SEARCH · Search PubMed

Results for “Flushing”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources

PubMed1990

Analyses of flushing response to alcohol and drinking behavior among shipyard workers and their family members in Hiroshima Prefecture, Japan.

This paper reports on the prevalence of flushing as a subjective symptom, amount of absolute alcohol required to evoke flushing (flushing dose), and relationships among those and drinking frequency or alcohol consumption in Japanese with age of 20 years and above. The percentage of flushers was 68.6% of males and 41.9% of females, non-flushers 18.3%, 11.2%, and unknowns 13.1%, 46.9%, respectively. The percentage of flushers decreased as drinking frequency increased. Flushers drank less than non-flushers among male drinkers, but such a difference in amount of intake between flushers and non-flushers was not found among female drinkers. Drinkers showed a statistically larger flushing dose than non-drinkers. Results of quantification analysis showed correlations between decreasing flushing dose and (a) "less than once a week" drinkers among males and "less than five times per year" drinkers among females, and (b) the initiation of flushing "less than 10 minutes" after ingestion and "upper half of the body" or "whole body" flushing among both males and females.

Adult↗

PubMed1987

Facial flushing secondary to hypoglycemia.

Facial flushing is usually not associated with hypoglycemia. Diabetics treated with chlorpropamide can have an antabuse-like flushing with ingestion of alcohol, but flushing secondary to hypoglycemia per se has not been reported. The first case demonstrating that facial flushing can occur in insulin-induced hypoglycemia is described. This patient had marked erythematous facial flushing that was repeatable with each instance of hypoglycemia. Endocrine evaluation revealed no evidence of carcinoid or a pheochromocytoma in this patient and the facial flushing was unrelated to alcohol. Without insulin-induced hypoglycemia, this diabetic patient has had no further facial flushing in one year follow-up.

Aged↗

PubMed1996

Management of hot flushes due to endocrine therapy for prostate carcinoma.

Endocrine manipulation plays a crucial role in the treatment of advanced prostate carcinoma. Recent enthusiasm for earlier use of endocrine therapy has increased the significance of diminishing treatment-related side effects, particularly vasomotor hot flushes, to ensure long-term patient compliance. Treatments that lower serum testosterone, such as orchiectomy or luteinizing hormone-releasing hormone (LHRH) analogs, cause hot flushes in over half of men. Lack of regulatory feedback in the hypothalamus from circulating serum testosterone is the presumed mechanism of hot flushes in these men. Most often, hot flushes are only mildly bothersome and can be tolerated without the need for treatment. However, if flushes are particularly annoying or problematic, treatment should be offered. Small doses of diethylstilbestrol (DES) are effective in relieving hot flushes but cause gynecomastia. Megestrol acetate, at a dose of 20 mg bid, completely eliminates hot flushes in most men, and the dose can be progressively lowered in some.

Antineoplastic Agents, Hormonal↗

PubMed2005

Continuous infusion versus intermittent flushing to prevent loss of function of peripheral intravenous catheters used for drug administration in newborn infants.

BACKGROUND: The use of peripheral intravenous cannulae is common in newborn babies. Many of them require an intravenous line only for medications and not for fluid. Currently there is little uniformity in methods used to maintain cannula patency. OBJECTIVES: The object of this review was to determine which method was better for maintaining intravenous lines used in neonates for intravenous medication only: intermittent flushing or continuous infusion SEARCH STRATEGY: We searched The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2004), CINAHL (from 1982 to June 2004) and MEDLINE (from 1966 to June 2004) . SELECTION CRITERIA: Randomised controlled trials comparing continuous infusion to intermittent flushing to maintain patency of intravenous cannulas. Units of randomisation might include individual catheters or individual babies. DATA COLLECTION AND ANALYSIS: Three reviewers independently assessed trial quality and extracted data. MAIN RESULTS: Two studies were eligible for inclusion. In one study only one of our primary outcomes was available: the duration of cannula patency for the first cannula used per infant was slightly longer in the continuous infusion group, but not significantly so, with a mean difference of -4.3 hours (95% CI -18.2 to 9.7). In the second study, only one of our primary outcomes was available: the mean (SD) number cannulas used per infant in the first 48 hours was less in the intermittent flush group with a mean difference of -0.76 cannulas (95% CI -1.37 to -0.15). No results were available for any of our other primary outcomes: in the published report, results were reported per catheter rather than per infant, a number of infants received more than one intravenous catheter (39 infants received an unknown number of catheters). The overall duration of cannula patency was significantly longer in the intermittent flush group with a mean duration of patency in the intermittent flush group of 2.1 days (SD 1.0) compared with the continuous infusion group where the mean duration of patency was 1.0 days (SD 0.5) - Student's t test P value 0.0003. AUTHORS' CONCLUSIONS: It is difficult to draw reliable conclusions given the way the data were analysed and reported in the two included studies. The reliability of the results is uncertain. However, given the caution in interpreting these data, it should also be noted that the use of intermittent flushes was not associated in either study with a decreased cannula life or any other disadvantages, thus lending some support for the use of intermittent flushing of cannulas in a selected population in neonatal nurseries.

Catheterization, Peripheral↗

PubMed2001

Arterial first pass gadolinium-CM dynamics as a function of several intravenous saline flush and Gd volumes.

This study was performed to evaluate the dynamics of an arterial first pass gadolinium (Gd) contrast medium (CM) bolus at the descending aorta (DAo), depending on various saline flush and Gd volumes. Using an ultra-fast two- dimensional GE-sequence (Siemens Vision, 1.5-T), 200 sequential cross-sectional images of the addressed vessel (1 slice/s) were obtained. Several saline flush volumes (15 mL, 30 mL, and 60 mL) were applied following the administration of 10 mL Gd (single dose) to a group of 4 normal volunteers (body weight 50-55 kg) using a mechanical MR injector (injection rate = 3.0 mL/s). Additionally, when performing a second test series, the saline volume remained constant, while the Gd volumes were varied from half doses to triple doses (5, 10, 20, and 30 mL Gd were given to every volunteer of the group). The signal intensity versus time (SI/T) curve at a measured region of interest (ROI) within the DAo was calculated. The bolus arrival time (BAT), the maximal signal-to-noise ratio (SNR(max)), the bolus time length (BL; 75% and 80% maximum intensity duration), the slope of the SI/T curve, and the areas below the SI/T curve for both the 80% and 75% maximum intensity duration level (INT(80%) and INT(75%)) were calculated. The increase of saline flush volume from 30 to 60 mL caused significant bolus lengthening of approximately 50% (mean BL = 9.5 s, 10.3 s, and 15.4 s for 15 mL, 30 mL, and 60 mL saline flush volumes, respectively, measured as SI/T duration at the 75% SNR(max) level). Using saline flush volumes equal to or higher than 30 mL increased the slope of the SI/T curve. A continuous increase of INT(75%/80%) by using higher saline flush volumes was found. Different saline and Gd volumes did not affect the SNR(max) and the BAT. Only the low dose (0.05 mmol/kg Gd) showed a 17%-21.6% significantly lower SNR(max). The BL and the INT increased mainly by enlarging of applied Gd volume from single to double dose (BL(75%) and INT(75%) were 9.6 s and 1305, 12.3 s and 2121, 38.5 s and 6181, 37.8 s and 6613 for 5, 10, 20, and 30 mL applied Gd volume, respectively). The arterial bolus length benefits from increasing Gd and saline flush volumes due to increased venous bolus length and wash out effects of Gd within the injection site of the vein. Doses larger than a single dose are not needed to increase the SNR in contrast-enhanced magnetic resonance angiography images of the thoracic aorta.

Aorta, Thoracic↗

PubMed2006

Flushing time and storage effects on the accuracy and precision of carbon and oxygen isotope ratios of sample using the Gasbench II technique.

Continuous-flow isotope ratio mass spectrometry interfaced with a Gasbench II is used for automated and faster analyses of delta(13)C and delta(18)O in water, carbonate, and air samples that are accurate and highly precise. Prior to online chemistry and measurement using the Gasbench technique, rubber septa-capped glass vials are routinely flushed to remove air. Due to the small amounts of sample gas required for isotope analyses using current techniques, care should be taken to properly flush these vials to avoid contamination of sample gas with air. Our results indicate that isotopic composition of sample CO(2) gas remains constant when 10 mL vials are flushed (rate of 100 mL/min) for > or =600 s, whereas for vials flushed <600 s, the isotopic composition becomes substantially lighter with decreasing time of flushing, which affects the accuracy of analyses. This largely depends on the isotopic composition (and volume) of air that still remains after flushing. This effect is more pronounced on delta(18)O than on delta(13)C of sample CO(2) gas because there is very little carbon in the air. After 24 h storage in vials with punctured septa, both delta(13)C and delta(18)O of CO(2) become isotopically heavier compared with first day analyses, suggesting time-dependent changes in isotopic composition. The magnitude of shift depends on the concentration and the isotopic composition of CO(2) in laboratory air as well as on fractionation due to outflow of sample gas or inflow of air via punctured septa. Contamination of sample gas with air can be observed as a secondary peak on chromatograms that precedes sample peaks, and the intensity of these peaks depends on the amount of air. Such peaks are always present with short flushing times. For accuracy and better precision, irrespective of the magnitude of the secondary peaks, the analyses should be discarded if these appear in the chromatograms.

Journal Article↗

PubMed1998

Warm flush at 37 degrees C following cold storage attenuates reperfusion injury in preserved rat livers.

Pretransplant rinse solutions have been shown to reduce reperfusion injury in cold-stored liver grafts, especially at the nonparenchymal level in sinusoidal endothelial cells (SEC). In this study, different rinse temperatures were tested in a rat liver preservation model. Livers were washed out in situ via the portal vein with cold (4 degrees C) University of Wisconsin (UW) solution, and after hepatectomy (t0), were stored for 8, 16, or 24 h of cold ischemia time (CIT). After storage, livers were flushed with UW solution at either 4 degrees C, 20 degrees C, or 37 degrees C and reperfused for 90 min (37 degrees C). Control livers were reperfused at t0 without preflush. Levels of hyaluronic acid (HA), purine nucleoside phosphorylase (PNP), AST, and LDH were measured in the reperfusion medium. Bile production was monitored during reperfusion. At the end of reperfusion, liver biopsies were taken for enzyme hystochemistry (5'-nucleotidase and LDH). After 8-h CIT and a flush at 4 degrees C, a release of endogenous HA (-7%) was observed, whereas uptake of exogenous HA occurred after the 20 degrees C flush (2%, P = NS) and after the 37 degrees C flush (24%, p < 0.001). HA release occurred at all three preflush temperatures after the 16-h CIT but was significantly lower when flushed at 37 degrees C (-10%) that at 4 degrees C and 20 degrees C (-64% and -17%, respectively, p = 0.05). After the 24-h CIT, the release of endogenous HA increased in the 4 degrees C and 20 degrees C preflush groups, but not in the 37 degrees C group. Levels of PNP and AST increased until the 24-h CIT in all groups but were significantly lower after preflush at 37 degrees C. Release of LDH did not increase with increasing periods of cold storage in any of the flush series. Compared to control livers, mean bile production during reperfusion was significantly decreased following preflush at 4 degrees C or 37 degrees C after all periods of CIT. No differences in mean bile production could be demonstrated in the three preflush groups after any period of CIT. LDH activity in liver tissue was best preserved after the 8 and 16-h CIT in combination with the 37 degrees C preflush, indicating less hepatocellular damage. In conclusion, in cold stored rat livers flushed at 37 degrees C before reperfusion, SEC and hepatocellular damage is attenuated.

Adenosine↗

PubMed1988

Influence of uterine flushings from superovulated cows on in vitro bovine morulae development.

To evaluate early embryo development, 248 good to excellent bovine morulae were cultured in Ham's F-10 medium, supplemented with 10% steer serum, uterine flushings from Days 6, 10 or 15 following estrus (0.01, 0.1, 1.0 and 10% protein; 64 mg protein/ml), and 1.0% uterine flushings and 10% steer serum. Final development scores for embryos in steer serum were significantly higher (range across experiments was: 4.06 to 4.37) than for embryos cultured in uterine flushings alone (-0.23 to 0.52). Treatment means were not different (P >0.05) when 10% steer serum was added to 1.0% uterine flushings. A higher percentage of embryos in 10% steer serum (92%) than in 10% steer serum plus 1.0% uterine flushing from Day 6 (33%), Day 10 (45%) and Day 15 (50%) developed to hatched blastocysts. Embryos cultured in 1.0% Day 6 uterine flushings plus 10% steer serum required more time to attain the early blastocyst and blastocyst stages, while embryos in 1.0% Day 15 uterine flushings and 10% steer serum developed at the same rate as controls to the expanded blastocyst stage, but hatched sooner (72.8 vs 96.5 h). These results suggest substance(s) in uterine secretions can have inhibitory and stimulatory influences on early bovine embryo development.

Journal Article↗

PubMed1988

Infection related to intravascular pressure monitoring: effects of flush and tubing changes.

The optimal frequency for changing pressure monitoring tubing and flush solution that minimizes catheter-related infection and contains cost has not yet been established. We conducted a pilot study to examine the effects of three protocols on catheter-related infection: group I, change of flush solution and pressure monitoring tubing every 24 hours; group II, change of flush solution every 24 hours and change of pressure monitoring tubing every 48 hours; group III, change of flush solution and pressure monitoring tubing every 48 hours. Thirty critically ill patients were randomly assigned to one of the three protocols. Semiquantitative cultures of the solution from the flush bag and catheter tip were obtained. Intervening variables were documented: duration of cannulization, number of entries into the system, presence of other invasive devices, white cell count, patient's temperature, presence of preexisting infection, patient's age and diagnosis, use of steroids and antibiotics, and host risk factors for immunocompromise. All flush solution cultures were negative for growth. Incidence of catheter-related bacteremia was zero. The cultures of four catheter tips were positive for Staphylococcus epidermidis; none in group I, three in group II, and one in group III. The results of this pilot study suggest that there is no difference in the incidence of catheter-related infection whether the change interval for flush solution and pressure monitoring solution is 24 or 48 hours. However, further study with a larger sample is needed.

Adult↗

PubMed2005

Abbreviated duration of superheat-and-flush and disinfection of taps for Legionella disinfection: lessons learned from failure.

One medical center in southern Taiwan faced an outbreak of nosocomial Legionnaires' disease; a total of 81 suspected cases were detected during an 8-month period. Baseline environmental surveillance showed that 80% of the distal sites in intensive care units (ICUs) were positive for Legionella pneumophila. Superheat-and-flush was selected for hospital water supply disinfection because it required no special equipment, and it can be initiated expeditiously. We conducted 2 episodes of superheat-and-flush based on the published recommendations from the Department of Health, Taiwan; US Centers for Disease Control and Prevention; and American Society of Heating, Refrigerating, and Air-Conditioning Engineers. Both flushes failed to control colonization of Legionella in the hospital water supply. The rate of distal sites positive for Legionella in wards and ICUs was 14% and 66%, respectively, 10 days after the second flush. The effect of replacement of faucets and showerheads in ICUs appeared to be insignificant in colonization of Legionella. The application of superheat-and-flush for flush duration of 5 minutes was ineffective. Superheat-and-flush may not be economic for a large medical center because it could be costly and labor intensive.

Academic Medical Centers↗

PubMed2005

Evaluation of low-dose venlafaxine hydrochloride for the therapy of hot flushes in breast cancer survivors.

OBJECTIVE: To evaluate the efficacy and tolerability of long-term treatment with venlafaxine at low dose for the reduction of vasomotor symptoms in breast cancer survivors. DESIGN: Forty consecutive breast cancer patients suffering troublesome hot flushes have been treated for 8 weeks with venlafaxine XR 37.5 mg/day in an open-label study. Vasomotor symptoms have been evaluated before starting treatment and every 4 weeks with a hot flushes diary pointing out the number and the severity of vasomotor symptoms. A Beck Depression Inventory (BDI) was completed at baseline and at the end of the treatment. RESULTS: Thirty patients had completed the first 4 weeks of treatment, reporting a reduction of hot flushes frequency of 39% as compared to baseline (p<0.001). After 8 weeks of treatment, a further significant reduction was observed both for the hot flushes frequency (-53%; p<0.001) and for the hot flushes score (-59%; p<0.001), a measure which reflects both the number and the severity of hot flushes. Very few side effects were reported, mostly nausea in the first 2 weeks of assumption and mouth dryness. Only 23 women had completed BDI at week 8; a reduction of 23% was observed (p=0.000). CONCLUSION: Venlafaxine is an effective treatment for the relief of vasomotor symptoms in patients previously treated for breast cancer. A favourable effect is maintained also in those patients using tamoxifen as adjuvant therapy. The use of the low dose (37.5 mg/day) is associated with minimal side effects and produces a good improvement in hot flushes if pursued over 8 weeks.

Adolescent↗

PubMed2005

Application of nonionic surfactant-enhanced in situ flushing to a diesel contaminated site.

Surfactant-enhanced in situ flushing was performed to remediate soil and groundwater at a diesel contaminated area, which had been used as a military vehicle repair area in Korea for 45 years. A pilot-scale site (4 m x 4 m x 4 m) was selected within the contaminated area for in situ flushing; the selected site was composed of heterogeneous sandy and silt-sandy soils, with an average hydraulic conductivity (K) of 2.0 x 10(-4)cm/s. Two percent of sorbitan monooleate (POE 20) was mixed with uncontaminated groundwater and five pore volumes of solution (three pore volumes of surfactant solution and two pore volumes of groundwater alone) were flushed to remove diesel from the site. The effluent TPH (total petroleum hydrocarbon) concentration with surfactant solution flushing increased to 1761 mg/L, which was over 200 times higher than the average concentration with only groundwater flushing. A total of 48 kg of TPH (about 88% of the initial TPH) was removed from the pilot site with five pore volumes of 2% sorbitan monooleate solution flushing; this total was more than 75 times the amount that was removed when flushing with water alone (less than 640 g). All of the extracted solution was treated by means of a chemical treatment process, which included the use of a dissolved air flotation system to lower the concentration of solution below 5mg/L and the treated solution was then disposed of in a nearby sewage drain.

Gasoline↗

PubMed1991

Retrograde seeding of endometrial epithelial cells by uterine-tubal flushing.

OBJECTIVE: To estimate the amount of endometrial epithelial cells in peritoneal fluid (PF) after uterine-tubal flushing (40 mL) throughout the menstrual cycle. DESIGN: We cultured the cell pellet of flush medium present in the peritoneal cavity. SETTING: University Hospital Nijmegen, The Netherlands. PATIENTS: Ninety-two women with various infertility-related factors. INCLUSION CRITERIA: (1) ovulatory cycle, (2) patent tubes, and (3) no adhesions. INTERVENTIONS: None MAIN OUTCOME MEASURE(S): The number of developing epithelial cell colonies were counted after 7 days. We started to record the amount of flush medium recovered during the study. RESULTS: The amount of flush medium recovered was positively correlated with the presence of endometriosis (P = 0.017). Endometrial epithelial cells were identified in 85 flush media (92%). The number of epithelial cell colonies varied from 0 to 100 or more and was higher when flushing was performed during the early follicular phase (P less than 0.01). High estradiol-17 beta and progesterone levels in culture medium did not change the number of developing cell colonies. Methylene blue significantly reduced the number of cell colonies (P = 0.002). CONCLUSIONS: Uterine-tubal flushing results in varying numbers of endometrial epithelial cells in PF. Methylene blue adversely affects the growth potential of these cells.

Cell Division↗

PubMed1993

Placental protein 14 levels in uterine flushing and plasma of women with unexplained infertility.

OBJECTIVES: To measure concentrations of placental protein 14 (PP14) in uterine flushings and plasma samples obtained from patients with unexplained infertility and to compare the results of those of normal fertile women. DESIGN: Prospective study. SETTING: Infertility and gynaecology outpatient clinics at the Jessop Hospital for Women, Sheffield, United Kingdom. PATIENTS: Sixteen patients with unexplained infertility and 12 normal fertile women who had been previously sterilized. INTERVENTIONS: Daily monitoring of luteinizing hormone (LH) to detect the LH surge; uterine flushings and blood samples were obtained on days 7, 10, and 12 after the LH surge. MAIN OUTCOME MEASURES: The measurement of PP14 concentration in uterine flushings and plasma samples throughout the luteal phase. RESULTS: Levels of PP14 in uterine flushings of patients with unexplained infertility were significantly lower than those of normal fertile women on days LH +10 and LH +12. No significant differences were observed between the two groups in PP14 levels in uterine flushings on day LH +7 and plasma samples on days LH +7, LH +10, and LH +12. CONCLUSIONS: Patients with unexplained infertility have reduced concentrations of PP14 in uterine flushings but not in plasma samples as compared with normal fertile women. Placental protein 14 measurement in uterine flushings may be a more valuable method of assessing endometrial function in infertile patients than plasma levels of the protein.

Adult↗

PubMed1997

Prospective randomized trial of the effect of two flushing media on oocyte collection and fertilization rates after in vitro fertilization.

OBJECTIVE: To assess the value of heparinized saline as a flushing medium for oocyte recovery. DESIGN: Prospective randomized study. SETTING: Academic tertiary referral center for fertility treatment. PATIENT(S): Thirty-five patients, with both ovaries intact having IVF-ET. INTERVENTION(S): Patients were randomized either to have the follicles of the left or right ovary flushed with heparinized normal saline at the time of oocyte recovery for IVF-ET. The contralateral ovary was flushed with heparinized culture medium. Oocytes obtained from each side were cultured separately and assessed for fertilization 18-21 hours after insemination. MAIN OUTCOME MEASURE(S): Collection and fertilization rates. RESULT(S): A total of 481 follicles were aspirated yielding 366 oocytes. Of these, 240 fertilized. From the side flushed with saline 185 oocytes were collected from 237 follicles, which was not significantly different from 181 oocytes collected from 244 follicles on the side flushed with culture medium (odds ratio = 1.23; 95% confidence interval = 0.79-1.92). Similarly, there was no significant difference observed in fertilization rates between oocytes obtained after saline (median 71.4%) and culture medium flush (median 75.0%) (odds ratio = 1.08; 95% confidence interval = 0.68-1.72). CONCLUSION(S): Heparinized normal saline is an equally good but cheaper and more convenient medium than standard heparinized culture medium and could replace it for flushing follicles during oocyte recovery for IVF-ET procedures.

Adult↗

PubMed2002

Co-surfactant of ethoxylated sorbitan ester and sorbitan monooleate for enhanced flushing of tetrachloroethylene.

This work evaluated the flushing efficiency of tetrachloroethylene (PCE) using the co-surfactant of non-ionic ethoxylated sorbitan ester (Tween) and oilphilic sorbitan monooleate (Span 80), which formed more hydrophobic micelles than Tween alone. The flushing efficiency was evaluated with laboratory columns filled with silica and aquifer sand. Results from column flushing were also compared to those of batch solubility experiments to study the removal mechanism by the co-surfactant solution. Compared to Tween 80 alone, the molar solubilization ratio and the affinity between the micelles and PCE increased 84% and 90%, respectively, by the co-surfactant solution of Tween 80 and Span 80 mixed at a 4:1 ratio. Flushing with 1% Tween 80 solution yielded a steady PCE recovery of 7% for both silica and aquifer sand in each pore volume (PV). Flushing with co-surfactant of 1% Tween 80 + Span 80 (4:1) further increased PCE recovery to 10% for silica sand and 13% for aquifer sand per PV. A comparison of results from column flushing and batch solubility tests indicated that the primary flushing mechanism of PCE using the co-surfactant solution of Tween 80 + Span 80 (4:1) was micellar solubilization.

Chromatography, Liquid↗

PubMed2001

Thiopental and phenytoin by aortic arch flush for cerebral preservation during exsanguination cardiac arrest of 20 minutes in dogs. An exploratory study.

We are systematically exploring in our exsanguination cardiac arrest (CA) outcome model in dogs suspended animation (SA), i.e. immediate preservation of brain and heart for resuscitative surgery during CA, with delayed resuscitation. We have shown in dogs that inducing moderate cerebral hypothermia with an aortic arch flush of 500 ml normal saline solution of 4 degrees C, at start of CA 20 min no-flow, leads to normal functional outcome. We hypothesized that, using the same model, adding thiopental (or even better thiopental plus phenytoin) to the flush at ambient temperature (24 degrees C), which would be more readily available in the field, will also achieve normal functional outcome. Thirty dogs (20-28 kg) were exsanguinated over 5 min to CA of 20 min no-flow, and resuscitated by closed-chest cardiopulmonary bypass. They received assisted circulation to 2 h, 34 degrees C post-CA to 12 h, controlled ventilation to 20 h, and intensive care to 72 h. At CA 2 min, the dogs received an aortic arch flush of 500 ml saline at 24 degrees C by a balloon-tipped catheter, inserted through the femoral artery (control group 1, n=14). In group 2 (n=9), thiopental (variable total doses of 15-120 mg/kg) was added to the flush and given with reperfusion. In group 3 (n=7), thiopental (15 or 45 mg/kg) plus phenytoin (10, 20, or 30 mg/kg) was given by flush and with reperfusion. Outcome was assessed in terms of overall performance categories (OPC 1, normal; 2, moderate disability; 3, severe disability; 4, coma; 5, brain death), neurologic deficit scores (NDS 0-10%, normal; 100%, brain death), and histologic deficit scores (HDS, total and regional). The flush reduced tympanic temperature to about 36 degrees C in all groups. In control group 1, one dog achieved OPC 1, three OPC 2, six OPC 3, and four OPC 4. In thiopental group 2, two dogs achieved OPC 1, two OPC 3, and five OPC 4. In thiopental/phenytoin group 3, one dog achieved OPC 1, two OPC 3, and four OPC 4 (p=0.5). Median NDS were 36% (IQR 22-62%) in group 1; 51% (IQR 22-56%) in group 2; and 55% (IQR 38-59%) in group 3 (p=0.7). Median total HDS were 67 (IQR 56-127) in group 1; 60 (IQR 52-138) in group 2; and 76 (IQR 48-132) in group 3 (p=1.0). Thiopental and thiopental/phenytoin dogs achieved significantly lower HDS only in the putamen. Thiopental in large doses caused side effects. We conclude that neither thiopental alone nor thiopental plus phenytoin by flush, with or without additional intravenous infusion, can consistently provide 'clinically significant' cerebral preservation for 20 min no-flow. Other drugs and drug-combinations should be tested with this model in search for a breakthrough effect.

Animals↗

PubMed2000

Treatment of hot flushes with mirtazapine: four case reports.

OBJECTIVE: To evaluate the effect of mirtazapine on the severity of hot flushes and bouts of perspiration in women. METHOD: In two women with depression a reduction in hot flushes was noticed by serendipity during treatment with mirtazapine 15-30 mg/daily. On the basis of this observation clinical studies were extended with two non-depressed and non-anxious women with hot flushes. Both subjects were prescribed mirtazapine daily. RESULTS: Four cases are described as case reports. All subjects reported a practically complete disappearance of hot flushes and associated perspiration, within the first week of treatment. CONCLUSION: Mirtazapine appears to have a substantial ameliorating effect on hot flushes and perspiration bouts. It is postulated that the 5-HT(2A) blocking properties of mirtazapine is accounted in the symptomatic relief of hot flushes. In addition it is hypothesized that the serotonergic system is crucially involved in the pathogenesis of hot flushes and perspiration bouts. Further evaluation in double-blind placebo-controlled studies is encouraged.

Adult↗