[Rheumatic carditis and its future (author's transl)]

Authors report results of the study of a series of rheumatic heart disease in 34 children between three and 14 years old, followed-up from one month to 14 years (mean six years and six months), and another one of 14 adults operated because of cardiac sequelae, in whom the average age was 48. The most significant results are: more common in autumn-winter (62%) and females (60%); family history of rheumatic fever (55%); low social level; mitral predominance with mitral regurgitation in children and stenosis in adults; during puberty age; without symptoms in the joints in 36%, and with better prognosis since 1974. Parameters with prognostic value in the prediction of sequelae were: family history of rheumatic fever; rural environment; increase in cardiac volume, PR prolongation in the ECG and inadequate treatment and prophylaxis. 36% of the mitral lesions and 20% of the aortic ones disappeared. The main conclusion is the need for intensive treatment during the acute period of the disease and continuous prevention during the rest of their lives of cardiac sequelae.

The applied pharmacology of azaperone in ponies

The butyrophenone tranquilliser, azaperone, was administered intramuscularly to ponies in five series of experiments, using a dose level of 0-4 mg/kg once and 0-8 mg/kg four times. An excellent or good sedative effect was usually obtained with both dose levels, but the response was more consistent with the higher dose. The onset of sedation was apparent within 10 min of administration, the maximal effect usually occurring between 20 and 60 min while sedation was no longer apparent after 2 to 6 h. Body temperature was reduced in all animals for at least 2 h and respiratory rate was increased in some ponies but not in others. A mild tachycardia occurred in the first hour after administering azaperone (0-8 mg/kg) and arterial blood pressure was reduced for at least 4 h. The hypothesis that azaperone reduced blood pressure by blocking alpha-adrenoceptors, thereby decreasing vasomotor tone, was tested by measuring the ability of azaperone (0-8 mg/kg) to antagonise the action of standard intravenous doses of adrenaline (1-5 mug/kg) on blood pressure, Azaperone partially antagonised the pressor action of adrenaline and in comparative studies the phenothiazine tranquilliser, acepromazine (0-1 mg/kg), also exerted a similar blocking effect.

Effects of azaperone on cardiovascular and respiratory functions in the horse

1 The butyrophenone tranquilizer, azaperone, was administered intramuscularly, at dose levels of 0.4 and 0.8 mg/kg, to ponies and its effects on cardiovascular and respiratory functions assessed. 2 Arterial blood pH, CO2 tension (PaCO2) and O2 tension (PaO2) remained relatively constant throughout the course of action of azaperone. 3 Azaperone did not modify plasma protein concentration but venous blood packed cell volume and haemoglobin concentration were reduced by 5 to 10% for at least 4 hours. These changes were probably caused by uptake of erythrocytes into the splenic reservoir. 4 Small increases in heart rate occurred for up to 60 min after administration of the drug, and this was followed by a slight bradycardia in some ponies. 5 Azaperone reduced mean arterial blood pressure (MAP) for at least 4 h, by which time its ataractic action was generally no longer apparent. The hypotension was caused, during the early phase of action at least, by a reduction in peripheral resistance, since cardiac output was increased slightly 20 min after its administration. Possible mechanisms underlying the cardiovascular changes are discussed. 6 In spite of reductions in arterial blood O2 content and MAP produced by azaperone, it is likely that tissue oxygenation was adequate, since arterial blood lactate concentrations were not increased.