Indometacin in connection with a combination of antiinflammatory, soothing and febrifugal properties to success is applied also at glomerulonephritises, uveites, radiculites, a neuralgia, a migraine, buy cipro cheap a phlebitis, inflammatory diseases of respiratory tracts, and also as a symptomatic agent at hematological and oncologic diseases, traumas, after operations etc. Thanks to the to effect it is used at a dysmenorrhea and solar combustions.
Indometacin side effects meet in 15-30 %, but, as a rule, do not happen serious. Gastralgias are most frequent, the nausea, diarrhoeia, a constipation, a headache, giddiness, drowsiness, depression, a sonitus, pruritic eruptions, become perceptible a liquid delay, BP rising, muscular delicacy, a gastroenteritis less often. At the big doses it is necessary to mean danger of ulcerogenic action and gastroenteric bleedings. Cytopenias, a bronchospasm, a staxis, mentality and sight disturbances, an icterus, a stomatitis are very seldom observed. The basic contraindication to indometacin application - ulcerative damages of a digestive tube. With the big care it is necessary to apply this preparation the patient with alienations, an epilepsy, a parkinsonism, an idiopathic hypertensia, a heart failure, and also to persons, whose trade demands special attention (drivers, assemblers-vysotniki etc.) . To children at early age, and also to women in a lactemia and pregnancy Indometacin to prescribe it is not recommended. () has some chemical generality with indometacin. The preparation originality consists that the basic antiinflammatory action renders not as that, and its sulphidic metabolite to which it turns in a liver. The period of semipurification of plasma for this active metabolite makes nearby 17 , that has formed the basis for the reference to part a daily dose on 2 receptions. Medical action speaks oppression .
After introduction in practice there was a number of articles specifying, that , 2 times prescribed on 100-200 mg a day, is equivalent to full doses of Acidum acetylsalicylicum at a pseudorheumatism and an osteoarthrosis, surpasses Brufenum at an osteoarthrosis and is peer to indometacin and Butadionum at sick Bekhterev's of illness and a gout. Our researches have shown, however, that such estimation is strongly exaggerated. Even (on 200 mg 3 times a day) concede of 600 mg in a daily dose to indometacin at Bekhterev's illness and at the majority sick of a pseudorheumatism. This preparation has justified itself basically at an osteoarthrosis. It is interesting, that theoretical calculations concerning reception possibility only 2 times have a day appeared obviously wrong. At such appointment the effect of a preparation was insufficient and considerably raised, when the medicine was used 3 times a day. buy rimonabant cheap As well as many other things nonsteroid preparations, at some sick the pseudorheumatism appeared especially adequate agent, surpassing on medical effect other medicines of this group.
Collateral influences: a pain in epigastriums, a nausea, a headache, attention disorders, dermal eruptions. It is not compatible with .
2.1.2.4. Derivatives of acetic acid
Voltarenum (Ortophenum, sodium diclofenac) can be surveyed as best of modern . It combines the expressed antiinflammatory effect with especially good shipping which does possible long reception of a preparation.
In a digestive tube it is soaked up practically completely, the maximum concentration is reached through 1-2 . The preparation is activly metabolized and in the form of the bound products of an exchange (which part also possesses antiinflammatory properties) is allocated with urine and bile. Concentration in plasma is proportional to the used dose. The preparation collects in the inflammation centres, in particular in liquids at an arthritis, where it unlike plasma is long (to 7) remains in almost invariable concentration (concentration in blood for this period considerably decreases). At appointment to feeding women it practically is not found out in milk. At simultaneous appointment of Acidum acetylsalicylicum and Voltarenum the maximum concentration of the last in plasma approximately on 30 % decreases in comparison with appointment of one Voltarenum.
среда, 19 ноября 2008 г.
In clinical
In clinical practice use also a preparation close to Butadionum in the form of tablets on 0,25 ; the daily dose of 0,75-1,5 before Butadionum it does not possess Essential advantage. The medical effect and a side effect of both preparations are close, but shipping , apparently, a little bit worse.
Antiinflammatory action of Amidopyrinum and order ultram cheap analginum is expressed much more weakly even at their use in full doses - 1,5 Amidopyrinum or 3-4 analginum a day. Therefore now independent value of these preparations in rheumatology the insignificant. Them apply sometimes as additional sedatives at a pseudorheumatism or an arthrosis (against more vigorous antiinflammatory treatment).
For last years in connection with occurrence new value preparations has sharply fallen.
2.1.2.3. Derivatives
Indometacin (Indocidum, Intebanum, Methindolum, etc.) - one of the most active ; is 1 ()-5--2--3- acid.
From a gastroenteric tract it is soaked up quickly and almost completely. The maximum concentration in plasma is framed through 2-3 after reception on an empty stomach and later - at usually applied appointment after meal. The period of semipurification of plasma fluctuates from 4 to 12 . A preparation find out practically in all tissues; in a spinal liquid its concentration is rather low. It is deduced mostly in the form of inactive metabolites with urine, excrements and bile. From 10 to 20 % of the entered indometacin it is allocated with kidneys, including at the expense of canalicular secretion. In this connection at patients with renal insufficiency of its dose should decrease accordingly. At preparation introduction in candles it is soaked up approximately on 80 %. The therapeutic effect comes through 1,5-2 after intake and proceeds 6 or a little bit more.
On the basis of experimental researches it is possible to believe, that indometacin brakes an inflammation owing to restriction of development , decreases of a hyperpermeability of capillaries and lysosomic membranes, vigorous inhibition of synthesis of Prostaglandinums. There are also data, that it oppresses mobility of neutrophils. Possesses the expressed soothing and febrifugal property.
The general indications to indometacin application same, as for Acidum acetylsalicylicum and Butadionum: presence in an organism of inflammatory process of any localisation, especially in a combination to a painful syndrome and a fever. The most accepted therapeutic doses of 100-150 mg, a maintenance dose - 75 mg/days apply the Preparation to adults - inside in tablets or capsules (on 25 and 50 mg) after meal or in candles on 50 or on 100 mg in everyone. There are also tablets rather convenient for application with slow remission of a preparation () on 75 mg in everyone.
In rheumatology the preparation gives vpxl cheap the brightest effect at sick of an ankylosing spondylitis at which it should be accepted practically constantly. Distinct positive takes are noted also at an acute attack of the gout, which indometacin usually stops for 1-3 days (thus in the first days sometimes prescribe 200 mg). Good results are received at all variants of arthroses, especially at a spondylosis (thus there can be sufficient a daily dose 75 and even 50 mg).
Indometacin widely use at a pseudorheumatism, and the best results are received at early stages of illness. At patients, refractory to other therapy, trial application of indometacin or attempt to attach it to earlier spent treatment which has appeared insufficiently effective are always rational. In many cases the preparation makes obvious antiinflammatory and soothing impact, and sometimes allows to reduce a dose of Prednisolonum at patients with .
Indometacin is effective at active rheumatic disease. By total results of treatment sick of rheumatic disease it has appeared more effective, than Salicylases and derivatives. The special attention is deserved by that fact, that at acute rheumatic disease the preparation is capable to eliminate carditis and polyarthritis implications completely. Indometacin has found also application in therapy of allergic (infectious-allergic) myocardites both at the isolated appointment, and in a combination to corticosteroids. At the big collagenoses value of indometacin the auxiliary. He plays rather big role at patients with a prevailing articulate syndrome.
Antiinflammatory action of Amidopyrinum and order ultram cheap analginum is expressed much more weakly even at their use in full doses - 1,5 Amidopyrinum or 3-4 analginum a day. Therefore now independent value of these preparations in rheumatology the insignificant. Them apply sometimes as additional sedatives at a pseudorheumatism or an arthrosis (against more vigorous antiinflammatory treatment).
For last years in connection with occurrence new value preparations has sharply fallen.
2.1.2.3. Derivatives
Indometacin (Indocidum, Intebanum, Methindolum, etc.) - one of the most active ; is 1 ()-5--2--3- acid.
From a gastroenteric tract it is soaked up quickly and almost completely. The maximum concentration in plasma is framed through 2-3 after reception on an empty stomach and later - at usually applied appointment after meal. The period of semipurification of plasma fluctuates from 4 to 12 . A preparation find out practically in all tissues; in a spinal liquid its concentration is rather low. It is deduced mostly in the form of inactive metabolites with urine, excrements and bile. From 10 to 20 % of the entered indometacin it is allocated with kidneys, including at the expense of canalicular secretion. In this connection at patients with renal insufficiency of its dose should decrease accordingly. At preparation introduction in candles it is soaked up approximately on 80 %. The therapeutic effect comes through 1,5-2 after intake and proceeds 6 or a little bit more.
On the basis of experimental researches it is possible to believe, that indometacin brakes an inflammation owing to restriction of development , decreases of a hyperpermeability of capillaries and lysosomic membranes, vigorous inhibition of synthesis of Prostaglandinums. There are also data, that it oppresses mobility of neutrophils. Possesses the expressed soothing and febrifugal property.
The general indications to indometacin application same, as for Acidum acetylsalicylicum and Butadionum: presence in an organism of inflammatory process of any localisation, especially in a combination to a painful syndrome and a fever. The most accepted therapeutic doses of 100-150 mg, a maintenance dose - 75 mg/days apply the Preparation to adults - inside in tablets or capsules (on 25 and 50 mg) after meal or in candles on 50 or on 100 mg in everyone. There are also tablets rather convenient for application with slow remission of a preparation () on 75 mg in everyone.
In rheumatology the preparation gives vpxl cheap the brightest effect at sick of an ankylosing spondylitis at which it should be accepted practically constantly. Distinct positive takes are noted also at an acute attack of the gout, which indometacin usually stops for 1-3 days (thus in the first days sometimes prescribe 200 mg). Good results are received at all variants of arthroses, especially at a spondylosis (thus there can be sufficient a daily dose 75 and even 50 mg).
Indometacin widely use at a pseudorheumatism, and the best results are received at early stages of illness. At patients, refractory to other therapy, trial application of indometacin or attempt to attach it to earlier spent treatment which has appeared insufficiently effective are always rational. In many cases the preparation makes obvious antiinflammatory and soothing impact, and sometimes allows to reduce a dose of Prednisolonum at patients with .
Indometacin is effective at active rheumatic disease. By total results of treatment sick of rheumatic disease it has appeared more effective, than Salicylases and derivatives. The special attention is deserved by that fact, that at acute rheumatic disease the preparation is capable to eliminate carditis and polyarthritis implications completely. Indometacin has found also application in therapy of allergic (infectious-allergic) myocardites both at the isolated appointment, and in a combination to corticosteroids. At the big collagenoses value of indometacin the auxiliary. He plays rather big role at patients with a prevailing articulate syndrome.
понедельник, 17 ноября 2008 г.
Parainfluenza. Unlike
Parainfluenza. Unlike a flu has no such accurate clinical picture, it is not observed also so big epidemic flashes buy cipro online which features could be used for differential diagnostics Influenzal epidemic flash develops acutely, even , as an incubation interval at a flu very short (12...
24, and at a paraflu-3... 6 days, and illness flash develop slowly. Rather a small number of the diseased, slow development of flash, its admixed character (i.e., besides a parainfluenza, during same time are observed and to other aetiology) do not give possibility so effectively as at flu, to use epidemiological data. At the same time, if to take a total annual case rate, the number ill with a parainfluenza can come nearer to number of the persons who have transferred a flu (at least in the organised collectives). Parainfluenza viruses happens about 20 % of all at adults and to 30 % - at children are caused, the case rate is observed during the cold period of year with its rising in the end of winter and in the beginning of spring.
The clinical picture of a parainfluenza essentially differs from that at a flu. Disease begins gradually is more often, and the maximum expression the clinical semiology reaches during 2... 3 days. On all extent of illness the body temperature, as a rule, remains subfebrile (to 38 °), symptoms of the general intoxication are expressed weakly. Only at separate patients the temperature can reach febrile digits but also then does not develop the expressed symptoms of a toxicosis. It is not observed, in particular, pains in eyeballs, the muscular pains, the raised sweating. These features can be used at differential diagnostics of a parainfluenza from a flu. The body temperature at a parainfluenza is normalised also to 3... To 5 day of illness.
Inflammatory changes of mucosas of respiratory tracts are presented 13 kind of a rhinitis, a pharyngitis and especially a laryngitis. In a larynx inflammatory changes, especially at children at whom the picture of a parainfluenza false croup (a stenosis of a larynx of 1-11 degrees) can develop even are most expressed. At adult patients of a croup does not happen. the bronchitis becomes perceptible seldom. Complications by a pneumonia arise less often, than at a flu.
Differential diagnostics of a parainfluenza from adenoviral diseases is complicated by that as thus, and at other disease the conjunctivitis (at 50 % of patients) often develops and the moderate augmentation of peripheric lymph nodes becomes perceptible.
For express diagnostics detection of a virus of a parainfluenza in slime of a fauces and a nose with the help a method is used. Serological tests are applied to retrospective diagnostics (, ) which spend with didymous Serums. Antiserum capacity increase in 4 times and more is diagnostic. At development of epidemic flash in any collective positive takes the researches, received with Serums of the first patients, allow to establish with the big buy rimonabant now degree of probability an aetiology at later arriving patients as parainfluenza flash (because of more long incubation interval) develops slowly and proceeds is long.
Thus, at moderate rising of a case rate in the end of winter and the beginning of spring in any collective, rather gradual course of a disease, prevalence of catarrh of the top respiratory tracts, the expressed laryngitis, a subfebrile body temperature and rather good state of health of the patient it is possible to think of possibility of parainfluenza disease. The diagnosis becomes rather probable when at the first patients from this collective the parainfluenza aetiology is laboratory established.
approximately with the same frequency as a flu and , proceed more often in the form of epidemic flashes, during time in separate collectives on their share it is necessary to 50 % and
from general number , whereas during interepidemic time no more than 3 % at adults and about 7 % - at children.
Flashes adenoviral disease become perceptible during the first 3 in again 4 » collectives. It speaks that viruses circulates very much (from above 30) and in the antigenic relation they essentially differ. In again generated collective there is as though"hashing", i.e. A mutual exchange of different types of adenoviruses. An incubation interval at adenoviral diseases long enough (more often 5... 7 days), and flash, as well as at a parainfluenza, develop slowly. Diseases meet mainly in a cold season.
24, and at a paraflu-3... 6 days, and illness flash develop slowly. Rather a small number of the diseased, slow development of flash, its admixed character (i.e., besides a parainfluenza, during same time are observed and to other aetiology) do not give possibility so effectively as at flu, to use epidemiological data. At the same time, if to take a total annual case rate, the number ill with a parainfluenza can come nearer to number of the persons who have transferred a flu (at least in the organised collectives). Parainfluenza viruses happens about 20 % of all at adults and to 30 % - at children are caused, the case rate is observed during the cold period of year with its rising in the end of winter and in the beginning of spring.
The clinical picture of a parainfluenza essentially differs from that at a flu. Disease begins gradually is more often, and the maximum expression the clinical semiology reaches during 2... 3 days. On all extent of illness the body temperature, as a rule, remains subfebrile (to 38 °), symptoms of the general intoxication are expressed weakly. Only at separate patients the temperature can reach febrile digits but also then does not develop the expressed symptoms of a toxicosis. It is not observed, in particular, pains in eyeballs, the muscular pains, the raised sweating. These features can be used at differential diagnostics of a parainfluenza from a flu. The body temperature at a parainfluenza is normalised also to 3... To 5 day of illness.
Inflammatory changes of mucosas of respiratory tracts are presented 13 kind of a rhinitis, a pharyngitis and especially a laryngitis. In a larynx inflammatory changes, especially at children at whom the picture of a parainfluenza false croup (a stenosis of a larynx of 1-11 degrees) can develop even are most expressed. At adult patients of a croup does not happen. the bronchitis becomes perceptible seldom. Complications by a pneumonia arise less often, than at a flu.
Differential diagnostics of a parainfluenza from adenoviral diseases is complicated by that as thus, and at other disease the conjunctivitis (at 50 % of patients) often develops and the moderate augmentation of peripheric lymph nodes becomes perceptible.
For express diagnostics detection of a virus of a parainfluenza in slime of a fauces and a nose with the help a method is used. Serological tests are applied to retrospective diagnostics (, ) which spend with didymous Serums. Antiserum capacity increase in 4 times and more is diagnostic. At development of epidemic flash in any collective positive takes the researches, received with Serums of the first patients, allow to establish with the big buy rimonabant now degree of probability an aetiology at later arriving patients as parainfluenza flash (because of more long incubation interval) develops slowly and proceeds is long.
Thus, at moderate rising of a case rate in the end of winter and the beginning of spring in any collective, rather gradual course of a disease, prevalence of catarrh of the top respiratory tracts, the expressed laryngitis, a subfebrile body temperature and rather good state of health of the patient it is possible to think of possibility of parainfluenza disease. The diagnosis becomes rather probable when at the first patients from this collective the parainfluenza aetiology is laboratory established.
approximately with the same frequency as a flu and , proceed more often in the form of epidemic flashes, during time in separate collectives on their share it is necessary to 50 % and
from general number , whereas during interepidemic time no more than 3 % at adults and about 7 % - at children.
Flashes adenoviral disease become perceptible during the first 3 in again 4 » collectives. It speaks that viruses circulates very much (from above 30) and in the antigenic relation they essentially differ. In again generated collective there is as though"hashing", i.e. A mutual exchange of different types of adenoviruses. An incubation interval at adenoviral diseases long enough (more often 5... 7 days), and flash, as well as at a parainfluenza, develop slowly. Diseases meet mainly in a cold season.
Observation over
Observation over dynamics of clinical semiology during flu epidemics has shown, that in the beginning of epidemic the flu proceeds more hardly, with typical clinical implications, and in the end of epidemic the easy forms of illness reminding on clinical picture of other aetiology start to prevail, and to carry out differential diagnostics begins more difficultly. order ultram 1mg In epidemic beginning the clinical semiology allows to allocate a flu from among other respiratory diseases. Illness begins acutely, the body temperature with a fever already in the first days reaches a maximum level (39... 40 °). The headache with localisation in frontal area, arches is sharply expressed. Only for a flu the pain in eyeballs (retroorbital) which appears at movement by eyes is characteristic, at pressing on eyeballs. The dacryagogue and a photophobia also are observed at a flu, but they can be and at others . Only at a flu strong pains in muscles of all body become perceptible. At others ( diseases, the parainfluenza and so forth), even in the presence of a high fever, muscular pains does not happen. The general intoxication is shown also in an adynamia, the raised sweating, depression of arterial pressure. At a high fever and sharply expressed toxicosis the boring of cerebral covers (a meningism, entsefalopat1/I) can be observed.
For differential diagnostics that the fever at a flu in overwhelming majority of cases (85 %) does not proceed more than 2 is very important... 4 days. If the fever remains over 5 days it not the flu or begins any complication of a flu (a pneumonia, etc.). From the flu differs first of all more expressed implications of the general intoxication and that it proceeds in the form of epidemics grasping many countries, and even pandemics, especially if there is a new antigenic variant of a virus of a flu And.
Gravity of disease at circulation of various strains of a virus of a flu, hour complication at different epidemic flashes essentially differ. The first patients at flu epidemic offensive can already be as though the standard on which it is possible to judge features of a flu in the river this concrete epidemic flash.
For a flu most typical presence of the expressed tracheitis. This place of the strongest inflammatory process. At sick the flu becomes perceptible change and other departments of a respiratory tract (a rhinitis, a pharyngitis, a laryngitis). Whereas the tracheitis is very poor clinical implications, and symptoms of a rhinitis, a pharyngitis and a laryngitis at some patients are expressed weakly, in such cases the diagnosis flu forms is quite often established. Actually such form of illness not . It is important for vpxl 1mg differential diagnostics. At a flu always to find, let even weakly expressed, inflammatory changes of mucosas of respiratory tracts, first of all a tracheitis. It is especially important for difference of a flu from so-called forms of other infectious diseases (an ornithosis, a salmonellosis, etc.).
In interepidemic on a flu time flu viruses in structure of case rate take very small place, making I..... 5 % from all case rate acute respiratory illnesses. Hence, at this time the probability of a flu is very insignificant. Besides, during interepidemic time the clinical semiology of a flu essentially varies. Diseases proceed mainly in the easy form with weakly expressed intoxication, there are no such important implications, as muscular pains, 5 in eyeballs, the high fever, the raised sweating. The clinical picture of a flu during this period as though approaches with semiology of other aetiology. During the interepidemic period reliably to differentiate a flu from others it is possible only on the basis of datas of laboratory. However a small specific gravity of a flu among others in time usually constrains carrying out of similar researches.
Laboratory acknowledgement of a flu probably by virus detection in slime of a fauces and a nose by means of a method of fluorescent antibodies. This method is suitable for express diagnostics as the answer can be received in some hours. Serologichesky methods can be used only for retrospective diagnostics as it is necessary to investigate : Serums (the first take till 6th day of the illness, the second - later 10... 14 days). By this time all implications of a flu already pass also researches often have only scientific value. Carry out such researches at atypical forms of a flu. Basically flu diagnostics remains clinical.
For differential diagnostics that the fever at a flu in overwhelming majority of cases (85 %) does not proceed more than 2 is very important... 4 days. If the fever remains over 5 days it not the flu or begins any complication of a flu (a pneumonia, etc.). From the flu differs first of all more expressed implications of the general intoxication and that it proceeds in the form of epidemics grasping many countries, and even pandemics, especially if there is a new antigenic variant of a virus of a flu And.
Gravity of disease at circulation of various strains of a virus of a flu, hour complication at different epidemic flashes essentially differ. The first patients at flu epidemic offensive can already be as though the standard on which it is possible to judge features of a flu in the river this concrete epidemic flash.
For a flu most typical presence of the expressed tracheitis. This place of the strongest inflammatory process. At sick the flu becomes perceptible change and other departments of a respiratory tract (a rhinitis, a pharyngitis, a laryngitis). Whereas the tracheitis is very poor clinical implications, and symptoms of a rhinitis, a pharyngitis and a laryngitis at some patients are expressed weakly, in such cases the diagnosis flu forms is quite often established. Actually such form of illness not . It is important for vpxl 1mg differential diagnostics. At a flu always to find, let even weakly expressed, inflammatory changes of mucosas of respiratory tracts, first of all a tracheitis. It is especially important for difference of a flu from so-called forms of other infectious diseases (an ornithosis, a salmonellosis, etc.).
In interepidemic on a flu time flu viruses in structure of case rate take very small place, making I..... 5 % from all case rate acute respiratory illnesses. Hence, at this time the probability of a flu is very insignificant. Besides, during interepidemic time the clinical semiology of a flu essentially varies. Diseases proceed mainly in the easy form with weakly expressed intoxication, there are no such important implications, as muscular pains, 5 in eyeballs, the high fever, the raised sweating. The clinical picture of a flu during this period as though approaches with semiology of other aetiology. During the interepidemic period reliably to differentiate a flu from others it is possible only on the basis of datas of laboratory. However a small specific gravity of a flu among others in time usually constrains carrying out of similar researches.
Laboratory acknowledgement of a flu probably by virus detection in slime of a fauces and a nose by means of a method of fluorescent antibodies. This method is suitable for express diagnostics as the answer can be received in some hours. Serologichesky methods can be used only for retrospective diagnostics as it is necessary to investigate : Serums (the first take till 6th day of the illness, the second - later 10... 14 days). By this time all implications of a flu already pass also researches often have only scientific value. Carry out such researches at atypical forms of a flu. Basically flu diagnostics remains clinical.
среда, 12 ноября 2008 г.
At a lesion
At a lesion of a secondary back fascicle the same basic functions n drop out. radialis, but already in a combination with a lesion n. axillaris.
Impellent fibers n. radialis иннервируют forearm extensors (m. triceps, m. anconeus), brushes (mm. extensores carpi radiales and carpi ulnares) and fingers (mm. extensores digitorum), buy cipro a forearm arch support (m. supinator), a muscle which is taking away the big finger (m. abductor pollicis longus) and m. brachio-radialis, taking part in a forearm flexion.
Sensitive fibers иннервируют a skin of a back surface of a shoulder (n. cutaneus brachii posterior), a dorsal surface of a forearm (n. cutaneus antibrachii dorsalis), the radial party of a dorsum of a brush and partially I, II and sometimes III fingers as it is shown on fig. 84, 85 and 86.
At a high lesion n. radialis, in an axillary fossa, in the top third of shoulder there is a paralysis of extensors of a forearm, a brush, the basic phalanxes of fingers, a muscle which are taking away the big finger, an arch support; the forearm flexion (т is weakened. brachio-radialis). The reflex from a tendon m dies away. tricipitis also it is a little weakened karpo-radial (at the expense of reduction deenergizing m. brachio-radialis). Sensitivity drops out on a dorsal surface of a shoulder, a forearm, partly a brush and fingers as it is shown on fig. 84, 85, 86. The zone of sensitive disorders on a brush quite often happens the zone considerably reduced because of overlapping by an innervation of the next nerves. The Sustavno-muscular feeling does not suffer. At lower levels of a lesion nerve function suffers ограниченно as above departing branches remain, that facilitates problems of topical diagnostics.
At a nerve lesion, rather frequent, at level of an average third of shoulder function of an extension of a forearm and a razgibatelno-ulnar reflex (m remains. triceps) sensitivity on a shoulder (n also is not broken. cutaneus brachii posterior).
At a lesion in the bottom third of shoulder there can be kept a function m. brachio-radialis and sensitivity on a dorsal surface of a forearm (n. cutaneus antibrachii dorsalis) as corresponding branches depart from the basic trunk of a nerve above, in an average third of a shoulder,
At a nerve lesion on предплечьи function m. brachio-radiatis and n. cutanei antibrachii dorsalis remains as a rule; buy rimonabant abaissements are limited to a lesion of extensors of a brush and fingers with sensitivity disturbances only on a brush. At a lesion even more low, in an average third of forearm, abaissement of impellent function can be even more limited; at safety of an extension of a brush the extension of the basic phalanxes of fingers can suffer only.
At a lesion of a radial nerve there is typical "falling", or hanging down, a brush (fig. 87).
Among numerous descriptions of assays or the tests defining impellent disorders at a lesion of a radial nerve, it is possible to note:
1) impossibility of an extension of a brush and fingers;
2) impossibility of abduction of the big finger;
3) at delution of the brushes combined together by palms with the straightened fingers, fingers of the amazed brush are not taken away, and incurvated - as though "slip" on a palm of a healthy, taken away brush (fig. 88).
N. ulnaris (an ulnar nerve)
The nerve admixed, is made of fibers CVIII - DI the roots which are passing then in structure at first primary bottom, then a secondary internal fascicle of a plexus.
At a lesion of roots CVIII - DI a primary bottom and secondary internal fascicle of a plexus nerve function suffers equally in a combination, to a lesion of dermal internal nerves of a shoulder and a forearm (nn. cutanei brachii and antibrachii mediales) and partial disturbance of function n. mediani, its bottom leg (weakening сгибателей fingers, muscles thenaris), that frames a clinical picture of paralysis Дежерин - Клюмпке.
Impellent function of a nerve basically consists in a palmar flexion of a brush (m. flexor carpi ulnaris), a flexion V, IV and partly III fingers (mm. lumbricales, flexor digitorum profundus, interossei, flexor digiti V), reduction of fingers, their delution (mm. interossei) and reduction of the big finger (m. adductor pollicis); besides, in an extension of average and trailer phalanxes of fingers (mm. lumbricales, interossei). Concerning an innervation of movements II - V fingers function of an ulnar nerve is interfaced to function median: the first has the primary relation to function V and IV, median - II and III fingers. Sensitive fibers иннервируют a skin ульнарного brush edges, V and partially IV, are more rare than III fingers as it is shown on fig. 86.
Impellent fibers n. radialis иннервируют forearm extensors (m. triceps, m. anconeus), brushes (mm. extensores carpi radiales and carpi ulnares) and fingers (mm. extensores digitorum), buy cipro a forearm arch support (m. supinator), a muscle which is taking away the big finger (m. abductor pollicis longus) and m. brachio-radialis, taking part in a forearm flexion.
Sensitive fibers иннервируют a skin of a back surface of a shoulder (n. cutaneus brachii posterior), a dorsal surface of a forearm (n. cutaneus antibrachii dorsalis), the radial party of a dorsum of a brush and partially I, II and sometimes III fingers as it is shown on fig. 84, 85 and 86.
At a high lesion n. radialis, in an axillary fossa, in the top third of shoulder there is a paralysis of extensors of a forearm, a brush, the basic phalanxes of fingers, a muscle which are taking away the big finger, an arch support; the forearm flexion (т is weakened. brachio-radialis). The reflex from a tendon m dies away. tricipitis also it is a little weakened karpo-radial (at the expense of reduction deenergizing m. brachio-radialis). Sensitivity drops out on a dorsal surface of a shoulder, a forearm, partly a brush and fingers as it is shown on fig. 84, 85, 86. The zone of sensitive disorders on a brush quite often happens the zone considerably reduced because of overlapping by an innervation of the next nerves. The Sustavno-muscular feeling does not suffer. At lower levels of a lesion nerve function suffers ограниченно as above departing branches remain, that facilitates problems of topical diagnostics.
At a nerve lesion, rather frequent, at level of an average third of shoulder function of an extension of a forearm and a razgibatelno-ulnar reflex (m remains. triceps) sensitivity on a shoulder (n also is not broken. cutaneus brachii posterior).
At a lesion in the bottom third of shoulder there can be kept a function m. brachio-radialis and sensitivity on a dorsal surface of a forearm (n. cutaneus antibrachii dorsalis) as corresponding branches depart from the basic trunk of a nerve above, in an average third of a shoulder,
At a nerve lesion on предплечьи function m. brachio-radiatis and n. cutanei antibrachii dorsalis remains as a rule; buy rimonabant abaissements are limited to a lesion of extensors of a brush and fingers with sensitivity disturbances only on a brush. At a lesion even more low, in an average third of forearm, abaissement of impellent function can be even more limited; at safety of an extension of a brush the extension of the basic phalanxes of fingers can suffer only.
At a lesion of a radial nerve there is typical "falling", or hanging down, a brush (fig. 87).
Among numerous descriptions of assays or the tests defining impellent disorders at a lesion of a radial nerve, it is possible to note:
1) impossibility of an extension of a brush and fingers;
2) impossibility of abduction of the big finger;
3) at delution of the brushes combined together by palms with the straightened fingers, fingers of the amazed brush are not taken away, and incurvated - as though "slip" on a palm of a healthy, taken away brush (fig. 88).
N. ulnaris (an ulnar nerve)
The nerve admixed, is made of fibers CVIII - DI the roots which are passing then in structure at first primary bottom, then a secondary internal fascicle of a plexus.
At a lesion of roots CVIII - DI a primary bottom and secondary internal fascicle of a plexus nerve function suffers equally in a combination, to a lesion of dermal internal nerves of a shoulder and a forearm (nn. cutanei brachii and antibrachii mediales) and partial disturbance of function n. mediani, its bottom leg (weakening сгибателей fingers, muscles thenaris), that frames a clinical picture of paralysis Дежерин - Клюмпке.
Impellent function of a nerve basically consists in a palmar flexion of a brush (m. flexor carpi ulnaris), a flexion V, IV and partly III fingers (mm. lumbricales, flexor digitorum profundus, interossei, flexor digiti V), reduction of fingers, their delution (mm. interossei) and reduction of the big finger (m. adductor pollicis); besides, in an extension of average and trailer phalanxes of fingers (mm. lumbricales, interossei). Concerning an innervation of movements II - V fingers function of an ulnar nerve is interfaced to function median: the first has the primary relation to function V and IV, median - II and III fingers. Sensitive fibers иннервируют a skin ульнарного brush edges, V and partially IV, are more rare than III fingers as it is shown on fig. 86.
root or primary
Lesion СVI of a root or primary average fascicle of a plexus causes appreciable abaissement of functions of a radial nerve (remains m. brachioradialis and т. supinator) and partial - median (fibers of order ultram its top leg, in particular, for m. flexor carpi radialis, m. pronator teres, etc.).
Primary fascicles of a plexus share further on forward and back branches. From forward branches of the top and average fascicles (CV, CVI; СVII) the secondary external fascicle (fasciculus lateralis) is made. The secondary internal fascicle is made Of forward branches of the bottom fascicle (CVIII-DII) (fasciculus medialis). At last, from all back branches of primary fascicles (CV, CVI, СVII, СVIII, DI, DII) the secondary back fascicle (fasciculus posterior) is formed. Names of secondary fascicles are caused by their locating rather a. axillaris round which they are located.
Secondary fascicles of a plexus are in a subclavial fossa; further they form nervous trunks of the top extremity: an external fascicle, - n. musculo-cutaneus and the top leg n. mediani; a back fascicle. - n. axillaris and n. radialis, and an internal fascicle. - n. ulnaris, the bottom leg n. mediani and пn. cutanei brachii and antibrachii mediales (fig. 83 see).
The lesion of an external fascicle of a plexus causes full disturbance of function n. musculo-cutanei, partial - n. mediani (fibers of its top leg, in particular m. pronator teres) and limited - n. radialis (mm. brachio-radialis, supinator).
Thus, similarity of a clinical picture of a lesion of the top primary fascicle and a lesion of the secondary external consists in abaissement both in that and in other case of function of a musculocutaneous nerve and the limited abaissement of function radial (for the account mm. brachio-radialis and supinator). The difference consists that at a lesion of a primary top fascicle this combination includes still function abaissement n. axillaris, which at. A lesion of an external secondary fascicle does not suffer; but in the latter case there is a partial lesion n. mediani.
The lesion of an internal fascicle of a plexus and lesion of the bottom primary fascicle give a similar clinical picture, i.e. A lesion combination n. ulnaris, nn. cutanei brachii et antibrachii mediales and a partial lesion n. mediani, its bottom leg. Symptom Горнера in this case as at more distal lesion, it is not observed (see above).
The lesion of a back fascicle is characterised by a lesion combination n. axillaris and n. radialis (except for kept mm. vpxl brachio-radialis and supinator). Similarity to a clinical picture of a lesion of an average primary fascicle consists in identical abaissement of function n. radialis; a difference that at a lesion of a primary average fascicle function n. axillaris remains, but function n instead is partially broken. mediani, its top leg.
Thus, fibers of the bottom primary fascicle pass in structure of a secondary internal fascicle of a plexus that causes similarity of a clinical picture at their lesion. N. radialis in the basic function suffers and at a lesion primary average and secondary back fascicles, but in the first case - in a combination with a partial lesion n. mediani, an in the second (a back fascicle) - with a lesion n. axillaris.
Function n. axillaris drops out as at a lesion primary top, and a secondary back fascicle because of corresponding transition of its fibers.
At last, n. musculo-cutaneus suffers equally and at a lesion primary top and secondary external fascicles, but century the first case - in a combination with n. axillaris, and in the second - with a partial lesion n. mediani.
At lesion CV - CVI roots or a primary top fascicle of a plexus (in a supraclavicular fossa) as it is observed at paralysis Эрба, the nerve suffers in a combination with n. musculo-cutaneus.
At a lesion of a secondary back fascicle (in a subclavial fossa) function n. axillaris it is broken together with n. radialis.
Impellent fibers of a nerve иннервируют m. deltoideus (and m. teres minor), sensitive - a skin of an external surface of a shoulder (n. cutaneus brachii lateralis).
At a lesion n. axillaris the atrophy of a deltoid muscle, impossibility of a raising of a shoulder in a face-to-face plane to a horizontal line and sensitivity disturbance in a skin of external area of a shoulder (fig. 84 and 85) is observed.
Primary fascicles of a plexus share further on forward and back branches. From forward branches of the top and average fascicles (CV, CVI; СVII) the secondary external fascicle (fasciculus lateralis) is made. The secondary internal fascicle is made Of forward branches of the bottom fascicle (CVIII-DII) (fasciculus medialis). At last, from all back branches of primary fascicles (CV, CVI, СVII, СVIII, DI, DII) the secondary back fascicle (fasciculus posterior) is formed. Names of secondary fascicles are caused by their locating rather a. axillaris round which they are located.
Secondary fascicles of a plexus are in a subclavial fossa; further they form nervous trunks of the top extremity: an external fascicle, - n. musculo-cutaneus and the top leg n. mediani; a back fascicle. - n. axillaris and n. radialis, and an internal fascicle. - n. ulnaris, the bottom leg n. mediani and пn. cutanei brachii and antibrachii mediales (fig. 83 see).
The lesion of an external fascicle of a plexus causes full disturbance of function n. musculo-cutanei, partial - n. mediani (fibers of its top leg, in particular m. pronator teres) and limited - n. radialis (mm. brachio-radialis, supinator).
Thus, similarity of a clinical picture of a lesion of the top primary fascicle and a lesion of the secondary external consists in abaissement both in that and in other case of function of a musculocutaneous nerve and the limited abaissement of function radial (for the account mm. brachio-radialis and supinator). The difference consists that at a lesion of a primary top fascicle this combination includes still function abaissement n. axillaris, which at. A lesion of an external secondary fascicle does not suffer; but in the latter case there is a partial lesion n. mediani.
The lesion of an internal fascicle of a plexus and lesion of the bottom primary fascicle give a similar clinical picture, i.e. A lesion combination n. ulnaris, nn. cutanei brachii et antibrachii mediales and a partial lesion n. mediani, its bottom leg. Symptom Горнера in this case as at more distal lesion, it is not observed (see above).
The lesion of a back fascicle is characterised by a lesion combination n. axillaris and n. radialis (except for kept mm. vpxl brachio-radialis and supinator). Similarity to a clinical picture of a lesion of an average primary fascicle consists in identical abaissement of function n. radialis; a difference that at a lesion of a primary average fascicle function n. axillaris remains, but function n instead is partially broken. mediani, its top leg.
Thus, fibers of the bottom primary fascicle pass in structure of a secondary internal fascicle of a plexus that causes similarity of a clinical picture at their lesion. N. radialis in the basic function suffers and at a lesion primary average and secondary back fascicles, but in the first case - in a combination with a partial lesion n. mediani, an in the second (a back fascicle) - with a lesion n. axillaris.
Function n. axillaris drops out as at a lesion primary top, and a secondary back fascicle because of corresponding transition of its fibers.
At last, n. musculo-cutaneus suffers equally and at a lesion primary top and secondary external fascicles, but century the first case - in a combination with n. axillaris, and in the second - with a partial lesion n. mediani.
At lesion CV - CVI roots or a primary top fascicle of a plexus (in a supraclavicular fossa) as it is observed at paralysis Эрба, the nerve suffers in a combination with n. musculo-cutaneus.
At a lesion of a secondary back fascicle (in a subclavial fossa) function n. axillaris it is broken together with n. radialis.
Impellent fibers of a nerve иннервируют m. deltoideus (and m. teres minor), sensitive - a skin of an external surface of a shoulder (n. cutaneus brachii lateralis).
At a lesion n. axillaris the atrophy of a deltoid muscle, impossibility of a raising of a shoulder in a face-to-face plane to a horizontal line and sensitivity disturbance in a skin of external area of a shoulder (fig. 84 and 85) is observed.
суббота, 8 ноября 2008 г.
The reaction of degeneration
The reaction of degeneration is observed at atrophies which develop as a result of a lesion of a peripheric impellent neurone. Other atrophic processes in muscles (артрогенные, from a divergence, at diseases of the most muscular apparatus) are not accompanied by degeneration reaction. Research buy cipro mg of reaction of a degeneration has certain value in clinic and allows to carry out differential diagnostics of muscular atrophies of the various nature. Besides, electroexcitability research gives the chance to establish early the diagnosis of disturbances of conductivity of a nerve, abilities of muscles and allows to judge dynamics of process, establishing, for example, transition from a full reaction of degeneration to partial in the course of flaccid paralysis restoration.
To judge normal electroexcitability of nerves and muscles or to establish those or other deviations from norm, it is necessary to know the average sizes of electroexcitability received as a result of research of a considerable quantity of healthy faces. Tab. 4 in which for some nerves and muscles the minimum and maximum sizes in norm of galvanic excitability are specified is resulted; the threshold of stimulation is defined in миллиамперах.
In the course of electroexcitability studying it has been established, that reduction is most easier turns out from certain sites of nerves and muscles, from so-called impellent points, or boring points. There are special schemes with their indicating (fig. 10 - 14).
The reaction of degeneration, characteristic for flaccid paralyses, concerns a category of qualitative changes of electroexcitability. The same category concern миотоническая
And myasthenic reactions. At миотонии excitability of a nerve remains normal, the muscle after the received reduction is relaxed extremely slowly. For a myasthenia the extreme fatigability of a muscle affecting in fast attrition сократительной of its ability at repeated borings by a current is characteristic.
Quantitative changes of electroexcitability of nerves and muscles concern: 1) its rising when for reduction reception currents smaller are required, than. In norm, forces, or 2) electroexcitability dropping when for effect reception application of currents of larger force, than for healthy people is necessary.
1 - n. hypoglossus; 2 - quadratus menti; 3 - levator menti: 4 - orbicularis oris; 5 - zygomaticus; 6 - orbicularis palpebra-rum; 7 - corrugatar superficialis; 8 - the item facialis; 9 - frontalis; 10 - temporalis; 11 - auricularis posterior; 12 - SJleiiius; 13 - n. accessorius.
Newer and much more sensitive method buy rimonabant mg of research of electroexcitability of nerves and muscles is the chronaximetry. It has been established, that current action is defined not only its intensity, but also duration of action on a nerve or a muscle.
At first the rheobase is defined, i.e. That minimum intensity of a direct current, which is necessary to cause effect - reduction. Then the current twice larger intensity (a double rheobase) is applied and the minimum time, sufficient for reductions (chronaxia) is defined in thousand shares of second (сигмах) by the special apparatus (chronaximeter).
Хронакоиметрия has allowed to establish a number of the new and interesting facts and patterns in physiology and pathologies of nervous system. The doctrine about a chronaxia is closely closed with concept about lability (N.E.Vvedensky, A.A.Ukhtomsky).
So, it has appeared, that proximally located muscles have shorter chronaxia, than distal; a muscle and иннервирующий its nerve have almost identical chronaxia; muscles-SYNERGISTS have an identical chronaxia, whereas muscles-antagonists - other; the top extremities have a chronaxia approximately in 2 times smaller, than extensors (on the bottom extremities there is a return parity).
To judge normal electroexcitability of nerves and muscles or to establish those or other deviations from norm, it is necessary to know the average sizes of electroexcitability received as a result of research of a considerable quantity of healthy faces. Tab. 4 in which for some nerves and muscles the minimum and maximum sizes in norm of galvanic excitability are specified is resulted; the threshold of stimulation is defined in миллиамперах.
In the course of electroexcitability studying it has been established, that reduction is most easier turns out from certain sites of nerves and muscles, from so-called impellent points, or boring points. There are special schemes with their indicating (fig. 10 - 14).
The reaction of degeneration, characteristic for flaccid paralyses, concerns a category of qualitative changes of electroexcitability. The same category concern миотоническая
And myasthenic reactions. At миотонии excitability of a nerve remains normal, the muscle after the received reduction is relaxed extremely slowly. For a myasthenia the extreme fatigability of a muscle affecting in fast attrition сократительной of its ability at repeated borings by a current is characteristic.
Quantitative changes of electroexcitability of nerves and muscles concern: 1) its rising when for reduction reception currents smaller are required, than. In norm, forces, or 2) electroexcitability dropping when for effect reception application of currents of larger force, than for healthy people is necessary.
1 - n. hypoglossus; 2 - quadratus menti; 3 - levator menti: 4 - orbicularis oris; 5 - zygomaticus; 6 - orbicularis palpebra-rum; 7 - corrugatar superficialis; 8 - the item facialis; 9 - frontalis; 10 - temporalis; 11 - auricularis posterior; 12 - SJleiiius; 13 - n. accessorius.
Newer and much more sensitive method buy rimonabant mg of research of electroexcitability of nerves and muscles is the chronaximetry. It has been established, that current action is defined not only its intensity, but also duration of action on a nerve or a muscle.
At first the rheobase is defined, i.e. That minimum intensity of a direct current, which is necessary to cause effect - reduction. Then the current twice larger intensity (a double rheobase) is applied and the minimum time, sufficient for reductions (chronaxia) is defined in thousand shares of second (сигмах) by the special apparatus (chronaximeter).
Хронакоиметрия has allowed to establish a number of the new and interesting facts and patterns in physiology and pathologies of nervous system. The doctrine about a chronaxia is closely closed with concept about lability (N.E.Vvedensky, A.A.Ukhtomsky).
So, it has appeared, that proximally located muscles have shorter chronaxia, than distal; a muscle and иннервирующий its nerve have almost identical chronaxia; muscles-SYNERGISTS have an identical chronaxia, whereas muscles-antagonists - other; the top extremities have a chronaxia approximately in 2 times smaller, than extensors (on the bottom extremities there is a return parity).
PERIPHERIC
PERIPHERIC (FLACCID, ATROPHIC) THE PARALYSIS
The flaccid paralysis is, as soon as that has been told, result of a lesion of peripheric impellent neurones, i.e. Cells of forward horns of a spinal cord (or impellent kernels order ultram 400mg of cranial nerves), lobbies. Roots and impellent fibers of spinal and cranial peripheric nerves. This type of paralyses is characterised by loss of reflexes, a hypotension and the degenerate atrophy of muscles accompanied by a so-called reaction of degeneration.
Loss of reflexes (or their weakening at an incomplete lesion) becomes clear if we recollect, that the peripheric impellent neurone is at the same time and a centrifugal, efferent part of a reflex arch. At a break of any department of last the reflex certificate is impossible or (at an incomplete break) is weakened.
The atony or hypotension of muscles speaks also a break of a reflex arch therefore the muscle loses inherent to it constant, so-called a tonus supported in norm by the same reflex arch. Besides, the atony can be strengthened an arising atrophy of muscular mass. Atonic muscles are to the touch flabby, flaccid, passive movements are superfluous, joints "are stirred up". Such condition of a musculation gives the basis to name a flaccid paralysis also flaccid, or atonic.
The atrophy of muscles results from dissociation with a cell of a forward horn, whence on an impellent nervous fiber to a muscle притекают the nervously-trophic impulses stimulating a normal exchange of a muscular tissue. Presence of muscular atrophies causes one more definition of a flaccid paralysis - as atrophic.
The atrophy of muscles comes after a degeneration and destruction of nervous impellent fibers, there is muscle "denervation". As a result in nerves impellent fibers disappear from top to bottom from a break place; in a muscle the degenerate process characterised by changes of muscular fibers, their destruction, development of a fatty and connecting tissue develops.
There are characteristic changes of electric reactions of the amazed nerves typical for a flaccid paralysis and the muscles, named a reaction of degeneration or degenerations ().
In norm at a nerve boring galvanic (at short circuit and disconnection) and faradic reduction иннервируемых it of muscles occurs currents; at a boring its reduction occurs the same currents of immediately muscle also, and on a galvanic current it arises extremely quickly ("immediately") and differs that катодозамыкательное reduction more than анодозамыкательное (the gas station).
At a reaction of degeneration (degeneration) the nerve does not spend a current to a muscle for its impellent centrifugal fibers перерождены and were lost; the muscle is denervated and loses ability of reduction on a boring a faradic current, keeping excitability only on the galvanic. But also this reduction becomes slow («червеобразным»), and big becomes already vpxl 400mg reduction (the gas station>). Such condition is called as a full reaction of degeneration and attacks 12 - 15th day after a break of a nerve or destruction of a cell of a forward horn.
At an incomplete lesion of a peripheric impellent neurone there can come a partial reaction of degeneration when excitability of a nerve on both currents is not lost, and is only weakened, no less than faradic excitability of a muscle; muscle reduction at a boring a galvanic current also arises slowly, with prevalence анодозамыкательного effect over катодозамыкательным (the gas station>).
The full reaction of degeneration yet is not a bad prognostic sign: under condition of restoration (neogenesis) of a nervous fiber it can be replaced through a phase of partial reaction with normal electroexcitability. But if the muscle at a flaccid paralysis remains completely denervated from above 12 - 14 months (sometimes and more longly) as a result of a progressing degeneration of muscular fibers they perish completely, are replaced with a fatty and connecting tissue, and there comes a cirrhosis of a muscle with loss already and its reactions to a galvanic current, i.e. Full loss of electroexcitability develops. Last specifies in irreversibility происшедших in a muscle of changes.
The flaccid paralysis is, as soon as that has been told, result of a lesion of peripheric impellent neurones, i.e. Cells of forward horns of a spinal cord (or impellent kernels order ultram 400mg of cranial nerves), lobbies. Roots and impellent fibers of spinal and cranial peripheric nerves. This type of paralyses is characterised by loss of reflexes, a hypotension and the degenerate atrophy of muscles accompanied by a so-called reaction of degeneration.
Loss of reflexes (or their weakening at an incomplete lesion) becomes clear if we recollect, that the peripheric impellent neurone is at the same time and a centrifugal, efferent part of a reflex arch. At a break of any department of last the reflex certificate is impossible or (at an incomplete break) is weakened.
The atony or hypotension of muscles speaks also a break of a reflex arch therefore the muscle loses inherent to it constant, so-called a tonus supported in norm by the same reflex arch. Besides, the atony can be strengthened an arising atrophy of muscular mass. Atonic muscles are to the touch flabby, flaccid, passive movements are superfluous, joints "are stirred up". Such condition of a musculation gives the basis to name a flaccid paralysis also flaccid, or atonic.
The atrophy of muscles results from dissociation with a cell of a forward horn, whence on an impellent nervous fiber to a muscle притекают the nervously-trophic impulses stimulating a normal exchange of a muscular tissue. Presence of muscular atrophies causes one more definition of a flaccid paralysis - as atrophic.
The atrophy of muscles comes after a degeneration and destruction of nervous impellent fibers, there is muscle "denervation". As a result in nerves impellent fibers disappear from top to bottom from a break place; in a muscle the degenerate process characterised by changes of muscular fibers, their destruction, development of a fatty and connecting tissue develops.
There are characteristic changes of electric reactions of the amazed nerves typical for a flaccid paralysis and the muscles, named a reaction of degeneration or degenerations ().
In norm at a nerve boring galvanic (at short circuit and disconnection) and faradic reduction иннервируемых it of muscles occurs currents; at a boring its reduction occurs the same currents of immediately muscle also, and on a galvanic current it arises extremely quickly ("immediately") and differs that катодозамыкательное reduction more than анодозамыкательное (the gas station).
At a reaction of degeneration (degeneration) the nerve does not spend a current to a muscle for its impellent centrifugal fibers перерождены and were lost; the muscle is denervated and loses ability of reduction on a boring a faradic current, keeping excitability only on the galvanic. But also this reduction becomes slow («червеобразным»), and big becomes already vpxl 400mg reduction (the gas station>). Such condition is called as a full reaction of degeneration and attacks 12 - 15th day after a break of a nerve or destruction of a cell of a forward horn.
At an incomplete lesion of a peripheric impellent neurone there can come a partial reaction of degeneration when excitability of a nerve on both currents is not lost, and is only weakened, no less than faradic excitability of a muscle; muscle reduction at a boring a galvanic current also arises slowly, with prevalence анодозамыкательного effect over катодозамыкательным (the gas station>).
The full reaction of degeneration yet is not a bad prognostic sign: under condition of restoration (neogenesis) of a nervous fiber it can be replaced through a phase of partial reaction with normal electroexcitability. But if the muscle at a flaccid paralysis remains completely denervated from above 12 - 14 months (sometimes and more longly) as a result of a progressing degeneration of muscular fibers they perish completely, are replaced with a fatty and connecting tissue, and there comes a cirrhosis of a muscle with loss already and its reactions to a galvanic current, i.e. Full loss of electroexcitability develops. Last specifies in irreversibility происшедших in a muscle of changes.
четверг, 6 ноября 2008 г.
(Finland) in 1964 is accepted
(Finland) in 1964 is accepted by 18th World medical assembly in Helsinki and (Japan) in 1975 is reconsidered by 29th World medical assembly in Tokyo order ultram 200mg
Mission of the doctor consists in people health protection. Its knowledge and experience is devoted to performance of this mission.
Improvement of diagnostic, therapeutic both preventive procedures and finding-out of an aetiology and pathogenesis of diseases should be the purpose of biomedical researches in public.
In the field of clinical researches the basic difference should be made between the medical researches which purpose is specification of the diagnosis or treatment of the patient, and the researches referred on finding-out of purely scientific questions without direct diagnostic or medical advantage for the person, subjected to research.
The world medical assembly has prepared following references for the doctor at carrying out of clinical researches.
Main principles 1. Biomedical researches in public should be spent according to the standard scientific principles and be based on adequate laboratory researches, experiments on animals and knowledge of the corresponding scientific literature.
2. The program and performance of each experimental research on the person should be accurately formulated in the experimental report which is represented to independent committee for treating, entering of remarks and offers.
3. Biomedical researches in public should be spent only by the qualified experts under observation of the competent doctor. Responsibility for health of the person is carried by the doctor, instead of investigated even if it has given on this consent.
4. Biomedical researches on the person cannot be spent, if the prospective advantage does not exceed possible risk.
5. Exact definition of degree of risk and potential advantage should precede each planned clinical research. Interests of the investigated should be above interests of a science and a society. vpxl 200mg
6. It is necessary to take measures for respect of the person of the examinee and reduction of influence of test on its physical and mental faculties.
7. Doctors should abstain from carrying out of researches in public, will not be convinced yet that possible harm is predicted. Any research is necessary for stopping, if harm from it outweighs potential advantage.
8. At the publication of the received results the doctor should observe their accuracy. Reports on the experiments spent without observance of principles, stated in the declaration, should not be accepted for the publication.
9. The participant of clinical researches should be informed on the purposes and methods of the research, expected advantage, possible harm, and also about all inconveniences bound to research. The right of refusal of participation in research or an exit from it at any moment should be given it. The doctor should receive preliminary from investigated the voluntary consent (in written form).
10. At reception of the written approval to participation in research the doctor should pay special attention that the examinee can be in a state of dependence. In this case the consent should be received other doctor who is not bound to research.
11. At physical or mental impossibility to give the written approval or if investigated is the minor, the permission can be received from relatives according to the national legislation.
12. In the research report the section with its ethical substantiation and a mark that it is made according to principles of this declaration should contain always.
The medical researches bound to the professional help
1. The doctor should have freedom in application of new diagnostic or medical measures if, in its opinion, they give hope of life salvage, recovery of health or simplification of suffering.
2. Probable advantage, harm and inconveniences of a new method should be estimated in comparison with advantages of best of existing diagnostic and medical methods.
3. In any medical research to each patient, including patients of control group if that is available, application of the best checked up methods of diagnostics and treatment should be guaranteed.
4. Refusal of the patient of participation in research should not break mutual relation of the doctor with the patient.
5. If the doctor considers, that it is not necessary to receive the written approval of the patient, the special reasons on that should be written down in the report and are submitted to treating to independent committee.
6. The doctor can combine medical researches with the professional help for reception of new medical knowledge in that degree to what these medical researches represent diagnostic or medical value for the patient.
Not medical biomedical researches
1. At purely scientific clinical researches spent in public, a duty of the doctor is protection of a life and health of the person - object of clinical research.
2. The examinee should be the volunteer.
3. The researcher should stop experiment if, in its opinion, at research continuation harm to the examinee can be done.
4. In researches on the person interests of a science and a society never should be put above health of the examinee.
Mission of the doctor consists in people health protection. Its knowledge and experience is devoted to performance of this mission.
Improvement of diagnostic, therapeutic both preventive procedures and finding-out of an aetiology and pathogenesis of diseases should be the purpose of biomedical researches in public.
In the field of clinical researches the basic difference should be made between the medical researches which purpose is specification of the diagnosis or treatment of the patient, and the researches referred on finding-out of purely scientific questions without direct diagnostic or medical advantage for the person, subjected to research.
The world medical assembly has prepared following references for the doctor at carrying out of clinical researches.
Main principles 1. Biomedical researches in public should be spent according to the standard scientific principles and be based on adequate laboratory researches, experiments on animals and knowledge of the corresponding scientific literature.
2. The program and performance of each experimental research on the person should be accurately formulated in the experimental report which is represented to independent committee for treating, entering of remarks and offers.
3. Biomedical researches in public should be spent only by the qualified experts under observation of the competent doctor. Responsibility for health of the person is carried by the doctor, instead of investigated even if it has given on this consent.
4. Biomedical researches on the person cannot be spent, if the prospective advantage does not exceed possible risk.
5. Exact definition of degree of risk and potential advantage should precede each planned clinical research. Interests of the investigated should be above interests of a science and a society. vpxl 200mg
6. It is necessary to take measures for respect of the person of the examinee and reduction of influence of test on its physical and mental faculties.
7. Doctors should abstain from carrying out of researches in public, will not be convinced yet that possible harm is predicted. Any research is necessary for stopping, if harm from it outweighs potential advantage.
8. At the publication of the received results the doctor should observe their accuracy. Reports on the experiments spent without observance of principles, stated in the declaration, should not be accepted for the publication.
9. The participant of clinical researches should be informed on the purposes and methods of the research, expected advantage, possible harm, and also about all inconveniences bound to research. The right of refusal of participation in research or an exit from it at any moment should be given it. The doctor should receive preliminary from investigated the voluntary consent (in written form).
10. At reception of the written approval to participation in research the doctor should pay special attention that the examinee can be in a state of dependence. In this case the consent should be received other doctor who is not bound to research.
11. At physical or mental impossibility to give the written approval or if investigated is the minor, the permission can be received from relatives according to the national legislation.
12. In the research report the section with its ethical substantiation and a mark that it is made according to principles of this declaration should contain always.
The medical researches bound to the professional help
1. The doctor should have freedom in application of new diagnostic or medical measures if, in its opinion, they give hope of life salvage, recovery of health or simplification of suffering.
2. Probable advantage, harm and inconveniences of a new method should be estimated in comparison with advantages of best of existing diagnostic and medical methods.
3. In any medical research to each patient, including patients of control group if that is available, application of the best checked up methods of diagnostics and treatment should be guaranteed.
4. Refusal of the patient of participation in research should not break mutual relation of the doctor with the patient.
5. If the doctor considers, that it is not necessary to receive the written approval of the patient, the special reasons on that should be written down in the report and are submitted to treating to independent committee.
6. The doctor can combine medical researches with the professional help for reception of new medical knowledge in that degree to what these medical researches represent diagnostic or medical value for the patient.
Not medical biomedical researches
1. At purely scientific clinical researches spent in public, a duty of the doctor is protection of a life and health of the person - object of clinical research.
2. The examinee should be the volunteer.
3. The researcher should stop experiment if, in its opinion, at research continuation harm to the examinee can be done.
4. In researches on the person interests of a science and a society never should be put above health of the examinee.
вторник, 4 ноября 2008 г.
As soon as the woman will feel, that has become pregnant
Healthy pregnancy
As soon as the woman will feel, that has become pregnant, to it follows immediately
To address for medical aid in consultation. As a rule, it order ultram 100mg
And arrive, as wishes to make sure that all goes normally.
Besides she aspires to come into constant contact to the person, from which
It is possible to receive the qualified council about all questions bound with
Birth of the child and which can organise to it a place in a maternity home
Or, if necessary, in antenatal unit of hospital.
We lower here the description of that joyful excitation which accompanies
To all these preparations, as well as that disappointment when it appears, that
Something goes not under the plan. Each woman, especially at first pregnancy,
Requires support, it is necessary for it to explain all phenomena unfamiliar to it.
The doctor, the nurse, all personnel of female consultation bear responsibility for
Preparation of the woman for a birth of the child, as these people in her eyes
Are the main experts on all questions bound to the future event.
For the young woman the beauty, grace are very important. She lawfully is proud of the
Figure; she wishes to keep appeal; it does not like a kind clumsy
Women on late durations of gestation; she is afraid of the swelled feet, pigmental
Maculae on the person, stretching lines (so-called extensions) on a stomach,
Enlarged mammary glands. The one who is anxious by its peace of mind,
Should not disregard its experience. vpxl 300mg
Certainly, in female consultation basin measurement, listening are spent and
Stomach palpation, measurement of arterial pressure, urine capture on the analysis
And bloods for group and Rh factor definition etc. But even if all in
Order, something is required to the woman larger, than a little simple
Councils-references about a diet and gymnastics. Whatever comprehensive was
Medical aid, it will give nothing, if will not affect mind of the woman. And what
Diagnostics and the correction was careful, all efforts will appear vain,
If there are the negative influences, capable all to cross out. Any woman
Should not arrive in hospital with fights, not having passed the corresponding
Preparations with the qualified teachers.
Happens and so, that future mother visits all
Preparatory employment in a maternity home or somewhere else - and only for
That during sorts to understand how a little she knows, necessary
For process of sorts. There is nothing more discouraging for the woman, than
Understanding of that incorrectly informed it, have incorrectly referred in
Judgement of its role in the course of a birth of the child. training is ready
Worse, than its full absence as it takes away from the woman trust to
To teachers and assistants.
Be protected those who tries to learn, itself never to nothing having learnt! In it
Case the approach by a birth of the child, as to natural physiological and
The high percent will be presented psychological process , and
Failures will frame bad reputation to a method which, actually, was simply
It is incorrectly applied. Except reading of scientific lectures about pregnancy and sorts,
The woman it is necessary to learn to breathe and be relaxed correctly still - without these
Knowledge cannot be expected a normal current of sorts.
And the such is possible also: on everyone employment it is told about perfect
Painless sorts. But for any qualified teacher
It is obvious, that it is impossible to guarantee full absence any
Deviations in a current of sorts. The good doctor will provide hundreds possible
Physical and emotional deviations which can appear harmful or
Even menacing to health of mother and the child - cases which will demand
Special medical intervention.
The women who have received inadequate preparation, often test the deep
Disappointment when at a deviation from a normal current of sorts it is required to them
The help of assistants. Quite often parturient women suffering from a pain in larger degree,
Than it was promised to them, sedatives easier do not dare to ask, and
Happens even, that refuse them when to them offer, than only
Aggravate difficulties. The women, had training wrong preparation, consider,
That application of injections, medicines and means a full failure, and from
It run into depression. Too often women blame themselves that in
Time of sorts have not done without a medical intervention. But it at all fault
Women. If it has been correctly prepared, would know, that in a number
Cases the help is necessary, the help will make labours much easier both for it, and for
The child.
It is possible to tell with confidence, that the woman who is not knowing about possibility correction
Actions in inconvenient cases, has not studied thoroughly principles
Natural sorts. After all there it is underlined and explained simple
Words, that the modern science can help with difficult cases. Knowledge gives
Confidence, instead of pavor.
As soon as the woman will feel, that has become pregnant, to it follows immediately
To address for medical aid in consultation. As a rule, it order ultram 100mg
And arrive, as wishes to make sure that all goes normally.
Besides she aspires to come into constant contact to the person, from which
It is possible to receive the qualified council about all questions bound with
Birth of the child and which can organise to it a place in a maternity home
Or, if necessary, in antenatal unit of hospital.
We lower here the description of that joyful excitation which accompanies
To all these preparations, as well as that disappointment when it appears, that
Something goes not under the plan. Each woman, especially at first pregnancy,
Requires support, it is necessary for it to explain all phenomena unfamiliar to it.
The doctor, the nurse, all personnel of female consultation bear responsibility for
Preparation of the woman for a birth of the child, as these people in her eyes
Are the main experts on all questions bound to the future event.
For the young woman the beauty, grace are very important. She lawfully is proud of the
Figure; she wishes to keep appeal; it does not like a kind clumsy
Women on late durations of gestation; she is afraid of the swelled feet, pigmental
Maculae on the person, stretching lines (so-called extensions) on a stomach,
Enlarged mammary glands. The one who is anxious by its peace of mind,
Should not disregard its experience. vpxl 300mg
Certainly, in female consultation basin measurement, listening are spent and
Stomach palpation, measurement of arterial pressure, urine capture on the analysis
And bloods for group and Rh factor definition etc. But even if all in
Order, something is required to the woman larger, than a little simple
Councils-references about a diet and gymnastics. Whatever comprehensive was
Medical aid, it will give nothing, if will not affect mind of the woman. And what
Diagnostics and the correction was careful, all efforts will appear vain,
If there are the negative influences, capable all to cross out. Any woman
Should not arrive in hospital with fights, not having passed the corresponding
Preparations with the qualified teachers.
Happens and so, that future mother visits all
Preparatory employment in a maternity home or somewhere else - and only for
That during sorts to understand how a little she knows, necessary
For process of sorts. There is nothing more discouraging for the woman, than
Understanding of that incorrectly informed it, have incorrectly referred in
Judgement of its role in the course of a birth of the child. training is ready
Worse, than its full absence as it takes away from the woman trust to
To teachers and assistants.
Be protected those who tries to learn, itself never to nothing having learnt! In it
Case the approach by a birth of the child, as to natural physiological and
The high percent will be presented psychological process , and
Failures will frame bad reputation to a method which, actually, was simply
It is incorrectly applied. Except reading of scientific lectures about pregnancy and sorts,
The woman it is necessary to learn to breathe and be relaxed correctly still - without these
Knowledge cannot be expected a normal current of sorts.
And the such is possible also: on everyone employment it is told about perfect
Painless sorts. But for any qualified teacher
It is obvious, that it is impossible to guarantee full absence any
Deviations in a current of sorts. The good doctor will provide hundreds possible
Physical and emotional deviations which can appear harmful or
Even menacing to health of mother and the child - cases which will demand
Special medical intervention.
The women who have received inadequate preparation, often test the deep
Disappointment when at a deviation from a normal current of sorts it is required to them
The help of assistants. Quite often parturient women suffering from a pain in larger degree,
Than it was promised to them, sedatives easier do not dare to ask, and
Happens even, that refuse them when to them offer, than only
Aggravate difficulties. The women, had training wrong preparation, consider,
That application of injections, medicines and means a full failure, and from
It run into depression. Too often women blame themselves that in
Time of sorts have not done without a medical intervention. But it at all fault
Women. If it has been correctly prepared, would know, that in a number
Cases the help is necessary, the help will make labours much easier both for it, and for
The child.
It is possible to tell with confidence, that the woman who is not knowing about possibility correction
Actions in inconvenient cases, has not studied thoroughly principles
Natural sorts. After all there it is underlined and explained simple
Words, that the modern science can help with difficult cases. Knowledge gives
Confidence, instead of pavor.
понедельник, 3 ноября 2008 г.
ACUTE POSTGIPOKSICHESKY ENCEPHALOPATHY
ACUTE POSTGIPOKSICHESKY ENCEPHALOPATHY
Clinic. Acute oxygen insufficiency depending on degree of a hypoxia of a brain can cause various disturbances of function of the central nervous system - from easy postgipoksi-cheskoj asthenias to a coma. At fast development of an acute hypoxia of a brain through 2-3 mines there can already come a coma, depth and which consequences depend on degree and prevalence of disturbance of function of a brain.
The most serious degree of a coma (terminal coma) ultram 100mg is caused by oppression of functions of all departments of a brain. It is clinically shown by a total hypomyotonia and an areflexia, disorder of breath and absence of electric activity of a brain. Warm and automatic activity of other organs remain at the expense of peripheric vegetative regulation.
At conservation of functions of caudal departments of a cerebral trunk against a hypomyotonia and an areflexia dermal and reflexes spontaneous breath (sometimes arrhythmic) is kept and corneal reflexes («a flaccid coma») cause. Tonic cramps, starts, a hyperthermia, and other vegetative disorders specify fluctuations of arterial pressure in disturbance of function of mezentse-falyju-diencephalic structures (a "hyperactive" coma). The subcortical coma is characterised by a decortication syndrome: reflexes of oral automatism, suhozhilno-nadkostnichnye reflexes high are expressed, cause pathological and reflexes. Extrapyramidal hyperkinesias of type choreic, miokloni-cheskih starts become perceptible. On ЭЭГ diffusive slow waves.
The stated signs of comas can be observed, though and not in full, at rendering assistance to the victim and at its exit from a deep asphyxia.
The further restoration of functions of a cortex of a brain is accompanied by various degree of disorder of consciousness from soporous to a somnolence. In case of a sopor patients react to painful external borings. At a condition they can answer questions, again plunging in a drowsy condition. After consciousness restoration the expressed dysmnesias, speeches, праксиса, symptoms of disturbance of function of a cerebellum, and extrapyramidal systems are taped. The specified signs of a diffusive lesion of a brain also define a syndrome acute encephalopathies. As the consequence of an acute hypoxia of a brain can be generated a syndrome asthenias.
Rendering assistance. In connection with a respiratory depression and disorder of activity of cardiovascular system of 0,5-1 ml intramusculary or intravenously, Corazolum of 10 % of a solution of 1 ml, analep-ticheskaja an admixture on 1-2 ml intramusculary or intravenously in an isotonic vpxl 200mg solution of sodium of Sodium chloridum or 5 % a glucose solution are shown Cytitonum. Oxygen or Carbogenum inhalation Is recommended. Patients are subject to hospitalisation in resuscitation unit. At serious forms гипоксической the encephalopathy accepts hyperbaric oxygenation.
Clinic. Acute oxygen insufficiency depending on degree of a hypoxia of a brain can cause various disturbances of function of the central nervous system - from easy postgipoksi-cheskoj asthenias to a coma. At fast development of an acute hypoxia of a brain through 2-3 mines there can already come a coma, depth and which consequences depend on degree and prevalence of disturbance of function of a brain.
The most serious degree of a coma (terminal coma) ultram 100mg is caused by oppression of functions of all departments of a brain. It is clinically shown by a total hypomyotonia and an areflexia, disorder of breath and absence of electric activity of a brain. Warm and automatic activity of other organs remain at the expense of peripheric vegetative regulation.
At conservation of functions of caudal departments of a cerebral trunk against a hypomyotonia and an areflexia dermal and reflexes spontaneous breath (sometimes arrhythmic) is kept and corneal reflexes («a flaccid coma») cause. Tonic cramps, starts, a hyperthermia, and other vegetative disorders specify fluctuations of arterial pressure in disturbance of function of mezentse-falyju-diencephalic structures (a "hyperactive" coma). The subcortical coma is characterised by a decortication syndrome: reflexes of oral automatism, suhozhilno-nadkostnichnye reflexes high are expressed, cause pathological and reflexes. Extrapyramidal hyperkinesias of type choreic, miokloni-cheskih starts become perceptible. On ЭЭГ diffusive slow waves.
The stated signs of comas can be observed, though and not in full, at rendering assistance to the victim and at its exit from a deep asphyxia.
The further restoration of functions of a cortex of a brain is accompanied by various degree of disorder of consciousness from soporous to a somnolence. In case of a sopor patients react to painful external borings. At a condition they can answer questions, again plunging in a drowsy condition. After consciousness restoration the expressed dysmnesias, speeches, праксиса, symptoms of disturbance of function of a cerebellum, and extrapyramidal systems are taped. The specified signs of a diffusive lesion of a brain also define a syndrome acute encephalopathies. As the consequence of an acute hypoxia of a brain can be generated a syndrome asthenias.
Rendering assistance. In connection with a respiratory depression and disorder of activity of cardiovascular system of 0,5-1 ml intramusculary or intravenously, Corazolum of 10 % of a solution of 1 ml, analep-ticheskaja an admixture on 1-2 ml intramusculary or intravenously in an isotonic vpxl 200mg solution of sodium of Sodium chloridum or 5 % a glucose solution are shown Cytitonum. Oxygen or Carbogenum inhalation Is recommended. Patients are subject to hospitalisation in resuscitation unit. At serious forms гипоксической the encephalopathy accepts hyperbaric oxygenation.
воскресенье, 2 ноября 2008 г.
Rendering assistance.
Rendering assistance. Wash out a stomach through a probe (a probe to oil) a solution of permanganate of a potassium 1: 1000 and enter saline laxative. Antidotal therapy is obligatory: repeated introductions subcutaneously a neostigmine methylsulfate of 0,05 % of a solution on 1 ml before improvement. To stop psychomotor excitation and cramps, intravenously enter 2-4 ml of 0,5 % of a solution of Sibazonum or 10 ml of 20 % of a solution of sodium of a hydroxybutyrate. To enter aminazine it is order ultram 100mgundesirable because of its oppressing action on brain structures. If the intoxication is expressed and there are no contraindications (the proof collapse, disturbances of function of kidneys with an oliguria, an azotemia and a hypercreatinuria), is shown an artificial diuresis, spend bloods. Intravenously enter a glucose with Acidum ascorbinicum, cardiovascular preparations under indications.
Poisoning with antihistamine preparations.
Clinic. Preparations of this group (etc.) reduce Dimedrol, Diazolinum, Suprastinum, Tavegilum reaction of an organism to Histaminum, taking out spastic strictures of a smooth musculation, warn development and facilitate a current of allergic reactions. Along with antihistaminic action some of them (Dimedrol, Diprazinum) have sedative an effect, brake carrying out of nervous excitation in vegetative ganglions, possess central care-noliticheskim action. In this connection they find application at sea and aeroembolism, vomiting of pregnant women, syndrome and also as abirritating and the hypnagogue is independent and in a combination to other soporific. Poisonings arise, as a rule, at a deliberate overdosage.
Symptoms of an intoxication Dimedrol, Diazolinum, Tavegilum (derivatives an Aether) are similar to those at a poisoning with atropine.
Rendering assistance. The same treatment, as at poisonings with atropine.
Poisoning with Sodium chloridums of hydrocarbons.
Clinic. couples-rehhloristyj apply Carboneum in the industry as dissolvents and raw materials to manufacture of plastic, and also in a life (glues, spot removers, etc.). They possess an aromatic smell that promotes the use inside for the purpose of intoxication. The lethal outcome can come even after reception of Sodium chloridums of hydrocarbons of 10-20 ml. The most serious poisonings occur at a combination to alcohol reception. At intake the highest concentration of substances in blood is observed through 3-4 ч from the moment of their reception, and rate of an absorption raises at joint reception with alcohol and Adepses. Being soaked up in blood, toxic substances collect in the tissues rich with lipids (a brain, a liver, an epiploon.надпочечники, a liver). Metabolism products дихлорэтана and four-chloride Carboneum cause disintegration of intracellular membranes with the subsequent лизисом cells. buy vpxl 100mg
At a peroral poisoning syndromes acute toxic an acute toxic gastroenteritis, disturbance of breath and cardiovascular activity, a toxic hepatopathy and a nephropathy are observed. Depending on intoxication severity level it is possible to allocate three basic forms of a clinical current acute a poisoning with Sodium chloridums of hydrocarbons.
Poisoning with antihistamine preparations.
Clinic. Preparations of this group (etc.) reduce Dimedrol, Diazolinum, Suprastinum, Tavegilum reaction of an organism to Histaminum, taking out spastic strictures of a smooth musculation, warn development and facilitate a current of allergic reactions. Along with antihistaminic action some of them (Dimedrol, Diprazinum) have sedative an effect, brake carrying out of nervous excitation in vegetative ganglions, possess central care-noliticheskim action. In this connection they find application at sea and aeroembolism, vomiting of pregnant women, syndrome and also as abirritating and the hypnagogue is independent and in a combination to other soporific. Poisonings arise, as a rule, at a deliberate overdosage.
Symptoms of an intoxication Dimedrol, Diazolinum, Tavegilum (derivatives an Aether) are similar to those at a poisoning with atropine.
Rendering assistance. The same treatment, as at poisonings with atropine.
Poisoning with Sodium chloridums of hydrocarbons.
Clinic. couples-rehhloristyj apply Carboneum in the industry as dissolvents and raw materials to manufacture of plastic, and also in a life (glues, spot removers, etc.). They possess an aromatic smell that promotes the use inside for the purpose of intoxication. The lethal outcome can come even after reception of Sodium chloridums of hydrocarbons of 10-20 ml. The most serious poisonings occur at a combination to alcohol reception. At intake the highest concentration of substances in blood is observed through 3-4 ч from the moment of their reception, and rate of an absorption raises at joint reception with alcohol and Adepses. Being soaked up in blood, toxic substances collect in the tissues rich with lipids (a brain, a liver, an epiploon.надпочечники, a liver). Metabolism products дихлорэтана and four-chloride Carboneum cause disintegration of intracellular membranes with the subsequent лизисом cells. buy vpxl 100mg
At a peroral poisoning syndromes acute toxic an acute toxic gastroenteritis, disturbance of breath and cardiovascular activity, a toxic hepatopathy and a nephropathy are observed. Depending on intoxication severity level it is possible to allocate three basic forms of a clinical current acute a poisoning with Sodium chloridums of hydrocarbons.
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