aggressive, and antisocial behavior and their families participated. The major findings were that (a) socioeconomic disadvantage, parent psychopathology and stress, and child dysfunction predicted therapeutic change from pretreatment to posttreatment; (b) barriers to participation in treatment also were significantly associated with therapeutic change and this effect was not explained by the other family, parent, and child predictors; (c) as the level of perceived barriers to participation in treatment increased among families, the amount of therapeutic change decreased; and (d) among children at risk for relatively little therapeutic change, the perception of few barriers to treatment increased the degree of child improvement. The implications for further work on predictors of therapeutic change and the role of barriers in the treatment process are discussed.

Adolescent↗
PubMed1995

[A comparative analysis of rhythm and conduction disorders in patients with dilated cardiomyopathy and chronic myocarditis].

Rhythm and conduction disturbances were compared for 20 patients with dilated cardiomyopathy (group 1) versus 20 patients with chronic myocarditis (group 2). The diagnosis was confirmed at coronary ventriculography and morphological examination of left and right ventricular endomyocardial biopsies. There were minor differences in the parameters studied I, though supraventricular arrhythmia varied more in group 2. The frequency of ventricular arrhythmia appeared higher in group 2 only in circulatory insufficiency stage 1-IIA. Quantitative differences in ventricular and supraventricular arrhythmias between the groups under moderate circulatory insufficiency may result from different morphological changes in the myocardium.

Adult↗
PubMed1990

Quality of perceived parenting in oppositional and conduct disordered adolescents.

In order to ascertain whether there was a relationship between parenting style and the development of conduct (CD) and oppositional (OD) disorder, the authors compared ratings on a self-report measure of perceived parenting (Parental Bonding Instrument) by normal adolescents (N = 62) and by adolescents with CD (N = 62) or OD (N = 49). No differences were found between the CD and OD groups. However, there were significant differences between the clinical groups and the normal control group: adolescents with CD or OD perceived their parents as more overprotective and less caring.

Adolescent↗