Background. From 1994 to 1996, 75 patients undergoing valve replacement were randomized to antegrade (36 patients, group 1) or antegrade/retrograde (39 patients, group 2) administration of cold blood cardioplegia. Met...
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Background. From 1994 to 1996, 75 patients undergoing valve replacement were randomized to antegrade (36 patients, group 1) or antegrade/retrograde (39 patients, group 2) administration of cold blood cardioplegia. Methods. Groups were comparable for age, sex, valve disease, and ventricular dysfunction. The aortic valve was replaced in 27 patients from group 1 and 24 patients from group 2, the mitral valve in 8 and 15 patients, and 1 patient in group 1 underwent double valve replacement (p = not significant). Results. Lengths of cardiopulmonary bypass and aortic cross-clamp averaged, respectively, 10 minutes (p = not significant) and 12 minutes (p = < 0.05) shorter in group 2. Total amount of cardioplegia solution infused averaged 1,279 +/- 406 mt and 1,341 +/- 379 mt (p = not significant), respectively, in groups 1 and 2, and the period of infusion averaged 44% and 72% (p = < 0.01) of the total period of aortic cross-clamping. No death occurred in group 1 compared to two in group 2 (p = not significant). The perioperative myocardial infarction and stroke rates were comparable in both groups. Peak enzyme release at 24 hours was similar both for creatine kinase-MB fraction (26 versus 37 IU/L) and for troponin T (2.1 versus 2.5 IU/L). Conclusions. Our study shows no significant advantage of the antegrade/retrograde administration of cardioplegia over the antegrade route in routine valvular replacement, other than a slightly shorter aortic cross-clamping time. (C) 1999 by The Society of Thoracic Surgeons.
The clearance of hookworm (Necator americanus) ova by a single dose of tetrachlorethylene (T.C.E.) was compared with that produced by single and multiple dose regimes of bephenium hydroxynaphthoate and pyrantel pamoat...
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The clearance of hookworm (Necator americanus) ova by a single dose of tetrachlorethylene (T.C.E.) was compared with that produced by single and multiple dose regimes of bephenium hydroxynaphthoate and pyrantel pamoate. Single doses of bephenium and pyrantel were inferior to T.C.E. Three daily doses of bephenium or pyrantel produced effects comparable with a single dose of T.C.E. Because of the low cost and lack of side effects, T.C.E. remains the drug of choice in the treatment of N. americanus in infections; the only disadvantage of T.C.E. is its unnoticed deterioration under tropical conditions.
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