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Navigation-guided transcaruncular orbital optic canal decompression in indirect traumatic optic neuropathy: long-term outcomes. Br J Ophthalmol 2024; 108:779-787. [PMID: 37414533 DOI: 10.1136/bjo-2023-323282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE To determine the surgical outcomes using navigation-guided transcaruncular orbital optic canal decompression (NGTcOCD) and investigate the relationship between visual prognosis. visual evoked potential (VEP), association with DeLano type of optic canal and Onodi cells in patients with indirect traumatic optic neuropathy (TON). DESIGN Prospective observational. METHODS Fifty-two consecutive patients with indirect TON unresponsive to steroid therapy were divided into three groups where Group I comprised of cases with optic canal fracture who underwent NGTcOCD, Group II without optic canal fracture who underwent NGTcOCD and Group III, no-decompression group who chose not to undergo NGTcOCD. An improvement in visual acuity (VA) at 1 week, 3 months and 1 year and amplitude and latency of VEP at 1 year were considered as primary and secondary outcomes, respectively. RESULTS The mean VA improved from 2.55±0.67 and 2.62±0.56 LogMAR at presentation to 2.03±0.96 and 2.33±0.72 LogMAR at final follow-up among Group I and Group II patients, respectively (p<0.001 and p=0.01). Statistically significant improvement observed among both the Groups in VEP amplitude (p=<0.01) and among Group II in VEP latency (p<0.01). Both Group I and Group II patients have better outcomes than patients in no-decompression group. VA at presentation and Type 1 DeLano optic canal were observed as significant prognostic factors. CONCLUSIONS NGTcOCD serves as a minimally invasive transcaruncular route to the optic canal which enables ophthalmologists to perform decompression from the anterior-most orbital end under direct visualisation. Patients with indirect TON with or without optic canal fracture and unresponsive to steroid therapy when managed with NGTcOCD have shown comparable and superior outcomes.
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Abstract
The current literature review aims to evaluate the ocular findings and associated ophthalmic features in Crouzon syndrome. Craniosynostoses are syndromes characterized by premature fusion of sutures of the skull and Crouzon syndrome is the most common of the craniosynostosis syndromes. Early fusion of sutures results in craniofacial anomalies, including abnormalities of the orbits. To prepare this review of the ophthalmic findings in this disorder, an organized search on online databases such as PubMed, Scopus, Cochrane Library, and Ovid was carried out. The key terms searched were "Crouzon", "craniosynostosis", "eye" and "ophthalmic", and 51 research items were found. A total of 17 articles were included after scrutiny of the databases and a further 25 articles were added after augmented search. A detailed review was performed from the final 42 articles. A comprehensive description of associated anomalies is given along with the author's own technique of surgical management in cases with Crouzon syndrome having bilateral luxation bulbi with exposure keratopathy. However, for optimum management of cranial and oculo-facial dysmorphisms, a multidisciplinary team of specialists is required.
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A Clinical Study of Peripheral Arterial Disease in Diabetes Mellitus with Reference to Ankle Brachial Pressure Index and Doppler sonography. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2020; 68:51. [PMID: 31979573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Dark Matter Search Results from the PICO-60 C_{3}F_{8} Bubble Chamber. PHYSICAL REVIEW LETTERS 2017; 118:251301. [PMID: 28696731 DOI: 10.1103/physrevlett.118.251301] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Indexed: 06/07/2023]
Abstract
New results are reported from the operation of the PICO-60 dark matter detector, a bubble chamber filled with 52 kg of C_{3}F_{8} located in the SNOLAB underground laboratory. As in previous PICO bubble chambers, PICO-60 C_{3}F_{8} exhibits excellent electron recoil and alpha decay rejection, and the observed multiple-scattering neutron rate indicates a single-scatter neutron background of less than one event per month. A blind analysis of an efficiency-corrected 1167-kg day exposure at a 3.3-keV thermodynamic threshold reveals no single-scattering nuclear recoil candidates, consistent with the predicted background. These results set the most stringent direct-detection constraint to date on the weakly interacting massive particle (WIMP)-proton spin-dependent cross section at 3.4×10^{-41} cm^{2} for a 30-GeV c^{-2} WIMP, more than 1 order of magnitude improvement from previous PICO results.
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A systematic review of outcome measures utilised to measure change in self-management in clinical trials in non-cancer chronic pain. Physiotherapy 2016. [DOI: 10.1016/j.physio.2016.10.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Epidemiology and antifungal susceptibility of Candida species in a tertiary care hospital, Kolkata, India. Curr Med Mycol 2016; 2:20-27. [PMID: 28681016 PMCID: PMC5490301 DOI: 10.18869/acadpub.cmm.2.2.5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background and Purpose: The incidence of fungal infection as well as candidemia has increased significantly, contributing to morbidity and mortality in the developed countries. The alarming increase in infections with multidrug resistant bacteria is due to overuse of a broad spectrum antimicrobials, which leads to over growth of Candida spp.; thus, enhancing its opportunity to cause the disease. A shift has been observed in the relative frequency of each Candida spp. Antifungal agents available for the treatment of systemic and invasive candidiasis are restricted to polyenes, allylamines, azoles, and the recent echinocandin class of molecules. In the past few decades, the incidence of resistance to antifungal treatment of Candida spp. has increased rapidly, which is of serious concern for healthcare professionals. Studies on prevalence of infections and antifungal susceptibility testing can help with deciding on clinical strategies to manage this problem. Herein, we aimed to identify the epidemiology of Candida spp. among blood culture isolates and to investigate the susceptibility pattern of these species to antifungal agents. Materials and Methods: Candida spp. were isolated from blood cultures from 70 patients in a tertiary care hospital, Kolkata, India. The growth of Candida spp. on sabouraud dextrose agar was confirmed by Gram staining, where gram-positive budding fungal cells were observed. The species identification as well as antifungal susceptibility testing were performed with VITEK 2 compact automated system using VITEK-2 cards for identification of yeast and yeast-like organisms) ID-YST card). Antifungal susceptibility testing was carried out with VITEK 2 fungal susceptibility card (AST-YS07 kit). Results: Out of 70 samples, Candidaalbicans were isolated from 34 (%48.57) samples. The remaining 36 (%51.43) were non-albicans Candida ) NAC). Out of 34 C. Albicans, antifungal susceptiblity was detected in 28 isolates, all of which were sensitive to fluconazole (FLC .( Resistance to amphotericine B) AMP), flucytosine (5FC), voriconazole (VRC), and itraconazole (ITC) was observed in, %44.12 , %52.94 , %8.82 and %17.65 of the cases, respectively. For other Candida spp. (other than C. Albicans ,( antifungal susceptibility was evaluated for 36 isolates, among which resistance to AMP, FLC , 5FC, VRC , and ITC was found in, %30.56 , %61.11 , %33.33 , %19.44 and %38.89 cases, respectively. Conclusion: Species-level identification of Candida and their antifungal sensitivity testing should to be performed to achieve better clinical result and to select an appropriate and effective antifungal therapy. High resistance to antifungal agents is an alarming sign to the healthcare professionals.
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Non-migratory tumorigenic intrinsic cancer stem cells ensure breast cancer metastasis by generation of CXCR4+ migrating cancer stem cells. Oncogene 2016; 35:4937-48. [DOI: 10.1038/onc.2016.26] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 11/02/2015] [Accepted: 11/27/2015] [Indexed: 12/18/2022]
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Quality assessment of fried potato wedges by fuzzy logic and texture analyses. ACTA ALIMENTARIA 2015. [DOI: 10.1556/aalim.2014.0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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MULTI-FREQUENCY, MULTI-EPOCH STUDY OF Mrk 501: HINTS FOR A TWO-COMPONENT NATURE OF THE EMISSION. ACTA ACUST UNITED AC 2014. [DOI: 10.1088/0004-637x/798/1/2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Alternative methods of frying and antioxidant stability in sesame and mustard oils. ACTA ALIMENTARIA 2013. [DOI: 10.1556/aalim.42.2013.1.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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P2-S2.08 Changing patterns and drivers of migration among female sex workers of Northern Karnataka to large cities of Maharashtra, India in the context of HIV/AIDS. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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P2-S2.12 Condom use within intimate partnerships of female sex workers in Southern India. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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P2-S2.23 Measuring the impact of HIV prevention programme on HIV/STI prevalence and condom use in Karnataka: a case-control approach. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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P2-S2.18 Are we doing enough to cover risk of STI/HIV transmission from the lovers "of female sex workers (FSWs)?". Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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P2-S2.01 Support groups as a strategy for reducing HIV vulnerability among female sex workers in Bellary, Northern Karnataka, India. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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O2-S6.02 Occupational and intimate partner violence and inconsistent condom use with clients among female sex workers in southern India. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050109.98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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P1-S2.12 Improving access to STI care among female sex workers by strengthening service provider networks in Bangalore, South India. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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O2-S6.05 Sexual violence against men who have sex with men and transgenders (MSM-T) in southern India. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050109.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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O2-S1.06 Community responses to an HIV epidemic in South India: knowledge, moral panic and cultural inertia. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050109.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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P2-S2.11 Focused and early intervention in rural areas can impact on HIV transmission in Southern India. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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P2-S6.15 Investigating the critical programme components of HIV prevention programme among MSM-Ts in Bangalore, Karnataka. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Haematological presentation of systemic lupus erythematosus. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2009; 57:767-768. [PMID: 20329445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Haematological manifestations are quite common in systemic lupus erythematosus (SLE) but bone marrow aplasia and secondary myelofibrosis are rare manifestations. We report a case of 45 years old male patient who presented with fever, malaena and anaemia without any clinical features of SLE. He had patches of vitiligo for 25 years for which he was applying psoralen with sunlight exposure. This probably precipitated SLE in this patient. The patient presented with pancytopenia which was due to a combination of Comb's positive haemolytic anaemia and myelofibrosis.
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Concepts and strategies for scaling up focused prevention for sex workers in India. Sex Transm Infect 2008; 84 Suppl 2:ii19-23. [PMID: 18799487 DOI: 10.1136/sti.2008.033134] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To describe the concepts, strategies and field results of a project to scale up prevention programmes and services for female sex workers (FSWs) in Karnataka, India. METHODS A strategy was developed to scale up urban sex worker interventions in 18 districts in the southern Indian state of Karnataka. Macro-level coverage objectives were defined by mapping the urban locations where FSWs operate and estimating their population size. Prevention programmes were initiated in the urban locations that contained at least 90% of the estimated urban FSW population in each district. Within each location, a micro-planning process was used by FSW peer educators and outreach workers to design local outreach and service delivery plans. RESULTS An estimated 48 973 FSWs were distributed across 1551 locations and 6232 spots. Outreach was conducted by 1043 peer educators. Services were provided through 170 drop-in centres, 93 programme-run clinics, 110 outreach clinics and 157 referral clinics. Within the first 3 years of the programme the cumulative number of individual FSWs contacted at least once was >78 000, with monthly contact established with 81% of the in situ population; >45 000 FSWs had visited a clinic and >10 000 visited monthly. Direct and indirect condom distribution by the programme amounted to more than 30 per contacted FSW, which is estimated to meet the condom requirement. CONCLUSIONS A strategy that involves geographically defined coverage and micro-level outreach planning can rapidly and effectively provide outreach and services to large dispersed FSW populations.
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Immunohistochemical Expression of Cutaneous Leiomyosarcoma. J Cutan Pathol 2008. [DOI: 10.1111/j.0303-6987.2005.0320u.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Detection of Helicobactor pylori by polymerase chain reaction: A comparison in sample preparation. INDIAN JOURNAL OF HUMAN GENETICS 2005. [DOI: 10.4103/0971-6866.16293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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A comparative study on the physical characteristics and cooking quality parameters of commercial brands of Basmati rice. Int J Food Sci Nutr 2000; 51:295-9. [PMID: 11027041 DOI: 10.1080/09637480050077185] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Randomly selected samples of three popular commercial brands of Basmati rice (designated as A, B and C) available in Mumbai city were studied with respect to their proximate composition and differences in their quality evaluated in terms of length by breadth and elongation ratio, differential length by breadth ratio, water uptake, loss of solids in cooking water, swelling index and volume expansion ratio. The l/b ratio and elongation ratio varied between 4.47 to 4.81 and 1.45 to 1.59 respectively. The differential length by breadth ratio showed a wide variation from 5.88 to 9.48 among the three brands studied. Brand A recorded the highest length by breadth and elongation ratio whereas brand C recorded the highest differential length by breadth ratio. The water uptake values and the loss of solids in the cooking gruel varied between 172 to 262 and 0.87 to 2.70 (g/100 g of rice) respectively, among the three commercial brands. The swelling index and the volume expansion ratio did not show much variation among the three brands ranging between 28 to 31 for the former and 2.00 to 2.21 for the latter. Based on the differential length by breadth ratio, water uptake and swelling index values, which are the most reliable quality indices; brand C was found to be the best followed by brands A and B. The study of the texture of the cooked rice grains indicated that brand C had the softest grains, which was in conformity with the findings in cooking quality characteristics.
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Single layer closure of caesarean section - A comparative study. Int J Gynaecol Obstet 2000. [DOI: 10.1016/s0020-7292(00)81561-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dispersion velocity of galactic dark matter particles. PHYSICAL REVIEW LETTERS 1996; 76:3886-3889. [PMID: 10061138 DOI: 10.1103/physrevlett.76.3886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Monopole annihilation and highest energy cosmic rays. PHYSICAL REVIEW. D, PARTICLES AND FIELDS 1995; 51:4079-4091. [PMID: 10018882 DOI: 10.1103/physrevd.51.4079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Erratum: Survivability of cosmological quark nuggets in the chromoelectric flux-tube fission model of baryon evaporation. PHYSICAL REVIEW. D, PARTICLES AND FIELDS 1994; 49:4306. [PMID: 10017438 DOI: 10.1103/physrevd.49.4306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Survivability of cosmological quark nuggets in the chromoelectric flux-tube fission model of baryon evaporation. PHYSICAL REVIEW. D, PARTICLES AND FIELDS 1993; 48:4630-4638. [PMID: 10016115 DOI: 10.1103/physrevd.48.4630] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Photon/proton ratio as a diagnostic tool for topological defects as the sources of extremely high-energy cosmic rays. PHYSICAL REVIEW. D, PARTICLES AND FIELDS 1992; 46:4188-4192. [PMID: 10014798 DOI: 10.1103/physrevd.46.4188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Grand unified theories, topological defects, and ultrahigh-energy cosmic rays. PHYSICAL REVIEW LETTERS 1992; 69:567-570. [PMID: 10046974 DOI: 10.1103/physrevlett.69.567] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Peroxo complexes of chromium(VI), molybdenum(VI), tungsten(VI) and zirconium(IV) ions containing tridentate and quadridentate neutral ligands. Polyhedron 1992. [DOI: 10.1016/s0277-5387(00)86012-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Synthesis and characterization of some metal complexes containing a quadridentate NSSN and a sexidentate ONSSNO ligand. Polyhedron 1991. [DOI: 10.1016/s0277-5387(00)86115-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cosmic strings and ultrahigh-energy cosmic rays. PHYSICAL REVIEW. D, PARTICLES AND FIELDS 1989; 40:3968-3975. [PMID: 10011778 DOI: 10.1103/physrevd.40.3968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Abstract
The efficacy of bromocriptine in the treatment of hypertension was assessed in a double-blind placebo controlled cross-over study preceded by a dose titration phase. A diuretic and/or a beta-blocker were administered concomitantly in constant dosage to 11 of the 20 patients who received bromocriptine. A wide range of doses of bromocriptine was tolerated. Side-effects of vomiting and postural hypertension did not occur, possibly due to the gradual increase in the administered doses. Plasma prolactin was not raised in this population of hypertensives. In the dose titration phase (n = 20), a small fall in diastolic but not in systolic blood pressure occurred with bromocriptine, but only with the patient standing and after exercise. In the double-blind phase (n = 9), there was no significant difference in blood pressure between the bromocriptine and placebo treatments. It is concluded that bromocriptine was not effective in lowering blood pressure in the present patients with essential hypertension.
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Abstract
Early trials of beta-blocking drugs in angina indicated an increase in symptoms above pretreatment levels when placebo was substituted for active drug. This was followed by some reports of sudden death after beta-blockade withdrawal. There is evidence of increased beta-receptor sensitivity as suggested by increased responsiveness to isoprenaline after propranolol withdrawal. This may be due to an increased beta-receptor population. Other factors may be a reversal of the reduced free triiodothyroxine, of the rightward shift of the oxyhaemaglobin dissociation curve, and of reduced platelet aggregation, when the beta-blocking drug is stopped. Finally, progression of the disease process may take place during treatment, which is unmasked when treatment is withdrawn. beta-Blocking agents may differ; we have observed that in normal volunteers, withdrawal of pindolol, which has partial agonist properties, was not associated with postblockade increase in response to isoprenaline. The beta-blocker withdrawal syndrome is a real phenomenon, although overall the incidence is low. Besides stopping the beta-blocker, exertion may be a frequent prerequisite for the development of significant clinical sequelae, so exertion should be restricted when stopping a beta-blocking drug. Also the dose should be reduced gradually, particularly the final decrements.
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The effect of intrinsic sympathomimetic activity on beta-receptor responsiveness after beta-adrenoceptor blockade withdrawal. Br J Clin Pharmacol 1982; 13:359S-364S. [PMID: 6125188 PMCID: PMC1402166 DOI: 10.1111/j.1365-2125.1982.tb01941.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
1 Heart rate (HR) and blood pressure (BP) changes supine, at 60 degrees tilt and in response to increasing exercise loads, and HR responses to Valsalva's manoeuvre and to isoprenaline bolus injections were studied in 19 healthy volunteers to assess the response to abrupt withdrawal of atenolol n = 6, propranolol n = 6 and pindolol n = 7. 2 The dosage of each drug administered double-blind was gradually increased over a period of 2 weeks and the dose to produce maximum inhibition of exercise-induced tachycardia was continued for one further week. 3 Plasma renin activity, plasma noradrenaline and serum free thyroid hormones were measured during control periods, maximum dosage and withdrawal periods. 4 An increased sensitivity to isoprenaline injections was seen on Day 5 after withdrawal in the atenolol treated group whereas the pindolol treated group showed decreasing hyposensitivity to isoprenaline for the 13 days of observation after withdrawal and propranolol showed an intermediate effect. 5 There was no overshoot in HR or BP measurements at rest or in response to tilting, Valsalva's manoeuvre or exercise with atenolol or propranolol and with pindolol the HR response to tilt only was significantly higher on the third day post-drug. 6 Plasma noradrenaline and serum free T3 were reduced on drug treatment and further reduced in the early withdrawal period but there were no consistent changes in plasma renin activity.
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Inheritance of Hairy Pinnae. Am J Hum Genet 1962; 14:434-435. [PMID: 17948475 PMCID: PMC1932340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
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