The renal manifestations of systemic sclerosis include proteinuria, hypertension, azotemia, and renal crisis. Two types of scleroderma renal crisis (SRC) are recognized. Typical SRC is a syndrome consisting of acute-onset malignant hypertension accompanied by rapidly progressive renal failure, hypertensive retinopathy, and elevated plasma renin activity. The other type is normotensive renal failure, which is generally accompanied by antineutrophil cytoplasmic autoantibody (ANCA)-positive crescentic glomerulonephritis. A 51-year-old woman with scleroderma without marked dermatological change developed ANCA-related renal failure. She had neither malignant hypertension nor an elevated plasma rennin concentration. Renal biopsy showed crescentic glomerulonephritis (pauci-immune type), and the myeloperoxidase-specific ANCA (MPO-ANCA) titer was elevated at 1015 AAU. She was cured using steroid pulse therapy, combined with an angiotensin-converting-enzyme inhibitor and angiotensin-II receptor blocker
Antibodies, Antineutrophil Cytoplasmic ; Azotemia ; Biopsy ; Chymosin ; Cytoplasm ; Female ; Glomerulonephritis ; Humans ; Hypertension ; Hypertension, Malignant ; Hypertensive Retinopathy ; Isonipecotic Acids ; Middle Aged ; Plasma ; Proteinuria ; Renal Insufficiency ; Renin ; Scleroderma, Systemic

No abstract available.
Buprenorphine* ; Meperidine*

No abstract available.
Hypersensitivity* ; Meperidine* ; Skin*

188 patients including 30 young adults and 158 old patients were successfully given spinal anesthesia with meperidine at doses of 1.2 - 1.4mg/kg -1b.w for surgery of the lower abdomen, peritoneal areas and the lower extremities. Mean duration of actions of spinal Meperidine were 80.56±12.75 minutes in young and old patients, respectively. There was no big difference of side effects of the spinal meperidine between these two groups of patients
Anesthesia, Spinal ; Meperidine

No abstract available.
Anesthesia and Analgesia* ; Anesthesia* ; Lidocaine ; Meperidine

No abstract available.
Animals ; Meperidine* ; Mice* ; Morphine* ; Naloxone*

A mixture of phenoperidine and haloperidol with inhalation of nitrous oxide-oxygen has been used to provide general anesthesia for gynecologic operations' in seven patients. The method afforded excellent hypnosis and analgesia together with remarkably stable circulation both during operative and immediate postoperative period. For operations requiring muscular relaxation a neuromuscular blocking agent had to be added. No central nervous system reactions (Parkinson-like, akathisia and cystonia) of an extrapyramidal type have been observed in the series.
Analgesia ; Anesthesia, General ; Central Nervous System ; Haloperidol ; Humans ; Hypnosis ; Inhalation ; Neuromuscular Blockade ; Phenoperidine ; Postoperative Period ; Psychomotor Agitation ; Relaxation

Adequate pain relief is a requisite for a successful closed manipulative reduction (CMR) of fractures and dislocations. This prospective study was undertaken to assess the mode and adequacy of pain relief given to patients undergoing such procedures at Seremban Hospital from the 1st April to the 31st May 2001. All patients with fractures and dislocations scheduled to undergo CMR were included in this study. The type of sedative agents and analgesia administered were recorded. Demographic data and the type of fracture or dislocation of the selected patients were documented. A visual analogue scale (VAS) for pain perception was given to both to the patients and the medical personnel who performed the procedure. All data were collected manually before entered into computerized database for analysis. Of 72 patients included in this study, 47% were Malay, 26% Indian, 21% Chinese and 6% others. There was male predominance and the patients' age ranged between 9 to 79 years (average 27.4 years). Upper limb injuries (79%) were mainly fractures of the radius and ulna (29%) and isolated fracture radius (21%). For the lower limb injuries (21%), combined tibia and fibula fractures constituted 10% of the total cases followed by isolated tibia fractures (10%) and hip dislocation (1%). The most common pain relieving agents given during the CMR were intravenous pethidine alone (43%) followed by combination of intravenous pethidine and valium (36%), intramuscular pethidine (17%) and intramuscular tramal (4%). The Visual Analogue Score (VAS) for pain perception revealed that 61% of the patients had moderate pain while 21% had severe pain during the course of the procedures. Suboptimal pain relief administered during CMR should prompt positive actions to ensure that the patient is not subjected to undue pain just for the sake of an acceptable fracture reduction.
Pain ; Reduction (chemical) ; Meperidine ; pain perception ; Intravenous

In view of the current trend towards carrying out termination of pregnancy as day cases it is also important that the patient should be free from pain with a rapid recovery from anesthesia and a minimum of post operative sequalae. We compared the effects of three other anesthetic techniques for the termination of pregnancy in 100 healthy womes as day cases. 1) Anesthesia with thiopental sodium alone was associated with a high score of pain sensation(2+/-0.93) and with considerably rapid recovery(103+/-57.6 mins). 2) The combination of thiopental sodium and meperidine was associated with a lower score of pain sensation(1.58+/-0.8) and with rapidl recovery(101+/-56.4 mins). 3) Meperidine with diazepam was associated with the lowest score of pain sensation(1.4+/-0.69), but had prolonged recovery time(206+/-126 mins) twice that of other techniques. It was conclued that the combination A thiopental sodium and meperidine was the technique of choice for termination of pregnancy as day-cases.
Anesthesia ; Diazepam ; Humans ; Meperidine ; Pregnancy* ; Thiopental

BACKGROUND: Although early reviews of clinical findings were mostly negative, there is still a widespread belief for the efficacy of preemptive analgesia among clinicians. In this study, we evaluated whether the preemptive use of ketamine decreases post operative pain in patients undergoing appendectomy. METHODS: In double-blind, randomized clinical trials, 80 adult male patients undergoing an operation for acute appendicitis were studied. Patients were randomly assigned to two groups. In the operating room, patients in the ketamine group received 0.5 mg/kg of ketamine IV 10 minutes before the surgical incision. In the control group, 0.5 mg/kg of normal saline was injected. The pain intensity was assessed at time 0 (immediately after arousal) and 4, 12, and 24 hours postoperatively using the 10 points visual analogue scale (VAS). RESULTS: Eighty patients (40 for both groups) were enrolled in this study. For all of the evaluated times, the VAS score was significantly lower in the ketamine group compared to the control. The interval time for the first analgesic request was 23.1 +/- 6.7 minutes for the case group and 18.1 +/- 7.3 minutes for the control (P = 0.02). The total number of pethidine injections in the first 24 hours postoperatively was 0.6 +/- 0.6 for the case group and 2.0 +/- 0.8 for the controls (P = 0.032). There were no drug side effects for the case group. CONCLUSIONS: A low dose of intravenously administered ketamine had a preemptive effect in reducing pain after appendectomy.
Adult ; Analgesia ; Appendectomy ; Appendicitis ; Humans ; Ketamine ; Male ; Meperidine ; Operating Rooms