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This study reports a case of a 13-year-old male with a 3-year history of severe and intermittent hypokalemia episodes of unknown origin, requiring admission to the intensive care unit (ICU) for long QT syndrome (LQTS), finally diagnosed of redistributive hypokalemia secondary to the abuse of β-adrenergic agonists in the context of a probable factitious disorder. RESUMO O presente estudo relata o caso de um jovem de 13 anos de idade com histórico, há três anos, de episódios de hipocalemia grave intermitente de origem desconhecida, internado em unidade de terapia intensiva (UTI) por síndrome do QT longo (SQTL). O paciente foi diagnosticado com hipocalemia por redistribuição secundária ao abuso de agonistas β-adrenérgicos, em contexto de provável transtorno factício.

Resume Position du probleme Le traitement des crises d’asthme aux urgences repose sur l’administration de β2 mimetiques inhales. Nous avons compare l’efficacite des β2 mimetiques selon qu’ils etaient administres en nebulisation ou par une chambre d’inhalation lors des crises d’asthme severes et potentiellement severes. Methode Des enfants âges de 4 a 15 ans, traites aux urgences pour une crise d’asthme severe ou potentiellement severe ont ete randomises, sans insu. Ils recevaient soit 6 nebulisations de 0,15 mg/kg de salbutamol (sous O2), soit 6 aerosols de 50 μg/kg de salbutamol (ou 125 μg/kg de terbutaline) en aerosol doseur couple a une chambre d’inhalation. La chambre et la molecule etaient choisies en fonction du traitement anterieur de l’enfant. Les familles etaient suivies par telephone aux 10e et 30e jours. Les criteres de jugement etaient le taux d’hospitalisation, la variation du score de Bishop, la SaO2, la frequence respiratoire (FR), la frequence cardiaque (FC) et le debit expiratoire de pointe (DEP)/valeur attendue, les effets secondaires, le temps necessaire a la realisation du traitement, le taux de rechute. Resultats Soixante-dix-neuf enfants (groupe nebulisation n = 40 vs groupe chambre n = 39) d’âge moyen 9 ans vs 9,4 ont ete inclus. Les DEP des enfants de plus de 6 ans etaient de 48,3 ± 16,0 et 55,7 ± 25,0 % des valeurs theoriques. Il y avait respectivement 20 et 14 crises severes avec des DEP de 40,8 ± 13,9 % et 44,5 ± 28,2 % (NS). Les deux groupes differaient pour la duree de leur gene respiratoire avant l’arrivee aux urgences (p Conclusion L’efficacite en terme d’hospitalisation des β2 mimetiques inhales au cours des crises d’asthme severes et potentiellement severes n’etant pas differente selon qu’ils sont administres par nebulisation ou avec une chambre d’inhalation, l’usage en premiere intention de la chambre pourrait etre plus frequent et procurer un gain de temps soignant destine a l’education de l’enfant asthmatique.

Liquid chromatographic resolution of six racemic β2‐blockers including bambuterol, clenbuterol, clenpropol, fumoterol, mabuterol, and terbutaline was studied on two Pirkle‐type chiral stationary phases (CSPs) such as α‐Burke‐2 and Pirkle‐1J. By varying the mobile phase compositions, five of the six β2‐blockers were successfully resolved on α‐Burke‐2 CSP, while only two β2‐blockers were resolved on Pirkle‐1J CSP.

Resume Dans l'asthme, l'œdeme de la muqueuse joue un role important dans l'obstruction des voies aeriennes. L'utilisation d'un produit ayant une activite alpha et betamimetique est un traitement logique de la crise d'asthme. L'objectif de ce travail a ete de comparer l'effet de l'adrenaline par voie sous-cutanee a celui de la terbutaline par voie sous-cutanee dans le traitement de la crise d'asthme du nourrisson. La justification de ce travail a ete aussi bien economique que physiopathologique. Patients et methodes Cinquante-quatre nourrissons âges de moins de 30 mois hospitalises pour crise d'asthme et n'ayant pas d'affections cardiovasculaire ou respiratoire de cause determinee ni de frequence cardiaque superieure a 200/min ont ete inclus dans l'etude. Apres une evaluation initiale et tirage au sort, les patients ont recu de l'adrenaline a la dose de 10 μ g/kg par voie sous-cutanee ou de la terbutaline a la meme dose et par la meme voie. Resultats La comparaison du groupe des nourrissons ayant recu de l'adrenaline ( n = 28) a celui des patients ayant recu de la terbutaline ( n = 26) montre que l'amelioration des signes de lutte, de la saturation percutanee en O 2 , de la PaO 2 et de la PCO 2 est comparable dans les deux groupes. La reduction de la frequence respiratoire est plus nette dans le groupe adrenaline ( p = 0,05). Il n'y a pas d'effet secondaire notable dans les deux groupes. Conclusion Nos resultats suggerent que l'adrenaline par voie sous-cutanee est aussi efficace que la terbutaline par voie souscutanee dans le traitement de la crise d'asthme du nourrisson de moins de 30 mois et qu'elle est sans risque d'effets secondaires. L'adrenaline, d'administration facile et de cout peu eleve, pourrait constituer un traitement de choix dans les pays en developpement.

The search for alternatives to metered-dose inhalers has accelerated recently in a bid to find effective products that do not use chlorofluorocarbon (CFC) propellants. This paper reviews the factors to be considered in developing dry powder inhalers (DPIs), particularly the formulation, metering design and flow path in the device. The advantages and disadvantages of current DPIs are discussed and possible future approaches outlined.

On a examine les effets d'un agoniste β 2 -adrenergique (agoniste β 2 ) et de l'AMPc sur la concentration de Ca 2+ cytosolique ([Ca 2+ ] c ) et sur le volume cellulaire dans les cellules de l'epithelium pulmonaire distal foetal. Tant la terbutaline (un agoniste β 2 specifique, 10 μM) que le dibutyryl AMPc (DBAMPc, 1 mM) ont augmente la [Ca 2+ ] c en presence de Ca 2+ extracellulaire. L'augmentation de [Ca 2+ ] c induite par le terbutaline a ete observee meme en l'absence de Ca 2+ extracellulaire, bien que l'augmentation ait ete transitoire. Toutefois, le DBAMPc n'a pas induit de variations significatives de la [Ca 2+ ] c . En presence de I mM de Ca 2+ extracellulaire, la terbutaline et le DBAMPc ont induit une degonflement cellulaire sensible a la quinine (un bloqueur des canaux K + ). Toutefois, dans une solution sans Ca 2+ , la terbutaline a induit un degonflement cellulaire rapide suivi d'un gonflement cellulaire transitoire sensible au benzamil (un bloqueur specifique des canaux Na + , analogue de l'amiloride). Dans une solution sans Ca 2+ , le DBAMPc a induit un gonflement cellulaire transitoire sensible au benzamil sans provoquer de degonflement cellulaire. Nos observations indiquent que l'agoniste β 2 a induit une elevation de [Ca 2+ ] c en augmentant tant l'influx de Ca 2+ de l'espace extracellulaire qu'une liberation de Ca 2+ des reserves intracellulaires, alors que le DBAMPc n'a stimule que l'influx de Ca 2+ de l'espace extracellulaire. Elles suggerent aussi que la terbutaline et le DBAMPc ont stimule les canaux sensibles au benzamil sans augmenter la [Ca 2+ ] c .

In this paper we examine how users interact with a computer-based infusion device adapted for terbutaline infusion to treat preterm labor in women experiencing high-risk pregnancies. This study examines (a) the human-computer interaction (HCI) deficiencies in the device as related to this context of use, (b) how the device characteristics increase the potential for error, and (c) the tailoring strategies developed by users to insulate themselves from failure. Interviews with nurses and tests of the behavior of the infusion device in different conditions identified several classic HCI deficiencies: complex and arbitrary sequences of operation, mode errors caused by poor differentiation of multiple operating modes intended for different contexts, ambiguous alarms, getting lost in multiple displays, and poor feedback on device state and behavior.

Nos ovinos, vários métodos de inseminação artificial (IA) já foram descritos. Atualmente, dois métodos são mais utilizados a campo, a IA transcervical e a laparoscópica. Contudo, trata-se de métodos que implicam em desconforto ao animal, tais como o tracionamento da parede vaginal com uma pinça cirúrgica, lateral à cérvix, além da posição de Trendelenburg (céfalo declive, num ângulo de 30 a 45°). Desta forma, este estudo teve como objetivo estudar técnicas que proporcionassem maior conforto ao animal, durante o procedimento. Foram utilizadas 43 ovelhas, da raça Morada Nova, divididas em quatro grupos: 11 IA vaginal, 11 IA vaginal associada a dilatadores cervicais (misoprostol e terbutalina), 10 IA cervical e 11 IA laparoscópica em decúbito lateral. O ciclo estral foi sincronizado com progestágenos e gonadotropina coriônica eqüina (eCG). Nenhuma complicação foi observada durante ou após os procedimentos. O diagnóstico de gestação foi realizado aos 30 e 60 dias após a IA. A taxa de gestação foi de 10% nas fêmeas inseminadas por via vaginal com e sem o uso de dilatadores e 54% nas fêmeas inseminadas por laparoscopia. Nenhuma fêmea inseminada pela via cervical apresentou-se gestante aos 30 e 60 dias. Conclui.se que a técnica de inseminação laparoscópica em decúbito lateral foi realizada com sucesso, reduziu o desconforto e apresentou taxa de gestação aceitável. In sheep, several methods of artificial insemination (AI) have already been described. Currently, two methods are most used in the field, transcervical and laparoscopic AI. However, these are methods that imply discomfort to the animal, such as traction of the vaginal wall with surgical forceps, lateral to the cervix, in addition to the Trendelenburg position (head slope, at an angle of 30 to 45 °). Thus, this study aimed to study techniques that provide greater comfort to the animal, during the procedure. 43 Morada Nova sheep were used, divided into four groups: 11 vaginal AI, 11 vaginal AI associated with cervical dilators (misoprostol and terbutaline), 10 cervical AI and 11 laparoscopic AI in lateral decubitus. The estrous cycle was synchronized with progestins and equine chorionic gonadotropin (eCG). No complications were observed during or after the procedures. The pregnancy diagnosis was made at 30 and 60 days after the AI. The pregnancy rate was 10% in females vaginally inseminated with and without the use of dilators and 54% in females inseminated by laparoscopy. No female inseminated through the cervical route was pregnant at 30 and 60 days. It was concluded that the laparoscopic insemination technique in lateral decubitus was performed successfully, reduced discomfort and presented an acceptable pregnancy rate.

OBJETIVO: avaliar um novo esquema terapêutico de emprego do atosibano quanto ao efeito tocolítico, eficácia e efeitos colaterais maternos e fetais. MÉTODOS: Estudo prospectivo com 80 gestantes em trabalho de parto prematuro admitidas para tocólise. Critérios de inclusão: gestação única, presença de contrações uterinas regulares, dilatação cervical >1 cm e 50%, idade gestacional entre 23 e 33 semanas e seis dias, membranas ovulares íntegras, índice de líquido amniótico >5 e

To assure the quality of drugs, impurities must be monitored carefully. It is important to understand what constitutes an impurity and to identify potential sources of such impurities. Selective analytical methods need to be developed to monitor them. It is generally desirable to profile impurities to provide a yardstick for comparative purposes. New impurities may be observed as changes are made in the synthesis, formulation, or production procedures, albeit for improving them. At times it is necessary to isolate and characterize an impurity when hyphenated methods do not yield the structure or when confirmation is necessary with an authentic material. Availability of an authentic material can also allow toxicological studies and provide a standard for routine monitoring of the drug product.

Editorial. El problema nutricional y su relación con la ciencia y la tecnología en Venezuela Salinas, Pedro José Control fisiológico en una fusión moa::lac de Escherichia coli K12:Cinéticas de expresión bajo diferentes condiciones de cultivo Physiological control in a fusion moa:: lac of Escherichia coli K12: Expression kinetics under different growth conditions. Ortega de López, Mariemmna Seguridad industrial: un asunto de salud organizacional Industrial Safety: a matter of organizational health Salom de Bustamante, Colombia Emponzoñamiento ofídico en el Instituto Autónomo Hospital Universitario de los Andes. Mérida, Venezuela Snake bites at the Autonomous Institute Hospital of the Andes. Mérida. Venezuela. Araujo Camacho, Sonia Rivas Padilla, Fernando Fisiología renal y el óxido nítrico. Una revisión Kidney physiology and nitric oxide. A review. Rondón Nucete, Miguel Efecto de la terbutalina sobre las lesiones inducidas por etanol en mucosa gástrica de ratas Effect of Terbutaline on lesions induced by ethanol on the gastric mucous of rats. Vásquez, Laura Chirinos, José Rojas, Gloria Valoración de la capacidad depredadora de Hydrophilus insularis y Thermoneutes circunscripta (Coleoptera: Hydrophilidae y Dytiscidae) en condiciones de laboratorio Predatory capacity assessment in Hydrophilus insularis and Thermoneutes circunscripta (Coleoptera: Hydrophilidae and Dytiscidae) in laboratory conditions. Valle, Sonia López, M. M. López, D. Espinoza, P. García, Israel Comparación entre aporte y consumo alimentarios relacionados con los requerimientos en ancianos semi-institucionalizados Food supply and consumption related to semi-institutionalized elderly people. Sanz Suárez, Belquis Vargas Bernal, Carmen T Pérez Feo, Mirna Incidencia de las anomalías anorrectales en pacientes del Hospital Universitario de los Andes. 1982-1994 Incidence of anorectal anomalies in patients of the Hospital Universitario de los Andes. 1982-1994. Tovitto Paredes, Gerardo José Kleiss P., Christina Conocimiento de la neurocisticercosis en los habitantes de Mérida Knowledge about neurocysticercosis in Merida, Venezuela, population. Peñalosa Martínez, Carlos Antonio Araujo Unda, Hilarión Montilla Linares, Dayana Factores de Riesgo Psicológicos y Socioeconómicos de las Embarazadas Adolescentes. Ambulatorio Ejido. Mérida, Venezuela. Psychological and socioeconomic risk factors in pregnant adolescent. Ambulatory Hospital Ejido. Mérida, Venezuela. Hernández, Morelia Salinas, Pedro José 32-36 lavasquez60hotmail.com semestral Nivel analítico

We report a case of recurrent priapism in a boy. There were no recurrences during or after oral treatment with Bricanyl (terbutaline).

Although the last couple of decades has seen tremendous progress in the ability to do chiral separations, the ability to do larger scale chiral separations has lagged somewhat behind the current analytical chiral separation state of the art. The potential of classical gel electrophoresis for chiral separation of milligram quantities of chiral material is examined. A protocol for the chiral separation of milligram quantities of terbutaline using sulfated cyclodextrin as a chiral additive is demonstrated. The possible advantages of the approach are discussed.

SummaryA new anticholinergic aerosol containing 0.5mg ipratropium bromide dissolved in 1mL of solution has been produced with the purpose of decreasing nebulization time for patients compared to the traditional formulation which is twice as voluminal (0.5mg/2mL, Boehringer-Ingelheim, France). The aim of this study was to compare aerosol characteristics (inhaled mass, particle size distribution and nebulization time) of these two formulations of ipratropium bromide, nebulized alone and with terbutaline (5mg/2mL, Astra Zeneca, Sweden), to determine whether the new formulation was equivalent to the old one. Four different jet nebulizers were used: PariLC+®, Atomisor NL9M®, Sidestream® and Mistyneb®. Statistical analysis of the results showed that for all types of nebulizer, the inhaled mass of ipratropium bromide 0.5mg/1mL was significantly lower than the inhaled mass of ipratropium bromide 0.5mg/2mL, and that there was no statistical difference between the inhaled mass of ipratropium bromide 0.5mg/1mL+terbutaline 5mg/2mL and the inhaled mass of ipratropium bromide 0.5mg/2mL+terbutaline 5mg/2mL. The study also showed that the new formulation of ipratropium bromide (0.5mg/1mL) mixed with terbutaline allowed a 26% decrease in nebulization time compared to the old formulation (0.5mg/2mL) mixed with terbutaline without changing aerosol characteristics (inhaled mass and particle size distribution). This leads to the conclusion that a 2mL minimum volume is required for nebulization, and that nebulization of ipratropium bromide 0.5mg/1mL alone must be avoided.