Base de dados : MEDLINE
Pesquisa : D02.033.100.291.310.500 [Categoria DeCS]
Referências encontradas : 122 [refinar]
Mostrando: 1 .. 10   no formato [Longo]

página 1 de 13 ir para página                         

  1 / 122 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
PMID:26242923
Autor:Rudinsky SL; Sharieff GQ; Law W; Kanegaye JT
Endereço:Division of Emergency Medicine, Rady Children's Hospital San Diego, San Diego, California; Department of Emergency Medicine, Naval Medical Center San Diego, San Diego, California.
Título:Inpatient Treatment after Multi-Dose Racemic Epinephrine for Croup in the Emergency Department.
Fonte:J Emerg Med; 49(4):408-14, 2015 Oct.
ISSN:0736-4679
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Emergency department (ED) discharge is safe when croup-related stridor has resolved after corticosteroids and a single dose of racemic epinephrine (RE). Little evidence supports the traditional practice of hospital admission after ≥ 2 doses of RE. OBJECTIVE: Our aim was to describe the frequency and timing of clinically important inpatient interventions after ≥ 2 ED RE doses. METHODS: We identified patients hospitalized for croup after ED treatment with corticosteroids and ≥2 doses of RE. We compared asymptomatic (admitted solely on the number of RE doses) and symptomatic (admitted due to disease severity) groups with regard to inpatient RE administration, supplemental oxygen, helium-oxygen mixture (heliox) therapy, intubation, or transfer to a higher level of care, time to hospital discharge, and revisit and readmission rates within 48 h of discharge. RESULTS: Of 200 subjects admitted after ≥ 2 ED RE doses, 72 (36%) received clinically important inpatient interventions: RE (n = 68 [34%]), heliox (n = 9 [5%]), and supplemental oxygen (n = 4 [2%]). Of patients who received inpatient RE, 53% received only 1 dose. No patients underwent intubation or transfer to higher level of care. The 112 asymptomatic patients had fewer interventions (14% vs. 63%; p < 0.001) and shorter hospital durations (14.5 vs. 22 h; p < 0.001). Only 14% of the asymptomatic group received RE, with 75% receiving a single dose. There were no differences in revisit and readmission rates. CONCLUSIONS: Inpatient interventions after ≥ 2 ED doses of RE for croup were infrequent, most commonly RE administration. Most patients asymptomatic upon admission require 0-1 inpatient RE doses and may be candidates for outpatient management.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Adrenal Cortex Hormones); 0 (Bronchodilator Agents); GR0L9S3J0F (Racepinephrine); S88TT14065 (Oxygen)


  2 / 122 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
PMID:25929218
Autor:Hoyt KS; Shea SS
Endereço:St. Mary Medical Center, Long Beach, California.
Título:Steeple sign: a case of croup.
Fonte:Adv Emerg Nurs J; 37(2):79-82, 2015 Apr-Jun.
ISSN:1931-4493
País de publicação:United States
Idioma:eng
Resumo:Croup, or laryngotracheobronchitis, is a common viral respiratory tract illness seen in the pediatric population (). This article describes the case of a child who presents with croup and the characteristic "steeple sign" seen on the radiograph. The patient received a diagnosis of croup secondary to the parainfluenza virus infection. It is imperative for advanced practice nurses to recognize the signs and symptoms of croup when these patient present to emergency care settings. Advanced practice nurses must also consider possible differential diagnoses, accurately interpret the radiographs, and intervene according with supportive care and appropriate management.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE
Nome de substância:0 (Anti-Inflammatory Agents); 0 (Bronchodilator Agents); 7S5I7G3JQL (Dexamethasone); GR0L9S3J0F (Racepinephrine)


  3 / 122 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
PMID:25921270
Autor:Penezic A; Ivkic M; Ivkic B; Baudoin T
Endereço:Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center "Sisters of Mercy", Vinogradska cesta 29, 10000 Zagreb, Croatia. Electronic address: apangercic@gmail.com.
Título:Subglottic laryngitis--Changes in therapy approach over the past 20 years.
Fonte:Auris Nasus Larynx; 42(5):390-5, 2015 Oct.
ISSN:1879-1476
País de publicação:Netherlands
Idioma:eng
Resumo:OBJECTIVE: To show changes in the management of subglottic laryngitis over the last twenty years in Croatia. METHODS: We sent questionnaires to paediatricians and otolaryngologists (ENT) in 9 Croatian hospitals in 1993, 2003 and 2013. In the questionnaire we presented a case of a child with moderately difficult subglottic laryngitis, after which they had to answer questions about the management of this kind of a patient and common therapy practice in their hospitals. All data were categorical, described in absolute frequencies and with relative percentages. The Cochran-Armitage test for trend was used in the analysis of different treatments over the years among ENT and paediatricians. Associations were statistically significant if p<0.05. RESULTS: During a twenty-year period main novelties included the introduction of racemic epinephrine use (ENT from 3.3% in 1993 to 92.3% in 2013; paediatricians from 17.2% in 1993 to 100.0% in 2013) and downfall of humidification (ENT from 60.0% to 23.3%; paediatricians from 60.0% to 12.0%), antibiotic (ENT from 53.0% to 2.3%; paediatricians from 21.0% to 0.0%) and antihistaminic use (ENT from 67.7% to 0%; paediatricians from 43.2% to 2%), while corticosteroids (both parenteral and nebulized form) remained the cornerstone in treatment of moderately severe subglottic laryngitis. CONCLUSION: Main novelties included the use of racemic epinephrine and downfall of antibiotic, antihistaminic and humidification therapy use, while corticosteroids remained the cornerstone in the treatment of moderately severe subglottic laryngitis. Differences between approaches among specialities are minimized during 20-year period.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Adrenal Cortex Hormones); 0 (Anti-Bacterial Agents); 0 (Bronchodilator Agents); 0 (Histamine Antagonists); GR0L9S3J0F (Racepinephrine)


  4 / 122 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
PMID:25213051
Autor:Mondal P; Kandala B; Ahrens R; Chesrown SE; Hendeles L
Endereço:Pulmonary Division, Department of Pediatrics, University of Florida, Gainesville, Fla.
Título:Nonprescription racemic epinephrine for asthma.
Fonte:J Allergy Clin Immunol Pract; 2(5):575-8, 2014 Sep-Oct.
ISSN:2213-2201
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Inhaled racepinephrine (RE) (Asthmanefrin) became available in September 2012 as a nonprescription treatment for bronchospasm based on a 1986 US Food and Drug Administration rule. It contains 11.25 mg RE in 0.5 mL and is delivered by a handheld electronic nebulizer. In 2001, we conducted a pilot study that was never published. Now that the product is promoted as a replacement for epinephrine chlorofluorocarbon metered-dose inhaler (Primatene), we provide the results of that study. Methacholine challenge was used as a bioassay. OBJECTIVE: To determine the dose of RE that is equivalent to nebulized albuterol. METHODS: Four subjects, 18 to 45 years old, with mild stable asthma completed the pilot study. Methacholine challenge was performed on the first screening day, without pretreatment, and then on different days, 15 minutes after 1.25 mg albuterol and 2.5, 5, 10, and 20 mg RE delivered by a Pari LC Plus nebulizer. The end point was the provocative concentration of methacholine that caused a 20% decrease in FEV1. Data were log transformed and analyzed by an ANOVA for repeated measures. RESULTS: There was a significant dose response for RE. The geometric mean provocative concentration of methacholine that caused a 20% decrease in FEV1 was 44 mg/mL (95% CI, 23-85 mg/mL) after albuterol, and 10.2 mg/mL (95% CI, 3.5-30 mg/mL) after the 10-mg dose of RE (approximate nonprescription dose) (P = .001). There were no adverse effects. CONCLUSION: RE provides less bronchoprotection from methacholine than does albuterol and may be less effective in treating acute bronchospasm.
Tipo de publicação: CLINICAL TRIAL; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
Nome de substância:0 (Bronchoconstrictor Agents); 0 (Bronchodilator Agents); 0 (Nonprescription Drugs); 0W5ETF9M2K (Methacholine Chloride); GR0L9S3J0F (Racepinephrine); QF8SVZ843E (Albuterol)


  5 / 122 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
PMID:24596395
Autor:Petrocheilou A; Tanou K; Kalampouka E; Malakasioti G; Giannios C; Kaditis AG
Endereço:Cystic Fibrosis Center, Aghia Sophia Children's Hospital, Athens, Greece.
Título:Viral croup: diagnosis and a treatment algorithm.
Fonte:Pediatr Pulmonol; 49(5):421-9, 2014 May.
ISSN:1099-0496
País de publicação:United States
Idioma:eng
Resumo:Viral croup is a frequent disease in early childhood. Although it is usually self-limited, it may occasionally become life-threatening. Mild croup is characterized by the presence of stridor without intercostal retractions, whereas moderate-to-severe croup is accompanied by increased work of breathing. A single dose of orally administered dexamethasone (0.15-0.6 mg/kg) is the mainstay of treatment with addition of nebulized epinephrine only in cases of moderate-to-severe croup. Nebulized budesonide (2 mg) can be given alternatively to children who do not tolerate oral dexamethasone. Exposure to cold air or administration of cool mist are treatment interventions for viral croup that are not supported by published evidence, but breathing heliox can potentially reduce the work of breathing related to upper airway obstruction. In summary, corticosteroids may decrease the intensity of viral croup symptoms irrespective to their severity on presentation to the emergency department.
Tipo de publicação: JOURNAL ARTICLE; REVIEW
Nome de substância:0 (Anti-Inflammatory Agents); 0 (Bronchodilator Agents); 206GF3GB41 (Helium); 51333-22-3 (Budesonide); 58933-55-4 (heliox); 7S5I7G3JQL (Dexamethasone); GR0L9S3J0F (Racepinephrine); S88TT14065 (Oxygen)


  6 / 122 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
PMID:24313094
Autor:Alverson B; McCulloh RJ; Dawson-Hahn E; Smitherman SE; Koehn KL
Endereço:Brown University, Providence, Rhode Island, USA. balverson@lifespan.org
Título:The clinical management of preterm infants with bronchiolitis.
Fonte:Hosp Pediatr; 3(3):244-50, 2013 Jul.
ISSN:2154-1663
País de publicação:United States
Idioma:eng
Resumo:OBJECTIVES: The goal of this study was to determine physician management choices for hospitalized premature infants with bronchiolitis compared with erm infants and to evaluate predictors of steroid use in premature infants. METHODS: A chart review was conducted of premature and nonpremature infants admitted to 2 children's hospitals with bronchiolitis. Reviewers selected charts based on International Classification of Diseases, Ninth Revision diagnosis codes and collected demographic and historical information, as well as evaluation, treatment, treatment effectiveness, length of stay, hospital readmission rates, and adverse outcomes. Reviewers compared documented rates of utilization and effectiveness of inhaled racemic epinephrine and albuterol between patients with and without a history of prematurity. Patients with a history of prematurity underwent subgroup analysis of factors relating to steroid use. RESULTS: A total of 1223 patients met the study criteria for inclusion. Premature infants represented 19% of all children hospitalized with bronchiolitis. These infants had a longer length of stay (3.8 vs 2.6 days; P < .001) and a more severe hospital course. Rates of inhaled therapy and steroid utilization did not differ between premature and term infants. There was no difference in rates of documented positive response to albuterol, but premature infants were more likely to have a positive response to epinephrine. Steroid use in premature infants was associated with older age, history of wheeze, and albuterol use; documentation of albuterol efficacy did not correlate with steroid use, however. CONCLUSIONS: Management decisions among term and premature infants with bronchiolitis were similar. Premature infants who received albuterol were more likely to receive steroids; however, the decision regarding steroid use was not associated with documentation of efficacy of albuterol.
Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
Nome de substância:0 (Adrenal Cortex Hormones); 0 (Anti-Bacterial Agents); 0 (Bronchodilator Agents); GR0L9S3J0F (Racepinephrine); QF8SVZ843E (Albuterol)


  7 / 122 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
PMID:24276176
Autor:Bengtsson BO; Spink LA; Grone JB
Endereço:1] Pediatrix Medical Group of California, Ventura, CA, USA [2] Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, CA, USA [3] Neonatal Intensive Care Unit, Community Memorial Hospital of San Buenaventura, Ventura, CA, USA.
Título:Local facial cutaneous vasoconstriction: an unusual complication of inhaled racemic epinephrine in a neonate.
Fonte:J Perinatol; 33(12):985-6, 2013 Dec.
ISSN:1476-5543
País de publicação:United States
Idioma:eng
Resumo:A term infant treated for post-extubation stridor with nebulized racemic epinephrine developed localized facial blanching due to cutaneous absorption of the aerosolized vasoconstrictor. Local application of heat restored circulation to the afflicted area. This complication of a commonly used medication is not previously reported in the medical literature and has the potential for severe sequelae.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE
Nome de substância:0 (Vasoconstrictor Agents); GR0L9S3J0F (Racepinephrine)


  8 / 122 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
PMID:24160663
Autor:Fernandes RM
Endereço:University of Lisbon, Lisboa, Portugal.
Título:On-demand, not scheduled, nebulization (epinephrine or saline) improves important clinical outcomes in hospitalized infants with bronchiolitis.
Fonte:J Pediatr; 163(5):1529-30, 2013 Nov.
ISSN:1097-6833
País de publicação:United States
Idioma:eng
Tipo de publicação: COMMENT; JOURNAL ARTICLE
Nome de substância:451W47IQ8X (Sodium Chloride); GR0L9S3J0F (Racepinephrine); YKH834O4BH (Epinephrine)


  9 / 122 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
Texto completo
PMID:24114291
Autor:Bjornson C; Russell K; Vandermeer B; Klassen TP; Johnson DW
Endereço:Department of Pediatrics, Faculty of Medicine, University of Calgary, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, Alberta, Canada, T3B 6A8.
Título:Nebulized epinephrine for croup in children.
Fonte:Cochrane Database Syst Rev; (10):CD006619, 2013 Oct 10.
ISSN:1469-493X
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: Croup is a common childhood illness characterized by barky cough, stridor, hoarseness and respiratory distress. Children with severe croup are at risk for intubation. Nebulized epinephrine may prevent intubation. OBJECTIVES: To assess the efficacy (measured by croup scores, rate of intubation and health care utilization such as rate of hospitalization) and safety (frequency and severity of side effects) of nebulized epinephrine versus placebo in children with croup, evaluated in an emergency department (ED) or hospital setting. SEARCH METHODS: We searched CENTRAL 2013, Issue 6, MEDLINE (1966 to June week 3, 2013), EMBASE (1980 to July 2013), Web of Science (1974 to July 2013), CINAHL (1982 to July 2013) and Scopus (1996 to July 2013). SELECTION CRITERIA: Randomized controlled trials (RCTs) or quasi-RCTs of children with croup evaluated in an ED or admitted to hospital. Comparisons were: nebulized epinephrine versus placebo, racemic nebulized epinephrine versus L-epinephrine (an isomer) and nebulized epinephrine delivered by intermittent positive pressure breathing (IPPB) versus nebulized epinephrine without IPPB. Primary outcome was change in croup score post-treatment. Secondary outcomes were rate and duration of intubation and hospitalization, croup return visit, parental anxiety and side effects. DATA COLLECTION AND ANALYSIS: Two authors independently identified potentially relevant studies by title and abstract (when available) and examined relevant studies using a priori inclusion criteria, followed by methodological quality assessment. One author extracted data while the second checked accuracy. We use the standard methodological procedures expected by the Cochrane Collaboration. MAIN RESULTS: Eight studies (225 participants) were included. In general, children included in the studies were young (average age less than two years in the majority of included studies). Severity of croup was described as moderate to severe in all included studies. Six studies took place in the inpatient setting, one in the ED and one setting was not specified. Six of the eight studies were deemed to have a low risk of bias and the risk of bias was unclear in the remaining two studies.Nebulized epinephrine was associated with croup score improvement 30 minutes post-treatment (three RCTs, standardized mean difference (SMD) -0.94; 95% confidence interval (CI) -1.37 to -0.51; I(2) statistic = 0%). This effect was not significant two and six hours post-treatment. Nebulized epinephrine was associated with significantly shorter hospital stay than placebo (one RCT, MD -32.0 hours; 95% CI -59.1 to -4.9). Comparing racemic and L-epinephrine, no difference in croup score was found after 30 minutes (SMD 0.33; 95% CI -0.42 to 1.08). After two hours, L-epinephrine showed significant reduction compared with racemic epinephrine (one RCT, SMD 0.87; 95% CI 0.09 to 1.65). There was no significant difference in croup score between administration of nebulized epinephrine via IPPB versus nebulization alone at 30 minutes (one RCT, SMD -0.14; 95% CI -1.24 to 0.95) or two hours (SMD -0.72; 95% CI -1.86 to 0.42). None of the studies sought or reported data on adverse effects. AUTHORS' CONCLUSIONS: Nebulized epinephrine is associated with clinically and statistically significant transient reduction of symptoms of croup 30 minutes post-treatment. Evidence does not favor racemic epinephrine or L-epinephrine, or IPPB over simple nebulization.The authors note that data and analyses were limited by the small number of relevant studies and total number of participants and thus most outcomes contained data from very few or even single studies.
Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW
Nome de substância:0 (Adrenergic alpha-Agonists); 0 (Adrenergic beta-Agonists); GR0L9S3J0F (Racepinephrine); YKH834O4BH (Epinephrine)


  10 / 122 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Registro de Ensaios Clínicos
Texto completo
PMID:23758233
Autor:Skjerven HO; Hunderi JO; Brügmann-Pieper SK; Brun AC; Engen H; Eskedal L; Haavaldsen M; Kvenshagen B; Lunde J; Rolfsjord LB; Siva C; Vikin T; Mowinckel P; Carlsen KH; Lødrup Carlsen KC
Endereço:Department of Pediatrics, Oslo University Hospital, Oslo, Norway.
Título:Racemic adrenaline and inhalation strategies in acute bronchiolitis.
Fonte:N Engl J Med; 368(24):2286-93, 2013 Jun 13.
ISSN:1533-4406
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Acute bronchiolitis in infants frequently results in hospitalization, but there is no established consensus on inhalation therapy--either the type of medication or the frequency of administration--that may be of value. We aimed to assess the effectiveness of inhaled racemic adrenaline as compared with inhaled saline and the strategy for frequency of inhalation (on demand vs. fixed schedule) in infants hospitalized with acute bronchiolitis. METHODS: In this eight-center, randomized, double-blind trial with a 2-by-2 factorial design, we compared inhaled racemic adrenaline with inhaled saline and on-demand inhalation with fixed-schedule inhalation (up to every 2 hours) in infants (<12 months of age) with moderate-to-severe acute bronchiolitis. An overall clinical score of 4 or higher (on a scale of 0 to 10, with higher scores indicating more severe illness) was required for study inclusion. Any use of oxygen therapy, nasogastric-tube feeding, or ventilatory support was recorded. The primary outcome was the length of the hospital stay, with analyses conducted according to the intention-to-treat principle. RESULTS: The mean age of the 404 infants included in the study was 4.2 months, and 59.4% were boys. Length of stay, use of oxygen supplementation, nasogastric-tube feeding, ventilatory support, and relative improvement in the clinical score from baseline (preinhalation) were similar in the infants treated with inhaled racemic adrenaline and those treated with inhaled saline (P>0.1 for all comparisons). On-demand inhalation, as compared with fixed-schedule inhalation, was associated with a significantly shorter estimated mean length of stay--47.6 hours (95% confidence interval [CI], 30.6 to 64.6) versus 61.3 hours (95% CI, 45.4 to 77.2; P=0.01) - as well as less use of oxygen supplementation (in 38.3% of infants vs. 48.7%, P=0.04), less use of ventilatory support (in 4.0% vs. 10.8%, P=0.01), and fewer inhalation treatments (12.0 vs. 17.0, P<0.001). CONCLUSIONS: In the treatment of acute bronchiolitis in infants, inhaled racemic adrenaline is not more effective than inhaled saline. However, the strategy of inhalation on demand appears to be superior to that of inhalation on a fixed schedule. (Funded by Medicines for Children; ClinicalTrials.gov number, NCT00817466; EudraCT number, 2009-012667-34.).
Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
Nome de substância:451W47IQ8X (Sodium Chloride); GR0L9S3J0F (Racepinephrine); YKH834O4BH (Epinephrine)



página 1 de 13 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde