Incidence and clinical importance of perioperative histamine release: randomised study of volume loading and antihistamines after induction of anaesthesia
TL;DR: The histamine-related disturbances under anaesthesia were remarkable for their severity (even with small rises in histamine concentrations), for the prevalence of bradycardia, and for the absence of skin signs.
About: This article is published in The Lancet.The article was published on 1994-04-16 and is currently open access. It has received 136 citations till now. The article focuses on the topics: Antihistamine & Haemaccel.
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01 Jan 2001TL;DR: In der Medizin, drei Formen der Entscheidungsfindung are defined: Medical Decision Making (MDM), Medical Decision Finding (MDF) and Medical Decision Generation (MDG).
Abstract: Entscheidungsfindung in der Medizin (medical decision making) ist ein Forschungsgebiet, das relativ unbeachtet zu wichtigen Erkenntnissen gelangt ist. In der Medizin gibt es drei Formen der Entscheidungsfindung.
2 citations
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TL;DR: This review will highlight the characteristics of H1 antihistamines and their indications in pediatric allergic disorders.
Abstract: Histamine is a key mediator in allergic diseases, where it exerts most of its effects through the H1 receptor and to a less extent the H2 receptor. H1-antihistamines provide rapid relief of many of the allergic symptoms and are considered the main stay of treatment of allergic rhinoconjunctivitis and urticaria. H1 antihistamines comprise first generation (old) and second generation (new) H 1 antihistamines with different pharmacological aspects, efficacy and safety profile. Few studies dealt with H1 antihistamines in pediatric population. This review will highlight the characteristics of H1 antihistamines and their indications in pediatric allergic disorders. Egypt J Pediatr Allergy Immunol 2012; 10(1):3-12
2 citations
Cites background from "Incidence and clinical importance o..."
...However, certain effects such as hypotension, tachycardia, flushing, headache, itching and nasal congestion are mediated through both H1 and H2 receptors.(2,7) Considering all the above roles of histamine on H1 receptors, it is clear that antiH1antihistamines are the most common drugs used to treat allergic diseases....
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01 Jan 1998
TL;DR: In einem solchen komplexen System werden infolge verschiedener interagierender Prophylaxen sowohl Risikoabnahmen wie auch -zunahmen beobachtet.
Abstract: Bei der Einfuhrung von Risikoforschung in die Chirurgie wurde fruher von einfachen Modellen (relatives Risiko, Risikofaktoren) ausgegangen, aber die perioperative Periode wird heute als ein komplexes System betrachtet. Dabei werden Risikofaktoren mit multivariaten Methoden analysiert (z.B. logistische Regression), die Pathogenese unerwunschter Verlaufe mit Markovprozessen und das Endergebnis (Outcome) mit einem Konstrukt aus mechanistischen und hermeneutisehen Endpunkten (Beispiel: McPeek Index). In einem solchen komplexen System werden infolge verschiedener interagierender Prophylaxen sowohl Risikoabnahmen wie auch -zunahmen beobachtet. Beispiel: Volumen-, Antibiotika- und Antihistaminikaprophylaxe. Bei Antibiotikagabe traten Herz-Kreislaufreaktionen auf, die sich auch im Tierversuch am isolierten Gefas (Aorta) demonstrieren liesen. Daraus folgt, das Prophylaxen im perioperativen Zeitraum mit breiter Outcome-Analyse und mit relevanten Zeitperioden verbunden werden mussen.
2 citations
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01 Jan 1998
TL;DR: In unserer Zeit, die ganz unter dem Eindruck der Erfolge von Molekularbiologie and rekombinanter Technologie, aber also der Datenautobahn and den Moglichkeiten von Informatik and elektronischer Datenverarbeitung steht, mussen die Methoden gefordert werden, die systematische Entscheidungsfindung and Prufung der Effektivitat von alten and neuen Verfahren un
Abstract: In unserer Zeit, die ganz unter dem Eindruck der Erfolge von Molekularbiologie und rekombinanter Technologie, aber auch der Datenautobahn und den Moglichkeiten von Informatik und elektronischer Datenverarbeitung steht, mussen die Methoden gefordert werden, die systematische Entscheidungsfindung und Prufung der Effektivitat von alten und neuen Verfahren unterstutzen. Nach einem Jahrhundert „biomedizinischen Faktenwissens“, nach revolutionarer „Praxisbezogenheit“ unter Nachahmung des amerikanischen Systems und der ideologischen Propagierung von „Sozialmedizin“ mus jetzt der Zweifel kultiviert werden. Problemlosungsstrategien stehen im Vordergrund (Lorenz et al.1994), nicht die Vermittlung von glanzender Technologie oder von babylonischem Wissen.
2 citations
References
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2,147 citations
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TL;DR: 80 reports of randomised clinical trials in four leading general medical journals were reviewed and the reporting of the methodology of randomisation was inadequate, and the handling of comparisons of baseline characteristics was inadequate.
473 citations
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TL;DR: The electrocardiographic changes consistent with ischemia during the 4 day perioperative period were documented and characterized in 100 patients with or at risk for coronary artery disease undergoing noncardiac surgery and postoperative ischemic episodes were the most severe.
321 citations
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TL;DR: Pancuronium is suggested to be the least likely currently available agent to provoke a major anaphylactoid reaction and Predisposing factors in patients sensitive to muscle relaxants were: female sex, previous allergy and atopy.
Abstract: Sixty one patients who had suffered intra-operative anaphylactoid reactions were studied. Intradermal testing identified the causative agent in 84% of cases and, in 75% of these, muscle relaxants were responsible. Predisposing factors in patients sensitive to muscle relaxants were: female sex, previous allergy and atopy. The incidence of previous exposure was considerably higher than that reported in the literature. Pancuronium is suggested to be the least likely currently available agent to provoke a major anaphylactoid reaction.
130 citations
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TL;DR: The effects of increasing concentrations of three opioids were studied on the release of preformed and de novo synthesized chemical mediators from human peripheral blood basophils and mast cells isolated from skin tissues or lung parenchyma.
Abstract: Opioids differ in their capacity to cause release of histamine. The effects of increasing concentrations of three opioids (morphine, buprenorphine, and fentanyl) were studied on the release of preformed (histamine and tryptase) and de novo synthesized (prostaglandin D2 [PGD2] and peptide-leukotriene C4 [LTC4]) chemical mediators from human peripheral blood basophils and mast cells isolated from skin tissues or lung parenchyma. Basophils released < 5% of their histamine content and did not synthesize significant amounts of LTC4 when incubated with any of the opioids. Mast cells showed markedly different responses to the three opioids. Morphine (10(-5)-3 x 10(-4) M), in a concentration-dependent manner, induced histamine and tryptase release from skin but not from lung mast cells, up to a maximum of 18.2 +/- 1.9% and 13.0 +/- 4.1 micrograms/10(7) cells, respectively. Morphine did not induce de novo synthesis of PGD2 from skin mast cells. Buprenorphine (10(-6)-10(-4) M), in a concentration-dependent manner, caused histamine and tryptase release from lung but not from skin mast cells, to a maximum of 47.6 +/- 7.2% and 35.1 +/- 13.6 micrograms/10(7) cells, respectively. Buprenorphine also induced de novo synthesis of PGD2 and LTC4 from lung mast cells. Fentanyl (10(-5)-10(-3) M) did not induce histamine and tryptase release or the de novo synthesis of PGD2 or LTC4 from any mast cells. Histamine release caused by buprenorphine from lung mast cells was slow (t1/2 = 11.2 +/- 3.6 min) compared with that induced by morphine from skin mast cells (t1/2 < 1 min, P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
113 citations