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Sample records for adiposidad intraabdominal por

  1. Mediciones de adiposidad intraabdominal por ultrasonido y factores asociados con riesgo cardiovascular en niños obesos

    OpenAIRE

    REYES,MARCELA; ESPINOZA,ANÍBAL; REBOLLO,M. JESÚS; MORAGA,FRANCISCO; MERICQ,VERÓNICA; CASTILLO-DURÁN,CARLOS

    2010-01-01

    Background: Cardiovascular risk factors are commonly present in obese children. Aim: To evaluate the association among radiological measurements of intra-abdominal adipose tissue, and cardiovascular risk factors, in prepuberal obese children. Patients and Methods: We evaluated 30 obese (body mass index > p95) children aged 6 to 12 years (15 males). Anthropometry and blood pressure were measured. Subcutaneous and intra-abdominal fat thickness and fat area were measured by ultrasound (US) and c...

  2. Aleitamento materno exclusivo e adiposidade

    OpenAIRE

    Moraes, José Fernando V. N.; Giugliano, Rodolfo

    2011-01-01

    OBJETIVO: Associar o tempo de amamentação exclusiva da criança à adiposidade central e periférica, por meio do índice de massa corporal, dos perímetros da cintura e do braço, e das dobras cutâneas triciptal, subescapular e a somatória destas em pré-escolares. MÉTODOS: Pesquisa de delineamento transversal, em que 134 pré-escolares entre três e cinco anos de idade de uma escola par-ticular de Brasília, DF, foram avaliados quanto a: massa corporal, estatura, perímetros do braço e da cintura, dob...

  3. Adiposidad, resistencia a la insulina y dislipidemia

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    Angélica María Serrano Cruz

    2011-12-01

    Full Text Available Tomando como punto de partida la discusión de un artículo publicado por la propia revista Finlay en su número anterior, esta carta se refiere específicamente a la relación entre la adiposidad visceral, la resistencia a la insulina y la dislipidemia.Adiposity, Insulin Resistance and Dyslipidemia Considering as a start point the discussion of an article published by this same journal (Finlay in its previous issue, this letter deals specifically with the relationship between visceral adiposity, insulin resistance and dyslipidemia.

  4. Aleitamento materno exclusivo e adiposidade Amamantamiento materno exclusivo y adiposidad Exclusive breastfeeding and adiposity

    OpenAIRE

    José Fernando V. N. Moraes; Rodolfo Giugliano

    2011-01-01

    OBJETIVO: Associar o tempo de amamentação exclusiva da criança à adiposidade central e periférica, por meio do índice de massa corporal, dos perímetros da cintura e do braço, e das dobras cutâneas triciptal, subescapular e a somatória destas em pré-escolares. MÉTODOS: Pesquisa de delineamento transversal, em que 134 pré-escolares entre três e cinco anos de idade de uma escola par-ticular de Brasília, DF, foram avaliados quanto a: massa corporal, estatura, perímetros do braço e da cintura, dob...

  5. Adiposidade corporal em crianças de baixa renda

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    Andréa Jaqueline Prates Ribeiro

    2008-10-01

    Full Text Available O objetivo deste estudo foi analisar os níveis de adiposidade corporal em crianças de baixa renda de 5 a 10 anos de idade, residentes na região de abrangência de Secretaria de Desenvolvimento Regional de São Miguel do Oeste/SC. Para tanto, 1089 crianças foram avaliadas. Realizou-se a avaliação do percentual de gordura (%G através da classificação proposta por Lohman. Os resultados apontam uma maior prevalência de meninas com nível de gordura “baixo” em comparação aos meninos (29,1% e 8,9%, respectivamente. Por outro lado, houve um maior percentual de meninos com adiposidade “alta” em relação às meninas (17,6% e 13,7%, respectivamente. No entanto, a maior parte dos meninos e meninas avaliados (73,5% e 57,1 %, respectivamente apresentaram porcentagem de gordura “adequada” para a idade. Conclui-se que há a necessidade de implantação de programas de prevenção e intervenção na região, pois altas prevalências de desnutrição e obesidade foram observadas.

  6. Aleitamento materno exclusivo e adiposidade Amamantamiento materno exclusivo y adiposidad Exclusive breastfeeding and adiposity

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    José Fernando V. N. Moraes

    2011-06-01

    Full Text Available OBJETIVO: Associar o tempo de amamentação exclusiva da criança à adiposidade central e periférica, por meio do índice de massa corporal, dos perímetros da cintura e do braço, e das dobras cutâneas triciptal, subescapular e a somatória destas em pré-escolares. MÉTODOS: Pesquisa de delineamento transversal, em que 134 pré-escolares entre três e cinco anos de idade de uma escola par-ticular de Brasília, DF, foram avaliados quanto a: massa corporal, estatura, perímetros do braço e da cintura, dobras cutâneas triciptal e subescapular. Os pais das crianças responderam a um questionário sobre tempo de amamentação. O diagnóstico de sobrepeso e obe-sidade foi realizado de acordo com a classificação da Organização Mundial da Saúde para o índice de massa corporal por idade. RESULTADOS: As meninas tiveram maior concentração adiposa na dobra cutânea triciptal (p=0,001, subescapular (p=0,044 e na somatória destas (p=0,003 em relação aos meninos. A prevalência de sobrepeso e obesidade foi similar nos dois sexos (25,4% nos meninos e 22,6% nas meninas, assim como o tempo médio de amamentação exclusiva (4,3 meses para meninos e 4,6 meses para meninas. Notou-se correlação inversa significativa entre tempo de amamentação exclusiva e perímetro da cintura (r=-0,166; p=0,05. As demais variáveis também mostraram tendência de correlação inversa com o tempo de aleitamento materno exclusivo, porém sem valores significativos. CONCLUSÕES: A associação inversa entre o tempo de ama-mentação e o perímetro da cintura mostra um possível efeito do aleitamento materno sobre a distribuição de gordura corporal no pré-escolar.OBJETIVO: Asociar el tiempo de amamantamiento exclusivo del niño con la adiposidad central y periférica mediante el índice de masa corporal, perímetros de la cintura y del brazo, y pliegues cutáneos ticipital, subescapular y la suma de estos en pre-escolares. MÉTODOS: Investigación de delineaci

  7. Análise da adiposidade subcutânea durante o ciclo menstrual

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    Joaquim Huaina Cintra Andrade

    2017-04-01

    Full Text Available Objetivo: analisar isoladamente o componente adiposo subcutâneo durante o ciclo menstrual. Método: a amostra foi composta por 30 mulheres saudáveis com idade entre 18 e 25 anos, com ciclo menstrual regular e que não utilizavam anticoncepcional oral ou injetável no período do estudo, na cidade de Fortaleza-CE, Brasil. A adiposidade corporal foi predita a partir da quantificação do somatório de seis dobras cutâneas (S ADIP. Essa variável foi utilizada no cálculo do escore de proporcionalidade (Z ADIP, subsidiando a realização do cálculo da massa adiposa absoluta (M ADIP. Resultados: a média de idade foi de 21,8 anos e de estatura 162,2 cm. Considerando a disposição de adiposidade por dobra cutânea, durante as três fases do ciclo menstrual, as dobras tricipital, subescapular, abdominal e espinal apresentaram maior média na fase lútea (14,8; 11,9; 19,5; 10,6 respectivamente; a dobra coxa apresentou valores de médias estatisticamente semelhantes nas fases folicular e ovulatória (20,1 e a dobra perna apresentou maior média na fase folicular (13,4. Analisando a prevalência do maior somatório de dobras cutâneas e a relação com a maior quantificação de massa adiposa absoluta, constatou-se que a fase folicular apresentou a maior média de somatório de dobras (89,6 e de massa adiposa (19,3. Considerações finais: os dados encontrados revelam que, durante as fases do ciclo menstrual, não há diferença significativa no somatório das dobras cutâneas e de massa adiposa absoluta. Este fato sugere que as alterações hormonais ocorridas durante o ciclo não estão diretamente associadas com o fator de variabilidade da adiposidade corporal.

  8. Consumo de bebida alcoólica e adiposidade abdominal em doadores de sangue Consumo de bebida alcohólica y adiposidad abdominal en donadores de sangre Alcohol consumption and abdominal fat in blood donors

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    Márcia Gonçalves Ferreira

    2008-12-01

    Full Text Available OBJETIVO: Analisar a associação entre o consumo de bebidas alcoólicas e adiposidade abdominal. MÉTODOS: Estudo transversal com uma amostra de homens doadores de sangue (N=1.235, de 20 a 59 anos, em Cuiabá (MT, realizado de agosto/1999 a janeiro/2000. Os indicadores de adiposidade abdominal foram circunferência da cintura e relação cintura/quadril, ajustados pela adiposidade total. As medidas aferidas foram: peso, estatura, circunferências da cintura e do quadril. O consumo de álcool foi avaliado utilizando-se um questionário sobre tipo, freqüência e quantidade da bebida consumida. A associação entre o consumo de álcool e adiposidade abdominal foi analisada por regressão linear múltipla, com os modelos ajustados para idade, atividade física, tabagismo e adiposidade total. RESULTADOS: Após ajuste, a circunferência da cintura e a relação cintura quadril mantiveram-se associadas positivamente ao consumo de cerveja (p=0,02 e ao total de álcool consumido (p=0,01 e 0,03, respectivamente. O consumo de aguardente mostrou associação somente com a circunferência da cintura (p=0,04. CONCLUSÕES: O consumo de álcool, particularmente de cerveja, associou-se com a localização abdominal de gordura.OBJETIVO: Analizar la asociación entre el consumo de bebidas alcohólica y adiposidad abdominal. MÉTODOS: Se efectuó estudio transversal con una muestra de hombres donadores de sangre (N= 1.235, de 20 a 59 años, en Cuiabá (Centro-Oeste de Brasil, realizado de agosto/1999 a enero/2000. Los indicadores de adiposidad abdominal fueron circunferencia de la cintura y relación cintura/cuadril, ajustadas por la adiposidad total. Las medidas verificables fueron: peso, estatura, circunferencias de la cintura y del cuadril. El consumo de alcohol fue evaluado utilizándose un cuestionario sobre tipo, frecuencia y cantidad de la bebida consumida. La asociación entre el consumo de alcohol y adiposidad abdominal fue analizada por regresi

  9. Aptitud cardiorrespiratoria y adiposidad frente al nivel de actividad física

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    Carlos Alberto Ramos Parrací

    2017-06-01

    Full Text Available Con el objetivo de determinar el comportamiento de la Aptitud Cardiorrespiratoria y la adiposidad frente al nivel de actividad física de la población adulta de la ciudad de Neiva, se evaluaron 972 sujetos entre 18 a 75 años de edad. Estudio Descriptivo Correlacional. Los datos se analizaron en SPSS-23 e InfoStat/Profesional 1,2. La metodología partió de la descripción de variables, posteriormente el grado de asociación entre ellas (coeficiente de correlación de Pearson, los grupos conformados se compararon (Prueba ANOVA y comparación multiple LSD Fisher; por último, se estableció el grado de agrupamiento entre las variables (Prueba Average Linkage. Los resultados evidenciaron diferencias significativas en índice de masa corporal (IMC, Frecuencia Cardiaca Reposo (FCR y Consumo Máximo de Oxigeno (VO2máx., entre activos e inactivos; asociación del 5%, entre el IMC con FCR y VO2máx, índice cintura–cadera (ICC y porcentaje grasa corporal (%GC; del ICC con %GC, VO2máx, Tensión Arterial Sistólica (TAS y Diastólica (TAD; del %GC con FCR, TAD y VO2máx; la FCR con VO2máx; la TAS con TAD y VO2máx rechazando la hipótesis de independencia. Concluyendo que los indicadores de adiposidad y aptitud cardiorrespiratoria evidencian la combinación de factores de riesgo de enfermedades de índole hipocinético en la población.

  10. Aggressive intraabdominal fibromatosis

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    Stojković Mirjana

    2006-01-01

    Full Text Available Background. Intraabdominal or mesenteric fibromatosis is a rare benign nonmetastatic neoplasm that appears as a sporadic lesion or in patients with familiar polyposis. Its evolution is unpredictable. About 10% of the cases show a very aggressive growth. Case report. We presented a 22-year-old woman in whom an aggressive intraabdominal fibromatosis had appeared during the first pregnancy as a well circumscribed ovoid tumor, involving the terminal ileum, the caecum, the ascending colon, the right kidney, the ureter, and the right common iliac artery. The tumor was excised with right colectomy, nephroureterectomy and resection of the involved artery using arterial reconstruction with graft interposition. Two years after the surgery the patient developed an inoperable tumor recurrence with a fatal outcome. Conclusion. In spite of a successful surgical excision during the original surgery intraabdominal or mesenteric fibromatosis might have an aggressive evolution leading to an inoperable tumor recurrency and a fatal outcome.

  11. [Intra-abdominal fibromatosis].

    Science.gov (United States)

    Brătucu, E; Marin, D; Ungureanu, D; Gheorghiu, D; Dragoncea, C

    1995-01-01

    The authors describe three cases of intraabdominal fibromathosis: two cases with intraperithoneal location and another one with retroperithoneal location. All of them are benign noncapsulated tumours of the fibrous tissue with tendancy to local recurrence. Abdominal fibromathosis may determine any form of acute or chronic digestive manifestations. Only to the accuracy of the histo-pathological examination is due the diagnosis between fibromathosis and fibrosarcoma, reactive fibrosis, mixoma and nodular fasceitis. The surgical excision must not be economical and the association with radiant therapy must also be considered.

  12. Relaci?n entre el consumo de bebidas azucaradas e indicadores de adiposidad en ni?os y adolescentes de Bogot?: estudio FUPRECOL 2014

    OpenAIRE

    Ruiz Castellanos, Erika Johana; Mart??nez Torres, Javier

    2016-01-01

    Antecedentes: El consumo de bebidas azucaradas es un tema de salud p?blica por los efectos negativos sobre el riesgo de sobrepeso y obesidad en ni?os y adolescentes. En Am?rica Latina, se ha aumentado el consumo de estas bebidas en las ?ltimas d?cadas. En Colombia, el mayor consumo de bebidas azucaradas se observa en las personas 9-30 a?os. Objetivo: Determinar la relaci?n entre el consumo de bebidas azucaradas e indicadores de adiposidad en ni?os y adolescentes escolares participantes de...

  13. Relación entre el consumo de bebidas azucaradas e indicadores de adiposidad en niños y adolescentes de Bogotá: estudio FUPRECOL 2014

    OpenAIRE

    Ruiz Castellanos, Erika Johana; Martínez Torres, Javier

    2016-01-01

    Antecedentes: El consumo de bebidas azucaradas es un tema de salud pública por los efectos negativos sobre el riesgo de sobrepeso y obesidad en niños y adolescentes. En América Latina, se ha aumentado el consumo de estas bebidas en las últimas décadas. En Colombia, el mayor consumo de bebidas azucaradas se observa en las personas 9-30 años. Objetivo: Determinar la relación entre el consumo de bebidas azucaradas e indicadores de adiposidad en niños y adolescentes escolares participantes de...

  14. Intraabdominal hypertension og abdominalt kompartmentsyndrom

    DEFF Research Database (Denmark)

    Sonne, Morten; Hillingsø, Jens

    2008-01-01

    Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare conditions with high mortality. IAH is an intraabdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAP is measured indirectly via the bladder or stomach. Various...

  15. Análisis de la adiposidad y la condición física en escolares colombianos

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    Constanza Palomino-Devia

    2016-09-01

    Full Text Available Introducción. El índice de masa corporal y la condición física son indicadores de un estilo de vida saludable. Objetivo. Analizar el grado de adiposidad y la condición física en estudiantes de instituciones educativas públicas de Armenia, Colombia, y estudiar las diferencias por sexo y edad. Materiales y métodos. Participaron 1.150 estudiantes, de los cuales 46,6 % eran de sexo masculino (n=536 y 53,4 % (n=614 de sexo femenino; el rango de edad fue de 10 a 20 años (15,45 ± 2,52. Las pruebas de condición física usadas fueron el test de Course-Navette, el de salto horizontal, el de la carrera de 20 m y el de Wills y Dillon. También, se evaluaron el índice de masa corporal y el porcentaje de grasa. Resultados. En comparación con los hombres, las mujeres tenían mayor adiposidad, índice de masa corporal (20,4 Vs. 19,5 y porcentaje de grasa (23 Vs. 11 %. En cuanto a la condición física, los hombres registraron un mejor rendimiento en todas las variables estudiadas, con diferencias significativas (p<0,001, excepto en la flexibilidad, en la que las mujeres alcanzaron mejores resultados (3,1 Vs. 1,3 cm; p=0,003. En ambos sexos, el índice de masa corporal aumentó con la edad (p<0,001; en los hombres, el porcentaje de grasa disminuyó con la edad (p<0,0001 y en las mujeres aumentó (p<0,001. La condición física de los hombres mejoró con la edad en todas las variables, mientras que en las mujeres no hubo diferencias significativas entre los grupos de edad, salvo en el consumo máximo de oxígeno (VO2máx (p<0,001. Conclusión. La adiposidad fue significativamente mayor en las mujeres que en los hombres. Los hombres tuvieron una mejor condición física en todas las variables, excepto en la flexibilidad. En los hombres la condición física mejoró significativamente con la edad, en tanto que en las mujeres no cambió.

  16. Adiposidade em adolescentes e obesidade materna Relationship between maternal obesity and adiposity in adolescents

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    Maria Fernanda Petroli Frutoso

    2011-02-01

    Full Text Available OBJETIVO: Descrever a relação entre adiposidade na adolescência e obesidade materna. MÉTODOS: Foi realizado estudo transversal com 660 indivíduos de 8 a 18 anos, de ambos os sexos, matriculados em uma escola pública e outra privada do município de São Paulo. A coleta de dados foi realizada por meio de entrevista, medidas antropométricas e inquérito alimentar. A adiposidade na adolescência foi mensurada a partir do índice de massa corporal e, por meio de análise de regressão, verificou-se sua relação com a obesidade materna, ajustada por sexo, idade, estágio de maturação sexual, valor energético total da dieta, atividade física, sedentarismo, peso ao nascer e escolaridade materna. RESULTADOS: Dos adolescentes estudados, 64,7% eram do sexo feminino. A média (desvio-padrão de idade foi de 12,4 (1,80, variando de 8 a 17 anos. Verificou-se maior prevalência de excesso de peso e obesidade entre os indivíduos do sexo masculino, não sendo observada associação significativa entre estado nutricional e sexo. Após ajuste pelas covariáveis, detectou-se que filhos de mães obesas têm risco quatro vezes maior de ser obesos, quando comparados aos adolescentes filhos de mães não obesas. CONCLUSÃO: Conclui-se que a obesidade materna representa fator de risco importante para o desenvolvimento da obesidade na adolescência.OBJECTIVE: This study aimed to describe the relationship between teenager's adiposity and maternal obesity. METHODS: A cross-sectional study was done with 660 teenagers aged 8 to 18 years, of both genders, students of private and public schools of São Paulo. The data were collected by interviews, anthropometric measurements and food intake records. Teenagers' adiposity was determined by body mass index and regression analyses was used to verify its relationship with maternal obesity adjusted for gender, age, stage of sexual development, energy intake, physical activity, sedentary lifestyle, birth weight and

  17. Disseminated Intra-Abdominal Hydatidosis

    Science.gov (United States)

    Concha, Fátima; Maguiña, Ciro; Seas, Carlos

    2013-01-01

    We present the case of a 26-year-old male Peruvian patient who presented with disseminated intra-abdominal hydatidosis. The patient was treated with surgical removal of the cysts and prolonged medical treatment with albendazole. PMID:24006293

  18. [Intraabdominal paraganglioma--case report].

    Science.gov (United States)

    Ordeanu, C; Mărginean, A

    2011-01-01

    Paraganglioma is a rare neuroendocrine neoplasm that may develop in the head, neck, torax or abdomen, with a not specified symptoms and the accurate diagnose is established histopathological. The authors present a case of one intraabdominal paraganglioma, incidentally found during ultrasonographic evaluation and diagnose with histopathological examination of excised pieces.

  19. Fatores sociodemográficos e comportamentais associados à adiposidade corporal em adolescentes

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    Rodrigo Bozza

    2014-09-01

    Full Text Available Objetivo: Identificar fatores sociodemográficos e comportamentais associados à obesidade abdominal (OA e ao percentual de gordura corporal elevado (%GC elevado em adolescentes de Curitiba-PR. Métodos: A amostra probabilística foi composta por 1.732 adolescentes, de 11 a 19 anos, de ambos os sexos, da rede pública de ensino. Foram coletadas as medidas de dobras cutâneas tricipital e panturrilha para o cálculo do %GC, além da medida da circunferência da cintura. Um questionário foi preenchido pelos adolescentes para avaliação das seguintes variáveis: sexo, idade, tipo de residência, nível socioeconômico, tempo gasto assistindo à TV durante a semana e o fim de semana, além do gasto energético diário. A regressão logística foi utilizada como medida de associação dos fatores sociodemográficos e comportamentais com a obesidade abdominal e o percentual de gordura corporal elevado. Resultados: As meninas apresentaram maior chance de ter o %GC elevado (OR: 2,73; IC95%: 2,32-3,33. Em contrapartida, têm menor chance de ter obesidade abdominal (OR: 0,58; IC95%: 0,44-0,78. Indivíduos mais velhos (16-19 anos apresentaram maior chance de ter o %GC elevado (OR: 1,36; IC95%: 1,02-1,83. Em contrapartida, as faixas etárias mais elevadas (13-15 anos e 16-19 anos tiveram uma associação inversa com a obesidade abdominal. Em relação ao gasto energético diário, os indivíduos menos ativos apresentaram maior chance de ter %GC elevado (OR: 1,36; IC95%: 1,07-1,71 e obesidade abdominal (OR: 1,40; IC95%: 1,09-1,80. Conclusões: Intervenções relacionadas ao aumento nos níveis de atividade física na população jovem devem ser elaboradas para o combate do excesso de adiposidade corporal.

  20. Composição corpórea, alterações bioquímicas e clínicas de adolescentes com excesso de adiposidade

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    Hiara Miguel Stanciola Serrano

    2010-10-01

    Full Text Available FUNDAMENTO: Adolescentes com excesso de adiposidade e eutróficas apresentam as mesmas alterações metabólicas esperadas em indivíduos obesos. OBJETIVO: Avaliar a composição corpórea, alterações antropométricas, bioquímicas e clínicas de adolescentes do sexo feminino. MÉTODOS: Foram avaliadas 113 adolescentes de escolas públicas de Viçosa, MG, divididas em três grupos: grupo 1 - constituído por adolescentes eutróficas com excesso de gordura corpórea; grupo 2 - eutróficas com gordura corpórea dentro dos limites de normalidade; e grupo 3 - com excesso de peso e de gordura corpórea. Peso, estatura, circunferência da cintura e quadril, pressão arterial foram aferidos. O índice de massa corporal (IMC e a relação cintura-quadril foram calculados. O porcentual de gordura corpórea foi obtido pela impedância bioelétrica horizontal, seguindo protocolo próprio para a referida avaliação. A avaliação do porcentual de gordura corpórea e bioquímica foi realizada após 12 horas de jejum, sendo analisados perfil lipídico, glicemia e insulina, homocisteína, leptina e Proteína C Reativa. A resistência à insulina foi calculada pelo índice HOMA. RESULTADOS: O grupo das adolescentes eutróficas, com elevada adiposidade, comportou-se, em relação à pressão arterial, fração HDL e glicemia, de modo semelhante às adolescentes com excesso de peso. Pode-se perceber que o índice HOMA, a insulina e a leptina aumentaram de acordo com o aumento da gordura corpórea. Mais da metade das adolescentes apresentava valores de colesterol total e PCR acima dos níveis recomendados. A alteração metabólica mais evidente relacionou-se ao perfil lipídico para os grupos estudados. CONCLUSÃO: O excesso de adiposidade em adolescentes eutróficas pode estar relacionado a alterações bioquímicas e clínicas semelhantes àquelas encontradas em adolescentes com excesso de peso.

  1. A associação entre a adiposidade corporal e a aptidão musculoesquelética em meninos é mediada pelo nível econômico?

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    Giseli Minatto

    2013-12-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2014v16n1p116   Objetivou-se estimar a prevalência de adiposidade corporal elevada e sua associação com a aptidão musculoesquelética, por nível econômico, em crianças e adolescentes do sexo masculino. Estudo epidemiológico transversal realizado em 1.531 escolares (6-17 anos da rede de ensino pública do município de Cascavel, PR, Brasil. A adiposidade corporal foi estimada pela técnica de dobras cutâneas. Foram coletadas informações referentes à idade, nível econômico e estágio maturacional, bem como ao desempenho nos testes de sentar e alcançar, abdominal em 1 minuto, impulsão horizontal e Shuttle run. As análises (teste t de student não pareado e regressão de Poisson foram realizadas por nível econômico alto e baixo (baixo+médio, com nível de significância de 5%. A prevalência de adiposidade corporal elevada foi de 30,4%, sendo maior (p<0,05 naqueles de nível econômico alto (33,3% vs 28,3%. Após ajuste para todas as variáveis, no nível econômico baixo, a adiposidade corporal elevada se associou a baixa resistência abdominal (RP=1,44; IC95%=1,05-1,99 e potência de membros inferiores (RP=2,09; IC95%=1,46-1,98. No nível econômico alto, o desfecho foi associado à baixa resistência abdominal (RP=1,72; IC95%=1,17-2,51 e, à média (RP=2,83; IC95%=1,76-4,55 e baixa (RP=3,90; IC95%=2,38-6,38 potência de membros inferiores. Em ambos os estratos sociais, o menor desempenho muscular (resistência abdominal e potência de membros inferiores conferiu maior probabilidade de ter adiposidade corporal elevada. Porém, a magnitude das valências musculares associadas à adiposidade corporal elevada parece diferir de acordo com o nível econômico.

  2. Eficácia da eletrolipólise na redução da adiposidade localizada: uma revisão integrativa = Electrolipolysis effectiveness in reducing localized adiposity: an integrative review

    Directory of Open Access Journals (Sweden)

    Campos, Gleice Braz de

    2016-01-01

    Full Text Available Introdução: A eletrolipólise é destinada ao tratamento das adiposidades e acúmulo de ácidos graxos localizados por meio da aplicação de pares de agulhas de acupuntura no tecido subcutâneo, ligadas a corrente de baixa frequência. Objetivo: Verificar a eficácia da eletrolipólise na redução da adiposidade localizada. Materiais e Métodos: Foi realizada uma revisão integrativa de literatura, nas bases de dados SciELO, LILACS e PubMed, utilizando o cruzamento dos descritores physiotherapy, esthetics, abdomen, adiposity, lipolysis e do termo electrolipolysis. Foram incluídos ensaios clínicos com seres humanos maiores de 18 anos, nos idiomas português e inglês, no período de 2005 a 2015. Resultados: Foram identificados cinco estudos cujo tamanho amostral variou entre oito a 16 sujeitos, totalizando 53 participantes, todos do sexo feminino, com idade entre 18 a 45 anos. A aplicação da eletrolipólise proporcionou desfechos significativos como reduções das medidas de adipometria de áreas como a região abdominal, glútea e em flancos. Conclusão: A eletrolipólise na redução de medidas antropométricas, como a adiposidade localizada apresenta resultados favoráveis à sua aplicação

  3. Intraabdominal Infections in Older Adults.

    Science.gov (United States)

    Berlin, Ana; Johanning, Jason Michael

    2016-08-01

    Intraabdominal infections represent a diagnostic and therapeutic challenge in the elderly population. Atypical presentations, diagnostic delays, additional comorbidities, and decreased physiologic reserve contribute to high morbidity and mortality, particularly among frail patients undergoing emergency abdominal surgery. While many infections are the result of age-related inflammatory, mechanical, or obstructive processes, infectious complications of feeding tubes are also common. The pillars of treatment are source control of the infection and judicious use of antibiotics. A patient-centered approach considering the invasiveness, risk, and efficacy of a procedure for achieving the desired outcomes is recommended. Structured communication and time-limited trials help ensure goal-concordant treatment. Published by Elsevier Inc.

  4. Influência da adiposidade global e da adiposidade abdominal nos níveis de proteína C-reativa em mulheres idosas Influence of overall and abdominal adiposity on C-reactive protein levels in elderly women

    Directory of Open Access Journals (Sweden)

    Jeffer Eidi Sasaki

    2007-10-01

    Full Text Available OBJETIVO: Examinar como a adiposidade global e a adiposidade abdominal, expressas pela circunferência da cintura (CC, pelo índice de massa corporal (IMC e pelo somatório de dobras cutâneas (sigmaDC, influenciam os níveis de proteína C-reativa (PCR em mulheres idosas. MÉTODOS: A amostra foi composta por 387 mulheres idosas, com idade superior a 60 anos (média, 68,9; desvio padrão, 5,9 anos. Foram avaliados o IMC, a CC, o sigmaDC, e os níveis de PCR. Foi utilizada a análise estatística ANOVA one-way para verificar as diferenças nas variáveis entre as categorias investigadas. Para avaliar a influência das medidas de adiposidade nos níveis de PCR foi utilizada a regressão logística. O nível de significância adotado foi de p OBJECTIVE: To investigate how overall and abdominal adiposity, measured by waist circumference (WC, body mass index (BMI, and sum of skinfolds (sigmaSK, affect plasma C-reactive protein levels (CRP in elderly women. METHODS: Study sample consisted of 387 women older than 60 years (mean age 68.9; standard deviation 5.9 years. BMI, WC, sigmaSK, and CRP levels were all measured. One-way ANOVA was performed to detect differences in study variables among the CRP levels investigated. Logistic regression analysis was used to determine the influence of body fat measurements on CRP levels. The significance level was set at p < 0.05. RESULTS: The analysis of variance showed that mean WC was lower in women with normal CRP levels, as compared to those with high CRP levels. Logistic regression analysis examined the influence of BMI, WC, and sigmaSK quartiles on CRP levels, yielding the following results: only WC was predictive of elevated CRP levels, its highest quartile (cut-off point of 94.0 cm showing levels nearly two times higher than its lowest quartile (odds ratio = 2.23; 95% confidence interval = 1.92-4.18; p = 0.012. CONCLUSION: The results of this study indicate that abdominal adiposity is a strong predictor of

  5. Intra-abdominal fungal pseudomycetoma in two cats.

    Science.gov (United States)

    Bianchi, Matheus V; Laisse, Cláudio J M; Vargas, Thainã P; Wouters, Flademir; Boabaid, Fabiana M; Pavarini, Saulo P; Ferreiro, Laerte; Driemeier, David

    Pseudomycetomas are deep cutaneous to subcutaneous lesions caused by Microsporum canis mainly described in Persian cats, with few reports of intra-abdominal location. This report describes the clinical signs and lesions of intra-abdominal pseudomycetomas caused by M. canis in two Persian cats. Two Persian cats with a history of previous laparotomy (ovariohysterectomy and nephrostomy) and fecal impaction were examined. Cat #1 was euthanized and subjected to necropsy, histopathology and mycological evaluation. Cat #2 presented with chronic dermatophytosis, and an intra-abdominal mass, that was subjected to histopathology evaluation. Cat #1 presented at necropsy a white-grayish, firm mass (6cm×3.5cm×2.8cm) in the uterine cervix. Cat #2 presented a firm whitish mass (6.5cm×1.5cm×0.5cm) located close to the left kidney. Histologically, both masses contained multifocal granules with hyphae and spores surrounded by Splendore-Hoeppli reaction, with a pyogranulomatous inflammatory infiltrate and fibrous connective tissue proliferation in the periphery. Hyphae and spores exhibited marked Grocott and periodic acid-Schiff staining. M. canis was identified by fungal isolation in cat #1. Pseudomycetoma should be considered as a differential diagnosis in cats, especially in Persian cats presenting with an intra-abdominal mass. Entrance of the agent into the cavity can occur during laparotomy. Copyright © 2016 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Intra-abdominal tuberculous peritonitis

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, G.; Ahlhelm, F.; Altmeyer, K.; Kramann, B. [Dept. of Diagnostic Radiology, University Hospital, Homburg (Germany); Hennes, P. [Dept. of Pediatrics, University Hospital, Homburg (Germany); Pueschel, W. [Dept. of Pathology, University Hospital, Homburg (Germany); Karadiakos, N. [Dept. of Pediatric Surgery, University Hospital, Homburg (Germany)

    2001-07-01

    We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion. Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy. This type of disease is a rare manifestation of extrapulmonary tuberculosis. The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented. Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed. This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies. (orig.)

  7. Intraabdominal panniculitis: clinical, radiographic, and CT features

    Energy Technology Data Exchange (ETDEWEB)

    Katz, M.E.; Heiken, J.P.; Glazer, H.S.; Lee, J.K.T.

    1985-08-01

    Intraabdominal panniculitis, also known as lipodystrophy, is an inflammatory condition of adipose tissue that may result in development of large masses containing necrotic fat (nodular intraabdominal panniculitis). Symptoms are secondary to inflammation or mass effect on adjacent organs. Barium studies may show nonspecific inflammatory changes and displacement of bowel loops. Computed tomography (CT) demonstrates inhomogeneous masses containing fat and soft tissue density. The diagnosis of intraabdominal panniculitis has seldom been made prospectively. However, the CT findings are characteristic and can aid in the evaluation and management of patients with this disease.

  8. [Intraabdominal hypertension and abdominal compartment syndrome

    DEFF Research Database (Denmark)

    Sonne, M.; Hilligsø, Jens Georg

    2008-01-01

    Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare conditions with high mortality. IAH is an intraabdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAP is measured indirectly via the bladder or stomach. Various...... medical and surgical conditions increase the intraabdominal volume. When the content exceeds the compliance of the abdominal wall, the IAP rises. Increased IAP affects the functioning of the brain, lungs, circulation, kidneys, and bowel. The treatment of ACS is a reduction of IAP Udgivelsesdato: 2008/2/11...

  9. Intra-abdominal Complications of Sarcoidosis

    OpenAIRE

    MacArthur, Kristin Loening; Forouhar, Faripour; Wu, George Yung-Hsing

    2010-01-01

    Sarcoidosis is an inflammatory disease characterized by non-caseating granulomas in the absence of other autoimmune processes, infectious diseases, or foreign agents. The etiology of sarcoidosis is not completely understood. Several organ systems can be affected, of which the most frequently involved include the lungs and lymph nodes. Intra-abdominal sarcoidosis is less common, but can be found in the absence of pulmonary or lymphatic disease. Intra-abdominal sarcoidosis is most often asympto...

  10. Intraabdominal Surgery and Anesthesia Management.

    Science.gov (United States)

    Hedley-Whyte, John

    2017-03-01

    Inspired Oxygenation in Surgical Patients During General Anesthesia With Controlled Ventilation: A Concept of Atelectasis. By Bendixen HH, Hedley-Whyte J, and Laver MB. New Engl J Med 1963; 269:991-996. Reprinted with permission. The purpose of this study was to determine if the pattern of ventilation, by itself, influences oxygenation during anesthesia and surgery and examine the hypothesis that progressive pulmonary atelectasis may occur during constant ventilation whenever periodic hyperventilation is lacking, but is reversible by passive hyperinflation of the lungs. Eighteen surgical patients, ranging in age from 24 to 87 yr, without known pulmonary disease, were studied during intraabdominal procedures and one radical mastectomy. Although ventilation remained constant, changes occurred in arterial oxygen tension and in total pulmonary compliance, with an average fall of 22% in oxygen tension and 15% in total pulmonary compliance. This fall in oxygen tension supports the hypothesis that progressive mechanical atelectasis may lead to increased venous admixture to arterial blood. The influence of the ventilator pattern on atelectasis and shunting is further illustrated by the reversibility of the fall in oxygen tension that follows hyperinflation. A relation between the degree of ventilation and the magnitude of fall in arterial oxygen tension was found, where large tidal volumes appear to protect against falls in oxygen tension, while shallow tidal volumes lead to atelectasis and increased shunting with impaired oxygenation.

  11. Estudo comparativo dos procedimentos percutâneos orientados por métodos de imagem no tratamento das coleções intraperitoneais A comparison study between image-guided percutaneous procedures in the treatment of intra-abdominal liquid collections

    Directory of Open Access Journals (Sweden)

    Giselle Guedes Netto de Mello

    2004-04-01

    Full Text Available OBJETIVO: Verificar e comparar a eficácia da aspiração percutânea (AP e da drenagem percutânea (DP, orientadas por métodos de imagem, no tratamento das coleções intraperitoneais. MATERIAIS E MÉTODOS: Foram encaminhados ao nosso setor 52 pacientes para tratamento percutâneo de coleções abdominais. Destes, 16 apresentavam coleções intraperitoneais, sendo dez complexas (multiloculadas ou múltiplas e seis, simples. O volume das coleções variou de 40 a 1.200 ml, com mediana de 200 ml. Foram submetidas a AP seis coleções (37,5% e a DP, dez (62,5%. Considerou-se como sucesso do método a resolução completa da coleção, com melhora clínico-laboratorial do paciente. RESULTADOS: O sucesso do procedimento ocorreu em 75% dos casos. Nas coleções submetidas a AP houve sucesso em 100%, e nas submetidas a DP o sucesso foi de 60%. O índice de sucesso no grupo submetido a DP foi de 50% nas coleções menores ou iguais a 200 ml e de 75% nas de maior volume. Obteve-se sucesso com a DP em 33,3% das coleções complexas, em 42,9% das infectadas e em 100% das não infectadas e simples. Foram observadas apenas duas complicações menores (bacteremia transitória e infecção cutânea após os procedimentos. CONCLUSÃO: A AP e a DP são métodos eficazes e seguros para tratamento das coleções intraperitoneais. No nosso estudo, a AP foi mais eficaz que a DP, principalmente nas coleções de menor volume.OBJECTIVE: To determine and compare the efficacy of image-guided percutaneous needle aspiration (PNA versus percutaneous catheter drainage (PCD in the treatment of intra-abdominal liquid collections. MATERIALS AND METHODS: A prospective study involving 52 patients referred to our service for percutaneous treatment of abdominal liquid collections was carried out. Sixteen of these patients had intra-abdominal liquid collections (six patients with simple localized collections and ten patients with complex, multiseptated or multiple, collections

  12. Intra-abdominal splenosis mimicking metastatic cancer.

    Science.gov (United States)

    Short, Nicholas J; Hayes, Teresa G; Bhargava, Peeyush

    2011-03-01

    Splenosis, the heterotopic autotransplantion of splenic tissue, is a common benign condition among patients with a history of splenic trauma. Most cases of splenosis are intra-abdominal due to direct seeding of surrounding structures, although these ectopic rests may occur almost anywhere in the body, and its diffuse nature may raise the suspicion of metastatic cancer. Confirmation of splenic tissue can be made by technetium-99m (Tc-99m) sulfur colloid scintigraphy or with Tc-99m heat-damaged red blood cells; however, in some cases, biopsy may be required for definitive diagnosis. Here, the authors present a patient with a remote history of posttraumatic splenectomy who was discovered to have multiple intra-abdominal nodules by CT scan. A diagnosis of diffuse metastatic disease was initially considered before a diagnosis of intraabdominal splenosis was ultimately made with the aid of Tc-99m sulfur colloid single-positron emission computed tomography (SPECT) and computed tomography imaging.

  13. Intra-abdominal complications of sarcoidosis.

    Science.gov (United States)

    MacArthur, Kristin Loening; Forouhar, Faripour; Wu, George Yung-Hsing

    2010-07-01

    Sarcoidosis is an inflammatory disease characterized by non-caseating granulomas in the absence of other autoimmune processes, infectious diseases, or foreign agents. The etiology of sarcoidosis is not completely understood. Several organ systems can be affected, of which the most frequently involved include the lungs and lymph nodes. Intra-abdominal sarcoidosis is less common, but can be found in the absence of pulmonary or lymphatic disease. Intra-abdominal sarcoidosis is most often asymptomatic. However, long-standing unrecognized disease can result in life-threatening complications. The identification, monitoring and prevention of these complications will be discussed, with emphasis on both clinical and histological presentations of intra-abdominal sarcoidosis. Copyright 2010 Formosan Medical Association & Elsevier. Published by Elsevier B.V. All rights reserved.

  14. Intra-abdominal Complications of Sarcoidosis

    Directory of Open Access Journals (Sweden)

    Kristin Loening MacArthur

    2010-07-01

    Full Text Available Sarcoidosis is an inflammatory disease characterized by non-caseating granulomas in the absence of other autoimmune processes, infectious diseases, or foreign agents. The etiology of sarcoidosis is not completely understood. Several organ systems can be affected, of which the most frequently involved include the lungs and lymph nodes. Intra-abdominal sarcoidosis is less common, but can be found in the absence of pulmonary or lymphatic disease. Intra-abdominal sarcoidosis is most often asymptomatic. However, long-standing unrecognized disease can result in life-threatening complications. The identification, monitoring and prevention of these complications will be discussed, with emphasis on both clinical and histological presentations of intra-abdominal sarcoidosis.

  15. 2013 WSES guidelines for management of intra-abdominal infections

    Science.gov (United States)

    2013-01-01

    Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The 2013 update of the World Society of Emergency Surgery (WSES) guidelines for the management of intra-abdominal infections contains evidence-based recommendations for management of patients with intra-abdominal infections. PMID:23294512

  16. Case Study: Intra-abdominal hypertension

    African Journals Online (AJOL)

    2014-06-15

    Jun 15, 2014 ... physical examination, the abdomen was distended and tender. Trans-bladder measurements revealed raised intra-abdominal pressure, ranging from 20-24 mmHg. He also presented with mild metabolic acidosis and a tapering urine output, which responded to fluids and furosemide. Immediate measures ...

  17. Composição corpórea, alterações bioquímicas e clínicas de adolescentes com excesso de adiposidade Composición corporal, alteraciones bioquímicas y clínicas de adolescentes con exceso de adiposidad Body composition, biochemical and clinical changes of adolescents with excessive adiposity

    Directory of Open Access Journals (Sweden)

    Hiara Miguel Stanciola Serrano

    2010-10-01

    Full Text Available FUNDAMENTO: Adolescentes com excesso de adiposidade e eutróficas apresentam as mesmas alterações metabólicas esperadas em indivíduos obesos. OBJETIVO: Avaliar a composição corpórea, alterações antropométricas, bioquímicas e clínicas de adolescentes do sexo feminino. MÉTODOS: Foram avaliadas 113 adolescentes de escolas públicas de Viçosa, MG, divididas em três grupos: grupo 1 - constituído por adolescentes eutróficas com excesso de gordura corpórea; grupo 2 - eutróficas com gordura corpórea dentro dos limites de normalidade; e grupo 3 - com excesso de peso e de gordura corpórea. Peso, estatura, circunferência da cintura e quadril, pressão arterial foram aferidos. O índice de massa corporal (IMC e a relação cintura-quadril foram calculados. O porcentual de gordura corpórea foi obtido pela impedância bioelétrica horizontal, seguindo protocolo próprio para a referida avaliação. A avaliação do porcentual de gordura corpórea e bioquímica foi realizada após 12 horas de jejum, sendo analisados perfil lipídico, glicemia e insulina, homocisteína, leptina e Proteína C Reativa. A resistência à insulina foi calculada pelo índice HOMA. RESULTADOS: O grupo das adolescentes eutróficas, com elevada adiposidade, comportou-se, em relação à pressão arterial, fração HDL e glicemia, de modo semelhante às adolescentes com excesso de peso. Pode-se perceber que o índice HOMA, a insulina e a leptina aumentaram de acordo com o aumento da gordura corpórea. Mais da metade das adolescentes apresentava valores de colesterol total e PCR acima dos níveis recomendados. A alteração metabólica mais evidente relacionou-se ao perfil lipídico para os grupos estudados. CONCLUSÃO: O excesso de adiposidade em adolescentes eutróficas pode estar relacionado a alterações bioquímicas e clínicas semelhantes àquelas encontradas em adolescentes com excesso de peso.FUNDAMENTO: Adolescentes con exceso de adiposidad y eutr

  18. Intra-abdominal pressure: an integrative review.

    Science.gov (United States)

    Milanesi, Rafaela; Caregnato, Rita Catalina Aquino

    2016-01-01

    There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. RESUMO Em pacientes críticos com quadros abdominais agudos a esclarecer é crescente a solicitação da aferição da pressão intra-abdominal. Sintetizar resultados de pesquisas sobre a mensuração da pressão intra-abdominal pela via vesical e analisar o nível de evidência foram os objetivos desta revisão integrativa da literatura, realizada nas bases LILACS, MEDLINE e PubMed, no período de 2005 a julho de 2012. Identificaram-se 20 artigos, sendo 12 revisões de literatura, 4 estudos exploratório-descritivos, 2 opiniões de especialistas, 1 estudo de coorte prospectivo e 1 relato de experiência. O método vesical para mensuração da pressão intra-abdominal foi considerado padrão-ouro. Existem variações na técnica, entretanto pontos em comum foram identificados: posição supina completa, na ausência de contratura abdominal, ao final da expiração e expressa em mmHg. A maioria indica posicionar o ponto zero do

  19. Efeito da massagem clássica estética em adiposidades localizadas: estudo piloto Effects of classic aesthetic massage on localized adiposity: a pilot study

    Directory of Open Access Journals (Sweden)

    Pascale Mutti Tacani

    2010-12-01

    Full Text Available Devido ao padrão de beleza imposto atualmente, tem aumentado a procura por tratamentos estéticos como a massagem clássica, porém sua suposta ação lipolítica ainda é uma questão controversa na literatura. O objetivo deste estudo foi verificar o efeito da massagem clássica estética nas adiposidades localizadas, por meio de perimetria do abdome, quadril e coxas e pela estimativa da espessura da tela subcutânea da parede abdominal (ETS por ultrassonografia. Oito voluntárias (idade 33,9±8,9 anos, peso 65,1±8,4 kg foram avaliadas quanto a MC, IMC e ETS 30 dias antes, logo antes do início da intervenção e após esta. Foram efetuadas 12 sessões de massagem clássica estética em coxas, glúteos e abdome por 30 minutos, três vezes por semana. Foi encontrada redução significativa apenas da perimetria na região do quadril (p=0,012, mas não da ETS (p=0,301. A massagem clássica estética contribuiu apenas para a redução da perimetria do quadril, e não modificou outras medidas nem a espessura da tela subcutânea da região abdominal.Due to current beauty standards, the search for aesthetic treatments, including classical massage, has increased; however, its presumed lipolytic action is still controversial in literature. The purpose of this study was to assess the effect of classical massage on localized adiposity, by means of abdomen, hip and thigh perimeter measuring, nd by estimating thickness of abdominal wall fat by ultrasonography. Eight volunteers (33.9±8.9 years old, 65.1±8.4 kg were assessed as to weight, body mass index, body perimeter measures and by abdomen ultrasonography at three moments: control (30 days before treatment, just before, and after treatment. The latter consisted of 12 thrice-weekly, 30-minute massage sessions on thighs, buttocks, and abdomen. Results showed a significant reduction at hip perimeter (p=0.012, but none of subcutaneous fat tissue thickness (p=0.301. Classical aesthetic massage hence did

  20. EFFECT OF RECOMBINANT TISSUE-PLASMINOGEN ACTIVATOR ON INTRAABDOMINAL ABSCESS FORMATION IN RATS WITH GENERALIZED PERITONITIS

    NARCIS (Netherlands)

    van Goor, Harry; de Graaf, JS; Kooi, K; Sluiter, WJ; Bom, VJJ; van der Meer, J; Bleichrodt, RP

    1994-01-01

    BACKGROUND: During generalized peritonitis, intraabdominal fibrin deposition is stimulated whereas fibrinolytic activity is reduced, which predisposes intra-abdominal abscess formation. We investigated the effects of increasing the intra-abdominal fibrinolytic activity on abscess formation by

  1. Relação entre diferentes índices de atividade física e preditores de adiposidade em adolescentes de ambos os sexos Relacion entre diferentes índices de atividad física y predictores de adiposidad en adolescentes de ambos sexos Relationship between different rates of physical activity and adiposity predictors in male and female adolescents

    Directory of Open Access Journals (Sweden)

    Luís Paulo Gomes Mascarenhas

    2005-08-01

    Full Text Available OBJETIVO: Determinar a relação entre diferentes índices de atividade física e preditores de adiposidade em adolescentes de ambos os sexos. MÉTODOS: Foram avaliadas 111 crianças (57 meninos e 54 meninas, com idade média de 11,62 ± 0,72. Como preditores de adiposidade foram determinados o IMC, percentagem de gordura corporal e a relação cintura/quadril (RCQ. Quanto aos indicadores de atividade física, calcularam-se o gasto energético total (GET, nível de atividade física habitual (NAFH, nível de atividade física (NAF e gasto energético com atividade física (GEat através do questionário de Bouchard e, para a taxa metabólica basal (TMB, a equação de Schofield-HW. RESULTADOS: A amostra apresentou diferenças significativas entre os sexos para idade, % de gordura corporal, RCQ, NAFH, NAF, TMB com p OBJETIVO: Determinar la relación entre diferentes índices de actividad física y predictores de adiposidad en adolescentes de ambos sexos. MÉTODOS: Fueron evaluados 111 chicos (57 niños y 54 niñas, con edad media de 11,62 ± 0,72 años. Como predictores de adiposidad fueron determinados por IMC, percentil de grasa, y relación cintuda nalga (RCQ. En cuanto a los indicadores de la actividad física se calculó el gasto energético total (GET,el nivel de actividad física habitual (NAFH, nível de actividad física (NAF y gasto energético con actividad física (GEat a través de un cuestionario de Bouchard y para la taxa metabólica basal (TMB la ecuaciónde Schofield-HW. RESULTADOS: La muestra presentó diferencias significativas entre los sexos para edades, percentil de grasa, RCQ, NAFH, NAF, TMB con (p OBJECTIVES: To determinate the relationship between different rates of physical activity and adiposity predictors in male and female adolescents. METHODS: One hundred and eleven children (57 boys and 54 girls with average age of 11.62 ± 0.72 were measured. As adiposity predictors, the BMI, the body fat percentage, and the waist

  2. Noninvasive detection and mapping of intraabdominal adhesions

    DEFF Research Database (Denmark)

    Zinther, Nellie Bering; Fedder, Jens; Friis-Andersen, Hans

    2010-01-01

    included and assessed. RESULTS: The search identified transabdominal ultrasonography (TAU) and cine magnetic resonance imaging (cine MRI) as relevant tools matching the search criteria. In all, 12 publications concerning TAU and 4 publications concerning cine MRI were identified. All but one...... of these publications had the methodologic limitation of not being blinded, which influenced the final sensitivity, specificity, and accuracy. CONCLUSION: Both TAU and cine MRI seem able to identify intraabdominal adhesions using visceral slide with accuracy of 76% to 92%. Unfortunately, the studies are biased by being...

  3. Assessing the severity of intraabdominal Infections; the value of ...

    African Journals Online (AJOL)

    This is a review of literature on one of the scoring systems that has made an impact in the standardization of intraabdominal sepsis:the APACHE II scoring system. This study will review the genesis, bedside application, uses, limitations and alternatives as a scoring system for intraabdominal infection. Over two decades of ...

  4. When and how should we measure intra-abdominal pressure ...

    African Journals Online (AJOL)

    A sustained increase in intra-abdominal pressure (IAP) may result in abdominal compartment syndrome (ACS). This is a well documented complication in critically ill patients, but there appears to be a reluctance to routinely measure IAP in patients at high risk of developing intra-abdominal hypertension (IAH) and ACS.

  5. [Antibacterial therapy of severe intra-abdominal infections].

    Science.gov (United States)

    Boĭko, V V; Ivanova, Iu V

    2011-09-01

    The experience of meropenem (Mepenam, manufactured by Corporation ARTERIUM, Ukraine) application as empirical therapy in severe intraabdominal infections was presented. The diseases outcome and the preparation efficacy were estimated, recommendations concerning its application in the treatment of severe intraabdominal infections were done.

  6. Intra-abdominal fat: Comparison of computed tomography fat ...

    African Journals Online (AJOL)

    Background: Intra-abdominal fat is an important factor in determining the metabolic syndrome/insulin resistance, and thus the risk of diabetes and ischaemic heart disease. Computed Tomography (CT) fat segmentation represents a defined method of quantifying intra-abdominal fat, with attendant radiation risks.

  7. Perfil lipídico de mulheres adultas e sua relação com adiposidade central

    Directory of Open Access Journals (Sweden)

    Paulo Augusto Ribeiro Neves

    2013-06-01

    Full Text Available Objetivo: Determinar o perfil lipídico de mulheres adultas e avaliar a sua relação com os índices antropométricos relacionados à adiposidade central. Métodos: Estudo transversal, conduzido em uma clínica-escola de nutrição de uma universidade pública de Minas Gerais, com 47 mulheres adultas em lista de espera para atendimento. Avaliaram-se as concentrações de colesterol total (CT, lipoproteína de alta densidade (HDL, lipoproteína de baixa densidade (LDL, lipoproteína de muito baixa densidade (VLDL, triglicerídeos (TG, peso, estatura, circunferência da cintura (CC e circunferência do quadril (CQ. Calculou-se o índice de massa corporal (IMC e a relação cintura-quadril (RCQ. A análise da associação entre concentrações séricas de lipídeos e variáveis de adiposidade ocorreu através do coeficiente de correlação de Pearson. Resultados: Do total de voluntárias, 22 (51,2% apresentaram níveis de CT acima dos valores limítrofes e 18 (41,9% apresentaram LDL elevada. A proporção de indivíduos com VLDL e TG elevados foi relativamente inferior (n=4; 9,3% e n=10; 23,3%, respectivamente. A CC e a RCQ se correlacionaram positivamente com os níveis de VLDL e TG (p<0,05. Nas voluntárias com IMC ≥ 25 kg/m², a prevalência de dislipidemias foi de 39,5% (n=17 e a CC se correlacionou positivamente com os níveis de CT (p = 0,04. Conclusão: Os resultados apontaram relação entre os lipídeos séricos e as medidas de adiposidade central, com frequências importantes de dislipidemias nas mulheres investigadas, especialmente níveis elevados de CT e LDL.

  8. Pressão intra-abdominal em cães

    Directory of Open Access Journals (Sweden)

    Ronald Paiva M. Gonçalves

    2011-09-01

    Full Text Available Sob consenso recente em pacientes humanos, os valores basais da pressão intra-abdominal (PIA e seus prováveis limiares em casos mórbidos, foram estipulados com intuito de favorecer a homogeneidade de estudos científicos, além de fornecer diretrizes para conduta diagnóstica e terapêutica destes pacientes. Valores basais e alterações na pressão intra-abdominal em animais não são ainda suficientemente conhecidos e cientificamente determinados. Médicos veterinários necessitam conhecer melhor os estados mórbidos que cursam com Hipertensão Intra-Abdominal (HIA ou Síndrome de Compartimento Abdominal (SCA. O presente estudo objetivou testar em cães a técnica já descrita sob consenso na medicina como modelo de mensuração da pressão intra-abdominal, assim como determinar os valores normais para a espécie. Foram utilizados 15 cães hígidos, machos e fêmeas, homogêneos e todos sem raça definida. A mensuração da pressão intra-abdominal foi realizada por meio da técnica indireta de sondagem vesical e utilização de coluna de água com régua graduada em cm de H2O, sendo seu valor final convertido para a unidade de mm de Hg. Foi observado valor mínimo subatmosférico (abaixo de zero mm de Hg até o valor máximo de 3,75 mmHg. Houve importante variação entre os valores encontrados individualmente em determinados cães, colocando sob discussão questões como massa corporal, freqüência/volume total de solução fisiológica a ser infundida e agitação destes pacientes no momento do exame. Os valores limítrofes encontrados são considerados fisiológicos, indicando confiabilidade da técnica e possibilidade do seu emprego clínico. A ausência de sedação e utilização de sonda uretral não inviabilizou a realização da mensuração, porém podendo culminar numa sub ou superestimativa dos valores encontrados.

  9. Socioeconomic status, birth weight, maternal smoking during pregnancy and adiposity in early adult life: an analysis using structural equation modeling Situação sócio-econômica, peso ao nascer, tabagismo na gravidez e adiposidade na vida adulta jovem: uma análise utilizando-se modelagem com equações estruturais

    Directory of Open Access Journals (Sweden)

    Antônio Augusto Moura da Silva

    2010-01-01

    Full Text Available We describe here an example of structural equation modeling in epidemiology. The association between birth weight and adiposity in early adult life, adjusted for the number of cigarettes smoked during pregnancy and socioeconomic status at birth, was evaluated. Data involving 2,063 adults from the 1978/1979 Ribeirão Preto cohort study were used. Adiposity was measured by body mass index (BMI, waist circumference (WC and the sum of triceps and subscapular skinfolds (STSS. Models were submitted to maximum likelihood estimation, separately for men and women. Birth weight had a small and significant effect on adiposity in men (standardized coefficient, SC = 0.08 and women (SC = 0.09. Smoking during pregnancy did not influence adiposity in men (SC = 0.004, but its effect was marginally significant in women (SC = 0.07; P = 0.056. Socioeconomic status at birth had a small and positive effect on adiposity in men (SC = 0.08 and a moderate and negative effect in women (SC = -0.16. In this young adult population, BMI, WC and STSS used alone or in combination were valid estimators of body adiposity.O objetivo desse artigo é apresentar um exemplo da modelagem com equações estruturais. Foi avaliada associação entre peso ao nascer e adiposidade na vida adulta jovem, ajustando-se para número de cigarros fumados na gravidez e situação sócio-econômica ao nascimento. Dados de 2.063 adultos da coorte de Ribeirão Preto, São Paulo, Brasil, de 1978/1979 foram utilizados. A adiposidade foi medida pelo índice de massa corporal (IMC, circunferência da cintura, e somatório das pregas cutâneas subescapular e a tricipital. Os modelos foram estimados por máxima verossimilhança, separadamente para homens e mulheres. O peso ao nascer teve efeito pequeno e significante na adiposidade em homens (CP - coeficiente padronizado = 0,08 e mulheres (CP = 0,09. Tabagismo materno durante a gravidez não influenciou a adiposidade em homens (CP = 0,004, mas em mulheres a

  10. Evaluation and treatment of intraabdominal bilomas

    Energy Technology Data Exchange (ETDEWEB)

    Vazquez, J.L.; Thorsen, M.K.; Dodds, W.J.; Quiroz, F.A.; Martinez, M.L.; Lawson, T.L.; Stewart, E.T.; Foley, W.D.

    1985-05-01

    In a 3-year period, 21 intraabdominal bilomas developed in 18 patients. Fifteen of the patients had a solitary biloma, and the other patients each had two separate concurrent bilomas. The major cause of biloma formation was postoperative bile leakage from a bile duct after laparotomy done primarily for surgery on the gallbladder or liver. Maximal diameter of the bilomas in the transaxial plane ranged from 2 to 19 cm. The contours of the bilomas were configured by the diaphragm, mesenteries, liver, and other abdominal organs. On CT and sonography, the bilomas were invariably well demarcated, but most did not have an identifiable capsule. In 19 bile collections, the CT numbers were less than 20 H. The combination of the clinical history, the location, and the CT appearance of the lesion led to the correct diagnosis in each case. Percutaneous drainage was an effective form of therapy that often eliminated the need for surgical drainage.

  11. [Intraabdominal desmoid tumors in familial adenomatous polyposis].

    Science.gov (United States)

    Galletto, Paula; Leoz, Maria Liz; Castells, Antoni; Balaguer, Francesc

    2013-11-01

    Desmoid tumors are currently the main cause of morbidity and mortality in patients with familial adenomatous polyposis. More than 10% of these patients will develop these tumors during their lifetime and more than a third will suffer their consequences. The main risk factors for their development are female sex and abdominal surgery. The most frequent localization is intraabdominal. The therapeutic approach to these tumors has changed, and the surgical treatment of choice is currently the subject of debate. If a watch and wait approach is adopted, more than 50% of tumors will prove to be indolent. Therefore, the therapeutic strategy should be based on clinical presentation and should be decided by a multidisciplinary team working in a center with experience of these tumors. The present article proposes a prognostic classification to guide the therapeutic approach. Copyright © 2012 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  12. Relação entre aptidão cardiorrespiratória e indicadores de adiposidade corporal em adolescentes Relationship between cardiorespiratory fitness and indicators of body adiposity in adolescents

    Directory of Open Access Journals (Sweden)

    Enio Ricardo V. Ronque

    2010-09-01

    Full Text Available OBJETIVO: Analisar a relação entre aptidão cardiorrespiratória e indicadores de adiposidade corporal em adolescentes de ambos os sexos. MÉTODOS: 78 sujeitos (45 rapazes e 33 moças foram avaliados quanto à massa corporal, estatura e dobras cutâneas tricipital e subescapular. O índice de massa corpórea e a somatória das duas dobras cutâneas foram calculados. A aptidão cardiorrespiratória foi analisada pelo teste de vai-e-vem de 20 metros de vários estágios e a estimativa do consumo máximo de oxigênio foi analisada por uma equação específica. Para a comparação entre os grupos, foi empregado o teste de Mann-Whitney e, para verificar a relação entre a aptidão cardiorrespiratória e os indicadores de adiposidade corporal, utilizou-se o coeficiente de correlação de Spearman. RESULTADOS: Os adolescentes com alta aptidão cardiorrespiratória apresentaram sistematicamente valores mais baixos de gordura corporal em relação a seus pares com baixa aptidão cardiorrespiratória (pOBJECTIVE: To analyze the relationship between cardiorespiratory fitness and indicators of body adiposity in adolescents of both genders. METHODS: 78 subjects (45 boys and 33 girls were evaluated for body mass, height and triceps and subscapular skinfold thickness. Body mass index and the sum of the two skinfolds thickness were determined. The cardiorespiratory fitness was determined by the maximal multistage 20 meters shuttle run test, and the estimate of maximal oxygen uptake was evaluated by a specific equation. Groups were compared by Mann-Whitney test. The Spearman correlation index was applied to verify the relationship between cardiorespiratory fitness and the indicators of body adiposity. RESULTS: The adolescents with high cardiorespiratory fitness presented lower values of body fat than their peers with low cardiorespiratory fitness (p<0.05, with differences varying between 36 to 42% for boys and 14 to 33% for girls. Statistically significant

  13. Bromelain: a natural proteolytic for intra-abdominal adhesion prevention

    National Research Council Canada - National Science Library

    Sahbaz, Ahmet; Aynioglu, Oner; Isik, Hatice; Ozmen, Ulku; Cengil, Osman; Gun, Banu Dogan; Gungorduk, Kemal

    2015-01-01

    .... To date, no effective agent exists for intra-abdominal adhesion prevention. Bromelain is the crude extract of the pineapple and it has fibrinolytic, antithrombotic, and anti-inflammatory properties...

  14. Adiposidade corporal e hipertensão arterial em crianças e adolescentes obesos - doi:10.5020/18061230.2009.p88

    Directory of Open Access Journals (Sweden)

    Joel Saraiva Ferreira

    2012-01-01

    Full Text Available Objetivo: Investigar a relação entre a hipertensão arterial e adiposidade corporal em crianças e adolescentes obesos. Métodos: Estudo transversal no qual 129 crianças e adolescentes obesos de ambos os gêneros com idade variando de 7 a 14 anos foram avaliados. A adiposidade foi caracterizada a partir dos dados obtidos como: índice de massa corporal (IMC, percentual de gordura corporal (%GC e relação cintura-quadril (RCQ. O grupo foi dividido em dois subgrupos (normotensos e hipertensos mediante o nível de pressão arterial (PA. O teste estatístico de Kruskal Wallis foi empregado para determinar a significância na relação entre dados antropométricos e níveis de pressão arterial. Adotou-se um valor de p ? 0,05. Resultados: Verificou-se que 101 (78,29% participantes eram normotensos e 28 (21,71% hipertensos. Em relação à adiposidade, o grupo dos hipertensos apresentou níveis mais elevados de IMC e o %GC quando comparado com o normotenso (p<0,05. A partir dos dados da RCQ, não houve associação estatística entre a relação cintura-quadril e o nível pressórico. Conclusões: As crianças e adolescentes obesos apresentaram relação estatisticamente significativa entre adiposidade corporal e níveis de pressão arterial; no entanto, a localização da gordura não foi um fator determinante desta diferença.

  15. Parathyroid Adenoma, Gastric Adenocarcinoma, and Intraabdominal Schwannoma in One Patient

    Directory of Open Access Journals (Sweden)

    Gülşah Elbüken

    2016-09-01

    Full Text Available Intraabdominal schwannomas, which occur quite rarely, are usually benign tumors. They are often discovered coincidentally when abdominal scans are performed for other reasons. We also coincidentally detected an intraabdominal schwannoma in addition to primary hyperparathyroidism related to a parathyroid adenoma and a gastric adenoma which caused partial pyloric obstruction in a 69-year-old female patient who was admitted to our emergency room with vomiting while we were further investigating hypercalcemia that was found during laboratory workup. It is rare to diagnose multiple tumors concurrently in a single patient which are components of certain neuroendocrine syndromes themselves. It is more interesting to see a rare tumor such as intraabdominal schwannoma coexisting with a parathyroid adenoma that can be a component of multiple endocrine neoplasia syndromes. In the literature, there are few case reports of the coexistence of intraabdominal schwannomas with adenocarcinoma of the gastrointestinal tract. Here, we present an unusual case of intraabdominal schwannoma coexisting with parathyroid adenoma and gastic adenocarcinoma, all diagnosed in a single patient. To our best knowledge, this is the first case report of such a rare coexistence which makes it rather interesting.

  16. [Procalcitonin as a marker of intra-abdominal infection].

    Science.gov (United States)

    Domínguez-Comesaña, Elías; Ballinas-Miranda, Julio Roberto

    2014-01-01

    Procalcitonin is a quite specific biomarker of infection and in recent years has shown its superiority to others markers of inflammation, such as C-reactive protein, for the diagnosis and monitoring of a variety of infections. For this reason, several researchers have studied the potential role of procalcitonin for diagnosis and management of these infections. Intra-abdominal infections are a heterogeneous group of infections that, sometimes, pose difficult challenges to physicians. The published studies have produced mixed results, leading to controversy on the utility of this marker in intra-abdominal infections. This review summarizes these data and discuss the utility of procalcitonin in several intra abdominal infections, including postoperative infections.

  17. Porcentaje de adiposidad y su relación con el índice de inmunorreactividad de los receptores hormonales en mujeres mexicanas con cáncer de mama

    OpenAIRE

    Luz Mª Adriana Balderas-Peña; Daniel Sat-Muñoz; Juan Manuel Castro Cervantes; Ricardo-Ernesto Ramírez-Orozco; Wenceslao-Guillermo Ángeles-Bueno; María-Rosa Flores-Márquez; Griselda-Guadalupe Macías-López; Sandra-Luz Ruiz-Quezada; Ana-Leticia Salcedo-Rocha; Javier-Eduardo García de Alba-García; Pedro Solano-Murillo

    2013-01-01

    Introducción: El tejido adiposo es una importante fuente de estrógenos, los cuales se encuentran implicados en el desarrollo de cáncer de mama. Objetivo: Establecer la relación entre el porcentaje de adiposidad y el índice de inmunorreactividad de los receptores a estrógenos y a progesterona en mujeres mexicanas con cáncer de mama. Métodos: Estudio transversal analítico en pacientes con cáncer de mama confirmado con estudio histopatológico. Se estimó el % de adiposidad, y el índice de inmunor...

  18. Efecto de la diabetes gestacional sobre los indicadores de adiposidad en los primeros 18 años: revisión sistemática

    OpenAIRE

    Arturo Jiménez Cruz; Armando Ortega Cisneros; Montserrat Bacardí Gascón

    2014-01-01

    Introducción: La diabetes gestacional ha sido asociada con la obesidad en períodos posteriores de la vida. Sin embargo, los resultados no han sido consistentes y algunos estudios contenían debilidades metodológicas. Objetivo: Analizar los resultados de estudios prospectivos y retrospectivos de cohorte que evalúen el efecto de la diabetes gestacional sobre indicadores de adiposidad en los hijos hasta los 18 años de edad. Metodología: Se realizó una búsqueda de estudios prospectivos o retrospec...

  19. Patrones de alimentarios, adiposidad y alteraciones metabólicas en niños y adolescentes en España

    OpenAIRE

    Vázquez Cobela, Rocío

    2016-01-01

    La OMS reconoce que la epidemia de la obesidad se debe a una combinación de factores prenatales, genéticos, medioambientales, socioeconómicos, de limitada actividad física y una dieta inadecuada. Esta epidemia de la obesidad y sus complicaciones podría iniciarse ya en el periodo prenatal. Nuestro estudio ha valorado estos riesgos junto al efecto de los patrones del consumo alimentario sobre el riesgo de la adiposidad y de sus alteraciones metabólicas. El 44,8% de los niños y ...

  20. Aetiology and Impact of Intra-abdominal Sepsis on Surgical ...

    African Journals Online (AJOL)

    An overview of intra-abdominal sepsis is necessary at this time with new experimental studies and audits on management outcomes. The understanding of the pathophysiology of the peritoneum in the manifestation of surgical sepsis and the knowledge of the source of pathogenic organisms which reach the peritoneal ...

  1. Conservative management of post-appendicectomy intra-abdominal abscesses

    Directory of Open Access Journals (Sweden)

    Dhaou Mahdi

    2010-10-01

    Full Text Available Abstract Purpose Appendicitis is the most common abdominal inflammatory process in children which were sometimes followed by complications including intra-abdominal abscess. This later needs classically a surgical drainage. We evaluated the efficacy of antibiotic treatment and surgical drainage. Methods Hospital records of children treated in our unit for intra-abdominal post appendectomy abscesses over a 6 years period were reviewed retrospectively. Results This study investigates a series of 14 children from 2 to 13 years of age with one or many abscesses after appendectomy, treated between 2002 and 2007. Seven underwent surgery and the others were treated with triple antibiotherapy. The two groups were comparable. For the 7 patients who receive medical treatment alone, it was considered efficient in 6 cases (85% with clinical, biological and radiological recovery of the abscess. There was one failure (14%. The duration of hospitalization from the day of diagnosis of intra-abdominal abscess was approximately 10.28 days (range 7 to 14 days. In the other group, the efficacy of treatment was considered satisfactory in all cases. The duration of hospitalization was about 13 days (range: 9 to 20. Conclusion Compared to surgical drainage, antibiotic management of intra-abdominal abscesses was a no invasive treatment with shorter hospitalization.

  2. Case Study: Intra-abdominal hypertension | Veldsman | South ...

    African Journals Online (AJOL)

    South African Journal of Clinical Nutrition. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 27, No 2 (2014) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Case Study: Intra-abdominal hypertension. L Veldsman. Abstract.

  3. Intra-abdominal pressure at ICU admission: Evaluation as a ...

    African Journals Online (AJOL)

    Background and aims. Approximately 20% of acute pancreatitis progresses to a severe form characterised by multiple extrapancreatic organ dysfunction. Elevated intra-abdominal pressure (IAP), a frequent finding in these patients, further adds to the mortality. Currently used prognostication indices have their own set of ...

  4. Intra-abdominal Adiposity In Preterm Infants: An Explorative Study

    Directory of Open Access Journals (Sweden)

    F. Taroni

    2012-12-01

    Full Text Available Objective: The aim of the present study was to compare the total body fat mass and the intra-abdominal adipose tissue between preterm infants assessed at term corrected age and full-term newborns. Methods: An observational explorative study was conducted. 25 preterm and 10 full term infants were evaluated at 0-1 month of corrected and postnatal age, respectively. The total body fat mass was assessed by means of an air displacement plethysmography system (Pea Pod COSMED, USA and the intra-abdominal adipose tissue by means of magnetic resonance imaging (software program SliceOMatic, Version 4.3,Tomovision, Canada. Results: Total body fat mass (g of preterm and term infants was 633 (±183 and 538 (±203 respectively while intra-abdominal fat mass (g was 14.2 (±4.9 and 19.9 (±11.4. Conclusions: Preterm infants, although exhibiting a total body fat mass higher than full term infants, do not show an increased intra-abdominal adipose tissue.

  5. Influência do excesso de peso corporal e da adiposidade central na glicemia e no perfil lipídico de pacientes portadores de diabetes mellitus tipo 2

    National Research Council Canada - National Science Library

    Vasques, Ana Carolina J; Pereira, Patrícia F; Gomide, Rita Maria; Batista, Maria Conceição R; Campos, Maria Teresa F.S; Sant'Ana, Luciana F.R; Rosado, Lina Enriqueta F.P.L; Priore, Silvia Eloiza

    2007-01-01

    O propósito do presente estudo foi avaliar, em pacientes diabéticos do tipo 2, a influência do excesso de peso corporal avaliado pelo IMC e da adiposidade central aferida pela circunferência da cintura (CC) no perfil lipídico...

  6. Associação entre ganho de peso no primeiro ano de vida com excesso de peso e adiposidade abdominal na idade pré-escolar Asociación entre ganancia de peso en el primer año de vida con exceso de peso y de adiposidad abdominal en la edad pre-escolar Association between weight gain in the first year of life with excess weight and abdominal adiposity at preschool age

    Directory of Open Access Journals (Sweden)

    Mariane Leite Bertotto

    2012-12-01

    Full Text Available OBJETIVO: Avaliar se a mudança no escore Z do índice de massa corpórea por idade >0,67 no primeiro ano de vida se associou ao excesso de peso na idade pré-escolar. MÉTODOS: Estudo de coorte aninhado a ensaio de campo randomizado realizado na cidade de São Leopoldo, no Rio Grande do Sul. Foram coletados dados de peso e estatura das crianças ao nascimento, dos seis aos oito meses e dos 12 aos 16 meses. Aos três e aos quatro anos, além destes dados aferiu-se a circunferência da cintura. Calculou-se o ganho de peso pela diferença no escore Z do índice de massa corpórea/idade dos 12 até os 16 meses em relação ao índice de massa corpórea/idade ao nascimento, adotando-se ponto de corte >0,67 para ganho de peso excessivo. A relação cintura/estatura foi realizada, considerando-se excesso de adiposidade central se valores >0,5. Utilizou-se a análise multivariada para o teste da associação entre os desfechos e as variáveis independentes. RESULTADOS: A prevalência do ganho de peso excessivo no primeiro ano de vida foi de 29,5% de um total de 338 crianças. Após ajuste para as variáveis sexo, grupo, peso ao nascer, tempo de aleitamento materno exclusivo e índice de massa corpórea da mãe, a mudança no escore Z >0,67 do nascimento até os 12 a 16 meses apresentou-se como fator de risco para o excesso de peso (RR 2,81; IC95% 1,53-5,16 e elevada relação cintura/altura na idade pré-escolar (RR 2,10; IC95% 1,19-3,72. CONCLUSÕES: O ganho de peso excessivo no primeiro ano de vida está associado ao excesso de peso e à elevada adiposidade abdominal na idade pré-escolar.OBJETIVO: Evaluar si el cambio en el escore Z del Índice de Masa Corporal (IMC por edad >0,67 en el primer año de vida se asoció al exceso de peso en la edad pre-escolar. MÉTODOS: Estudio de cohorte aunado a ensayo de campo aleatorio realizado en la ciudad de São Leopoldo (Rio Grande do Sul. Se recogieron datos de peso y estatura de los niños al nacer, 6 a 8 y

  7. Normalização da estatura e excesso de adiposidade corporal em crianças com a forma perdedora de sal da deficiência da 21-hidroxilase

    Directory of Open Access Journals (Sweden)

    Carolina T Mendes-dos-Santos

    2011-06-01

    Full Text Available OBJETIVO: Avaliar crescimento e composição corporal de portadores da forma clássica perdedora de sal da hiperplasia adrenal congênita por deficiência da 21-hidroxilase, comparando-os com crianças saudáveis. MÉTODOS: Foram incluídos 21 pacientes (oito meninos e 13 meninas, entre 2,1 e 10,2 anos, e 67 controles pré-púberes (36 meninos e 31 meninas, entre 1,2 e 11,7 anos. Avaliou-se peso, estatura, perímetro braquial, dobras cutâneas, composição corporal por bioimpedância e idade óssea. Foram obtidas dos prontuários dos pacientes as seguintes informações: estatura dos pais, valores de 17-OH progesterona e Δ4-androstenediona, dose de hidrocortisona prescrita, dados de peso e estatura ao nascimento, no início do tratamento e aos 2 anos de idade. RESULTADOS: Os pacientes apresentaram menor escore z de peso e de altura na primeira consulta em relação à situação de nascimento, com posterior recuperação após o início do tratamento, sem apresentar avanço da idade óssea. A média do escore z da altura dos controles (0,28±0,86 foi maior que a dos casos (-0,61±0,99, p < 0,001. Essa diferença desaparece quando se ajusta a altura dos pacientes para a idade óssea (0,33±1,68, p = 0,912. Os pacientes apresentaram maiores índices de massa corporal (p < 0,001, massa gorda (p < 0,001 e índice de massa gorda (p < 0,001 do que os controles. Não houve diferença entre as dobras cutâneas dos 2 grupos (p = 0,157. CONCLUSÕES: Os pacientes apresentaram recuperação do crescimento com média de estatura semelhante à da população geral, porém com maior adiposidade corporal, que parece ser visceral, já que não houve diferença entre as dobras cutâneas.

  8. Retained Intraabdominal Gossypiboma, Five Years after Bilateral Orchiopexy

    Directory of Open Access Journals (Sweden)

    Mohammad Kazem Moslemi

    2010-01-01

    Full Text Available Introduction. Gossypiboma or textiloma is used to describe a retained surgical swab in the body after an operation. Intraabdominal surgical sponge is an uncommon surgical error. The incidence of gossypiboma has been reported as high as 1 in 1000 to 15,000 intraabdominal operations. Gossypiboma may cause serious morbidity and may lead to mortality. Case presentation. Herein, we report a 24 years-old man who was admitted due to the intraabdominal mass after evaluation of primary infertility. He had a surgical history of bilateral abdominal orchiopexy 5 years previously, performed at another hospital. Hydatid cyst was suspected by abdominal computed tomography. After laparotomy excision, the cyst wall opened incidentally, and draining of a large amount of thick pus with retained surgical gauze within the cyst was found, with final diagnosis of gossypiboma. Conclusion. The policy that prevention is far more important than cure is highly appreciated. Accurate sponge and instrument counts, along with radiologic evaluation when a discrepancy is found, can be helpful. Although human errors cannot be completely avoided, continuous medical training and strict adherence to rules of the operation room should reduce the incidence of gossypiboma to a minimum. Surgical sponges should be counted once at the start and twice at the end of all surgical operations.

  9. Perfil antropométrico e adiposidade abdominal de escolares entre 6 a 10 anos de idade do Sul do Brasil

    Directory of Open Access Journals (Sweden)

    Gabriela Dalsasso Ricardo

    2012-10-01

    Full Text Available http://dx.doi.org/10.5007/1980-0037.2012v14n6p636 O estudo teve como objetivo avaliar a associação de medidas antropométricas com o Índice de Massa Corporal (IMC e verificar a presença de adiposidade abdominal em escolares. Estudo transversal realizado entre 2007-2008, com 4.964 escolares de 6 a 10 anos de idade, matriculados em 345 escolas de oito municípios do Estado de Santa Catarina. As variáveis independentes utilizadas foram: dobras cutâneas subescapular (DCS e tricipital (DCT, circunferências do braço (CBr, cintura (CC e quadril (CQ e relações cintura/quadril (RCQ e cintura/estatura (RCEst. O IMC foi utilizado como variável dependente. Associações brutas e ajustadas foram estimadas mediante regressão linear e expressados como coeficiente de regressão (β. Para análise ajustada, todas as medidas antropométricas foram controladas entre si, mantendo-se no modelo aquelas com p<0,20. Classificou-se a adiposidade abdominal com a RCEst ≥ 0.5. Os resultados mostram que o IMC médio dos meninos foi 17,4kg/m2 (DP=2,8 e das meninas 17,2kg/ m2 (DP=2,8. As médias das medidas antropométricas para os sexos masculino e fe­minino foram, respectivamente: DCS=7,2 e 8,3mm; DCT=10,8 e 12,6mm; CBr=20,0 e 20,2cm; CC=60,1 e 58,5cm; CQ=71,3 e 71,9cm; RCQ=0,84 e 0,81; RCEst=0,45 e 0,44. Todas as medidas antropométricas se associaram positivamente com o IMC na análise bruta, para ambos os sexos. Na análise ajustada, nos meninos, mantiveram-se associadas: DCS (β=0,05, CBr (β=0,17, CC (β=0,19 e RCEst (β=30,5. Nas meninas, continuaram associadas a DCS (β=0,19, CBr (β=0,17, CC (β=0,13, RCQ (β=-6,2 e RCEst (β=32,1. Apresentaram adiposidade abdominal 11,9% (n=589 dos escolares, de acordo com a RCEst. Pode-se concluir que os indicadores DCS, CBr, CC e RCEst apresentaram boa relação com o IMC em escolares de ambos os sexos. Estas medidas poderiam ser utilizadas como complemento ao IMC para determinação da adiposidade corporal total e

  10. Intra-Abdominal Hypertension and Abdominal Compartment Syndrome after Abdominal Wall Reconstruction: Quaternary Syndromes?

    Science.gov (United States)

    Kirkpatrick, A W; Nickerson, D; Roberts, D J; Rosen, M J; McBeth, P B; Petro, C C; Berrevoet, Frederik; Sugrue, M; Xiao, Jimmy; Ball, C G

    2017-06-01

    Reconstruction with reconstitution of the container function of the abdominal compartment is increasingly being performed in patients with massive ventral hernia previously deemed inoperable. This situation places patients at great risk of severe intra-abdominal hypertension and abdominal compartment syndrome if organ failure ensues. Intra-abdominal hypertension and especially abdominal compartment syndrome may be devastating systemic complications with systematic and progressive organ failure and death. We thus reviewed the pathophysiology and reported clinical experiences with abnormalities of intra-abdominal pressure in the context of abdominal wall reconstruction. Bibliographic databases (1950-2015), websites, textbooks, and the bibliographies of previously recovered articles for reports or data relating to intra-abdominal pressure, intra-abdominal hypertension, and the abdominal compartment syndrome in relation to ventral, incisional, or abdominal hernia repair or abdominal wall reconstruction. Surgeons should thus consider and carefully measure intra-abdominal pressure and its resultant effects on respiratory parameters and function during abdominal wall reconstruction. The intra-abdominal pressure post-operatively will be a result of the new intra-peritoneal volume and the abdominal wall compliance. Strategies surgeons may utilize to ameliorate intra-abdominal pressure rise after abdominal wall reconstruction including temporizing paralysis of the musculature either temporarily or semi-permanently, pre-operative progressive pneumoperitoneum, permanently removing visceral contents, or surgically releasing the musculature to increase the abdominal container volume. In patients without complicating shock and inflammation, and in whom the abdominal wall anatomy has been so functionally adapted to maximize compliance, intra-abdominal hypertension may be transient and tolerable. Intra-abdominal hypertension/abdominal compartment syndrome in the specific setting of

  11. Bromelain: a natural proteolytic for intra-abdominal adhesion prevention.

    Science.gov (United States)

    Sahbaz, Ahmet; Aynioglu, Oner; Isik, Hatice; Ozmen, Ulku; Cengil, Osman; Gun, Banu Dogan; Gungorduk, Kemal

    2015-02-01

    Peritoneal adhesions are pathological fibrous connections between peritoneal surfaces resulting from incomplete peritoneal repair. Adhesions cause various health problems ranging from pelvic pain and bowel obstruction to infertility. To date, no effective agent exists for intra-abdominal adhesion prevention. Bromelain is the crude extract of the pineapple and it has fibrinolytic, antithrombotic, and anti-inflammatory properties. Bromelain has been shown to be effective for removing necrotic tissues and has been found to be effective for treating various wounds, inflammatory conditions, and thrombotic pathologies. In the present study, we evaluated bromelain as a novel agent for preventing intra-abdominal adhesions. Group 1 (control group): Adhesions were produced by cecal abrasion method, and no treatment was applied. Group 2 (i.p. bromelain-treated group): After adhesion formation, 10 mg/kg/BW of bromelain dissolved in 1 mL saline solution was applied intraperitoneally for 10 days. Group 3 (i.p. saline-treated group): After adhesion formation, 1 mL saline solution was applied intraperitoneally for 10 days. On postoperative day 10, all animals were sacrificed. All 30 rats survived surgery. Throughout the follow-up period, no complications were observed. Statistically significant differences were found between the groups with regards to macroscopic adhesion scores, inflammation, fibrosis and neo-vascularization (p bromelain-treated group. Bromelain, acting through its barrier, anti-inflammatory, antioxidant, and proteolytic effects and without increasing bleeding tendency or having any adverse effects on wound healing, may be a suitable agent for intra-abdominal adhesion prevention. Copyright © 2015 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  12. Toxicity from Intra-Abdominal Injection of Chlorfenapyr

    OpenAIRE

    Jina Lee; Jun Hyun Lee; Jong Min Baek; Do Sang Lee; Il Young Park; Jong Man Won; Ki Young Sung

    2013-01-01

    Introduction. Chlorfenapyr is commonly used for food crops in Korea. However, chlorfenapyr toxicity in humans has not yet been studied. Case. A 74-year-old man was admitted to the emergency room after he intra-abdominally injected 20 mL of chlorfenapyr in an attempt to commit suicide. Emergency surgery was performed and accumulation of approximately 500 mL of reactive fluid in the abdomen was observed. The entire small intestine showed congestion. After surgery, additional surgery to drain th...

  13. [Disease picture of intra-abdominal hernias in childhood].

    Science.gov (United States)

    Waldschmidt, J; Pankrath, K; Charissis, G

    1985-01-01

    Through the demonstration of 3 cases (6-year-old-girl with right mesenterico-parietal hernia; 2 year-old-boy with a transverso-mesocolic hernia; 10-months-old-boy with a hernia in the mesenterium of a M.D.) we discuss the problems of intraabdominal hernia. The evaluation of the disease can take many forms. Only one third of the children remains without symptoms; the other third has a chronic evaluation and the last third an acute abdomen. Once diagnosed internal hernia must soon be operated.

  14. Prolonged antibiotic treatment does not prevent intra-abdominal abscesses in perforated appendicitis.

    NARCIS (Netherlands)

    Wijck, K. van; Jong, J.R. de; Heurn, L.W.E. van; Zee, D.C. van der

    2010-01-01

    BACKGROUND: Children with perforated appendicitis have a relatively high risk of intra-abdominal abscesses. There is no evidence that prolonged antibiotic treatment after surgery reduces intra-abdominal abscess formation. We compared two patient groups with perforated appendicitis with different

  15. Adiposidade corporal, mas não resistência insulínica, associa-se ao polimorfismo -675 4G/5G no gene PAI-1 em uma amostra de crianças mexicanas

    Directory of Open Access Journals (Sweden)

    Ulises de la Cruz-Mosso

    2013-10-01

    Full Text Available OBJETIVO: Elaboramos este estudo para avaliar se o polimorfismo -675 4G/5G no gene inibidor 1 do ativador do plasminogênio se associa à obesidade e à resistência insulínica em crianças mexicanas. MÉTODOS: Foi realizado um estudo transversal em 174 crianças, 89 delas com peso normal e 85 obesas, variando sua idade de 6 a 13 anos. Todas as crianças eram do estado de Guerrero e foram recrutadas de três escolas primárias na cidade de Chilpancingo, México. Os níveis de insulina foram determinados por prova imunoenzimática. Foi usado o modelo de avaliação da homeostase para determinar resistência insulínica. O polimorfismo -675 4G/5G no gene PAI-1 foi analisado pelo método reação de polimerase em cadeia-polimorfismo no comprimento dos fragmentos de restrição. RESULTADOS: A prevalência de resistência insulínica no grupo obeso foi mais alta (49,41% do que no grupo com peso normal (16,85%. O polimorfismo 4G/5G do PAI-1 foi encontrado em equilíbrio de Hardy Weinberg. O genótipo 4G/5G contribuiu para um aumento significativo da relação cintura-quadril (β = 0,02, p = 0,006, da circunferência da cintura (β = 4,42, p = 0,009 e da espessura da prega subescapular (β = 1,79, p = 0,04, mas não se relacionou com a resistência insulínica. CONCLUSÃO: O genótipo -675 4G/5G do gene PAI-1 se associou a aumento da adiposidade corporal em crianças mexicanas.

  16. Toxicity from intra-abdominal injection of chlorfenapyr.

    Science.gov (United States)

    Lee, Jina; Lee, Jun Hyun; Baek, Jong Min; Lee, Do Sang; Park, Il Young; Won, Jong Man; Sung, Ki Young

    2013-01-01

    Introduction. Chlorfenapyr is commonly used for food crops in Korea. However, chlorfenapyr toxicity in humans has not yet been studied. Case. A 74-year-old man was admitted to the emergency room after he intra-abdominally injected 20 mL of chlorfenapyr in an attempt to commit suicide. Emergency surgery was performed and accumulation of approximately 500 mL of reactive fluid in the abdomen was observed. The entire small intestine showed congestion. After surgery, additional surgery to drain the fluid was performed on POD 12. But immediately after administration of general anesthesia, flat rhythm was observed by electrocardiogram (ECG) monitoring, requiring cardiopulmonary resuscitation (CPR). Discussion. The color of the bowel was purple, indicating ischemic injury. This could be attributed to direct absorption of the substance through the peritoneum, leading to chemical injury to the small intestine serosa, unlike in the case of oral ingestion. This resulted in an ischemic change in the small intestine, eventually leading to sepsis. Conclusion. Only a few cases of chlorfenapyr toxicity have been reported in the literature, and death occurred in all cases, including our case. Therefore, careful and aggressive treatments are necessary. This is the first reported case of intra-abdominal injection of chlorfenapyr.

  17. A Unique Case of Intraabdominal Polyorchidism: A Case Study

    Directory of Open Access Journals (Sweden)

    Javier Otero

    2016-01-01

    Full Text Available Background. Polyorchidism, alternatively supernumerary testes (SNT, is a condition where an individual is born with more than two testicles. This congenital anomaly is quite rare and the literature has described various presentations. Questions/Purposes. To our knowledge, this presentation of polyorchidism has yet to be described in the literature. The goal of this case study is to add to the pediatric, general, and urologic surgery’s body of knowledge of the subject matter. Case Study. A nine-month-old boy was admitted for an impalpable right testis and phimosis. At the time of surgical exploration, there appeared to be polyorchid testis on the right-hand side, with three masses that potentially appeared to be undescended testes. Discussion. Proponents of a conservative approach argue that infertility is common in patients with polyorchidism and, by preserving a potentially functional SNT, there may be improved spermatogenesis. When performing definitive surgical treatment, meticulous intra-abdominal and intrainguinal exploration must be undertaken. Orchiopexy should be performed to reduce the chances of torsion, malignancy, and infertility. Conclusion. Our case is important to the literature as it is the first known case of polyorchidism with 3 SNT on the right side, located intra-abdominally, and in a patient less than 1 year of age.

  18. Toxicity from Intra-Abdominal Injection of Chlorfenapyr

    Directory of Open Access Journals (Sweden)

    Jina Lee

    2013-01-01

    Full Text Available Introduction. Chlorfenapyr is commonly used for food crops in Korea. However, chlorfenapyr toxicity in humans has not yet been studied. Case. A 74-year-old man was admitted to the emergency room after he intra-abdominally injected 20 mL of chlorfenapyr in an attempt to commit suicide. Emergency surgery was performed and accumulation of approximately 500 mL of reactive fluid in the abdomen was observed. The entire small intestine showed congestion. After surgery, additional surgery to drain the fluid was performed on POD 12. But immediately after administration of general anesthesia, flat rhythm was observed by electrocardiogram (ECG monitoring, requiring cardiopulmonary resuscitation (CPR. Discussion. The color of the bowel was purple, indicating ischemic injury. This could be attributed to direct absorption of the substance through the peritoneum, leading to chemical injury to the small intestine serosa, unlike in the case of oral ingestion. This resulted in an ischemic change in the small intestine, eventually leading to sepsis. Conclusion. Only a few cases of chlorfenapyr toxicity have been reported in the literature, and death occurred in all cases, including our case. Therefore, careful and aggressive treatments are necessary. This is the first reported case of intra-abdominal injection of chlorfenapyr.

  19. A user's guide to intra-abdominal pressure measurement.

    LENUS (Irish Health Repository)

    Sugrue, Michael

    2015-01-01

    The intra-abdominal pressure (IAP) measurement is a key to diagnosing and managing critically ill medical and surgical patients. There are an increasing number of techniques that allow us to measure the IAP at the bedside. This paper reviews these techniques. IAP should be measured at end-expiration, with the patient in the supine position and ensuring that there is no abdominal muscle activity. The intravesicular IAP measurement is convenient and considered the gold standard. The level where the mid-axillary line crosses the iliac crest is the recommended zero reference for the transvesicular IAP measurement; moreover, marking this level on the patient increases reproducibility. Protocols for IAP measurement should be developed for each ICU based on the locally available tools and equipment. IAP measurement techniques are safe, reproducible and accurate and do not increase the risk of urinary tract infection. Continuous IAP measurement may offer benefits in specific situations in the future. In conclusion, the IAP measurement is a reliable and essential adjunct to the management of patients at risk of intra-abdominal hypertension.

  20. Nódulo umbilical metastático (nódulo da Irmã Maria José: um sinal de alerta para tumoração maligna intra-abdominal - relato de caso Sister Mary Joseph's nodule: a warning sign for intra-abdominal malignant tumors. A case report

    Directory of Open Access Journals (Sweden)

    Homero Soares Fogaça

    2003-07-01

    Full Text Available O nódulo da "Irmã Maria José" é tumor metastático que acomete a cicatriz umbilical e pode ser a primeira evidência de neoplasia intra-abdominal disseminada. Os autores relatam o caso de uma paciente com o nódulo da "Irmã Maria José" no qual o diagnóstico do tumor primário só foi possível por meio dos testes imuno-histoquímicos da lesão biopsiada da pele.The umbilical metastatic tumoral nodule, Sister Mary Joseph's nodule, is a rare clinical sign indicative of disseminated intra-abdominal tumor, and may be the first evidence of malignancy. The authors report a case of a patient with umbilical metastatic nodule in whom the diagnosis of the primary tumor was possible by immunohistochemistry of the lesion biopsy.

  1. Leptina e exercício físico aeróbio: implicações da adiposidade corporal e insulina Leptin and endurance exercise: implications of adiposity and insulin

    Directory of Open Access Journals (Sweden)

    Fabiana Braga Benatti

    2007-08-01

    Full Text Available Atualmente, a obesidade pode ser classificada como uma pandemia e suas conseqüências vão desde o diabetes mellitus até a doença cardíaca. Tanto fatores genéticos como ambientais contribuem para isso, porém, em humanos, o componente genético ainda é pouco definido. Com a clonagem do gene ob de ratos e do seu receptor, foi descoberta a leptina, o "hormônio da saciedade". A leptina é secretada, principalmente, pelo tecido adiposo e reflete a quantidade de gordura depositada no tecido adiposo de um indivíduo. Entretanto, diversos fatores influenciam sua expressão e síntese, tais como jejum, atividade simpática, exercício físico e alterações no balanço energético. Os efeitos da atividade física aeróbia sobre esse hormônio ainda não estão muito claros, visto que existem muitas contradições na literatura sobre sua possível ação na regulação da leptina. Estudos transversais sugerem que as concentrações plasmáticas de leptina não são alteradas após uma sessão de exercício aeróbio. Entretanto, se o esforço físico for extremo, como em uma ultramaratona, na qual há um balanço energético negativo, induzido pela atividade física extenuante, ocorre diminuição dessas concentrações. Além disso, exercícios de longa duração (> 60 min parecem estar associados à diminuição tardia das concentrações de leptina, aproximadamente 48h após a atividade, provavelmente em função de um possível desequilíbrio energético. Em relação aos estudos longitudinais, após o treinamento aeróbio, alguns autores não observam alterações na leptina plasmática, outros encontram alterações em função apenas das alterações da adiposidade e, por fim, alguns estudos observam diminuição da concentração plasmática e/ou expressão de leptina, independentemente de alterações da massa gorda. Tal fato sugere que haja outro, ou outros, fatores, além do conteúdo de gordura corporal, que modulam a diminuição das

  2. Effect of hemodialysis on intra-abdominal pressure Efeito da hemodiálise sobre a pressão intra-abdominal

    Directory of Open Access Journals (Sweden)

    Roberta Fernandes Bonfim

    2007-01-01

    Full Text Available OBJECTIVE: To study the effect of hemodialysis on intra-abdominal pressure. METHODS: Five patients admitted between July and November of 2003 were evaluated in the intensive care unit. Intra-abdominal pressure was measured before and after hemodialysis, maintaining the ventilatory parameters except for PEEP (positive-end expiratory pressure. RESULTS: Intra-abdominal pressure was significantly reduced by hemodialysis in all the 5 patients. CONCLUSION: Hemodialysis significantly reduced intra-abdominal pressure in the 5 patients, an effect which could have influence over other organic systems. This reduction is related to the weight variation before and after hemodialysis, as well as to the loss of volume caused by this procedure.OBJETIVO: Pesquisar o efeito da hemodiálise sobre a pressão intra-abdominal. MÉTODOS: Foram avaliados cinco pacientes internados entre julho e novembro de 2003, na Unidade de Terapia Intensiva do Serviço de Nefrologia do Hospital das Clínicas de São Paulo. Mensurou-se a pressão intra-abdominal antes e após a hemodiálise, mantendo os parâmetros ventilatórios exceto a PEEP (positive end expiratory pressure. RESULTADOS: Constatou-se que a hemodiálise foi capaz de reduzir significativamente a PIA em cinco pacientes na Unidade de Terapia Intensiva CONCLUSÃO: A hemodiálise reduziu a pressão intra-abdominal numa amostra de cinco pacientes, de maneira significativa, o que poderia influenciar os demais sistemas orgânicos. Essa redução está relacionada com a variação de peso pré e pós-hemodiálise, e com a perda de volume promovida pelo procedimento.

  3. Proteus syndrome: report of intra-abdominal lipomatosis.

    Science.gov (United States)

    Erginel, Basak; Akin, Melih; Yildiz, Abdullah; Karadag, Cetin; Sever, Nihat; Tanik, Canan; Erturk, Mehmet; Dokucu, Ali Ihsan

    2013-06-01

    Proteus syndrome (PS) is an extremely rare sporadic disorder that manifests as an asymmetric, disproportionate overgrowth of any connective tissues, such as bone, fat, or epidermal nevi, in a mosaic or patchy pattern. This hamartoneoplastic syndrome was first described by Cohen and Hayden. Its prevalence is approximately 1 per 1,000,000 live births, and intra-abdominal expansion has been reported in no more than 20 cases in the literature. The phenotypes of the patients differ because of the variation in the pattern of the overgrowths, making diagnosis difficult. Extremely large subcutaneous lipomas and internal lipomas, which occur rarely, are one of the presentation phenotypes. Here, we present the second patient in the literature with PS involving the epiploon.

  4. Pylephlebitis: a rare complication of an intra-abdominal infection

    Directory of Open Access Journals (Sweden)

    Katherine Wong

    2013-07-01

    Full Text Available Pylephlebitis is defined as an inflamed thrombosis of the portal vein. It is a rare complication of an intra-abdominal infection, and the diagnosis is often missed due to its nonspecific clinical presentation. Symptoms may include abdominal pain, fever, chills, fatigue, nausea, and vomiting. It is important to consider this differential when a patient presents with signs of abdominal sepsis since it has a high mortality rate and is often diagnosed postmortem. Pylephlebitis can be diagnosed via abdominal ultrasound or CT demonstrating a thrombus in the portal vein, and it must be treated early and aggressively with broad-spectrum antibiotics. We are presenting a case of pylephlebitis as well as discussing the diagnosis and treatment of this potentially lethal condition.

  5. The use of anti-gravity suits for the control of critical intra-abdominal hemmorhage

    Science.gov (United States)

    Kravik, S.; Landmark, K.

    1980-01-01

    The history and use as well as the physiology of the use of antigravity suits for the control of critical intra-abdominal hemorrhages is reviewed. The use of this suit is highly recommended, especially for first aid.

  6. Medical Versus Interventional Treatment of Intra-Abdominal Abscess in Patients With Crohn Disease.

    Science.gov (United States)

    Graham, Emily; Rao, Krishna; Cinti, Sandro

    2017-01-01

    Few studies exist to guide the treatment approach to intra-abdominal abscesses in Crohn disease, which can include antimicrobials alone or in conjunction with percutaneous drainage or surgery. The primary aim of this study is to review outcomes from different treatment approaches to intra-abdominal abscess in Crohn disease. Medical records were reviewed for patients admitted to the University of Michigan health care system with Crohn disease and intra-abdominal abscess over a 4-year period. Outcomes were compared among medical and interventional approaches. The χ(2) test was used to test for statistical significance. Of the 33 patients included, 13 were in the medical group and 20 were in the interventional group. Abscess recurrence/nonresolution occurred in 31% of patients in the medical group and 25% of patients in the interventional group (P = .7). In this study, there was no significant difference in outcome between medical and interventional therapy for intra-abdominal abscess in Crohn disease.

  7. Does elevated intra-abdominal pressure during laparoscopic colorectal surgery cause acute gastrointestinal injury?

    OpenAIRE

    Cai, Zhenghao; Malbrain, Manu L. N. G.; Sun, Jing; Pan, Ruijun; Ma, Junjun; Feng, Bo; Dong, Feng; Zheng, Minhua

    2015-01-01

    Introduction The incidence of acute gastrointestinal injury (AGI) after colorectal surgery is low when laparoscopic techniques are used. While elevated intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) are associated with AGI grade II, little is known about the relation between increased IAP during laparoscopy and subsequent AGI. Aim To assess the impact of increased IAP during laparoscopic colorectal surgery on the incidence of postoperative AGI. Material and methods Sixt...

  8. Structural characteristics of polysaccharides that induce protection against intra-abdominal abscess formation.

    OpenAIRE

    Tzianabos, A O; Onderdonk, A B; Zaleznik, D F; Smith, R S; Kasper, D L

    1994-01-01

    Bacteroides fragilis is the anaerobe most commonly isolated from clinical cases of intra-abdominal sepsis. In a rodent model of this disease process, intraperitoneal injection of the capsular polysaccharide complex (CPC) from B. fragilis provokes abscess formation, while subcutaneous administration of this complex confers protection against B. fragilis-induced intra-abdominal abscesses. The CPC consists of two discrete polysaccharides, polysaccharides A and B (PS A and PS B), each possessing ...

  9. Efficacy of tigecycline versus ceftriaxone plus metronidazole for the treatment of complicated intra-abdominal infections

    DEFF Research Database (Denmark)

    Qvist, Niels; Warren, Brian; Leister-Tebbe, Heidi

    2012-01-01

    This randomized, open-label, multi-center trial compared tigecycline (TGC), a broad-spectrum glycylcycline, with ceftriaxone-metronidazole (CTX/MET) for the treatment of complicated intra-abdominal infections (cIAI).......This randomized, open-label, multi-center trial compared tigecycline (TGC), a broad-spectrum glycylcycline, with ceftriaxone-metronidazole (CTX/MET) for the treatment of complicated intra-abdominal infections (cIAI)....

  10. [Intra-abdominal pressure as a surgery predictor in patients with acute abdominal pain].

    Science.gov (United States)

    Campos-Muñoz, Manuel Alejandro; Villarreal-Ríos, Enrique; Chimal-Torres, Mariano; Pozas-Medina, Josué Atila

    2016-01-01

    Intra-abdominal pressure is the pressure's state of balance within the abdominal cavity when a patient is at rest. This pressure may vary during mechanical ventilation or spontaneous breathing. The objective was to establish the intra-abdominal pressure as a surgery predictor in patients with acute abdominal pain. From April to December, 2013, it was carried out a nested case-control study on patients with acute abdominal pain in the emergency room of a second level hospital. Thirty-seven patients fit the inclusion criteria; they all underwent surgery with a previous measurement of the intra-abdominal pressure. Based on the results of the anatomopathological study, we divided the patients into two groups: those with evidence of acute abdominal inflammatory process (n=28) (case group), and patients without evidence of acute abdominal inflammatory process (n=9) (control group). In the case group, 100 % of patients shown high intra-abdominal pressure with a p=0.01 (OR=5 [95 % CI=2.578-9.699]. In the case group, the mean intra-abdominal pressure was 11.46, and in the control group 9.2 (p=0.183). Abdominal pain requiring surgical intervention is directly related to intra-abdominal pressure>5 mmHg.

  11. Estatura, longitud de las piernas, evaluación de la adiposidad y el riesgo metabólico-cardiovascular en mujeres de 35 a 55 años Height, leg length, adiposity and metabolic-cardiovascular risk in women aged 35-55 years

    OpenAIRE

    Martín Moreno, V.; J. B. Gómez Gandoy; Mª. J. Antoranz González; A. Gómez de la Cámara

    2003-01-01

    Objetivo: Estatura y adiposidad están asociadas al riesgo metabólico-cardiovascular, aunque su interrelación no está clara, analizándose en este estudio la asociación entre los segmentos corporales que conforman la estatura y los parámetros que evalúan la adiposidad y el riesgo metabólico-cardiovascular. Métodos: Estudio descriptivo transversal. Se analizó en 30 mujeres de 35-55 años la asociación entre componentes de la estatura (talla total, segmento corporal superior, longitud del tronco y...

  12. Estudios aleatorizados sobre el efecto del consumo de bebidas azucaradas sobre la adiposidad en menores de 16 años: revisión sistemática

    OpenAIRE

    Arturo Jiménez-Cruz; Luis Mario Gómez-Miranda; Montserrat Bacardí-Gascón

    2013-01-01

    Introducción: Se ha observado una asociación entre el consumo de bebidas azucaradas y diversas enfermedades metabólicas. Objetivo: Analizar estudios aleatorizados de 52 o más semanas de intervención, en individuos < 16 años de edad, que evalúen el efecto de la reducción en el consumo de bebidas azucaradas, saborizadas, jugos de frutas y bebidas carbonatadas, sobre indicadores de adiposidad. Metodología: Se realizó una búsqueda en PubMed, de estudios aleatorizados publicados hasta el 21 de ago...

  13. Does massive intraabdominal free gas require surgical intervention?

    Science.gov (United States)

    Furihata, Tadashi; Furihata, Makoto; Ishikawa, Kunibumi; Kosaka, Masato; Satoh, Naoki; Kubota, Keiichi

    2016-01-01

    We describe a rare case of an 81-year-old man who presented with severe epigastralgia. A chest radiograph showed massive free gas bilaterally in the diaphragmatic spaces. Computed tomography (CT) scan also showed massive free gas in the peritoneal cavity with portal venous gas. We used a wait-and-see approach and carefully considered surgery again when the time was appropriate. The patient received conservative therapy with fasting, an intravenous infusion of antibiotics, and nasogastric intubation. The patient soon recovered and was able to start eating meals 4 d after treatment; thus, surgical intervention was avoided. Thereafter, colonoscopy examination showed pneumatosis cystoides intestinalis in the ascending colon. On retrospective review, CT scan demonstrated sporadic air-filled cysts in the ascending colon. The present case taught us a lesson: the presence of massive intraabdominal free gas with portal venous gas does not necessarily require surgical intervention. Pneumatosis cystoides intestinalis should be considered as a potential causative factor of free gas with portal venous gas when making the differential diagnosis. PMID:27621584

  14. Intra-abdominal pressure correlates with extracellular water content.

    Directory of Open Access Journals (Sweden)

    Wojciech Dąbrowski

    Full Text Available Secondary increase in intra-abdominal pressure (IAP may result from extra-abdominal pathology, such as massive fluid resuscitation, capillary leak or sepsis. All these conditions increase the extravascular water content. The aim of this study was to analyze the relationship between IAP and body water volume.Adult patients treated for sepsis or septic shock with acute kidney injury (AKI and patients undergoing elective pharyngolaryngeal or orthopedic surgery were enrolled. IAP was measured in the urinary bladder. Total body water (TBW, extracellular water content (ECW and volume excess (VE were measured by whole body bioimpedance. Among critically ill patients, all parameters were analyzed over three consecutive days, and parameters were evaluated perioperatively in surgical patients.One hundred twenty patients were studied. Taken together, the correlations between IAP and VE, TBW, and ECW were measured at 408 time points. In all participants, IAP strongly correlated with ECW and VE. In critically ill patients, IAP correlated with ECW and VE. In surgical patients, IAP correlated with ECW and TBW. IAP strongly correlated with ECW and VE in the mixed population. IAP also correlated with VE in critically ill patients. ROC curve analysis showed that ECW and VE might be discriminative parameters of risk for increased IAP.IAP strongly correlates with ECW.

  15. [Peritonitis determined by the site of intra-abdominal surgery].

    Science.gov (United States)

    Chylak, J; Michalska, W; Drews, M; Marciniak, R; Deja, A

    1999-01-01

    The aim of this study was to determine bacterial flora infecting the peritoneal cavity during intraabdominal surgery by site of operation. Three groups of patients were examined. 29 patients who underwent surgery on the stomach, duodenum, biliary tract or pancreas, 15 patients operated on because of acute appendicitis and 63 patients operated on because of colon or rectum tumours. At the end of the operation but before closure cultures were obtained by swab from the completed anastomosis site. Samples were placed into transport medium and transported promptly to the laboratory. The results of the bacteriological examinations showed that the peritoneal cavity of all patients operated on were infected with bacteria characteristic for the digestive tract, especially by Enterobacteriaceae spp., Enterococcus spp. and Bacteroides spp. From patients operated on because of rectum or colon tumours 3 or 4 bacterial species were isolated most often and they were often infected with P. aeruginosa and C. albicans. This was in contrast to patients from the other groups. In patients infected with polymicrobial flora, B. fragilis and E. coli or enterococci and E. coli and enterococci were most often seen.

  16. The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections

    NARCIS (Netherlands)

    Sartelli, M.; Chichom-Mefire, A.; Labricciosa, F.M.; Hardcastle, T.; Abu-Zidan, F.M.; Adesunkanmi, A.K.; Ansaloni, L.; Bala, M.; Balogh, Z.J.; Beltran, M.A.; Ben-Ishay, O.; Biffl, W.L.; Birindelli, A.; Cainzos, M.A.; Catalini, G.; Ceresoli, M.; Che Jusoh, A.; Chiara, O.; Coccolini, F.; Coimbra, R.; Cortese, F.; Demetrashvili, Z.; Saverio, S. Di; Diaz, J.J.; Egiev, V.N.; Ferrada, P.; Fraga, G.P.; Ghnnam, W.M.; Lee, J.G.; Gomes, C.A.; Hecker, A.; Herzog, T.; Kim, J.I.; Inaba, K.; Isik, A.; Karamarkovic, A.; Kashuk, J.; Khokha, V.; Kirkpatrick, A.W.; Kluger, Y.; Koike, K.; Kong, V.Y.; Leppaniemi, A.; Machain, G.M.; Maier, R.V.; Marwah, S.; McFarlane, M.E.; Montori, G.; Moore, E.E.; Negoi, I.; Olaoye, I.; Omari, A.H.; Ordonez, C.A.; Pereira, B.M.; Junior, G.A.; Pupelis, G.; Reis, T.; Sakakhushev, B.; Sato, N.; Segovia Lohse, H.A.; Shelat, V.G.; Soreide, K.; Uhl, W.; Ulrych, J.; Goor, H. van; Velmahos, G.C.; Yuan, K.C.; Wani, I.; Weber, D.G.; Zachariah, S.K.; Catena, F.

    2017-01-01

    Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide. The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial

  17. Intra-abdominal pressure in third trimester pregnancy complicated by acute pancreatitis: an observational study.

    Science.gov (United States)

    Sun, Liqun; Li, Weiqin; Sun, Fuxi; Geng, Yanxia; Tong, Zhihui; Li, Jieshou

    2015-09-22

    It is known that intra-abdominal hypertension has high morbidity in acute pancreatitis and has detrimental effects on patients. For third trimester pregnancy complicated by acute pancreatitis, the intra-abdominal pressure may have its own characteristic. This article will discuss this clinical scenario. This observational study in a cohort group was performed in the surgical intensive care unit of a tertiary hospital. Medical records were reviewed from each acute pancreatitis exactly in third trimester pregnancy. The main statistical methods were Mann-Whitney U test and bivariate Pearson correlation analysis. During the study interval, there were totally 17 pregnancies complicated by acute pancreatitis in the third trimester. All cases with moderate or severe acute pancreatitis had intra-abdominal hypertension of mean value of 16.7 mm Hg (range, 12.9-22.0 mm Hg). The intra-abdominal pressure had significant correlation with APACHE II score (r = 0.7456, p = 0.0006), while a negative correlation was showed with the umbilical artery pH value and with 1-min Apgar score (r = -0.8232, p = 0.0005; r = -0.7465, p = 0.0034; respectively). The intra-abdominal pressure of those with live infants was lower than that of those with dead ones (13.78 ± 2.554 vs. 19.84 ± 1.695, p = 0.0019). The incidence of intra-abdominal hypertension seems higher in moderate or severe acute pancreatitis in third trimester pregnancy than the non-pregnant cases but there's no significance in this study. Acute elevated intra-abdominal pressure accounts for great association with mother's serious scenario and fetal mortality.

  18. Dynamics of Albumin Synthetic Response to Intra-Abdominal Abscess in Patients with Gastrointestinal Fistula

    Science.gov (United States)

    Zhou, Bo; Han, Gang; Chen, Yu; A, Jiye; Gu, Guosheng; Chen, Jun; Wang, Gefei; Li, Jieshou

    2014-01-01

    Abstract Background: Low serum albumin concentration is a predictor of failure of source control for intra-abdominal infection. However, data on dynamics of albumin synthesis in these patients and to what extent these changes contribute to hypoalbuminemia are relatively scarce. We investigated in a group of patients with gastrointestinal fistula the dynamic response of liver albumin synthesis to intra-abdominal abscess and how these related to hypoalbuminemia and circulating endocrine hormone profiles. Methods: Eight gastrointestinal fistula patients scheduled to undergo percutaneous abscess sump drainage were enrolled prospectively to measure albumin synthesis rates at different stages of the inflammatory response (immediately after diagnosis and 7 d following sump drainage when clinical signs of intra-abdominal sepsis had been eradicated). Eight age-, sex-, and body mass index–matched intestinal fistula patients were studied as control patients. Consecutive arterial blood samples were drawn during a primed-constant infusion (priming dose: 4 micromol·kg−1, infusion rate: 6 micromol·kg−1·min−1) to determine the incorporation rate of L-[ring-2H5]-phenylalanine directly into plasma albumin using gas chromatography/mass spectrometry analysis. Results: Patients suffering from intra-abdominal infection had reduced plasma albumin and total plasma protein concentrations, compared with control patients. Albumin fractional synthesis rates in patients with intra-abdominal abscess were decreased, compared with those in the control group. When the source of infection was removed, albumin synthesis rates returned to control values, whereas albumin concentrations did not differ significantly from the corresponding concentrations in control subjects and patients with intra-abdominal abscess. Conclusion: Despite nutritional intervention, albumin synthesis rate is decreased in intestinal fistula patients with intra-abdominal abscess; albumin synthesis returns to

  19. Intra-abdominal pressure and abdominal compartment syndrome in acute general surgery.

    LENUS (Irish Health Repository)

    Sugrue, Michael

    2012-01-31

    BACKGROUND: Intra-abdominal pressure (IAP) is a harbinger of intra-abdominal mischief, and its measurement is cheap, simple to perform, and reproducible. Intra-abdominal hypertension (IAH), especially grades 3 and 4 (IAP > 18 mmHg), occurs in over a third of patients and is associated with an increase in intra-abdominal sepsis, bleeding, renal failure, and death. PATIENTS AND METHODS: Increased IAP reading may provide an objective bedside stimulus for surgeons to expedite diagnostic and therapeutic work-up of critically ill patients. One of the greatest challenges surgeons and intensivists face worldwide is lack of recognition of the known association between IAH, ACS, and intra-abdominal sepsis. This lack of awareness of IAH and its progression to ACS may delay timely intervention and contribute to excessive patient resuscitation. CONCLUSIONS: All patients entering the intensive care unit (ICU) after emergency general surgery or massive fluid resuscitation should have an IAP measurement performed every 6 h. Each ICU should have guidelines relating to techniques of IAP measurement and an algorithm for management of IAH.

  20. Predictors of "occult" intra-abdominal injuries in blunt trauma patients.

    Science.gov (United States)

    Parreira, José Gustavo; Malpaga, Juliano Mangini Dias; Olliari, Camilla Bilac; Perlingeiro, Jacqueline A G; Soldá, Silvia C; Assef, José Cesar

    2015-01-01

    to assess predictors of intra-abdominal injuries in blunt trauma patients admitted without abdominal pain or abnormalities on the abdomen physical examination. We conducted a retrospective analysis of trauma registry data, including adult blunt trauma patients admitted from 2008 to 2010 who sustained no abdominal pain or abnormalities on physical examination of the abdomen at admission and were submitted to computed tomography of the abdomen and/or exploratory laparotomy. Patients were assigned into: Group 1 (with intra-abdominal injuries) or Group 2 (without intra-abdominal injuries). Variables were compared between groups to identify those significantly associated with the presence of intra-abdominal injuries, adopting ptrauma mechanism (ptrauma mechanism (p=0.008 - OR 2.85; 95%CI 1.13-6.22) and abnormal neurological physical exam at admission (p=0.015 - OR 0.44; 95%CI 0.22-0.85). Intra-abdominal injuries were predominantly associated with trauma mechanism and presence of chest injuries.

  1. Blunt intraabdominal arterial injury in pediatric trauma patients: injury distribution and markers of outcome.

    Science.gov (United States)

    Hamner, Chad E; Groner, Jonathon I; Caniano, Donna A; Hayes, John R; Kenney, Brian D

    2008-05-01

    The epidemiology of pediatric blunt intraabdominal arterial injury is ill defined. We analyzed a multiinstitutional trauma database to better define injury patterns and predictors of outcome. The American College of Surgeons National Trauma Database was evaluated for all patients younger than 16 years with blunt intraabdominal arterial injury from 2000 to 2004. Injury distribution, operative treatment, and variables associated with mortality were considered. One hundred twelve intraabdominal arterial injuries were identified in 103 pediatric blunt trauma patients. Single arterial injury (92.2%) occurred most frequently: renal (36.9%), mesenteric (24.3%), and iliac (23.3%). Associated injuries were present in 96.1% of patients (abdominal visceral, 75.7%; major extraabdominal skeletal/visceral, 77.7%). Arterial control was obtained operatively (n = 46, 44.7%) or by endovascular means (n = 6, 5.8%) in 52 patients. Overall mortality was 15.5%. Increased mortality was associated with multiple arterial injuries (P = .049), intraabdominal venous injury (P = .011), head injury (P = .05), Glasgow Coma Score less than 8 (P cardiac arrest (P Trauma Score [P Injury Severity Score [P = .001], and TRISS [P = .002]). Blunt intraabdominal arterial injury in children usually affects a single vessel. Associated injuries appear to be nearly universal. The high mortality rate is influenced by serious associated injuries and is reflected by overall injury severity scores.

  2. O papel coadjuvante das catequinas do chá verde (Camellia sinensis na redução da adiposidade

    Directory of Open Access Journals (Sweden)

    Mirza de Souza Conceição

    2015-03-01

    Full Text Available O chá é uma das bebidas mais consumidas no mundo, vem sendo utilizado pela população como coadjuvante no tratamento da redução de peso, uma vez que aumenta a termogênese e em muitos casos promove a saciedade. O objetivo deste trabalho foi mostrar como as catequinas do chá verde auxiliam no tratamento da obesidade. Foram realizadas buscas por artigos científicos nas bases de dados Science Direct, Google Acadêmico, Scielo, BVS, Medline e Wilson. Os artigos escolhidos foram publicados no período de 2000 a 2014. Observa-se que o tratamento da obesidade envolve necessariamente a reeducação alimentar, o aumento da atividade física e eventualmente, o uso de algumas medicações auxiliares. Outra alternativa, é o uso de fitoterápicos como por exemplo o chá verde. Estudos têm mostrado que este chá, que é obtido pela infusão da erva Camellia sinensis é rico em catequinas, responsáveis na redução de peso, pois promovem a termogênese e aumentam a saciedade. A epigalocatequina (EGCG, é a catequina mais abundante e mais forte do chá verde. É importante ressaltar que o chá usado de maneira inadequada pode causar hepatotoxicidade. O uso do chá associado a um plano alimentar equilibrado pode trazer benefícios à saúde além da perda de peso. Porém os estudos ainda não são conclusivos, sendo necessários mais estudos para que possa confirmar a eficácia do chá verde na obesidade e a quantidade a ser utilizada. Entretanto, a reeducação alimentar, exercício físico continuam sendo os fatores mais importantes no tratamento da obesidade, Onde o consumo de chá verde deve está associado a uma alimentação saudável.

  3. Intra-abdominal pressure and procalcitonin are valid prognostic markers of acute pancreatitis severity (intra-abdominal pressure and procalcitonin

    Directory of Open Access Journals (Sweden)

    Stojanović Maja

    2017-01-01

    Full Text Available Introduction. Early assessment of the severity and etiology of acute pancreatitis is very important for further treatment procedures. The aim of the study was to investigate the association between intra-abdominal pressure (IAP and procalcitonin as an indicator of severity of acute pancreatitis. Method. The IAP is measured every 12 hours through the urinary catheter placed in the bladder, in 65 patients with acute pancreatitis. Procalcitonin is measured within 24 hours of receipt of the patient, after 48 hours and after 78 hours. These values of procalcitonin and IAP were compared to each other and in relation to the Acute Physiology, Age and Chronic Health Evaluation II (APACHE II scoring system. Patients with APACHE II score > 8 are defined with moderate and severe acute pancreatitis. Results. The values of IAP (18,1 ± 4,5 mmHg vs 8,9 ± 2,67 mmHg; p = 0,01 , procalcitonin (15,43 + 2,25 ng/ml vs 3,14 + 1,12 ng/ml; p =0,031 and APACHE II scoring system (17,3 ± 6,24 vs 6,5 ± 1,0; p = 0,013 were significantly higher in patients with moderate and severe acute pancreatitis. The increase in the value of IAP was accompanied by an increase in the value of procalcitonin (r = 0,581, p = 0,01. The sensitivity in the prediction of severe acute pancreatitis after 24 hours of receiving the patient is 91,7% for the IAP, 87,8% for procalcitonin and 84,9% for APACHE II scoring system. Conclusion. The increase in the value of the IAP is accompanied by an increase in the values of procalcitonin, also patients with higher values of APACHE II scoring sys­tem have higher values of IAP and procalcitonin. The values of IAP and procalcitonin can be used as markers of acute pancreatitis severity.

  4. Severe intra-abdominal infection due to Streptococcus Milleri following adjustable gastric banding.

    Science.gov (United States)

    Stelzmueller, Ingrid; Hoeller, Elisabeth; Wiesmayr, Silke; Kafka, Reinhold; Aigner, Franz; Weiss, Helmut; Bonatti, Hugo

    2005-04-01

    Laparoscopic adjustable gastric banding represents a safe and effective bariatric surgical method. Nevertheless, complications such as intraabdominal infections are associated with high morbidity and mortality. A 50-year old morbidly obese female patient underwent adjustable gastric banding with the Swedish band (SAGB). After an uneventful postoperative follow-up of 2 years, she developed band infection due to colon microperforation during endoscopic polypectomy. As the causative microorgansim, Streptococcus Milleri was revealed. Band removal was required, and recovery was quite prolonged. Intra-abdominal infection with Streptococcus Milleri can cause severe and life-threatening disease. Therefore, early diagnosis and surgical intervention combined with body weight adapted antibiotic therapy for a sufficiently long period of time seems necessary. In patients with intra-abdominal implanted devices such as the SAGB who undergo endoscopic polypectomy, antibiotic prophylaxis should therefore be considered.

  5. Intraabdominal abscess related fungaemia caused by Rhodotorula glutinis in a non-neutropenic cancer patient.

    Science.gov (United States)

    Diktas, H; Gulec, B; Baylan, O; Oncul, O; Turhan, V; Acar, A; Gorenek, L

    2013-01-01

    Rhodotorula glutinis is a rare fungal infection that is especially observed in immune-compromised patients. It is common in the skin, faeces, nails, sputum, gastrointestinal system and adenoid tissue. However, the incidence of Rhodotorula glutinis is increased in both local and systemic infections in recent years. Presented here is a case of Rhodotorula glutinis fungaemia that isolated from subhepatic abscess formation and blood in a patient who was operated with Roux-en-Y technique due to gastric adenocarcinoma. Fungal sepsis is an important cause of fever resistant to antibiotic therapy that is often taken into marginal account. It should instead be particularly considered in patients with a history of intraabdominal surgery and non-neutropenic cancer patients. The case described illustrates an episode of systemic infection by Rhodotorula glutinis, correlated with the presence of intraabdominal abscess and without central venous catheters. This is the first case of fungaemia by Rhodotorula glutinis with an intraabdominal abscess source reported from Turkey.

  6. Peritoneal infusion with cold saline decreased postoperative intra-abdominal adhesion formation.

    Science.gov (United States)

    Fang, Cheng-Chung; Chou, Tzung-Hsin; Lin, Geng-Shiau; Yen, Zui-Shen; Lee, Chien-Chang; Chen, Shyr-Chyr

    2010-04-01

    Postoperative intra-abdominal adhesion is a common morbidity after laparotomy. We try to determine whether peritoneal infusion with cold saline may decrease postoperative intra-abdominal adhesion formation. Ninety-six male BALB/c mice weighing 25-30 g were randomized into four groups: (I) adhesion model with infusion of 4 degrees C cold saline, (II) adhesion model with infusion of room temperature saline, (III) adhesion model without infusion of saline, and (IV) sham operation without infusion of saline. Adhesion scores, incidence of adhesion, and serum cytokines were measured at postoperative days 1, 3, 7, and 14. Group I had lower adhesion scores than groups II and III (P cold saline may decrease the degree of postoperative intra-abdominal adhesion formation.

  7. Intra-abdominal migration of a lag screw in gamma nailing: report of a case.

    Science.gov (United States)

    Heineman, David J; van Buijtenen, Jesse M; Heuff, Gijsbert; Derksen, Eric J; Pöll, Ruud G

    2010-12-01

    An 83-year-old female patient was referred to the emergency room with progressive pain on mobilization. Three weeks before presentation, she had been treated with a gamma nail for an unstable right intertrochanteric fracture. Pelvic x-ray showed an intra-abdominally migrated lag screw. No evidence of intra-abdominal lesions was visible on computed tomographic scan. The lag screw as well as the intramedullary nail was extracted and in a second operation, a total hip arthroplasty was implanted. Unfortunately, the total hip implant dislocated and needed reduction. The three consecutive operations seriously weakened the soft tissue envelope. A plaster cast and brace, immobilizing the right hip and pelvis, were provided to prevent recurrences of dislocation. After 6 weeks of immobilization, the patient did well. No late complication occurred. A review of the literature with an emphasis on pathophysiology of intra-abdominal or retroperitoneal migration of lag screws in gamma nailing is presented.

  8. Streptococcus milleri in intraabdominal abscesses in children after appendectomy: incidence and course.

    Science.gov (United States)

    Leeuwenburgh, Marjolein M N; Monpellier, Valerie; Vlaminckx, Bart J M; Go, Peter M N Y H

    2012-03-01

    Intraabdominal abscesses are a common complication after appendectomy, especially in children. In this study, we describe the incidence and course of this complication in relation to the cultured pathogens found in intraabdominal abscesses. The charts of all patients between 1 and 18 years of age undergoing appendectomy in 3 hospitals between January 2006, and July 2009, were retrospectively reviewed. Presence of an intraabdominal abscess was confirmed with abdominal ultrasound examination. We collected all details concerning the appendectomy, pus cultures, and postoperative course in these patients. Two hundred fifty-nine patients underwent appendectomy during the study period. Subsequently, abdominal ultrasound studies showed an intraabdominal abscess in 18 (7%) patients. Intraabdominal abscesses developed more frequently after perforated appendicitis (23%) than after simple appendicitis (2%). The incidence of postoperative abscesses did not differ significantly between open (5.6%) or laparoscopic (6.3%) appendectomy. However, the rate was high (38%) in the patients in whom the appendectomy was converted from laparoscopic to open. In 15 out of the 18 patients with a postoperative abscess drainage was performed. In pus cultures of the drained abscesses Streptococcus milleri and Escherichia coli were the most commonly isolated pathogens. Presence of S milleri was associated with prolonged hospital stay (13.9 versus 9.0 days, P = .105) and prolonged antibiotic treatment (11.3 versus 4.8 days, P = .203). The incidence of intraabdominal abscesses is high after perforated appendicitis in children (23%). Our data suggest that the presence of S milleri correlates with a more complicated postoperative course after appendectomy in children. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Mechanical Intestinal Obstruction in a Porcine Model: Effects of Intra-Abdominal Hypertension. A Preliminary Study.

    Directory of Open Access Journals (Sweden)

    L Correa-Martín

    Full Text Available Mechanical intestinal obstruction is a disorder associated with intra-abdominal hypertension and abdominal compartment syndrome. As the large intestine intraluminal and intra-abdominal pressures are increased, so the patient's risk for intestinal ischaemia. Previous studies have focused on hypoperfusion and bacterial translocation without considering the concomitant effect of intra-abdominal hypertension. The objective of this study was to design and evaluate a mechanical intestinal obstruction model in pigs similar to the human pathophysiology.Fifteen pigs were divided into three groups: a control group (n = 5 and two groups of 5 pigs with intra-abdominal hypertension induced by mechanical intestinal obstruction. The intra-abdominal pressures of 20 mmHg were maintained for 2 and 5 hours respectively. Hemodynamic, respiratory and gastric intramucosal pH values, as well as blood tests were recorded every 30 min.Significant differences between the control and mechanical intestinal obstruction groups were noted. The mean arterial pressure, cardiac index, dynamic pulmonary compliance and abdominal perfusion pressure decreased. The systemic vascular resistance index, central venous pressure, pulse pressure variation, airway resistance and lactate increased within 2 hours from starting intra-abdominal hypertension (p<0.05. In addition, we observed increased values for the peak and plateau airway pressures, and low values of gastric intramucosal pH in the mechanical intestinal obstruction groups that were significant after 3 hours.The mechanical intestinal obstruction model appears to adequately simulate the pathophysiology of intestinal obstruction that occurs in humans. Monitoring abdominal perfusion pressure, dynamic pulmonary compliance, gastric intramucosal pH and lactate values may provide insight in predicting the effects on endorgan function in patients with mechanical intestinal obstruction.

  10. Correlation between intra-abdominal pressure and pulmonary volumes after superior and inferior abdominal surgery

    Directory of Open Access Journals (Sweden)

    Roberto de Cleva

    2014-07-01

    Full Text Available OBJECTIVE:Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior.METHODS:We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique.RESULTS:The mean age of the patients was 56±13 years, and 41.6% 25 were female; 50 patients (83.3% had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior. The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6±0.6 L and FVC (2.0±0.7 L with maintenance of FEV1/FVC of 0.8±0.2 in both groups. The maximum intra-abdominal pressure values were similar (p= 0.59 for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed.CONCLUSIONS:Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery.

  11. Streptococcus milleri and Recurrent Intra-Abdominal Abscesses: A Case Report and Literature Review.

    Science.gov (United States)

    Gana, Tabitha M; Awolaran, Olugbenga; Akhtar, Sobia

    2016-01-01

    We report a case of recurrent intra-abdominal abscesses as a postoperative complication following diverticular perforation in which Streptococcus milleri (SM) was isolated. SM is evaluated here as a potent pyogenic organism commonly associated with intra-abdominal abscess especially in the postoperative setting. With the commonly adopted conservative management, the challenges of recurrence and prolonged hospital stay experienced in the indexed case as well as many other previous reports are highlighted. We also present a recommendation of the need for a more intensive approach of SM-related abscess drainage along with areas that would benefit further research.

  12. Streptococcus milleri and Recurrent Intra-Abdominal Abscesses: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Tabitha M. Gana

    2016-01-01

    Full Text Available We report a case of recurrent intra-abdominal abscesses as a postoperative complication following diverticular perforation in which Streptococcus milleri (SM was isolated. SM is evaluated here as a potent pyogenic organism commonly associated with intra-abdominal abscess especially in the postoperative setting. With the commonly adopted conservative management, the challenges of recurrence and prolonged hospital stay experienced in the indexed case as well as many other previous reports are highlighted. We also present a recommendation of the need for a more intensive approach of SM-related abscess drainage along with areas that would benefit further research.

  13. [Antimicrobial treatment of nosocomial intra-abdominal infections--new treatment options with tygecycline].

    Science.gov (United States)

    Vyhnánek, F; Adámková, V; Duchác, V; Teplan, V; Jirásek, T

    2009-09-01

    Nosocomial, intra-abdominal infections are extremely serious conditions, considering possibilities for their early diagnosis, as well as for their effective therapy. Multiresistant bacteria (Enterobacteriacae producing extended-spectrum beta-lactamases - ESBL Escherichia coli, Klebsiella species, vancomycin-resistant enterococci [VRE], and methicillin-resistant Staphylococcus aureus [MRSA]) are frequently isolated as pathogens of these infections. Tygecycline is among the novel wide- spectrum antibiotics affecting multiresistant bacteria, which are being introduced in clinical practice. The aim of this study is to assess actual sensitivity of tygecycline to the commonest pathogens of intra-abdominal infections, generated in hospitalized surgical patients. Based on the sensitivity tests, tygecycline was indicated for targeted antibiotic therapy in intraabdominal infections. Sensitivity to tygecycline, aminopenicillins, fluorochinoloni and gentamycine was established for the following bacteria: Escherichia coli, Klebsiella pneumonie, Enterobacter cloacea, Proteus mirabilis. Sensitivity to oxacillin, clincamycine and tygecycline was tested in Staphylococcus aureus, and to fluorochinolini, gentamycine and tygecycline in Enterococcus faecalis, and to fluorochinoloni, gentamycine, ceftazidime and gentamycine in Pseudomonas aeruginosa. Based on the sensitivity results, tygecycline was administered in two patients with postsurgical intra-abdominal infections caused by ESBL Escherichia coli and Klebsiella pneumonie. The initital dose of tygecycline was 100 mg i.v., followed by tygecycline 50 mg i.v. every 12 hours for 7 days. The isolated bacteria showed 98-100% sensitivity to tygecycline, except Psudomonas aeruginosa, where 100% resistance was demonstrated. Targeted antimicrobial medication with tygecycline proved effective in postoperative nosocomial intra-abdominal infections, the both concerned patients recovered. The choice of antimicrobial medication in nosocomial

  14. Interaction between intra-abdominal pressure and positive-end expiratory pressure

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    Jamili Anbar Torquato

    2009-02-01

    Full Text Available OBJECTIVE: The aim of this study was to quantify the interaction between increased intra-abdominal pressure and Positive-End Expiratory Pressure. METHODS: In 30 mechanically ventilated ICU patients with a fixed tidal volume, respiratory system plateau and abdominal pressure were measured at a Positive-End Expiratory Pressure level of zero and 10 cm H2O. The measurements were repeated after placing a 5 kg weight on the patients' belly. RESULTS: After the addition of 5 kg to the patients' belly at zero Positive-End Expiratory Pressure, both intra-abdominal pressure (p<0.001 and plateau pressures (p=0.005 increased significantly. Increasing the Positive-End Expiratory Pressure levels from zero to 10 cm H2O without weight on the belly did not result in any increase in intra-abdominal pressure (p=0.165. However, plateau pressures increased significantly (p< 0.001. Increasing Positive-End Expiratory Pressure from zero to 10 cm H2O and adding 5 kg to the belly increased intra-abdominal pressure from 8.7 to 16.8 (p<0.001 and plateau pressure from 18.26 to 27.2 (p<0.001. Maintaining Positive-End Expiratory Pressure at 10 cm H2O and placing 5 kg on the belly increased intra-abdominal pressure from 12.3 +/- 1.7 to 16.8 +/- 1.7 (p<0.001 but did not increase plateau pressure (26.6+/-1.2 to 27.2 +/-1.1 -p=0.83. CONCLUSIONS: The addition of a 5kg weight onto the abdomen significantly increased both IAP and the airway plateau pressure, confirming that intra-abdominal hypertension elevates the plateau pressure. However, plateau pressure alone cannot be considered a good indicator for the detection of elevated intra-abdominal pressure in patients under mechanical ventilation using PEEP. In these patients, the intra-abdominal pressure must also be measured.

  15. Effect of exercise training on in vivo lipolysis in intra-abdominal adipose tissue in rats

    DEFF Research Database (Denmark)

    Enevoldsen, L H; Stallknecht, B; Fluckey, J D

    2000-01-01

    Intra-abdominal obesity is associated with cardiovascular disease and non-insulin-dependent diabetes mellitus, and physical training has been suggested to alleviate these conditions. We compared epinephrine-stimulated lipolysis in vivo in three intra-abdominal adipose tissues (ATs: retroperitoneal......, parametrial, and mesenteric) and in subcutaneous AT, and we also studied the effect of physical training. Moreover, we studied the effect of physical training on epinephrine-stimulated lipolysis in muscle in vivo. Female rats were either swim trained (15 wk, n = 8) or sedentary (n = 7). Under anesthesia......: 73 +/- 12 (trained) vs. 14 +/- 4 (sedentary) ml. 100 g(-1). min(-1), P

  16. Effect of intra-abdominal volume increment technique for the treatment of intra-abdominal hypertension on the liver after resuscitation of hemorrhagic shock in pig

    Directory of Open Access Journals (Sweden)

    Zheng-gang WANG

    2012-02-01

    Full Text Available Objective  To observe the effect of vacuum sealing drainage (VSD assisted intra-abdominal volume increment (IAVI technique on the liver in the treatment of intra-abdominal hypertension (IAH following hemorrhagic shock resuscitation in pigs. Methods  Twelve healthy mini-pigs (Bama, Guangxi were selected for bloodletting from the femoral artery to reproduce hemorrhagic shock model (mean arterial blood pressure, 50mmHg, 1h, and IAH model was successfully reproduced in eight pigs by partial occlusion of portal vein. The eight pigs were randomly divided into the intra-abdominal volume increment treatment (IT group (n=4 and sham operation control (SC group (n=4. Vesical pressure (VP and inferior vena cava pressure (IVCP were observed before shock, 2h after IAH, and 22h after IAVI treatment. Aspartate aminotransferase (AST and alanine aminotransferase (ALT were measured. In addition, the ratio of the abdominal anteroposterior diameter to the transverse diameter was assessed, and the liver CT values were measured after enhanced CT scanning. The pigs were sacrificed 26h after operation. Liver specimens were collected to measure the ratio of wet weight to dry weight and pathological examination. Results  The VP in 8 IAH pigs was 21.16±4.63mmHg. The ratio of abdominal anteroposterior diameter to the transverse diameter increased remarkably 2h after IAH compared with that before shock (1.22±1.41 vs 0.96±0.08, PPvs 42.73±4.92HU, PPPvs 5.14±0.71, PConclusions  The established model could better reproduce the symptoms of IAH after hemorrhagic shock and fluid resuscitation, accompanied by liver damage. IAVI helps to relieve liver functional disturbance after IAH, which is related to decreased intra-abdominal pressure and hypoxia-ischemia of the liver.

  17. Pirfenidone vs. sodium hyaluronate/carboxymethylcellulose as prevention of the formation of intra-abdominal adhesions after colonic surgery. A randomized study in an experimental model.

    Science.gov (United States)

    Bello-Guerrero, Jorge Alberto; Cruz-Santiago, César Alberto; Luna-Martínez, Javier

    2016-01-01

    Up to 93% of patients undergoing abdominal surgery will develop intra-abdominal adhesions with the subsequent morbidity that they represent. Various substances have been tested for the prevention of adhesions with controversial results; the aim of our study is to compare the capability of pirfenidone in adhesion prevention against sodium hyaluronate/carboxymethylcellulose. A randomized, prospective, longitudinal experimental study with Winstar rats. They were divided into 3 groups. The subjects underwent an exploratory laparotomy and they had a 4cm(2) cecal abrasion. The first group received saline on the cecal abrasion, and groups 2 and 3 received pirfenidone and sodium hyaluronate/carboxymethylcellulose respectively. All rats were sacrificed on the 21st day after surgery and the presence of adhesions was evaluated with the modified Granat scale. Simple frequency, central tendency and dispersion measures were recorded. For the statistical analysis we used Fisher's test. To evaluate adhesions we used the Granat's modified scale. The control group had a median adhesion formation of 3 (range 0-4). The pirfenidone group had 1.5 (range 0-3), and the sodium hyaluronate/carboxymethylcellulose group had 0 (range 0-1). There was a statistically significant difference to favor sodium hyaluronate/carboxymethylcellulose against saline and pirfenidone (Phyaluronate/carboxymethylcellulose is effective for the prevention of intra-abdominal adhesions. More experimental studies are needed in search for the optimal adhesion prevention drug. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Iatrogenic syringomyelia secondary to lumboperitoneal shunt altered by the raised intra-abdominal pressure of pregnancy.

    Science.gov (United States)

    Kersey, James; Cato-Addison, William; Holliman, Damian

    2017-03-06

    We report a case of a 37 year old female with syringomyelia secondary to lumboperitoneal (LP) shunt. Syrinx regression occurred with raised intra-abdominal pressure due to pregnancy and subsequently redeveloped after parturition. To our knowledge a case of pregnancy associated syringomyelia regression has not been previously reported.

  19. Waist circumference adjusted for body mass index and intra-abdominal fat mass

    DEFF Research Database (Denmark)

    Berentzen, Tina Landsvig; Ängquist, Lars; Kotronen, Anna

    2012-01-01

    The association between waist circumference (WC) and mortality is particularly strong and direct when adjusted for body mass index (BMI). One conceivable explanation for this association is that WC adjusted for BMI is a better predictor of the presumably most harmful intra-abdominal fat mass (IAFM...

  20. Functional cine MR imaging for the detection and mapping of intraabdominal adhesions: method and surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Buhmann-Kirchhoff, Sonja; Reiser, Maximilian; Lienemann, Andreas [University Hospital Grosshadern, Ludwig-Maximilians-University Munich, Department of Clinical Radiology, Munich (Germany); Lang, Reinhold; Steitz, Heinrich O.; Jauch, Karl W. [University Hospital Munich-Grosshadern, Department of Surgery, Munich (Germany); Kirchhoff, Chlodwig [University Hospital Munich-Innenstadt, Department of Surgery, Munich (Germany)

    2008-06-15

    The purpose of this study was to evaluate the presence and localization of intraabdominal adhesions using functional cine magnetic resonance imaging (MRI) and to correlate the MR findings with intraoperative results. In a retrospective study, patients who had undergone previous abdominal surgery with suspected intraabdominal adhesions were examined. A true fast imaging with steady state precession sequence in transverse/sagittal orientation was used for a section-by-section dynamic depiction of visceral slide on a 1.5-Tesla system. After MRI, all patients underwent anew surgery. A nine-segment abdominal map was used to document the location and type of the adhesions. The intraoperative results were taken as standard of reference. Ninety patients were enrolled. During surgery 71 adhesions were detected, MRI depicted 68 intraabdominal adhesions. The most common type of adhesion in MRI was found between the anterior abdominal wall and small bowel loops (n = 22, 32.5%) and between small bowel loops and pelvic organs (n = 14, 20.6%). Comparing MRI with the intraoperative findings, sensitivity varied between 31 and 75% with a varying specificity between 65 and 92% in the different segments leading to an overall MRI accuracy of 89%. Functional cine MRI proved to be a useful examination technique for the identification of intraabdominal adhesions in patients with acute or chronic pain and corresponding clinical findings providing accurate results. However, no differentiation for symptomatic versus asymptomatic adhesions is possible. (orig.)

  1. Management of intra-abdominal hypertension and abdominal compartment syndrome: a review

    Science.gov (United States)

    2014-01-01

    Patients in the intensive care unit (ICU) are at risk of developing of intra abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Aim: This review seeks to define IAH and ACS, identify the aetiology and presentation of IAH and ACS, identify IAP measurement techniques, identify current management and discuss the implications of IAH and ACS for nursing practice. A search of the electronic databases was supervised by a health librarian. The electronic data bases Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, EMBASE, and the World Wide Web was undertaken from 1996- January 2011 using MeSH and key words which included but not limited to: abdominal compartment syndrome, intra -abdominal hypertension, intra-abdominal pressure in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool. Data derived from the retrieved material are discussed under the following themes: (1) etiology of intra-abdominal hypertension; (2) strategies for measuring intra-abdominal pressure (3) the manifestation of abdominal compartment syndrome; and (4) the importance of nursing assessment, observation and interventions. Intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have the potential to alter organ perfusion and compromise organ function. PMID:24499574

  2. Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis

    NARCIS (Netherlands)

    Smit, M.; Buddingh, K. T.; Bosma, B.; Nieuwenhuijs, V. B.; Hofker, H. S.; Zijlstra, J. G.

    Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS, in

  3. Laparoscopic evaluation of testicular mobility as a guide to management of intra-abdominal testes.

    Science.gov (United States)

    Banieghbal, B; Davies, M

    2003-05-01

    The optimal management of intra-abdominal testes is the subject of an ongoing debate as the result of widespread use of laparoscopy since early 1990's. A simple laparoscopic technique uses cord mobility to act as a guide to cord length and therefore predict the success of a conventional orchidopexy in cases of true intra-abdominal testes. In the technique described, the testis is displaced by stretching the testes to overly the opposite internal inguinal ring. Over a 3-year period, a total of 36 boys with 38 intra-abdominal testes, confirmed laparoscopically, were prospectively assessed. The reported "stretching maneuver" was carried out in all cases. Successful conventional orchidopexy as predicted by a positive stretch maneuver was carried out in 20 testes. When the stretch maneuver failed, conventional 2-stage open operation was done in 3 patients and Fowler-Stephens orchidopexies for the remaining 13 children. A simple test determining testicular mobility assessed during laparoscopic evaluation of intra-abdominal testes provides information of significant importance upon which the correct surgical approach can be based.

  4. Diagnostic yield of EUS-guided FNA and cytology in suspected tubercular intra-abdominal lymphadenopathy

    DEFF Research Database (Denmark)

    Puri, Rajesh; Mangla, Rakhee; Eloubeidi, Mohamad

    2012-01-01

    Intra-abdominal lymphadenopathy is a common diagnostic challenge faced by clinicians. In the absence of palpable peripheral nodes, tissue is usually obtained from the abdominal nodes by image-guided biopsy or surgery. We speculate that EUS-guided FNA (EUS-FNA) avoids the morbidity of a laparotomy...

  5. The effect of intra-abdominal hypertension on gastro-intestinal function

    African Journals Online (AJOL)

    To evaluate the impact of raised intra-abdominal pressure (IAP) on GI function and success of enteral nutrition support in an adult intensive care unit (ICU) population at risk of abdominal compartment syndrome (ACS). Methods. In a prospective observational study, critically ill patients in whom the IAP was monitored ...

  6. Wireless system for monitoring Intra-abdominal pressure in patient with severe abdominal pathology

    Science.gov (United States)

    Sokolovskiy, S. S.; Shtotskiy, Y. V.; Leljanov, A. D.

    2017-01-01

    The paper discusses an experimental design of the wireless system for monitoring intra-abdominal pressure (IAP) using Bluetooth Low Energy technology. The possibility of measuring IAP via the bladder using a wireless pressure sensor with a hydrophobic bacteria filter between the liquid transmitting medium and the sensor element is grounded.

  7. Deep neuromuscular blockade leads to a larger intraabdominal volume during laparoscopy

    DEFF Research Database (Denmark)

    Lindekaer, Astrid Listov; Halvor Springborg, Henrik; Istre, Olav

    2013-01-01

    for measuring the intra-abdominal space available to the surgeon during laproscopy, in order to examine whether the relaxation produced by deep neuromuscular blockade can increase the working surgical space sufficiently to permit a reduction in the CO2 insufflation pressure. Using the laproscopic grasper...

  8. Validation of the urine column measurement as an estimation of the intra-abdominal pressure.

    NARCIS (Netherlands)

    Steeg, H.J.J. van der; Akkeren, J.P. van; Houterman, S.; Roumen, R.M.H.

    2009-01-01

    OBJECTIVE: To evaluate the efficacy of the urine column (UC) measurement compared to the intra-vesicular pressure (IVP) measurement as an estimation of intra-abdominal pressure (IAP) in patients with IAP up to 30 mmHg. METHODS: Fifteen patients undergoing a laparoscopic cholecystectomy were studied.

  9. Intra-abdominal Migration of a Lag Screw in Gamma Nailing: Report of a Case

    NARCIS (Netherlands)

    Heineman, D.J.; van Buijtenen, J.M.; Heuff, G.; Derksen, E.J.; Pöll, R.G.

    2010-01-01

    An 83-year-old female patient was referred to the emergency room with progressive pain on mobilization. Three weeks before presentation, she had been treated with a gamma nail for an unstable right intertrochanteric fracture. Pelvic X-ray showed an intra-abdominally migrated lag screw. No evidence

  10. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

    NARCIS (Netherlands)

    Sartelli, M.; Weber, D.G.; Ruppe, E.; Bassetti, M.; Wright, B.J.; Ansaloni, L.; Catena, F.; Coccolini, F.; Abu-Zidan, F.M.; Coimbra, R.; Moore, E.E.; Moore, F.A.; Maier, R.V.; Waele, J.J. De; Kirkpatrick, A.W.; Griffiths, E.A.; Eckmann, C.; Brink, A.J.; Mazuski, J.E.; May, A.K.; Sawyer, R.G.; Mertz, D.; Montravers, P.; Kumar, A.; Roberts, J.A.; Vincent, J.L.; Watkins, R.R.; Lowman, W.; Spellberg, B.; Abbott, I.J.; Adesunkanmi, A.K.; Al-Dahir, S.; Al-Hasan, M.N.; Agresta, F.; Althani, A.A.; Ansari, S.; Ansumana, R.; Augustin, G.; Bala, M.; Balogh, Z.J.; Baraket, O.; Bhangu, A.; Beltran, M.A.; Bernhard, M.; Biffl, W.L.; Boermeester, M.A.; Brecher, S.M.; Cherry-Bukowiec, J.R.; Buyne, O.R.; Cainzos, M.A.; Cairns, K.A.; Camacho-Ortiz, A.; Chandy, S.J.; Jusoh, A. Che; Chichom-Mefire, A.; Colijn, C.; Corcione, F.; Cui, Y.; Curcio, D.; Delibegovic, S.; Demetrashvili, Z.; Simone, B. De; Dhingra, S.; Diaz, J.J.; Carlo, I. Di; Dillip, A.; Saverio, S. Di; Doyle, M.P.; Dorj, G.; Dogjani, A.; Dupont, H.; Eachempati, S.R.; Enani, M.A.; Egiev, V.N.; Elmangory, M.M.; Ferrada, P.; Fitchett, J.R.; Fraga, G.P.; Guessennd, N.; Giamarellou, H.; Ghnnam, W.; Gkiokas, G.; Goldberg, S.R.; Gomes, C.A.; Gomi, H.; Guzman-Blanco, M.; Haque, M.; Hansen, S.; Hecker, A.; Heizmann, W.R.; Herzog, T.; Hodonou, A.M.; Hong, S.K.; Kafka-Ritsch, R.; Kaplan, L.J.; Kapoor, G.; Karamarkovic, A.; Kees, M.G.; Kenig, J.; Kiguba, R.

    2016-01-01

    Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric

  11. Effect of Resveratrol on the Prevention of Intra-Abdominal Adhesion Formation in a Rat Model

    Directory of Open Access Journals (Sweden)

    Guangbing Wei

    2016-06-01

    Full Text Available Background: Intra-abdominal adhesions are a very common complication following abdominal surgery. Our previous studies have demonstrated that the inhibition of inflammation at the sites of peritoneal injury can prevent the formation of intra-abdominal adhesions. Resveratrol is a natural extract with a broad range of anti-inflammatory effects. Therefore, we propose that resveratrol can reduce the formation of intra-abdominal adhesions after surgery. The aim of this study was to investigate the effect of resveratrol on intra-abdominal adhesion prevention in a rat model with surgery-induced peritoneal adhesions. Materials and Methods: The cecum wall and its opposite parietal peritoneum were abraded following laparotomy to induce intra-abdominal adhesion formation. Varying doses of resveratrol were administered to the animals. On the eighth day after surgery, the adhesion score was assessed using a visual scoring system. Picrosirius red staining and a hydroxyproline assay were used to assess the amount of collagen deposition in the adhesion tissues. The levels of serum interleukin-6 (IL-6, tumor necrosis factor (TNF-α, and transforming growth factor beta-1 (TGF-β1 were determined by an enzyme-linked immunosorbent assay (ELISA. Western blotting was performed to determine the protein expression of TGF-β1, fibrinogen, and α-smooth muscle actin (α-SMA in rat peritoneal adhesion tissue. Real-time RT-PCR was performed to quantify the mRNA expression of TGF-β1, fibrinogen, and α-SMA. Results: Resveratrol significantly reduced intra-abdominal adhesion formation and fibrin deposition in the rat model. Furthermore, resveratrol significantly reduced the serum levels of IL-6, TNF-α, and TGF-β1. The protein and mRNA expression of TGF-β1, fibrinogen, and α-SMA in the rat peritoneum and adhesion tissues were also down-regulated due to resveratrol intervention. Conclusion: Resveratrol can effectively prevent the formation of postoperative intra-abdominal

  12. Fatal intra-abdominal hemorrhage as a result of avulsion of the gallbladder: A postmortem case report

    Directory of Open Access Journals (Sweden)

    Akihito Usui

    2013-03-01

    Full Text Available Gallbladder injuries are extremely rare in blunt trauma, with a reported incidence of <2%. We report an autopsy case of fatal hemorrhagic shock due to intra-abdominal bleeding resulting from complete avulsion of the gallbladder associated with liver cirrhosis. Multiplanar images derived from multislice computed tomography (MSCT performed as part of pre-autopsy screening showed complete avulsion of the gallbladder without any other associated intra-abdominal injuries, facilitating forensic autopsy planning. In this report, we discuss the role of MSCT in cases of fatal intra-abdominal bleeding caused by avulsion of the gallbladder and discuss the mechanism of this injury.

  13. Accuracy of physical and ultrasonographic examinations by emergency physicians for the early diagnosis of intraabdominal haemorrhage in blunt abdominal trauma.

    Science.gov (United States)

    Soyuncu, S; Cete, Y; Bozan, H; Kartal, M; Akyol, A J

    2007-05-01

    To determine the accuracy of physical examination and ultrasonographic evaluation performed by emergency physicians in cases of blunt abdominal trauma for the early diagnosis of intraabdominal haemorrhage. In this clinical prospective study, trauma patients were evaluated with four-quadrant ultrasonography by emergency physicians after initial stabilisation and physical examination. Diagnoses based on demographic data, physical examination and emergency physician's ultrasonography were compared with the subsequent clinical course. A total of 442 patients participated in the study. The sensitivity and specificity of emergency physician's ultrasonographic examination to detect intraabdominal haemorrhage were 86 and 99%, respectively. Pre-test sensitivity and specificity of physical examination to detect intraabdominal haemorrhage were 39 and 90%, respectively. Physical examination was not a reliable method to detect intraabdominal haemorrhage in cases of blunt abdominal trauma. In contrast, abdominal ultrasonography performed by emergency physicians was a reliable diagnostic tool. Emergency physicians should be familiar with abdominal ultrasonographic examination, which should be routine in cases of blunt abdominal trauma.

  14. The Incidence, Clinical Outcomes, and Risk Factors of Thrombocytopenia in Intra-Abdominal Infection Patients: A Retrospective Cohort Study

    Science.gov (United States)

    Wu, Qin; Ren, Jianan; Wang, Gefei; Li, Guanwei; Gu, Guosheng; Wu, Xiuwen; Li, Yuan; Chen, Jun; Zhao, Yunzhao; Li, Jieshou

    2016-01-01

    Background Studies on the incidence and risk factors of thrombocytopenia among intra-abdominal infection patients remain absent, hindering efficacy assessments regarding thrombocytopenia prevention strategies. Methods We retrospectively studied 267 consecutively enrolled patients with intra-abdominal infections. Occurrence of thrombocytopenia was scanned for all patients. All-cause 28-day mortality was recorded. Variables from univariate analyses that were associated with occurrence of hospital-acquired thrombocytopenia were included in a multivariable logistic regression analysis to determine thrombocytopenia predictors. Results Median APACHE II score and SOFA score of the whole cohort was 12 and 3 respectively. The overall ICU mortality was 7.87% and the 28-day mortality was 8.98%. The incidence of thrombocytopenia among intra-abdominal infection patients was 21.73%. Regardless of preexisting or hospital-acquired one, thrombocytopenia is associated with an increased ICU mortality and 28-day mortality as well as length of ICU or hospital stay. A higher SOFA and ISTH score at admission were significant hospital-acquired thrombocytopenia risk factors. Conclusions This is the first study to identify a high incidence of thrombocytopenia in patients with intra-abdominal infections. Our findings suggest that the inflammatory milieu of intra-abdominal infections may uniquely predispose those patients to thrombocytopenia. More effective thrombocytopenia prevention strategies are necessary in intra-abdominal infection patients. PMID:26808492

  15. Intra-abdominal pectus bar migration – a rare clinical entity: case report

    Directory of Open Access Journals (Sweden)

    Athanasiou Thanos

    2008-07-01

    Full Text Available Abstract We present the case of a 20-year-old male who underwent successful surgical correction of pectus excavatum with the Highly Modified Ravitch Repair (HMRR. At 29 months the attempted operative removal of the Ravitch bar was unsuccessful despite the impression of adequate bar location on chest x-ray. Subsequent imaging with computed tomography was unclear in determining whether the bar was supra or infra-diaphragmatic due to the tissue distortion subsequent to initial surgery. Video assisted thoracoscopic surgery (VATS successfully retrieved the bar and revealed that it was not in the thorax, but had migrated to the intra-abdominal bare area of the liver, with no evidence of associated diaphragmatic defect or hernia. Intra-abdominal pectus bar migration is a rare clinical entity, and safe removal can be facilitated by the use of the VATS technique.

  16. Common errors in the treatment of intra-abdominal infections: the irrational use of antimicrobial agents

    Directory of Open Access Journals (Sweden)

    Belinda De Simone

    2016-06-01

    Full Text Available Antimicrobial resistance (AR is a global, emergent problem because an increasing numbers of serious community acquired and nosocomial infections are caused by resistant bacterial pathogens. It is a direct consequence of the excessive and irrational use of antibiotics. The use of antimicrobial agents – aimed to decrease morbidity and mortality rate related to intra-abdominal infections – is very high, often improper, in the Departments of General and Emergency Surgery and Intensive Cure Units. Source control and empiric antibiotic therapy have to be administrated as early as possible to decrease high mortality rates in patients with severe sepsis or septic shock and, in this, the general surgeon has a crucial role. Proper antimicrobial stewardship in selecting an appropriate antibiotic and optimizing its dose and duration to cure intraabdominal infections may prevent the emergence of AR and decrease costs for antibiotics.

  17. Acute Abdomen Due to Uncontrolled Use of Warfarin: Spontaneous Intra-abdominal

    Directory of Open Access Journals (Sweden)

    Fatih Dal

    2017-12-01

    Full Text Available Warfarin is an oral anticoagulant, which is commonly used in the treatment and prophylaxis of thromboembolic conditions. Bleeding is the primary adverse effect associated with warfarin. The majority of warfarin-related bleedings are spontaneous minor hemorrhages occurring in the subcutaneous or intramuscular tissues and can be treated by decreasing the dose of oral anticoagulants. However, although rare, it is possible to encounter spontaneous major bleedings with increased risk of mortality. Conservative approach is the preferred initial therapy for hemodynamically stable patients with major intra-abdominal hemorrhages that we define as the intermediate group patients. Nevertheless, surgery is required for hemodynamically unstable patients with acute abdominal pain in cases of ongoing active hemorrhage, generalized peritonitis, obstruction, acute abdomen, intestinal ischemia, and perforation. In this article, we present a rare case of acute abdomen and spontaneous intra-abdominal hemorrhage resulting from uncontrolled use of warfarin and a new classification requirement.

  18. Nodular intra-abdominal panniculitis: an accompaniment of colorectal carcinoma and diverticular disease

    DEFF Research Database (Denmark)

    Bak, Martin

    1996-01-01

    Intra-abdominal panniculitis is a tumour-like inflammatory condition of adipose tissue. The aetiology and pathogenesis of the disease is unknown, but a number of associated diseases have been recorded. It has been customary to deal with only primary cases in the literature. This study was underta....... Primary diseases involved are, among others, colorectal carcinoma and diverticulosis. The aetiologic agent(s) are still unknown, but substances liberated from a damaged bowel might play a pathogenetic role....

  19. Severity and treatment of "occult" intra-abdominal injuries in blunt trauma victims.

    Science.gov (United States)

    Parreira, José G; Oliari, Camilla B; Malpaga, Juliano M D; Perlingeiro, Jacqueline A G; Soldá, Silvia C; Assef, José C

    2016-01-01

    to assess the severity and treatment of "occult" intra-abdominal injuries in blunt trauma victims. Retrospective analysis of charts and trauma register data of adult blunt trauma victims, admitted without abdominal pain or alterations in the abdominal physical examination, but were subsequently diagnosed with intra-abdominal injuries, in a period of 2 years. The severity was stratified according to RTS, AIS, OIS and ISS. The specific treatment for abdominal injuries and the complications related to them were assessed. Intra-abdominal injuries were diagnosed in 220 (3.8%) out of the 5785 blunt trauma victims and 76 (34.5%) met the inclusion criteria. The RTS and ISS median (lower quartile, upper quartile) were 7.84 (6.05, 7.84) and 25 (16, 34). Sixty seven percent had a GCS≥13 on admission. Injuries were identified in the spleen (34), liver (33), kidneys (9), intestines (4), diaphragm (3), bladder (3) and iliac vessels (1). Abdominal injuries scored AIS≥3 in 67% of patients. Twenty-one patients (28%) underwent laparotomy, 5 of which were nontherapeutic. The surgical procedures performed were splenectomy (8), suturing of the diaphragm (3), intestines (3), bladder (2), kidneys (1), enterectomy/anastomosis (1), ligation of the common iliac vein (1), and revascularization of the common iliac artery (1). Angiography and embolization of liver and/or spleen injuries were performed in 3 cases. Three patients developed abdominal complications, all of which were operatively treated. There were no deaths directly related to the abdominal injuries. Severe "occult" intra-abdominal injuries, requiring specific treatment, may be present in adult blunt trauma patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Hypothermia Increases Tissue Plasminogen Activator Expression and Decreases Post-Operative Intra-Abdominal Adhesion

    OpenAIRE

    Lee, Meng-Tse Gabriel; Lee, Chien-Chang; Wang, Hsuan-Mao; Chou, Tzung-Hsin; Wu, Meng-Che; Hsueh, Kuang-Lung; Chen, Shyr-Chyr

    2016-01-01

    Background Therapeutic hypothermia during operation decreases postoperative intra-abdominal adhesion formation. We sought to determine the most appropriate duration of hypothermia, and whether hypothermia affects the expression of tissue plasminogen activator (tPA). Methods 80 male BALB/c mice weighing 25?30 g are randomized into one of five groups: adhesion model with infusion of 15?C saline for 15 minutes (A); 30 minutes (B); 45 minute (C); adhesion model without infusion of cold saline (D)...

  1. A soluble suppressor T cell factor protects against experimental intraabdominal abscesses.

    OpenAIRE

    Zaleznik, D F; Finberg, R W; Shapiro, M E; Onderdonk, A B; Kasper, D L

    1985-01-01

    This paper describes a suppressor T cell factor which protects mice against intraabdominal abscesses caused by Bacteroides fragilis. This soluble cell-free factor (ITF) is derived from splenic T cells from mice immunized with capsular polysaccharide (CP) of B. fragilis. Mice receiving ITF are protected from developing abscesses caused by B. fragilis to the same degree as animals receiving intact immune splenic T cells. The factor appears to be small in molecular size as protective activity is...

  2. A Large Intra-Abdominal Hiatal Hernia as a Rare Cause of Dyspnea

    Science.gov (United States)

    Sahin, Cem; Akın, Fatih; Cullu, Nesat; Özseker, Burak; Kirli, İsmail; Altun, İbrahim

    2015-01-01

    Giant hiatal hernias, generally seen at advanced ages, can rarely cause cardiac symptoms such as dyspnea and chest pain. Here, we aimed to present a case with a large hiatal hernia that largely protruded to intrathoracic cavity and caused dyspnea, particularly at postprandial period, by compressing the left atrium and right pulmonary vein. We considered presenting this case as large hiatal hernia is a rare, intra-abdominal cause of dyspnea. PMID:26229693

  3. A Large Intra-Abdominal Hiatal Hernia as a Rare Cause of Dyspnea

    Directory of Open Access Journals (Sweden)

    Cem Sahin

    2015-01-01

    Full Text Available Giant hiatal hernias, generally seen at advanced ages, can rarely cause cardiac symptoms such as dyspnea and chest pain. Here, we aimed to present a case with a large hiatal hernia that largely protruded to intrathoracic cavity and caused dyspnea, particularly at postprandial period, by compressing the left atrium and right pulmonary vein. We considered presenting this case as large hiatal hernia is a rare, intra-abdominal cause of dyspnea.

  4. Minimal Invasive Cystometry and Intra-Abdominal Pressure Assessments in Rodents: A Novel Animal Study

    OpenAIRE

    Yang, Yafei; Yang, Jin; Chen, Lin; Hu, Jianyun; Xing, Shasha; Amend, Bastian; Stenzl,Arnulf; Wei, Xin; Hu, Haifeng

    2017-01-01

    Background The abdominal straining pattern can act as a novel parameter for improving the prediction of bladder outlet obstruction (BOO). To preserve detrusor function in the early stage of urinary system impairment, such as BOO, we establish a novel method for cystometry and Intra-abdominal pressure (IAP) assessments in rodents without cystostomy. Material/Methods Twenty mice and rats were divided into three groups (control, sham-operated and BOO group) respectively. The cystometry and IAP a...

  5. The effect of body position on compartmental intra-abdominal pressure following liver transplantation

    OpenAIRE

    Cresswell, Adrian B; Jassem, Wayel; Srinivasan, Parthi; Andreas A Prachalias; Sizer, Elizabeth; Burnal, William; Auzinger, Georg; Muiesan, Paolo; Rela, Mohammed; Heaton, Nigel D; Bowles, Matthew J.; Wendon, Julia A

    2012-01-01

    Background Current assumptions rely on intra-abdominal pressure (IAP) being uniform across the abdominal cavity. The abdominal contents are, however, a heterogeneous mix of solid, liquid and gas, and pressure transmission may not be uniform. The current study examines the upper and lower IAP following liver transplantation. Methods IAP was measured directly via intra-peritoneal catheters placed at the liver and outside the bladder. Compartmental pressure data were recorded at 10-min intervals...

  6. Treatment of complicated intra-abdominal infections in the era of multi-drug resistant Bacteria

    Directory of Open Access Journals (Sweden)

    Herzog T

    2010-11-01

    Full Text Available Abstract The management of severe intra-abdominal infections remains a major challenge facing surgeons and intensive care physicians, because of its association with high morbidity and mortality. Surgical management and intensive care medicine have constantly improved, but in the recent years a rapidly continuing emergence of resistant pathogens led to treatment failure secondary to infections with multi-drug resistant bacteria. In secondary peritonitis the rate of resistant germs at the initial operation is already 30%. The lack of effective antibiotics against these pathogens resulted in the development of new broad-spectrum compounds and antibiotics directed against resistant germs. But so far no "super-drug" with efficacy against all resistant bacteria exists. Even more, soon after their approval, reports on resistance against these novel drugs have been reported, or the drugs were withdrawn from the market due to severe side effects. Since pharmaceutical companies reduced their investigations on antibiotic research, only few new antimicrobial derivates are available. In abdominal surgery you may be in fear that in the future more and more patients with tertiary peritonitis secondary to multi-drug resistant species are seen with an increase of mortality after secondary peritonitis. This article reviews the current treatment modalities for complicated intra-abdominal infections with special reference to the antibiotic treatment of complicated intra-abdominal infections with multi-drug resistant species.

  7. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

    Directory of Open Access Journals (Sweden)

    Sartelli Massimo

    2012-11-01

    Full Text Available Abstract The CIAO Study (“Complicated Intra-Abdominal infection Observational” Study is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012. Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs were included in the study. 2,152 patients with a mean age of 53.8 years (range: 4–98 years were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified. The overall mortality rate was 7.5% (163/2.152. According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation, a delayed initial intervention (a delay exceeding 24 hours, sepsis and septic shock in the immediate post-operative period, and ICU admission. Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs throughout Europe.

  8. [Pylephlebitis: a rare but possible complication of intra-abdominal infections].

    Science.gov (United States)

    Pérez-Bru, Susana; Nofuentes-Riera, Carmen; García-Marín, Andrés; Luri-Prieto, Paloma; Morales-Calderón, Miguel; García-García, Salvador

    2015-01-01

    Pylephlebitis or septic thrombophlebitis of the portal venous system is a rare but serious complication of intra-abdominal infections which drain into the portal venous system. Its diagnosis is based on clinical suspicion and imaging tests, mainly a computed tomography scan, given the lack of specificity of the signs and symptoms. Spread of septic emboli is the major cause of morbidity and mortality. The aim of the study was to analyse patients diagnosed in our hospital. Retrospective descriptive study of patients diagnosed with pylephlebitis in our hospital. Four patients were included, 3 men and one woman. In 3 cases it was acute cholecystitis that led to the diagnosis of pylephlebitis at the same time as the intra-abdominal infection. Emergency surgery was performed in one case, whilst the other 2 were treated conservatively. Blood cultures were performed in all cases, and empirical antibiotic treatment was used. In the only case of acute appendicitis, diagnosis of pylephlebitis was achieved during the study of postoperative fever, with empirical antibiotic treatment also being started. The haematologist was requested to start the required anticoagulation therapy in all cases. Pylephlebitis is a rare complication of intra-abdominal infections that may make lead to a worse outcome. A high level of suspicion is required as well as imaging tests to make an early diagnosis and appropriate treatment. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  9. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA).

    Science.gov (United States)

    Sartelli, Massimo; Weber, Dieter G; Ruppé, Etienne; Bassetti, Matteo; Wright, Brian J; Ansaloni, Luca; Catena, Fausto; Coccolini, Federico; Abu-Zidan, Fikri M; Coimbra, Raul; Moore, Ernest E; Moore, Frederick A; Maier, Ronald V; De Waele, Jan J; Kirkpatrick, Andrew W; Griffiths, Ewen A; Eckmann, Christian; Brink, Adrian J; Mazuski, John E; May, Addison K; Sawyer, Rob G; Mertz, Dominik; Montravers, Philippe; Kumar, Anand; Roberts, Jason A; Vincent, Jean-Louis; Watkins, Richard R; Lowman, Warren; Spellberg, Brad; Abbott, Iain J; Adesunkanmi, Abdulrashid Kayode; Al-Dahir, Sara; Al-Hasan, Majdi N; Agresta, Ferdinando; Althani, Asma A; Ansari, Shamshul; Ansumana, Rashid; Augustin, Goran; Bala, Miklosh; Balogh, Zsolt J; Baraket, Oussama; Bhangu, Aneel; Beltrán, Marcelo A; Bernhard, Michael; Biffl, Walter L; Boermeester, Marja A; Brecher, Stephen M; Cherry-Bukowiec, Jill R; Buyne, Otmar R; Cainzos, Miguel A; Cairns, Kelly A; Camacho-Ortiz, Adrian; Chandy, Sujith J; Che Jusoh, Asri; Chichom-Mefire, Alain; Colijn, Caroline; Corcione, Francesco; Cui, Yunfeng; Curcio, Daniel; Delibegovic, Samir; Demetrashvili, Zaza; De Simone, Belinda; Dhingra, Sameer; Diaz, José J; Di Carlo, Isidoro; Dillip, Angel; Di Saverio, Salomone; Doyle, Michael P; Dorj, Gereltuya; Dogjani, Agron; Dupont, Hervé; Eachempati, Soumitra R; Enani, Mushira Abdulaziz; Egiev, Valery N; Elmangory, Mutasim M; Ferrada, Paula; Fitchett, Joseph R; Fraga, Gustavo P; Guessennd, Nathalie; Giamarellou, Helen; Ghnnam, Wagih; Gkiokas, George; Goldberg, Staphanie R; Gomes, Carlos Augusto; Gomi, Harumi; Guzmán-Blanco, Manuel; Haque, Mainul; Hansen, Sonja; Hecker, Andreas; Heizmann, Wolfgang R; Herzog, Torsten; Hodonou, Adrien Montcho; Hong, Suk-Kyung; Kafka-Ritsch, Reinhold; Kaplan, Lewis J; Kapoor, Garima; Karamarkovic, Aleksandar; Kees, Martin G; Kenig, Jakub; Kiguba, Ronald; Kim, Peter K; Kluger, Yoram; Khokha, Vladimir; Koike, Kaoru; Kok, Kenneth Y Y; Kong, Victory; Knox, Matthew C; Inaba, Kenji; Isik, Arda; Iskandar, Katia; Ivatury, Rao R; Labbate, Maurizio; Labricciosa, Francesco M; Laterre, Pierre-François; Latifi, Rifat; Lee, Jae Gil; Lee, Young Ran; Leone, Marc; Leppaniemi, Ari; Li, Yousheng; Liang, Stephen Y; Loho, Tonny; Maegele, Marc; Malama, Sydney; Marei, Hany E; Martin-Loeches, Ignacio; Marwah, Sanjay; Massele, Amos; McFarlane, Michael; Melo, Renato Bessa; Negoi, Ionut; Nicolau, David P; Nord, Carl Erik; Ofori-Asenso, Richard; Omari, AbdelKarim H; Ordonez, Carlos A; Ouadii, Mouaqit; Pereira Júnior, Gerson Alves; Piazza, Diego; Pupelis, Guntars; Rawson, Timothy Miles; Rems, Miran; Rizoli, Sandro; Rocha, Claudio; Sakakhushev, Boris; Sanchez-Garcia, Miguel; Sato, Norio; Segovia Lohse, Helmut A; Sganga, Gabriele; Siribumrungwong, Boonying; Shelat, Vishal G; Soreide, Kjetil; Soto, Rodolfo; Talving, Peep; Tilsed, Jonathan V; Timsit, Jean-Francois; Trueba, Gabriel; Trung, Ngo Tat; Ulrych, Jan; van Goor, Harry; Vereczkei, Andras; Vohra, Ravinder S; Wani, Imtiaz; Uhl, Waldemar; Xiao, Yonghong; Yuan, Kuo-Ching; Zachariah, Sanoop K; Zahar, Jean-Ralph; Zakrison, Tanya L; Corcione, Antonio; Melotti, Rita M; Viscoli, Claudio; Viale, Perluigi

    2016-01-01

    Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.

  10. Packing for damage control of nontraumatic intra-abdominal massive hemorrhages.

    Science.gov (United States)

    Filicori, Filippo; Di Saverio, Salomone; Casali, Marco; Biscardi, Andrea; Baldoni, Franco; Tugnoli, Gregorio

    2010-09-01

    The Damage Control Surgery (DCS) approach to massive intraperitoneal hemorrhage has been shown to significantly reduce the morbidity and mortality in severely injured trauma patients. We applied the same principles to patients who developed a massive hemorrhage and the "lethal triad" (acidosis, hypothermia, coagulopathy) during a surgical procedure in order to assess feasibility and efficacy of DCS on nontraumatic grounds. A retrospective analysis of eight consecutive cases was performed aimed at collecting information on laboratory parameters, fluids requirements, operative times, APACHE II score, damage control surgery procedure, angioembolization, morbidity, mortality, and need for repacking. Average APACHE II score was 25.5 (predicted mortality rate = 54%); overall and early mortality in the nontraumatic group was nil, while the intra-abdominal septic (packing-related) complication rate was 12.5%. Intra-abdominal packing was shown to be feasible, safe, and effective for patients with intra-abdominal nontraumatic massive hemorrhage, and the application of the principles of DCS may improve survival in cases of surgical hemorrhage with development of the lethal triad.

  11. Detecção de hipertensão arterial em adolescentes através de marcadores gerais e adiposidade abdominal Detección de hipertensión arterial en adolescentes por medio de marcadores generales y adiposidad abdominal High blood pressure detection in adolescents by clustering overall and abdominal adiposity markers

    Directory of Open Access Journals (Sweden)

    Diego G. D Christofaro

    2011-06-01

    Full Text Available FUNDAMENTO: A obesidade está ligada à hipertensão arterial (HA na infância. Entretanto, o papel da gordura como preditor de HA em adolescentes permanece desconhecido. OBJETIVO: Investigar a associação entre obesidade geral e abdominal com HA e identificar a sensibilidade e especificidade desses indicadores para detectar HA em adolescentes. MÉTODOS: A amostra consistiu em 1.021 adolescentes com idade de 10-17 anos. Os indivíduos foram classificados como normal, sobrepeso/obesidade, de acordo com as medidas do IMC, e como não-obeso com obesidade abdominal, de acordo com as medidas da circunferência da cintura (CC. A pressão arterial sistólica (PAS e diastólica (PAD foi avaliada através de um dispositivo oscilométrico. Regressão logística e curvas ROC foram usadas na análise estatística. RESULTADOS: A prevalência geral de HA foi 11,8% (13,4% em meninos e 10,2% em meninas. A prevalência de HA em meninos e meninas com sobrepeso/obesidade foi 10% e 11,1%, respectivamente. A prevalência de HA em meninos com obesidade abdominal foi 28,6%. Para ambos os sexos, o odds ratio (OR para HA foi mais alto na obesidade abdominal do que no sobrepeso/obesidade geral (4,09 [OR IC95% = 2,57-6,51] versus 1,83 [OR IC95% = 1,83-4,30]. O OR para HA foi mais alto quando sobrepeso/obesidade geral e obesidade abdominal estavam agrupados (OR = 4,35 [OR IC95% = 2,68 -7,05], do que quando identificados como sobrepeso/obesidade geral ou obesidade abdominal apenas (OR = 1,32 [OR IC95% = 0,65- 2,68]. Entretanto, ambos os tipos de obesidade apresentavam baixo poder preditivo na detecção de HA. CONCLUSÃO: Obesidade geral e obesidade abdominal foram associadas com HA; entretanto, a sensibilidade e especificidade dessas variáveis na detecção de HA são baixas em adolescentes brasileiros.BACKGROUND: Obesity is linked to high blood pressure (HBP in childhood. However, the role of fat as a predictor of HBP in adolescents remains unknown. OBJECTIVE: To investigate the association between general and abdominal obesity with HBP and to identify the sensitivity and specificity of these indicators to detect HBP in adolescents. METHODS: The sample was composed of 1,021 adolescents aged 10-17 years. Subjects were classified as normal, overweight/obese, according to BMI measurements, and as non-obese and with abdominal obesity, according to waist circumference (WC measurements. Systolic (SBP and diastolic (DBP blood pressure were assessed using an oscillometric device. Logistic regression and ROC curves were used in the statistical analysis. RESULTS: The overall prevalence of HBP was 11.8% (13.4% in boys and 10.2% in girls. The prevalence of HBP among general overweight/obese boys and girls was 10% and 11.1%, respectively. The prevalence of HBP among boys with abdominal obesity was 28.6%. For both genders, the odds ratio (OR for HBP was higher in abdominal obesity than in general overweight/obesity (4.09 [OR95%CI = 2.57-6.51] versus 1.83 [OR95%CI = 1.83-4.30]. The OR for HBP was higher when general overweight/obesity and abdominal obesity were clustered (OR = 4.35 [OR95%CI = 2.68-7.05], than when identified by either general overweight/obesity or abdominal obesity alone (OR = 1.32 [OR95%CI = 0.65-2.68]. However, both types of obesity had low predictive power in HBP detection. CONCLUSION: General and abdominal obesity were associated to HBP, however, the sensitivity and specificity of these variables to detect HBP are low in Brazilian adolescents.

  12. Keratinocyte Growth Factor Combined with a Sodium Hyaluronate Gel Inhibits Postoperative Intra-Abdominal Adhesions

    Directory of Open Access Journals (Sweden)

    Guangbing Wei

    2016-09-01

    Full Text Available Postoperative intra-abdominal adhesion is a very common complication after abdominal surgery. One clinical problem that remains to be solved is to identify an ideal strategy to prevent abdominal adhesions. Keratinocyte growth factor (KGF has been proven to improve the proliferation of mesothelial cells, which may enhance fibrinolytic activity to suppress postoperative adhesions. This study investigated whether the combined administration of KGF and a sodium hyaluronate (HA gel can prevent intra-abdominal adhesions by improving the orderly repair of the peritoneal mesothelial cells. The possible prevention mechanism was also explored. The cecum wall and its opposite parietal peritoneum were abraded after laparotomy to induce intra-abdominal adhesion formation. Animals were randomly allocated to receive topical application of HA, KGF, KGF + HA, or normal saline (Control. On postoperative day 7, the adhesion score was assessed with a visual scoring system. Masson’s trichrome staining, picrosirius red staining and hydroxyproline assays were used to assess the magnitude of adhesion and tissue fibrosis. Cytokeratin, a marker of the mesothelial cells, was detected by immunohistochemistry. The levels of tissue plasminogen activator (tPA, interleukin-6 (IL-6, and transforming growth factor β1 (TGF-β1 in the abdominal fluid were determined using enzyme-linked immunosorbent assays (ELISAs. Western blotting was performed to examine the expression of the TGF-β1, fibrinogen and α-smooth muscle actin (α-SMA proteins in the rat peritoneal adhesion tissue. The combined administration of KGF and HA significantly reduced intra-abdominal adhesion formation and fibrin deposition and improved the orderly repair of the peritoneal mesothelial cells in the rat model. Furthermore, the combined administration of KGF and HA significantly increased the tPA levels but reduced the levels of IL-6, tumor necrosis factor α (TNF-α and TGF-β1 in the abdominal fluid. The

  13. Keratinocyte Growth Factor Combined with a Sodium Hyaluronate Gel Inhibits Postoperative Intra-Abdominal Adhesions

    Science.gov (United States)

    Wei, Guangbing; Zhou, Cancan; Wang, Guanghui; Fan, Lin; Wang, Kang; Li, Xuqi

    2016-01-01

    Postoperative intra-abdominal adhesion is a very common complication after abdominal surgery. One clinical problem that remains to be solved is to identify an ideal strategy to prevent abdominal adhesions. Keratinocyte growth factor (KGF) has been proven to improve the proliferation of mesothelial cells, which may enhance fibrinolytic activity to suppress postoperative adhesions. This study investigated whether the combined administration of KGF and a sodium hyaluronate (HA) gel can prevent intra-abdominal adhesions by improving the orderly repair of the peritoneal mesothelial cells. The possible prevention mechanism was also explored. The cecum wall and its opposite parietal peritoneum were abraded after laparotomy to induce intra-abdominal adhesion formation. Animals were randomly allocated to receive topical application of HA, KGF, KGF + HA, or normal saline (Control). On postoperative day 7, the adhesion score was assessed with a visual scoring system. Masson’s trichrome staining, picrosirius red staining and hydroxyproline assays were used to assess the magnitude of adhesion and tissue fibrosis. Cytokeratin, a marker of the mesothelial cells, was detected by immunohistochemistry. The levels of tissue plasminogen activator (tPA), interleukin-6 (IL-6), and transforming growth factor β1 (TGF-β1) in the abdominal fluid were determined using enzyme-linked immunosorbent assays (ELISAs). Western blotting was performed to examine the expression of the TGF-β1, fibrinogen and α-smooth muscle actin (α-SMA) proteins in the rat peritoneal adhesion tissue. The combined administration of KGF and HA significantly reduced intra-abdominal adhesion formation and fibrin deposition and improved the orderly repair of the peritoneal mesothelial cells in the rat model. Furthermore, the combined administration of KGF and HA significantly increased the tPA levels but reduced the levels of IL-6, tumor necrosis factor α (TNF-α) and TGF-β1 in the abdominal fluid. The expression

  14. Relación entre la presión intrabdominal en diálisis peritoneal con las hernias y fugas The link between intra-abdominal pressure in peritoneal dialysis and hernias and fugues

    Directory of Open Access Journals (Sweden)

    Concepción Blasco Cabañas

    2012-06-01

    Full Text Available La presión intrabdominal normal es igual a la atmosférica (cero. En Diálisis Peritoneal con la introducción del líquido intraperitoneal, la presión intrabdominal aumenta. En varios estudios se aconseja que esta no supere los 16-20 cm. H2O. Además de las posibles molestias abdominales, una presión intrabdominal elevada puede tener relación con los problemas de la pared abdominal, como hernias y fugas y tener implicaciones en el transporte peritoneal y el déficit de ultrafiltración. Los objetivos del presente trabajo fueron: conocer los niveles de presión intrabdominal de los enfermos prevalentes en diálisis peritoneal, valorar los factores que influyen en los valores de esta presión y estudiar retrospectivamente la relación entre presión intrabdominal y desarrollo de hernias y fugas. Realizamos un estudio transversal, observacional y retrospectivo de valoración de la presión intrabdominal en los enfermos prevalentes, estables, con más de tres meses en diálisis peritoneal. La presión intrabdominal se midió mediante el método descrito por Durand: paciente en decúbito supino, con el volumen peritoneal diurno. La presión intrabdominal final es la media entre las mediciones realizadas durante la inspiración y la espiración, se expresa en cm. de H2O, y se especifica el volumen drenado. También se realizó una medida en sedestación y en bipedestación. Se estudiaron 34 pacientes, 66% varones, edad media de 61.2±14 años, 3 con poliquistosis renal, un índice de comorbilidad de Charlson medio de 7,9, un índice de masa corporal medio de 27.4±4.2 y un tiempo medio en DP de 21±12 meses. El volumen medio diurno fue de 1796±385 mL y el nocturno de 2100±254 mL. Un 32% de los pacientes tenían antecedentes de cirugía abdominal y un 5% de hernias, reparadas antes del inicio de la diálisis peritoneal. La media de presión intrabdominal en decúbito fue de 17.5±4.1 cm. de H2O, y un volumen medio por superficie corporal de 1141

  15. Consumo de álcool por frequentadores de academia de ginástica

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    Daiane Gonçalves de Oliveira

    2014-07-01

    Full Text Available Objetivo Como não há na literatura informações sobre o perfil de consumo alcoólico entre desportistas, o objetivo deste trabalho foi avaliar o perfil de consumo alcoólico por frequentadores de academia de ginástica associando com a antropometria e a intensidade do treino. Métodos Foram convidados a participar do estudo indivíduos praticantes de musculação, por no mínimo seis meses, com idade entre 20 e 40 anos, de ambos os sexos. Foram realizadas medidas antropométricas e de composição corporal. Para avaliação do consumo alcoólico, utilizou-se o questionário AUDIT (The Alcohol Use Disorders Identification Test. A intensidade do treino foi identificada por meio de um questionário semiestruturado. Resultados Dos participantes, 74,1% (n = 35 disseram ter feito uso de álcool. Além disso, 19 voluntários (38,8% apresentaram comportamento de risco para o consumo de álcool (AUDIT ≥ 8. Considerando o consumo alcoólico em binge, 32 voluntários (65,3% consumiram seis ou mais doses de álcool em alguma ocasião no ano anterior, não havendo diferença entre os sexos. A adiposidade corporal estava acima dos valores recomendados entre os que relataram consumo em binge. Não houve associação entre a intensidade do treinamento físico e o consumo de álcool em binge, nem entre a intensidade do treinamento e o comportamento de risco para o consumo de álcool. Conclusão A maioria dos desportistas apresentou consumo de bebidas alcoólicas no padrão binge, não sendo associado à intensidade do treinamento. Este não condiz com os seus objetivos ao frequentar academias de ginástica. A adiposidade corporal estava acima dos valores recomendados.

  16. Inhibition of cyclooxygenase-2 prevents intra-abdominal adhesions by decreasing activity of peritoneal fibroblasts

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    Wei G

    2015-06-01

    Full Text Available Guangbing Wei,1 Xin Chen,2 Guanghui Wang,1 Pengbo Jia,1,3 Qinhong Xu,2 Gaofeng Ping,1 Kang Wang,1 Xuqi Li1 1Department of General Surgery, 2Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University College of Medicine, Xi’an, 3Department of General Surgery, First People’s Hospital of Xianyang City, Xianyang, People’s Republic of China Background: Postoperative intra-abdominal adhesions are common complications after abdominal surgery. The exact molecular mechanisms that are responsible for these complications remain unclear, and there are no effective methods for preventing adhesion formation or reformation. The aim of the study reported here was to investigate the preventive effects and underlying potential molecular mechanisms of selective cyclooxygenase-2 (COX-2 inhibitors in a rodent model of postoperative intra-abdominal adhesions.Materials and methods: The expression of COX-2 in postoperative intra-abdominal adhesions and normal peritoneal tissue was examined by immunohistochemistry and Western blot analysis. Assays were performed to elucidate the effect of COX-2 inhibition on hypoxia-induced fibroblast activity in vitro and on intra-abdominal adhesion formation in vivo.Results: Hypoxia-induced COX-2 expression in peritoneal fibroblasts was increased in postoperative intra-abdominal adhesions. Inhibition of COX-2 attenuated the activating effect of hypoxia on normal peritoneal fibroblasts in vitro. Data indicate that selective COX-2 inhibitor prevents in vivo intra-abdominal adhesion by inhibition of basic fibroblast growth factor and transforming growth factor-beta expression, but not through an antiangiogenic mechanism. Furthermore, using selective COX-2 inhibitors to prevent intra-abdominal adhesions did not adversely affect the weight, bowel motility, or healing of intestinal anastomoses in a rat model.Conclusion: These results show that hypoxia-induced COX-2 expression in peritoneal

  17. [Procalcitonin and C-reactive protein as early indicators of postoperative intra-abdominal infection after surgery for gastrointestinal cancer].

    Science.gov (United States)

    Domínguez-Comesaña, Elías; López-Gómez, Victoria; Estevez-Fernández, Sergio Manuel; Mariño Padín, Esther; Ballinas-Miranda, Julio; Carrera-Dacosta, Ester; Piñon-Cimadevila, Miguel Ángel; Barreiro-Morandeira, Francisco

    2014-04-01

    to evaluate the association between serum levels of procalcitonin and C-reactive protein, on the first 3 postoperative days, and the appearance of postoperative intra-abdominal infection. Prospective observational study including 67 patients operated on for colo-rectal, gastric and pancreatic cancer. Serum levels of procalcitonin and C-reactive protein were analyzed before surgery and daily until the third postoperative day. Values of procalcitonin (PCT) and C-reactive protein (CRP) were recorded as well as their accuracy for detection of postoperative intra-abdominal infection (PIAI). The incidence of postoperative intra-abdominal infection was 13.4%. CRP serum levels at 72h, PCT serum levels at 24, 48 and 72h and the ratio between serum levels of CRP at 72hours and serum levels of CRP at 48hours (CRP D3/CRP D2) were significantly associated with the appearance of postoperative intra-abdominal infection. The highest sensitivity corresponded to PCT at 72hours (88.9%); the highest specificity and positive predictive value corresponded to the ratio CRP D3/CRP D2 (96.49% and 71.4%, respectively); the highest negative predictive value to procalcitonin at 72h and 24h. Serum levels of PCT are significantly associated with the appearance of postoperative intra-abdominal infection. Sensitivity and predictive positive values are low, but negative predictive value is high, even at 24h after surgery. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  18. Intra-Abdominal Cooling System Limits Ischemia-Reperfusion Injury During Robot-Assisted Renal Transplantation.

    Science.gov (United States)

    Meier, R P H; Piller, V; Hagen, M E; Joliat, C; Buchs, J-B; Nastasi, A; Ruttimann, R; Buchs, N C; Moll, S; Vallée, J-P; Lazeyras, F; Morel, P; Bühler, L

    2018-01-01

    Robot-assisted kidney transplantation is feasible; however, concerns have been raised about possible increases in warm ischemia times. We describe a novel intra-abdominal cooling system to continuously cool the kidney during the procedure. Porcine kidneys were procured by standard open technique. Groups were as follows: Robotic renal transplantation with (n = 11) and without (n = 6) continuous intra-abdominal cooling and conventional open technique with intermittent 4°C saline cooling (n = 6). Renal cortex temperature, magnetic resonance imaging, and histology were analyzed. Robotic renal transplantation required a longer anastomosis time, either with or without the cooling system, compared to the open approach (70.4 ± 17.7 min and 74.0 ± 21.5 min vs. 48.7 ± 11.2 min, p-values < 0.05). The temperature was lower in the robotic group with cooling system compared to the open approach group (6.5 ± 3.1°C vs. 22.5 ± 6.5°C; p = 0.001) or compared to the robotic group without the cooling system (28.7 ± 3.3°C; p < 0.001). Magnetic resonance imaging parenchymal heterogeneities and histologic ischemia-reperfusion lesions were more severe in the robotic group without cooling than in the cooled (open and robotic) groups. Robot-assisted kidney transplantation prolongs the warm ischemia time of the donor kidney. We developed a novel intra-abdominal cooling system that suppresses the noncontrolled rewarming of donor kidneys during the transplant procedure and prevents ischemia-reperfusion injuries. © 2017 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.

  19. Intraabdominal candidiasis in surgical ICU patients treated with anidulafungin: A multicenter retrospective study.

    Science.gov (United States)

    Maseda, Emilio; Rodríguez-Manzaneque, Marta; Dominguez, David; González-Serrano, Matilde; Mouriz, Lorena; Álvarez-Escudero, Julián; Ojeda, Nazario; Sánchez-Zamora, Purificación; Granizo, Juan-José; Giménez, María-José

    2016-02-01

    Patients with recent intraabdominal events are at uniquely risk for intraabdominal candidiasis (IAC). Candida peritonitis is a frequent and life-threatening complication in surgically ill patients. International guidelines do not specifically address IAC. This study describes clinical features of IAC in critical patients treated with anidulafungin in Surgical ICUs (SICUs). A practice-based retrospective study was performed including all adults with IAC admitted to 19 SICUs for ≥24h treated with anidulafungin. IAC was documented (Candida isolation from blood/peritoneal fluid/abscess fluid and/or histopathological confirmation) or presumptive (host factors plus clinical criteria without mycological support). Total population and the subgroup of septic shock patients were analyzed. One hundred and thirty nine patients were included, 94 (67.6%) with septic shock, 112 (86.2%) after urgent surgery. Of them, 77.7% presented peritonitis and 21.6% only intraabdominal abscesses. Among 56.8% cases with documented IAC, C. albicans (52.8%) followed by C. glabrata (27.8%) were the most frequent species. Anidulafungin was primarily used as empirical therapy (59.7%), microbiologically directed (20.9%) and anticipated therapy (15.8%). Favourable response was 79.1% (76.6% among patients with septic shock). Intra-SICU mortality was 25.9% (28.7% among patients with septic shock). Among IACs managed at SICUs, peritonitis was the main presentation, with high percentage of patients presenting septic shock. C. albicans followed by C. glabrata were the main responsible species. Anidulafungin treatment was mostly empirical followed by microbiologically directed therapy, with a favourable safety profile, even among patients with septic shock.

  20. The effect of body position on compartmental intra-abdominal pressure following liver transplantation.

    Science.gov (United States)

    Cresswell, Adrian B; Jassem, Wayel; Srinivasan, Parthi; Prachalias, Andreas A; Sizer, Elizabeth; Burnal, William; Auzinger, Georg; Muiesan, Paolo; Rela, Mohammed; Heaton, Nigel D; Bowles, Matthew J; Wendon, Julia A

    2012-07-05

    Current assumptions rely on intra-abdominal pressure (IAP) being uniform across the abdominal cavity. The abdominal contents are, however, a heterogeneous mix of solid, liquid and gas, and pressure transmission may not be uniform. The current study examines the upper and lower IAP following liver transplantation. IAP was measured directly via intra-peritoneal catheters placed at the liver and outside the bladder. Compartmental pressure data were recorded at 10-min intervals for up to 72 h following surgery, and the effect of intermittent posture change on compartmental pressures was also studied. Pelvic intra-peritoneal pressure was compared to intra-bladder pressure measured via a FoleyManometer. A significant variation in upper and lower IAP of 18% was observed with a range of differences of 0 to 16 mmHg. A sustained difference in inter-compartmental pressure of 4 mmHg or more was present for 23% of the study time. Head-up positioning at 30° provided a protective effect on upper intra-abdominal pressure, resulting in a significant reduction in all patients. There was excellent agreement between intra-bladder and pelvic pressure. A clinically significant variation in inter-compartmental pressure exists following liver transplantation, which can be manipulated by changes to body position. The existence of regional pressure differences suggests that IAP monitoring at the bladder alone may under-diagnose intra-abdominal hypertension and abdominal compartment syndrome in these patients. The upper and lower abdomen may need to be considered as separate entities in certain conditions.

  1. The Predictive Role of Procalcitonin On the Treatment of Intra-Abdominal Infections

    OpenAIRE

    Mahmutaj, Dafina; Krasniqi, Shaip; Braha, Bedri; Limani, Dalip; Neziri, Burim

    2017-01-01

    Aim: This study aims to evaluate the algorithm of procalcitonin (PCT) and its role on the duration of antibiotics prescription for intra-abdominal infections. Materials and Methods: This study is a prospective controlled study that is conducted in groups of 50 hospitalised patients and 50 controlled group patients. Results: The results indicated that the average duration of antibiotic delivery to the PCT group was -10.6 days (SD ± 6.6 days), while in the control group -13.2 days (SD ±...

  2. Variations in the risk of acute kidney injury across intraabdominal surgery procedures.

    Science.gov (United States)

    Kim, Minjae; Brady, Joanne E; Li, Guohua

    2014-11-01

    The literature on perioperative acute kidney injury (AKI) focuses mainly on cardiac and major vascular surgery. Among noncardiac general surgery procedures, intraabdominal general surgery has been identified as high risk for developing AKI, but variations in AKI risk and its impact on 30-day mortality among different types of abdominal surgeries are not well characterized. We used the American College of Surgeons National Surgical Quality Improvement Program (2005-2010) to identify patients in 15 intraabdominal general surgery procedure categories (n = 457,656). AKI was defined as an increase in the creatinine level of >2 mg/dL above baseline and/or dialysis. Relative risk regression modeling was used to assess the relative risks of AKI across the procedures. The relationships among surgical procedure, AKI, and 30-day mortality stratified by procedure type were assessed using relative risk regression. The overall incidence of AKI among intraabdominal surgery patients was 1.1%, which varied from 0.2% in appendectomy and 0.3% in gastric bypass patients to 2.6% in small bowel resection and 3.5% in exploratory laparotomy patients. Of the patients who developed AKI, 31.3% died within 30 days, compared with 1.9% of those who did not develop AKI. After adjusting for comorbidities and operative factors, AKI was associated with a 3.5-fold increase in the risk of 30-day mortality (adjusted risk ratio, 3.51, 95% confidence interval [CI], 3.29-3.74). Among individual procedures, the estimated adjusted risk ratio of 30-day mortality associated with AKI ranged from 1.87 (95% CI, 1.62-2.17) in exploratory laparotomy to 31.6 (95% CI, 17.9-55.9) in gastric bypass. The incidence of AKI and the impact of AKI on 30-day mortality vary markedly across procedures within intraabdominal general surgery. This highlights the importance of preoperative risk stratification and identifies procedure type as a significant risk factor for AKI and 30-day mortality.

  3. Structural characteristics of polysaccharides that induce protection against intra-abdominal abscess formation.

    Science.gov (United States)

    Tzianabos, A O; Onderdonk, A B; Zaleznik, D F; Smith, R S; Kasper, D L

    1994-11-01

    Bacteroides fragilis is the anaerobe most commonly isolated from clinical cases of intra-abdominal sepsis. In a rodent model of this disease process, intraperitoneal injection of the capsular polysaccharide complex (CPC) from B. fragilis provokes abscess formation, while subcutaneous administration of this complex confers protection against B. fragilis-induced intra-abdominal abscesses. The CPC consists of two discrete polysaccharides, polysaccharides A and B (PS A and PS B), each possessing oppositely charged structural groups critical to the ability of these carbohydrates to induce the formation of abscesses. Other bacterial polysaccharides that possess oppositely charged groups (such as the group antigen or capsular polysaccharide from Streptococcus pneumoniae type 1 strains) also exhibited potent abscess-inducing capabilities. We report here that positively and negatively charged groups on polysaccharides are also essential for inducing protection against abscess formation. Vaccination of rats with B. fragilis PS A, PS B, or the S. pneumoniae type 1 capsule protected against intra-abdominal abscesses subsequent to intraperitoneal challenge with each of these polysaccharides. Chemical conversion of the free amino or carboxyl groups on PS A to uncharged N-acetyl or hydroxymethyl groups, respectively, abrogated the ability of this polymer to confer protection against polysaccharide-mediated abscess formation. Adoptive transfer of splenic T cells from polysaccharide-vaccinated rats to naive animals demonstrated that T cells mediated this protective activity. T cells transferred from animals vaccinated with a polysaccharide repeating unit (Salmonella typhi Vi antigen) that normally contains one carboxyl group but was chemically converted to a polymer that possesses both free amino and carboxyl groups (accomplished by de-N-acetylating the Vi antigen) protected naive T-cell recipients against polysaccharide-induced abscesses. These results demonstrate that a distinct

  4. Intra-abdominal adhesions in ultrasound. Part II: The morphology of changes

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    Andrzej Smereczyński

    2013-03-01

    Full Text Available Despite their frequent appearance, intra-abdominal adhesions are rarely the subject of clinical studies and academic discussions. For many years the operators have been trying to reduce such unfavourable consequences of interventions in the abdominal structures. The aim of this article is to present the possibilities of intra-abdominal adhesion diagnostics by means of ultrasound imaging based on authors’ own experience and information included in pertinent literature. The anatomy and examination technique of the abdominal wall were discussed in Part I of the article. In order to evaluate intraperitoneal adhesions, one should use a convex transducer with the frequency of 3.5–6 MHz. The article provides numerous examples of US images presenting intra-abdominal adhesions, particularly those which appeared after surgical procedures. The significance of determining their localisation and extensiveness prior to a planned surgical treatment is emphasized. Four types of morphological changes in the ultrasound caused by intra-abdominal adhesions are distinguished and described: visceroperitoneal adhesions, intraperitoneal adhesions, adhesive obstructions as well as adhesions between the liver and abdominal wall with a special form of such changes, i.e. hepatic pseudotumour. Its ultrasound features are as follows: 1. The lesion is localised below the scar in the abdominal wall after their incision. 2. The lesion is localised in the abdominal part of the liver segments III, IV and V. 3. With the US beam focus precisely set, the lack of fascia – peritoneum complex may be noticed. An uneven liver outline or its ventral displacement appears. 4. A hepatic adhesion-related pseudotumour usually has indistinct margins, especially the posterior one, and, gradually, from top to bottom, loses its hypoechogenic nature. 5. In a respiration test, this liver fragment does not present the sliding movement – a neoplastic tumour rarely shows such an effect

  5. Epidemiology and antimicrobial susceptibility of Gram-negative aerobic bacteria causing intra-abdominal infections during 2010-2011.

    Science.gov (United States)

    Hawser, Stephen; Hoban, Daryl J; Badal, Robert E; Bouchillon, Samuel K; Biedenbach, Douglas; Hackel, Meredith; Morrissey, Ian

    2015-02-01

    The study for monitoring antimicrobial resistance trends (SMART) surveillance program monitors the epidemiology and trends in antibiotic resistance of intra-abdominal pathogens to currently used therapies. The current report describes such trends during 2010-2011. A total of 25,746 Gram-negative clinical isolates from intra-abdominal infections were collected and classified as hospital-associated (HA) if the hospital length of stay (LOS) at the time of specimen collection was ≥48 hours, community-associated (CA) if LOS at the time of specimen collection was <48 hours, or unknown (no designation given by participating centre). A total of 92 different species were collected of which the most common was Escherichia coli: 39% of all isolates in North America to 55% in Africa. Klebsiella pneumoniae was the second most common pathogen: 11% of all isolates from Europe to 19% of all isolates from Asia. Isolates were from multiple intra-abdominal sources of which 32% were peritoneal fluid, 20% were intra-abdominal abscesses, and 16.5% were gall bladder infections. Isolates were further classified as HA (55% of all isolates), CA (39% of all isolates), or unknown (6% of all isolates). The most active antibiotics tested were imipenem, ertapenem, amikacin, and piperacillin-tazobactam. Resistance rates to all other antibiotics tested were high. Considering the current data set and high-level resistance of intra-abdominal pathogens to various antibiotics, further monitoring of the epidemiology of intra-abdominal infections and their susceptibility to antibiotics through SMART is warranted.

  6. Germ cells may survive clipping and division of the spermatic vessels in surgery for intra-abdominal testes

    DEFF Research Database (Denmark)

    Thorup, J M; Cortes, D; Visfeldt, J

    1999-01-01

    PURPOSE: Laparoscopy is a well described modality that provides an accurate visual diagnosis upon which further management of intra-abdominal testes may be based. Laparoscopic ligation of spermatic vessels as stage 1 of the procedure is a natural extension of laparoscopy. A staged approach provides...... studied 17 nonpalpable testes in 10 patients 1 year and 7 months to 13(1/2) years old. Results of testicular biopsies of 13 intra-abdominal testes taken at stages 1 and 2 of surgery were available for histological comparison. RESULTS: Median number of spermatogonia per tubular cross section...

  7. Impacto de um programa de exercício físico na adiposidade e na condição muscular de mulheres pós-menopáusicas Impact of an exercise program in adiposity and muscular condition of postmenopausal women

    Directory of Open Access Journals (Sweden)

    Josiane Santos Brant Rocha

    2012-09-01

    Full Text Available OBJETIVO: Avaliar o efeito de um programa de exercício na massa gorda (MG, área de adiposidade visceral (AAV, massa muscular esquelética (MME e índice de massa muscular esquelética (IMME de mulheres pós-menopáusicas. MÉTODOS: A amostra com 169 mulheres (56,8±6,4 anos foi randomizada em grupo de exercício (GE, n=91 e controle (GC=78. O primeiro realizou 12 meses de exercício físico de step, musculação e flexibilidade, envolvendo 3 sessões semanais de 60 minutos cada. A taxa metabólica basal (TMB e a composição corporal foram avaliadas por meio da bioimpedância octopolar InBody 720 e o método de registro alimentar foi considerado. Determinou-se a taxa de modificação (D das variáveis e a comparação dos valores médios foi realizada por testes t de Student, sendo respeitado grau de significância estatística de 5%. RESULTADOS: Em termos absolutos, o GC aumentou (pPURPOSE: To evaluate the effect of an exercise program on fat mass (FM, visceral fat area (VFA, skeletal muscle mass (SMM and skeletal muscle mass index (SMMI of post-menopausal women. METHODS: A sample of 169 women (56.8±6.4 years was randomized into an exercise group (EG, n=91 and a control group (CG=78. The first performed 12 months of physical exercise, including step, weight training and flexibility, with three weekly sessions of 60 minutes each. The basal metabolic rate (BMR and the corporal composition were evaluated by octopolar InBody 720 bioimpedance and the food record method was considered. The variables modification rates were determined and the comparison of the average values was realized by Student's t-test, with the level of significance of 5%. RESULTS: In absolute terms, the CG increased (p<0.01 the FM (1.8% and VFA (3.9 cm² and worsened muscle condition (-1.06%, with consequences for BMR (-27.9 kcal/day. Differences were found (p<0.05 between the EG and the CG for Δ% FM (-4.2%, ΔVFA (-4.00 cm², ΔSM (3.09%, ΔSMI (0.03% and ΔBMR (2

  8. The effects of intra-abdominal hypertension on the secretory function of canine adrenal glands.

    Science.gov (United States)

    Yu, Jian; Fu, XiaoJuan; Chang, MingTao; Zhang, LiangChao; Chen, ZhiQiang; Zhang, LianYang

    2013-01-01

    Intra-abdominal hypertension (IAH) can damage multiple organ systems, but the explicit impact on the adrenal gland is unclear. To evaluate the effects of intra-abdominal pressure (IAP) on the secretory function of the adrenal glands, we established canine models of IAH. By comparing morphology; hemodynamics; plasma cortisol, aldosterone, epinephrine, and norepinephrine concentrations; and the expression of IL-1, IL-6, and TNF-α in adrenal gland tissue from these dogs, we found that hemodynamic instability occurred after IAH and that IAH increased the plasma cortisol, aldosterone, epinephrine, and norepinephrine concentrations. Higher IAPs resulted in more significant changes, and the above indicators gradually returned to normal 2 h after decompression. Compared with the sham-operated group, IAH significantly increased IL-1, IL-6, and TNF-α levels in adrenal tissue, with larger increases in the presence of higher IAPs. However, the concentrations of these markers remained higher than those in the sham-operated group despite their decrease after 2 h of decompression. Histopathological examination revealed congestion, red blood cell exudation, and neutrophil infiltration in the adrenal glands when IAP was elevated; these conditions became more significant with more severe IAH. These results suggest that the secretion of adrenal hormones and adrenal gland inflammation are positively correlated with IAP and that abdominal decompression effectively corrects adrenal gland function.

  9. The Predictive Role of Procalcitonin On the Treatment of Intra-Abdominal Infections

    Science.gov (United States)

    Mahmutaj, Dafina; Krasniqi, Shaip; Braha, Bedri; Limani, Dalip; Neziri, Burim

    2017-01-01

    AIM: This study aims to evaluate the algorithm of procalcitonin (PCT) and its role on the duration of antibiotics prescription for intra-abdominal infections. MATERIALS AND METHODS: This study is a prospective controlled study that is conducted in groups of 50 hospitalised patients and 50 controlled group patients. RESULTS: The results indicated that the average duration of antibiotic delivery to the PCT group was -10.6 days (SD ± 6.6 days), while in the control group -13.2 days (SD ± 4.2 days). These data showed a significant difference in the duration of antibiotic therapy and the monitoring role of PCTs in the prediction success of antibiotic treatment. The antibiotic delivery was longer in the septic shock 17 (SD ± 11.7) that corresponds to high PCT values of 67.8 (SD ± 50.9). Recurrence of the infection after the cessation of antibiotics occurred in 2 cases (4%) in the standard group, while it occurred in 3 cases (6%) in the control group. CONCLUSION: The treatment of the intra-abdominal infections based on the PCT algorithm shortens the duration of antibiotic treatment and does not pose a risk for the recurrence of the infection. PMID:29362617

  10. Intra-Abdominal Hypertension and Gastrointestinal Symptoms in Mechanically Ventilated Patients

    Directory of Open Access Journals (Sweden)

    Annika Reintam Blaser

    2011-01-01

    Full Text Available Background. We aimed to describe the incidence of intra-abdominal hypertension (IAH and gastrointestinal (GI symptoms and related outcome in mechanically ventilated (MV patients. Methods. Intra-abdominal pressure (IAP and gastric residual volumes were measured at least twice daily. IAH was defined as a mean daily value of IAP≥12 mmHg. Results. 398 patients were monitored for all together 2987 days. GI symptom(s occurred in 80.2% patients. 152 (38.2% patients developed IAH. Majority (93.4% of patients with IAH had GI symptoms. The more severe IAH was associated with the higher number of concomitant GI symptoms (P<.001. 142 (35.7% patients developed both IAH and at least one GI symptom at any time in ICU, and in 77 patients they occurred simultaneously on the same day. This subgroup had the highest ICU mortality (21.8%. In contrast, the small group of patients presenting only IAH, but not GI symptoms (10 patients, had no lethal outcome. Three patients (4.4% died without showing either IAH or GI symptoms. Conclusions. GI symptoms and IAH often, but not always, occur together. The patients having IAH solely without developing GI symptoms have rather good outcome.

  11. Hypothermia Increases Tissue Plasminogen Activator Expression and Decreases Post-Operative Intra-Abdominal Adhesion.

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    Meng-Tse Gabriel Lee

    Full Text Available Therapeutic hypothermia during operation decreases postoperative intra-abdominal adhesion formation. We sought to determine the most appropriate duration of hypothermia, and whether hypothermia affects the expression of tissue plasminogen activator (tPA.80 male BALB/c mice weighing 25-30 g are randomized into one of five groups: adhesion model with infusion of 15°C saline for 15 minutes (A; 30 minutes (B; 45 minute (C; adhesion model without infusion of cold saline (D; and sham operation without infusion of cold saline (E. Adhesion scores and tPA levels in the peritoneum fluid levels were analyzed on postoperative days 1, 7, and 14.On day 14, the cold saline infusion groups (A, B, and C had lower adhesion scores than the without infusion of cold saline group (D. However, only group B (cold saline infusion for 30 minutes had a significantly lower adhesion scores than group D. Also, group B was found to have 3.4 fold, 2.3 fold, and 2.2 fold higher levels of tPA than group D on days 1, 7, and 14 respectively.Our results suggest that cold saline infusion for 30 minutes was the optimum duration to decrease postoperative intra-abdominal adhesion formation. The decrease in the adhesion formations could be partly due to an increase in the level of tPA.

  12. Successful treatment of intra-abdominal eumycotic mycetoma caused by Penicillium duponti in a dog.

    Science.gov (United States)

    Janovec, J; Brockman, D J; Priestnall, S L; Kulendra, N J

    2016-03-01

    A 2-year-old female neutered golden retriever was presented for investigation of an intra-abdominal mass. Computed tomography revealed a mass associated with the caudal pole of the right kidney. Incisional biopsy findings were consistent with eumycotic mycetoma. The mass was subsequently removed in conjunction with right ureteronephrectomy. Two years later, the dog re-presented with a splenic mass and fungal plaques located throughout the peritoneum. Splenectomy was performed and the mass was diagnosed as eumycotic mycetoma caused by Penicillium duponti. Indefinite systemic treatment with 10 mg/kg itraconazole orally once a day was initiated. Thirty-two months after the last surgery, there were no clinical signs apart from mild polydipsia. Haematology and biochemistry results were unremarkable. To the authors' knowledge, this is the first report of successful treatment of intra-abdominal eumycotic mycetoma with a combination of surgery and systemic antifungal therapy in the dog. Penicillium duponti has not apparently been reported to cause disease in animals or humans. © 2015 British Small Animal Veterinary Association.

  13. Antibiotic management of complicated intra-abdominal infections in adults: The Asian perspective

    Directory of Open Access Journals (Sweden)

    Asok Kurup

    2014-09-01

    Full Text Available Regional epidemiological data and resistance profiles are essential for selecting appropriate antibiotic therapy for intra-abdominal infections (IAIs. However, such information may not be readily available in many areas of Asia and current international guidelines on antibiotic therapy for IAIs are for Western countries, with the most recent guidance for the Asian region dating from 2007. Therefore, the Asian Consensus Taskforce on Complicated Intra-Abdominal Infections (ACT-cIAI was convened to develop updated recommendations for antibiotic management of complicated IAIs (cIAIs in Asia. This review article is based on a thorough literature review of Asian and international publications related to clinical management, epidemiology, microbiology, and bacterial resistance patterns in cIAIs, combined with the expert consensus of the Taskforce members. The microbiological profiles of IAIs in the Asian region are outlined and compared with Western data, and the latest available data on antimicrobial resistance in key pathogens causing IAIs in Asia is presented. From this information, antimicrobial therapies suitable for treating cIAIs in patients in Asian settings are proposed in the hope that guidance relevant to Asian practices will prove beneficial to local physicians managing IAIs.

  14. Intraoperative ultrasonography in nine dogs with intra-abdominal neoplasm suspect

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    Daniella Matos da Silva

    Full Text Available ABSTRACT: Intraoperative ultrasonography (IOUS is used in medicine for diagnosis and guidance during oncologic surgery. The aims of this study were to assess the performance, feasibility, advantages and difficulties of the IOUS technique in dogs with suspected intra-abdominal tumors. The study included nine client-owed dogs that had suspected intra-abdominal tumors (spleen, liver or bowel based on transabdominal ultrasound examination and that were subsequently referred for exploratory laparotomy surgery. During surgery, IOUS was performed; results of preoperative transabdominal ultrasonography, inspection by the surgeon and IOUS were compared on a case-by-case basis. IOUS was helpful in determining lesion resection in all cases. Lesions detected solely by the use of IOUS were observed in seven out of nine cases. Analysis of these cases demonstrated that IOUS can be a tool to assist during oncology surgery on the liver, spleen or bowel. Dogs with hepatic tumors can have small non-palpable intraparenchymal nodules, which may be visible by IOUS.

  15. Analyzing intra-abdominal pressures and outcomes in patients undergoing emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Khan Shehtaj

    2010-01-01

    Full Text Available Background : Studies have documented the impact of intra-abdominal hypertension (IAH on virtually every organ. However, it still remains strangely underdiagnosed. The aims of the study were to assess, in patients undergoing emergency laparotomy, whether intra-abdominal pressure (IAP is an independent predictor of morbidity and mortality, to evaluate the effects of IAH, and to identify hidden cases of abdominal compartment syndrome (ACS. Materials and Methods : The study comprised 197 patients undergoing emergency laparotomy. IAP was measured preoperatively and then postoperatively at 0, 6, and 24 hours. Duration of hospital stay, occurrence of burst abdomen, and mortality were noted as outcomes. Results : At admission, incidence of IAH was 80%. No significant association was found between IAP and occurrence of burst abdomen (P > 0.1. IAP was found to be a significant predictor of mortality in patients undergoing laparotomy (P < 0.001. Elevated IAP was found to affect all the organ systems adversely. The incidence of post-op ACS was 3.05% in the general population and 13.16% in trauma patients. The mortality rate for this subgroup was 100%. Conclusions : IAP is a significant predictor of mortality in patients undergoing laparotomy. IAH has detrimental effects on various organ systems. A more frequent monitoring with prompt decompression may be helpful in decreasing the mortality rate. Further studies are required to establish a screening protocol in patients undergoing laparotomy to detect and manage cases of IAH and ACS.

  16. The recurrence with isolated intra-abdominal lymph node in patients with colorectal cancer: A study of the Turkish Descriptive Oncological Researches Group (intra-abdominal lymph node and colon cancer

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    Ozgur Tanriverdi

    2016-08-01

    Conclusions: The presence of lymphovascular invasion and mutant-type K-ras status may be poor prognostic risk factors for isolated intra-abdominal lymph node metastasis in patients with colorectal cancer. However, studies involving larger patient series, molecular indicators, and cohorts with metastasis in other areas are been needed to verify this study.

  17. Effect of severe maternal dietary restriction on growth and intra-abdominal adipose tissue weights in offspring rats.

    Science.gov (United States)

    Suzuki, Mikiko; Shibanuma, Mayumi; Kimura, Shuichi

    2010-01-01

    In Japan, the number of low weight birth babies is increasing. The increase in the number of slim young women is considered to be associated with the rising number of low birth weight babies in Japan. In 1993, Barker et al. published highly influential findings indicating a relationship between low birth weight and increased risk of developing symptoms of metabolic syndrome. Here, we report on results that occur when dietary restriction is applied during all periods of pregnancy. It was shown that, at 5 d, the mean weight of pups in the dietary restriction group was lower than the mean weight of pups in the control group. Catch-up growth began when milk yields of the dietary restriction group pups attained the same levels as those of the control group pups. Intra-abdominal adipose tissue weights of the dietary restricted group were significantly higher than those of the control group in males at 280 d after birth. Intra-abdominal adipose tissue weights of the dietary restricted group had a tendency to be higher than those of the control group for female rats. In male rats, it is considered that increase in intra-abdominal adipose tissue is related to lean body mass but it is not related to the function of brown adipose tissue (BAT). In female rats, it is considered that the increase in intra-abdominal adipose tissue is related to the function of BAT and lean body mass.

  18. Recognition and management of intra-abdominal hypertension and abdominal compartment syndrome; a survey among Dutch surgeons

    NARCIS (Netherlands)

    K.D. Strang; E.M.M. van Lieshout (Esther); R.A. Verhoeven (Roelof A.); O.J.F. van Waes (Oscar); M.H.J. Verhofstad (Michiel); Iah-Acs Study Group

    2017-01-01

    textabstractPurpose: Intra-abdominal hypertension (IAH) and Abdominal compartment syndrome (ACS) are relatively rare, but severe complications. Although many advances were made in recent years, the recognition and management remain subject of debate. The aim of this study was to determine the

  19. Varix of the fetal intra-abdominal umbilical vein: prenatal sonographic diagnosis and suggested in utero management.

    Science.gov (United States)

    Zalel, Y; Lehavi, O; Heifetz, S; Aizenstein, O; Dolitzki, M; Lipitz, S; Achiron, R

    2000-10-01

    Varix of the fetal intra-abdominal umbilical vein (FIUV) is a rare entity. We describe an ultrasound diagnosis of this condition together with a review of the literature relating to its prognosis and management. Our conclusion is that close fetal monitoring should be performed, and delivery should be induced when lung maturity has been accomplished or any fetal distress is apparent.

  20. Profiling of Candida albicans gene expression during intra-abdominal candidiasis identifies biologic processes involved in pathogenesis.

    Science.gov (United States)

    Cheng, Shaoji; Clancy, Cornelius J; Xu, Wenjie; Schneider, Frank; Hao, Binghua; Mitchell, Aaron P; Nguyen, M Hong

    2013-11-01

    The pathogenesis of intra-abdominal candidiasis is poorly understood. Mice were intraperitoneally infected with Candida albicans (1 × 10(6) colony-forming units) and sterile stool. nanoString assays were used to quantitate messenger RNA for 145 C. albicans genes within the peritoneal cavity at 48 hours. Within 6 hours after infection, mice developed peritonitis, characterized by high yeast burdens, neutrophil influx, and a pH of 7.9 within peritoneal fluid. Organ invasion by hyphae and early abscess formation were evident 6 and 24 hours after infection, respectively; abscesses resolved by day 14. nanoString assays revealed adhesion and responses to alkaline pH, osmolarity, and stress as biologic processes activated in the peritoneal cavity. Disruption of the highly-expressed gene RIM101, which encodes an alkaline-regulated transcription factor, did not impact cellular morphology but reduced both C. albicans burden during early peritonitis and C. albicans persistence within abscesses. RIM101 influenced expression of 49 genes during intra-abdominal candidiasis, including previously unidentified Rim101 targets. Overexpression of the RIM101-dependent gene SAP5, which encodes a secreted protease, restored the ability of a rim101 mutant to persist within abscesses. A mouse model of intra-abdominal candidiasis is valuable for studying pathogenesis and C. albicans gene expression. RIM101 contributes to persistence within intra-abdominal abscesses, at least in part through activation of SAP5.

  1. Germ cells may survive clipping and division of the spermatic vessels in surgery for intra-abdominal testes

    DEFF Research Database (Denmark)

    Thorup, J M; Cortes, Dina; Visfeldt, J

    1999-01-01

    Laparoscopy is a well described modality that provides an accurate visual diagnosis upon which further management of intra-abdominal testes may be based. Laparoscopic ligation of spermatic vessels as stage 1 of the procedure is a natural extension of laparoscopy. A staged approach provides adequate...

  2. Safety and Tolerability of Doripenem in Hospitalized Children With Complicated Intra-Abdominal Infection, Complicated Urinary Tract Infections and Pneumonia.

    Science.gov (United States)

    Cannavino, Christopher R; Castaneda-Ruiz, Bibiana; Redman, Rebecca; Go, Oscar; Cirillo, Iolanda; Barauskas, Vidmantas; Senatorova, Ganna; Emeryk, Andrzej; Bradley, John S

    2015-11-01

    Three multicenter, randomized, controlled studies evaluated doripenem in children 3 months to complicated intra-abdominal or urinary tract infections and bacterial pneumonia.In the 66 patients treated with doripenem before early termination of the studies for nonsafety reasons, doripenem was safe and generally well tolerated. Low enrollment limited ability to assess benefits and risks of doripenem in children.

  3. Validation of the Measurement of Intra-abdominal Fat Between Ultrasound and CT Scan in Women with Obesity and Infertility

    NARCIS (Netherlands)

    Kuchenbecker, Walter K. H.; Groen, Henk; Pel, Heleen; Bolster, Johanna H. T.; Wolffenbuttel, Bruce H. R.; Land, Jolande A.; Hoek, Annemieke; Corpeleijn, Eva

    Objective: To compare the means and changes over time of intra-abdominal fat (IAF) and subcutaneous abdominal fat (SAF) measured by abdominal ultrasound (US) and computerized tomography (CT). Design and Methods: Prospective cohort study of 53 women with obesity and infertility undergoing a lifestyle

  4. In women with polycystic ovary syndrome and obesity, loss of intra-abdominal fat is associated with resumption of ovulation

    NARCIS (Netherlands)

    Kuchenbecker, W.K.H.; Groen, H.; van Asselt, S.J.; Bolster, J.H.T.; Zwerver, J.; Slart, R.H.J.; van der Jagt, E.J.; Kobold, A.C.M.; Wolffenbuttel, B.H.R.; Land, J.A.; Hoek, A.

    BACKGROUND: It is not clear why some anovulatory women with polycystic ovary syndrome (PCOS) and obesity resume ovulation and others remain anovulatory after weight loss. The objective of this study was to compare the changes in body fat distribution and specifically intra-abdominal fat (IAF) and

  5. Prevalência de sobrepeso e obesidade e indicadores de adiposidade central em escolares de Santa Catarina, Brasil Prevalence of overweight and obesity and central adiposity indexes among school-aged children in Santa Catarina, Brazil

    Directory of Open Access Journals (Sweden)

    Gabriela Dalsasso Ricardo

    2009-09-01

    Full Text Available OBJETIVO: Estimar a prevalência de sobrepeso e obesidade entre escolares e sua associação com região, sexo, faixa etária e rede de ensino, e a correlação entre os índices antropométricos. MÉTODO: Estudo transversal com 4.964 escolares entre 6 a 10 anos de idade matriculados em 345 escolas do ensino fundamental do Estado de Santa Catarina. Foi utilizado o índice de massa corporal para diagnosticar sobrepeso e obesidade. Como indicadores de distribuição de gordura foram utilizadas circunferência de cintura, relação cintura-quadril, relação cintura-altura, dobras cutâneas triciptal e subescapular e razão subescapular-triciptal. Foram estimadas as razões de chance com IC 95% e calculada correlação de Pearson para avaliar a relação entre índice de massa corporal e índices antropométricos. RESULTADO: Do total dos escolares, 52,2% eram do sexo feminino. A prevalência de sobrepeso foi de 15,4% e de obesidade 6,0%. Não foi encontrada associação entre sobrepeso ou obesidade com regiões, sexo e faixa etária, somente entre sobrepeso e rede particular. Os escolares da rede particular apresentaram 1,46 (1,22-1,74 vezes mais chance de desenvolverem sobrepeso. Foi encontrada correlação forte entre o índice de massa corporal e a circunferência de cintura (r = 0,90. CONCLUSÃO: Os escolares da rede particular estão mais expostos ao sobrepeso e à obesidade, sugerindo que a condição socioeconômica dos escolares possa ser a explicação. A circunferência de cintura, além de indicador de adiposidade central, poderá ser utilizada como indicador de adiposidade total.OBJECTIVE: To estimate the prevalence of overweight and obesity in school children, their association with region, gender, age, school system, and correlation between anthropometric indexes. METHOD: Cross-sectional study with 4,964 children between 6 and 10 years of age of 345 elementary schools in the state of Santa Catarina. Body mass index was used to

  6. Effects of anabolic steroids on acute phase responses in intra-abdominal sepsis

    Directory of Open Access Journals (Sweden)

    K. Mealy

    1997-01-01

    Full Text Available The acute phase response is an important adaptive response to sepsis and injury. As anabolic steroids increase protein synthesis we postulated that these agents might also increase hepatic acute phase protein synthesis. Male Wistar rats were pretreated with testosterone or danazol for 48 h prior to caecal ligation and puncture (CLP. Thirty-six h following surgery the animals were killed and blood taken for full blood count, total protein, albumin, α, β and γ globulin fractions on serum electrophoresis, complement C3 and transferrin levels. Danazol increased the α1, α2 and β1 globulin serum protein fractions in comparison with no surgery and CLP alone groups. These results indicate that danazol increases plasma acute phase proteins, as measured by electrophoresis, in this model of intra-abdominal sepsis.

  7. Diagnostic accuracy of C-reactive protein for intraabdominal infections after colorectal resections

    DEFF Research Database (Denmark)

    Kørner, Hartwig; Nielsen, Hans Jørgen; Søreide, Jon Arne

    2009-01-01

    BACKGROUND: Intraabdominal infections are caused mainly by anastomotic leaks and represent a serious complication. Diagnosis is usually made when patients become critically ill. Though inflammatory markers, including C-reactive protein (CRP) and white blood count (WBC), may contribute to an early...... diagnosis, their clinical roles remain unclear. The diagnostic accuracy of continuous tests depends on the choice of cut-off values. We analyzed the diagnostic accuracy of serial CRP and WBC measurements to detect infectious complications after colorectal resections. PATIENTS AND METHODS: The CRP and WBC...... were routinely measured postoperatively in 231 consecutive patients undergoing colorectal resection. Clinical outcome was registered with regard to postoperative complications. The diagnostic accuracy of CRP and WBC was analyzed by receiver operating characteristics (ROC) curve analysis with intra...

  8. Abdominal compartment syndrome – Intra-abdominal hypertension: Defining, diagnosing, and managing

    Science.gov (United States)

    Papavramidis, Theodossis S; Marinis, Athanasios D; Pliakos, Ioannis; Kesisoglou, Isaak; Papavramidou, Nicki

    2011-01-01

    Abdominal compartment syndrome (ACS) and intra-abdominal hypertension (IAH) are increasingly recognized as potential complications in intensive care unit (ICU) patients. ACS and IAH affect all body systems, most notably the cardiac, respiratory, renal, and neurologic systems. ACS/IAH affects blood flow to various organs and plays a significant role in the prognosis of the patients. Recognition of ACS/IAH, its risk factors and clinical signs can reduce the morbidity and mortality associated. Moreover, knowledge of the pathophysiology may help rationalize the therapeutic approach. We start this article with a brief historic review on ACS/IAH. Then, we present the definitions concerning parameters necessary in understanding ACS/IAH. Finally, pathophysiology aspects of both phenomena are presented, prior to exploring the various facets of ACS/IAH management. PMID:21769216

  9. Identifying patients at risk for high-grade intra-abdominal hypertension following trauma laparotomy.

    Science.gov (United States)

    Strang, Steven G; Van Imhoff, Diederik L; Van Lieshout, Esther M M; D'Amours, Scott K; Van Waes, Oscar J F

    2015-05-01

    Abdominal Compartment Syndrome (ACS) is an uncommon but deleterious complication after trauma laparotomy. Early recognition of patients at risk of developing ACS is crucial for their outcome. The aim of this study was to compare the characteristics of patients who developed high-grade intra-abdominal hypertension (IAH) (i.e., grade III or IV; intra-abdominal pressure, IAP >20 mm Hg) following an injury-related laparotomy versus those who did not (i.e., IAP ≤20 mm Hg). A retrospective analysis of consecutive trauma patients admitted to a level 1 trauma centre in Australia between January 1, 1995 and January 31, 2010 was performed. A comparison was made between characteristics of patients who developed high-grade IAH following trauma laparotomy versus those who did not. A total of 567 patients (median age 31 years) were included in this study. Of these patients 10.2% (58/567) developed high-grade IAH of which 51.7% (30/58) developed ACS. Patients with high-grade IAH were older (pgrade IAH received larger volumes of crystalloids (pgrade IAH suffered higher mortality rates (25.9% (15/58) vs. 12.2% (62/509); p=0.012). Of all patients who underwent a trauma laparotomy, 10.2% developed high-grade IAH, which increases the risk of mortality. Patients with acidosis, coagulopathy, and hypothermia were especially at risk. In these patients, the abdomen should be left open until adequate resuscitation has been achieved, allowing for definitive surgery. This is a level III retrospective study. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Obesity Is Not Associated with Antimicrobial Treatment Failure for Intra-Abdominal Infection.

    Science.gov (United States)

    Dietch, Zachary C; Duane, Therese M; Cook, Charles H; O'Neill, Patrick J; Askari, Reza; Napolitano, Lena M; Namias, Nicholas; Watson, Christopher M; Dent, Daniel L; Edwards, Brandy L; Shah, Puja M; Guidry, Christopher A; Davies, Stephen W; Willis, Rhett N; Sawyer, Robert G

    2016-08-01

    Obesity and commonly associated comorbidities are known risk factors for the development of infections. However, the intensity and duration of antimicrobial treatment are rarely conditioned on body mass index (BMI). In particular, the influence of obesity on failure of antimicrobial treatment for intra-abdominal infection (IAI) remains unknown. We hypothesized that obesity is associated with recurrent infectious complications in patients treated for IAI. Five hundred eighteen patients randomized to treatment in the Surgical Infection Society Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial were evaluated. Patients were stratified by obese (BMI ≥30) versus non-obese (BMI≥30) status. Descriptive comparisons were performed using Chi-square test, Fisher exact test, or Wilcoxon rank-sum tests as appropriate. Multivariable logistic regression using a priori selected variables was performed to assess the independent association between obesity and treatment failure in patients with IAI. Overall, 198 (38.3%) of patients were obese (BMI ≥30) versus 319 (61.7%) who were non-obese. Mean antibiotic d and total hospital d were similar between both groups. Unadjusted outcomes of surgical site infection (9.1% vs. 6.9%, p = 0.36), recurrent intra-abdominal infection (16.2% vs. 13.8, p = 0.46), death (1.0% vs. 0.9%, p = 1.0), and a composite of all complications (25.3% vs. 19.8%, p = 0.14) were also similar between both groups. After controlling for appropriate demographics, comorbidities, severity of illness, treatment group, and duration of antimicrobial therapy, obesity was not independently associated with treatment failure (c-statistic: 0.64). Obesity is not associated with antimicrobial treatment failure among patients with IAI. These results suggest that obesity may not independently influence the need for longer duration of antimicrobial therapy in treatment of IAI versus non-obese patients.

  11. Therapeutic Role of Interleukin 22 in Experimental Intra-abdominal Klebsiella pneumoniae Infection in Mice.

    Science.gov (United States)

    Zheng, Mingquan; Horne, William; McAleer, Jeremy P; Pociask, Derek; Eddens, Taylor; Good, Misty; Gao, Bin; Kolls, Jay K

    2016-01-04

    Interleukin 22 (IL-22) is an IL-10-related cytokine produced by T helper 17 (Th17) cells and other immune cells that signals via IL-22 receptor alpha 1 (IL-22Ra1), which is expressed on epithelial tissues, as well as hepatocytes. IL-22 has been shown to have hepatoprotective effects that are mediated by signal transducer and activator of transcription 3 (STAT3) signaling. However, it is unclear whether IL-22 can directly regulate antimicrobial programs in the liver. To test this hypothesis, hepatocyte-specific IL-22Ra1 knockout (Il22Ra1(Hep-/-)) and Stat3 knockout (Stat3(Hep-/-)) mice were generated and subjected to intra-abdominal infection with Klebsiella pneumoniae, which results in liver injury and necrosis. We found that overexpression of IL-22 or therapeutic administration of recombinant IL-22 (rIL-22), given 2 h postinfection, significantly reduced the bacterial burden in both the liver and spleen. The antimicrobial activity of rIL-22 required hepatic Il22Ra1 and Stat3. Serum from rIL-22-treated mice showed potent bacteriostatic activity against K. pneumoniae, which was dependent on lipocalin 2 (LCN2). However, in vivo, rIL-22-induced antimicrobial activity was only partially reduced in LCN2-deficient mice. We found that rIL-22 also induced serum amyloid A2 (SAA2) and that SAA2 had anti-K. pneumoniae bactericidal activity in vitro. These results demonstrate that IL-22, through IL-22Ra1 and STAT3 singling, can induce intrinsic antimicrobial activity in the liver, which is due in part to LCN2 and SAA2. Therefore, IL-22 may be a useful adjunct in treating hepatic and intra-abdominal infections. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  12. Rhubarb vs. glycerin enema for treatment of critically ill patients with intra-abdominal hypertension.

    Science.gov (United States)

    Wan, Bing; Zhang, Hao; Yin, Jiangtao; Fu, Haiyan; Chen, Yikun; Yang, Liping; Liu, Dadong; Lv, Tangfeng; Song, Yong

    2017-07-01

    Rhubarb has been used as an evacuant for thousands of years. However, recent research has indicated that rhubarb inhibits inflammation and protects organ function. In the current study, the use of rhubarb was investigated in patients with intra-abdominal hypertension (IAH). Specifically, its dual role in attenuating lung and bowel injury by catharsis and inhibiting inflammation was evaluated. Patients in the glycerin group (n=56) received 110 ml of glycerin enema by coloclysis once daily for 7 to 9 days. Patients in the rhubarb group (n=56) were treated with a mixture of 0.3 g/kg body weight rhubarb powder in 100 ml warm water. The Acute Physiology and Chronic Health Evaluation II (APACHE II), Sepsis-Related Organ Failure Assessment (SOFA), intra-abdominal pressure, procalcitonin (PCT), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin (IL)-6 levels were recorded. The duration of mechanical ventilation (MV), respiratory parameters, first day of enteral nutrition (EN), intensive care unit (ICU) hospital stay and 30-day mortality were also recorded. The APACHE II scores were significantly lower in the rhubarb group compared with the glycerin group from day 3 to 9 (Pglycerin group from day 5 to 9 (Pglycerin group. The TNF-α and IL-6 were significantly lower in the rhubarb group compared with the glycerin group from day 3 to 9 (Pglycerin group at day 3, 5 and 7 (Pglycerin group (all P<0.05). Rhubarb treatment was indicated to be beneficial in IAH, by inhibiting inflammation and restoring intestinal function.

  13. Use of near-infrared spectroscopy as a physiologic monitor for intra-abdominal hypertension.

    Science.gov (United States)

    Widder, Sandy; Ranson, Michael K; Zygun, David; Knox, Linda; Laupland, Kevin B; Laird, Philip; Ball, Chad G; Kirkpatrick, Andrew W

    2008-05-01

    Intra-abdominal hypertension (IAH) is increasingly recognized as an important parameter in critically ill (ICU) patients. IAH affects perfusion to all abdominal components including the abdominal wall (AW). Near infrared spectroscopy (NIRS) measures changes in three chromophores including oxygenated hemoglobin (HbO2), deoxygenated hemoglobin (Hb), and cytochrome aa3 (Cyt), providing information concerning dysoxia. We sought to examine whether NIRS measurement of the AW was safe, and correlated with intra-abdominal pressure (IAP) in ICU patients. A NIU-Pro001 system recorded NIRS data over 24 hours from the AW of 9 ICU patients at risk for IAH. IAP was recorded from the bladder. Changes in chromophore values are interpolated from best-fit polynomial curves. Sixty-six paired IAP and NIRS readings were taken from 9 ICU (4-12 observations/patient) patients. No measurement related adverse reactions occurred. The mean (range) first values measured in these patients were; IAP 17.2 mm Hg (9-31); HbO2 0.41 micromol/L (-8.4 to 7.6); Hb 2.6 micromol/L (-3.1 to 12.2); and Cyt 0.65 micromol/L (-3.4 to 4.8). A significant, inverse (or negative) association was found between DeltaNIRS HbO2 level and DeltaIAP (coefficient, -0.1588; p = 0.008). No association was found between DeltaNIRS Hb or DeltaCyt and DeltaIAP. NIRS of the AW appears safe. NIRS measurement of changes in HbO2 appears to be associated with DeltaIAP, and warrant further study in greater numbers of ICU patients with more frequent IAP readings, over longer periods of critical illness.

  14. Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis

    Directory of Open Access Journals (Sweden)

    Edivaldo Massazo Utiyama

    Full Text Available OBJECTIVE: to present our experience with scheduled reoperations in 15 patients with intra-abdominal sepsis. METHODS: we have applied a more effective technique consisting of temporary abdominal closure with a nylon mesh sheet containing a zipper. We performed reoperations in the operating room under general anesthesia at an average interval of 84 hours. The revision consisted of debridement of necrotic material and vigorous lavage of the involved peritoneal area. The mean age of patients was 38.7 years (range, 15 to 72 years; 11 patients were male, and four were female. RESULTS: forty percent of infections were due to necrotizing pancreatitis. Sixty percent were due to perforation of the intestinal viscus secondary to inflammation, vascular occlusion or trauma. We performed a total of 48 reoperations, an average of 3.2 surgeries per patient. The mesh-zipper device was left in place for an average of 13 days. An intestinal ostomy was present adjacent to the zipper in four patients and did not present a problem for patient management. Mortality was 26.6%. No fistulas resulted from this technique. When intra-abdominal disease was under control, the mesh-zipper device was removed, and the fascia was closed in all patients. In three patients, the wound was closed primarily, and in 12 it was allowed to close by secondary intent. Two patients developed hernia; one was incisional and one was in the drain incision. CONCLUSION: the planned reoperation for manual lavage and debridement of the abdomen through a nylon mesh-zipper combination was rapid, simple, and well-tolerated. It permitted effective management of severe septic peritonitis, easy wound care and primary closure of the abdominal wall.

  15. Intra-abdominal obesity: an untreated risk factor for Type 2 diabetes and cardiovascular disease.

    Science.gov (United States)

    Després, J P

    2006-01-01

    The prevalence of Type 2 diabetes is showing a rapid progression worldwide, a phenomenon largely resulting from the epidemic proportions reached by obesity in various populations of the world. However, physicians have been puzzled by the heterogeneity of obesity as not every obese patient is characterized by chronic complications. In this regard, body fat distribution, especially intra-abdominal adipose tissue accumulation, has been found to be a key correlate of a cluster of diabetogenic, atherogenic, prothrombotic and inflammatory metabolic abnormalities increasing the risk of Type 2 diabetes and cardiovascular disease. In this regard, it has been recently demonstrated that abdominal obesity was independently associated with an increased risk of coronary heart disease and Type 2 diabetes independently of overall adiposity. Lifestyle modification programs have shown the benefits on cardiometabolic risk variables of a moderate weight loss as it has been found to be associated with a substantial loss of intra-abdominal fat in viscerally obese patients. However, to be successful, such programs require the support of a multidisciplinary team not available to most clinicians. In this context, it is proposed that pharmacotherapy of obesity should target abdominally obese patients at high risk of Type 2 diabetes and cardiovascular disease, such risk being encompassed by the notion of "cardiometabolic risk". The recent discovery of the endocannabinoid-cannabinoid receptor type 1 (CB1 receptor) system and of its impact on the regulation of energy metabolism represents a significant advance which could help physicians to target abdominal obesity and its related metabolic complications. In this regard, studies have shown that rimonabant (the first CB1 blocker developed) therapy could be useful for the management of clustering cardiovascular disease risk factors in high-risk abdominally obese patients through its marked effects on both abdominal adiposity and related

  16. Recent developments in antibiotic agents for the treatment of complicated intra-abdominal infections.

    Science.gov (United States)

    Lin, Shang-Yi; Huang, Chung-Hao; Ko, Wen-Chien; Chen, Yen-Hsu; Hsueh, Po-Ren

    2016-01-01

    Treatment of complicated intra-abdominal infections (cIAIs) is becoming increasingly difficult because of the widespread emergence of multidrug-resistant organisms. In this review, we discuss the effectiveness of several new antibiotics for the treatment of cIAIs, including new β-lactamase inhibitor combinations (BLICs) and tetracycline-class drugs, recently developed aminoglycosides and quinolones, and novel lipoglycopeptides and oxazolidinones. Of the new BLICs, ceftolozane/tazobactam is associated with adequate clinical cure rates in patients with cIAIs. Currently, two new β-lactamase inhibitors, namely avibactam and MK-7655, are under development for clinical use in the treatment of cIAIs. Eravacycline, a novel, fully synthetic tetracycline-class drug, has been shown in Phase II and III clinical trials to be more potent than tigecycline against a significant number of multidrug-resistant organisms causing cIAIs. Plazomicin, a next-generation aminoglycoside, is a promising agent for treatment of cIAIs due to multidrug-resistant pathogens. Of the recently developed quinolones, delafloxacin and finafloxacin have been shown to be effective against pathogens that survive and multiply in mildly acidic environments, although further clinical studies examining their clinical utility in the treatment of cIAIs are warranted. Oritavancin, a new semisynthetic lipoglycopeptide agent, has been demonstrated to be a potent antibiotic in the treatment of cIAIs due to drug-resistant Gram-positive organisms. Several other new antibiotics in development also show promise and will hopefully broaden the possibilities for treatment of complicated intra-abdominal infections due to MDR pathogens.

  17. EPICO 3.0. Recommendations on invasive candidiasis in patients with complicated intra-abdominal infection and surgical patients with ICU extended stay.

    Science.gov (United States)

    Maseda, Emilio; Rodríguez, Alejandro H; Aguilar, Gerardo; Pemán, Javier; Zaragoza, Rafael; Ferrer, Ricard; Llinares, Pedro; Grau, Santiago

    Although in the last decade the management of invasive fungal infections has improved, a number of controversies persist regarding the management of complicated intra-abdominal infection and surgical extended length-of-stay (LOS) patients in intensive care unit (ICU). To identify the essential clinical knowledge and elaborate a set of recommendations, with a high level of consensus, necessary for the management of postsurgical patients with complicated intra-abdominal infection and surgical patients with ICU extended stay. A Spanish prospective questionnaire, which measures consensus through the Delphi technique, was anonymously answered and e-mailed by 30 multidisciplinary national experts, all of them specialists in fungal invasive infections from six scientific national societies; these experts were intensivists, anesthesiologists, microbiologists, pharmacologists and specialists in infectious diseases. They answered 11 questions drafted by the coordination group after conducting a thorough review of the literature published in the last few years. For a category to be selected, the level of agreement among the experts in each should be equal to or greater than 70%. In a second round, 73 specialists attended a face-to-face meeting which was held after extracting recommendations from the chosen topics and in which they validated the pre-selected recommendations and derived algorithm. After the second Delphi round, the following 11 recommendations with high degree of consensus were validated. For "surgical patients" seven recommendations were validated: (1) risk factors for invasive candidiasis (IC), (2) usefulness of blood culture and direct examination of abdominal fluid to start empirical treatment; (3) PCR for treatment discontinuation; (4) start antifungal treatment in patients with anastomotic leaks; (5) usefulness of Candida score (CS) but not (6) the Dupont score for initiating antifungal therapy in the event of anastomotic leakage or tertiary peritonitis

  18. Associação entre ganho de peso no primeiro ano de vida com excesso de peso e adiposidade abdominal na idade pré-escolar

    OpenAIRE

    Bertotto, Mariane Leite; Valmórbida, Júlia; Broilo, Mônica Cristina; Campagnolo, Paula Dal B.; Vitolo, Márcia Regina

    2012-01-01

    OBJETIVO: Avaliar se a mudança no escore Z do índice de massa corpórea por idade >0,67 no primeiro ano de vida se associou ao excesso de peso na idade pré-escolar. MÉTODOS: Estudo de coorte aninhado a ensaio de campo randomizado realizado na cidade de São Leopoldo, no Rio Grande do Sul. Foram coletados dados de peso e estatura das crianças ao nascimento, dos seis aos oito meses e dos 12 aos 16 meses. Aos três e aos quatro anos, além destes dados aferiu-se a circunferência da cintura. Calculou...

  19. Successful laparoscopic repair of an incarcerated Bochdalek hernia associated with increased intra-abdominal pressure during use of blow gun: A case report

    Directory of Open Access Journals (Sweden)

    Manabu Harada

    2016-01-01

    Conclusion: An incarcerated Bochdalek hernias associated with increased intra-abdominal pressure is an uncommon clinical finding in an adult, and laparoscopic repair of an incarcerated Bochdalek hernia is safe, feasible, and an excellent option as it is minimally invasive.

  20. Ceftazidime-avibactam (CTZ-AVI) as a treatment for hospitalized adult patients with complicated intra-abdominal infections.

    Science.gov (United States)

    Gardiner, Bradley J; Golan, Yoav

    2016-01-01

    Avibactam, a novel β-lactamase inhibitor, has recently been co-formulated with ceftazidime and approved for use in patients with complicated intra-abdominal and urinary tract infections, where no better treatment alternative exists. The basis for its FDA approval has been the extensive clinical experience with ceftazidime and the demonstration in vitro and in animal models that the addition of avibactam reverses resistance to ceftazidime in extended-spectrum β-lactamase and some carbapenemase-producing Enterobacteriaceae. Early clinical data are promising, with efficacy demonstrated in patients with complicated intra-abdominal and urinary tract infections. This review will summarize the in vitro, animal and clinical data available on this agent to date.

  1. Successful Management of Perforated Duodenal Diverticulitis With Intra-abdominal Drainage and Feeding Jejunostomy: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Chin-Fan Chen

    2008-08-01

    Full Text Available We report the clinical experience of one patient with perforated duodenal diverticulitis who was successfully treated by intra-abdominal drainage and feeding jejunostomy. A 53-year-old male patient visited our hospital due to acute onset of abdominal pain and distension. Physical examination revealed tenderness over the epigastric area and right-lower quadrant of the abdomen without obvious rebound tenderness or muscle guarding. Duodenal diverticulitis with a retroperitoneal abscess was identified by abdominal computed tomography scan. Surgical intervention was performed after the failure of conservative treatment. The operative findings were compatible with perforated duodenal diverticulitis, and intra-abdominal drainage of retroperitoneal abscess with simultaneous feeding jejunostomy was undertaken. The patient was doing well at the 4-month postoperative follow-up visit. We suggest the use of a conservative operative method, as opposed to conventional diverticulectomy and duodenorrhaphy, as an alternative approach for the management of this disorder, especially when conservative treatment has failed.

  2. Ceftazidime-avibactam for the treatment of complicated urinary tract infections and complicated intra-abdominal infections.

    Science.gov (United States)

    Mawal, Yogesh; Critchley, Ian A; Riccobene, Todd A; Talley, Angela K

    2015-01-01

    Treatment of complicated urinary tract infections and complicated intra-abdominal infections is increasingly difficult due to the rising prevalence of multidrug-resistant Gram-negative bacteria. Ceftazidime-avibactam is a combination of the established third-generation cephalosporin ceftazidime with avibactam, a novel non-β-lactam β-lactamase inhibitor, which restores the activity of ceftazidime against many β-lactamase-producing Gram-negative bacteria, including extended-spectrum β-lactamases and Klebsiella pneumoniae carbapenemases. Clinical and nonclinical studies supporting the safety and efficacy of ceftazidime-avibactam include microbiological surveillance studies of clinically relevant pathogens, in vivo animal models of infection, pharmacokinetic/pharmacodynamic target attainment analyses, Phase I clinical pharmacology studies, and Phase II/III studies in the treatment of complicated intra-abdominal infections and complicated urinary tract infections, including patients with ceftazidime-nonsusceptible Gram-negative infections.

  3. La medición de la presión intrabdominal, una herramienta diagnóstica para el médico de familia Intra-abdominal pressure measurement, a diagnostic tool for family physician

    Directory of Open Access Journals (Sweden)

    Nizahel Estévez Álvarez

    2010-09-01

    Full Text Available Resulta muy oportuno establecer un diagnóstico precoz de las afecciones intrabdominales agudas, por eso consideramos prudente poner en manos de nuestro personal de salud que labora en el sistema de urgencia del nivel primario, una herramienta diagnóstica más para el Médico de Familia, como es la medición de la presión intrabdominal, por no existir prácticamente experiencias de su empleo fuera de las unidades de atención al paciente grave. Es este un método perfectamente implementable en nuestro medio por su fácil aplicabilidad técnica y su alta especificidad diagnóstica, que permite inferir, en las primeras horas de evolución de los pacientes con cuadros dolorosos abdominales, cuáles resultarían potencialmente necesitados de tratamiento quirúrgico, y de esta manera, ganar en resolutividad. La imposibilidad de realizar esta técnica nunca debería de retrasar la remisión del paciente para su valoración por un especialista en cirugía general, por tanto, esta solo pudiera ser considerada como un complemento más del arsenal diagnóstico al alcance del Médico de Familia, en centros acondicionados para su implementación y con el entrenamiento previo adecuado.It is very appropriate to establish an early diagnosis of acute intra-abdominal infections, thus, authors believe cautious that our health staff working in the primary level of emergence system to count on another diagnostic tool for Family Physician, the intra-abdominal pressure measurement, due to practically the lack of experience of its job out of the care units for the severe patient. This is a method perfectly applicable in our environment by its easy technical application and its high diagnostic specificity allowing inferring during the first hours of evolution of patients presenting with abdominal painful symptoms, who will be potentially needed of surgical treatment and so to achieve a solution. The impossibility to perform this technique never must to retard the

  4. Alterações vasculares em ratos obesos por dieta rica em gordura: papel da Via L-arginina/NO Endotelial

    Directory of Open Access Journals (Sweden)

    Thiago Bruder Nascimento

    2011-07-01

    Full Text Available FUNDAMENTO: Mecanismos subjacentes a anormalidades vasculares na obesidade ainda não estão completamente esclarecidos. OBJETIVO: Foi avaliada a via do óxido nítrico/L-arginina na resposta vascular de ratos obesos por dieta rica em gordura, enfocando as células endoteliais e do músculo liso. MÉTODOS: Ratos com 30 dias de vida foram divididos em 2 grupos: controle (C e obeso (OB, ratos sob dieta rica em gordura por 30 semanas. Após 30 semanas, foram registrados o peso corporal, índice de adiposidade, pressão arterial e perfis metabólicos e endócrinos dos animais. Foram obtidas curvas para noradrelanina na ausência e presença de inibidor de óxido nítrico sintase (L-NAME, 3x10-4M em aorta torácica intacta e com desnudamento em ratos C e OB. RESULTADOS: As medidas de peso corporal, índice de adiposidade, leptina e insulina aumentaram nos ratos OB, enquanto a pressão arterial permaneceu inalterada. A obesidade também produziu tolerância à glicose e resistência à insulina. A reatividade à noradrenalina da aorta intacta foi similar em ratos C e OB. A presença de L-NAME produziu um aumento similar nas respostas máximas, mas um desvio maior à esquerda das respostas nas aortas intactas dos ratos C em relação aos ratos OB [EC50 (x10-7M: C = 1,84 (0,83-4,07, O = 2,49 (1,41-4,38; presença de L-NAME C = 0,02 (0,01-0,04*, O = 0,21 (0,11-0,40*†,*p < 0,05 vs controle respectivo,†p < 0,05 vs controle mais L-NAME, n = 6-7]. Nenhum dos protocolos alterou a reatividade à noradrenalina de aortas com desnudamento. CONCLUSÃO: A obesidade induzida por dieta rica em gordura promove alterações metabólicas e vasculares. A alteração vascular envolveu uma melhora da via endotelial L-arginina/NO provavelmente relacionada à hiperinsulinemia e hiperleptinemia induzidas por dieta. A maior resistência aos efeitos do L-NAME na aorta de ratos obesos diz respeito a menor vulnerabilidade de indivíduos obesos na presença de patologias

  5. The clinical significance of incidental intra-abdominal findings on positron emission tomography performed to investigate pulmonary nodules

    Directory of Open Access Journals (Sweden)

    Gill Richdeep S

    2012-01-01

    Full Text Available Abstract Background Lung cancer is a common cause of cancer-related death. Staging typically includes positron emission tomography (PET scanning, in which18F-fluoro-2-dexoy-D-glucose (FDG is taken up by cells proportional to metabolic activity, thus aiding in differentiating benign and malignant pulmonary nodules. Uptake of FDG can also occur in the abdomen. The clinical significance of incidental intraabdominal FDG uptake in the setting of pulmonary nodules is not well established. Our objective was to report on the clinical significance of incidental intra-abdominal FDG activity in the setting of lung cancer. Methods Fifteen hundred FDG-PET reports for studies performed for lung cancer were retrospectively reviewed for the presence of incidental FDG-positive intraabdominal findings. Patient charts with positive findings were then reviewed and information extracted. Results Twenty-five patients (25/1500 demonstrated incidental intraabdominal FDG uptake thought to be significant (1.7% with a mean patient age of 71 years. Colonic uptake was most common (n = 17 with 9 (52% being investigated further. Of these 9 cases, a diagnosis of malignancy was made in 3 patients, pre-malignant adenomas in 2 patients, a benign lipoma in 1 patient and no abnormal findings in the remaining patients. 8 patients were not investigated further (3 diagnosed with metastatic lung cancer and 2 were of advanced age secondary to poor prognosis. Conclusion Incidental abdominal findings in the colon on FDG-PET scan for work-up of pulmonary nodules need to be further investigated by colonoscopy.

  6. Peritoneal lavage using chlorhexidine gluconate at the end of colon surgery reduces postoperative intra-abdominal infection in mice.

    Science.gov (United States)

    Shams, Wael E; Hanley, Gregory A; Orvik, Andrea; Lewis, Nicole; Shurbaji, M Salah

    2015-05-01

    The use of peritoneal lavage with antiseptic solutions after bowel surgery remains controversial. This study compared peritoneal lavage using chlorhexidine gluconate at low concentrations and normal saline in mice with cecal ligation and perforation. A total of 180 mice were randomized to six groups. Groups A, B, and C received one-time intraperitoneal injections of normal saline, chlorhexidine gluconate 0.05%, and chlorhexidine gluconate 0.025%, respectively. Groups D, E, and F were all subject to cecal ligation and perforation, then underwent partial cecectomy and peritoneal lavage with normal saline only, chlorhexidine gluconate 0.05% followed by normal saline, and chlorhexidine gluconate 0.025% followed by normal saline, respectively. Animals were followed postoperatively then sacrificed and examined at necropsy for occurrence of intra-abdominal abscesses, adhesions, or other pathology. A total of 48 mice (26.7%) developed postoperative intra-abdominal abscesses. Group E mice that had chlorhexidine gluconate 0.05% lavage had significantly lower incidence of postoperative intra-abdominal abscesses compared with that of group D mice that had saline lavage only (P = 0.0113). There was no significant difference in occurrence of macroscopic adhesions among mice groups that had or did not have surgery. (P = 1 and P = 0.3728). Microscopic peritoneal fibrosis occurred significantly more among group E mice that had chlorhexidine gluconate 0.05% lavage compared with group D mice that had saline lavage only (P = Chlorhexidine gluconate 0.05% peritoneal lavage after partial colectomy (cecectomy) in mice reduces postoperative intra-abdominal infection without significant macroscopic adhesion formation. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. [Effect of transpulmonary pressure-directed mechanical ventilation on respiration in severe acute pancreatitis patient with intraabdominal hypertension].

    Science.gov (United States)

    Wu, Xiaoyan; Zheng, Ruiqiang; Lin, Hua; Zhuang, Zhiqing; Zhang, Min; Yan, Peixia

    2015-10-20

    To assess the effect of mehanical ventilation (MV) guided by transpulmonary pressure (Ptp) on respiratory mechanics and gas exchange in severe acute pancreatitis patient with intraabdominal hypertension. Twelve severe acute pancreatitis patient with intraabdominal hypertension and acute respiratory distress syndrome(ARDS) underwent mechanical ventilation were involved from Jan to Dec 2013. PEEP levels were set to achieve a Ptp of 0 to 10 cm of water at end expiration. We also limited tidal volume to keep Ptp at less than 25 cm of water at end inspiration. Respiratory mechanics and gas-exchange were measured. Plat pressure (Pplat) increased and the compliance of chest wall (Ccw) decreased when intraabdominal pressure (IAP) increased. Pplat correlated with IAP positively (r2=0.741 9, P0.05). Compared with baseline, after guiding MV with Ptp, the Level of PEEP (14.6±4.2) cmH2O vs (8.3±2.0) cmH2O, and Ptp-e (1.5±0.5) cmH2O vs (-2.3±1.4) cmH2O increased (P0.05). Ptp-e correlated with PEEP (r2=0.549, P0.05). Compared with baseline, lung compliance (CL) (48.1±10.3) cmH2O vs (25.7±6.4) cmH2O and oxygenation index (PaO2/FiO2) (235±48) mmHg vs (160±35) mmHg improved obviously (P0.05). Transpulmonary pressure-directed mechanical ventilation in ARDS secondary to severe acute pancreatitis patient with intraabdominal hypertension could not only recruit the collapsed alveoli, improve lung compliance, increase oxygenation index and decrease dead space ventilation but also monitor lung stress to avoid alveoli overinflation, which might be lung protective.

  8. Harrahill's technique: a simple screening test for intra-abdominal pressure measurement.

    Science.gov (United States)

    Otto, J; Binnebösel, M; Junge, K; Jansen, M; Dembinski, R; Schumpelick, V; Schachtrupp, A

    2010-08-01

    Repair of giant incisional hernias may lead to an increase in intra-abdominal pressure (IAP) and, sometimes, to abdominal compartment syndrome. Measurement of IAP using Kron's technique (Kron et al. in Ann Surg 199:28-30, 1984) is currently accepted as the gold standard, whereas Harrahill has described a simple measurement setup using urinary drainage manometry (Harrahill in J Emerg Nurs 24:465-466, 1998). The aim of this clinical trail was to evaluate the correlation, reproducibility and effectiveness of this device. A prospective cohort study was performed in 43 patients undergoing elective standard abdominal intervention with laparotomy. These patients remain under surveillance in the intensive care unit and require a urinary catheter because of the operation. We performed comparative measurements of IAP using both Korn's (IVM) and Harrahill's (UDM) technique. Evaluating the correlation between the IVM and UDM techniques, we measured median IAPs of 9.8 +/- 4.1 mmHg (2.9-19.9 mmHg) and 10.0 +/- 4.1 mmHg (min-max: 1.5-19.9 mmHg), respectively. Pearson's coefficient of correlation was r = 0.97. The average of difference between UDM and IVM was -0.2 +/- 0.9 mmHg with limits of agreement of -1.7 to 2.0 mmHg. Evaluating the reproducibility of Harrahill's technique, we found median IAPs of 10.4 +/- 2.1 mmHg (min-max: 2.9-19.1 mmHg) and 10.4 +/- 2.7 mmHg (3.7-19.9 mmHg), respectively, in 43 comparative measurements (Pearson's coefficient of correlation, r = 0.97. The average difference between both measurements was -0.1 +/- 1.1 mmHg with limits of agreement of -2.3 to 2.2 mmHg. We were able to demonstrate good correlation and high reproducibility of IAP measurement using Harrahill's technique compared to the gold standard Korn method. We consider this technique as a suitable method for quick and simple screening test for intra-abdominal hypertension, especially after repair of giant incisional hernias.

  9. Monitoreo de la presión intraabdominal (PIA en el paciente quirúrgico grave

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    Benigno Filgueiras Ramos

    2001-03-01

    Full Text Available Se realizó un estudio prospectivo-investigativo sobre el valor de la medición de la presión intraabdominal (PIA en nuestro medio para determinar su valor como diagnóstico y pronóstico en los pacientes quirúrgicos admitidos en la Unidad de Terapia Intensiva del Hospital Universitario Clinicoquirúrgico «Gustavo Aldereguía Lima», del 1ro. de marzo al 31 de diciembre de 1998 (n:80. A la totalidad de los casos se le realizó medición y aplicó encuesta para determinar valores al ingreso y a las 6, 12, 24 y 48 horas y cierre de su evolución, así como la presencia de complicaciones y aparición de signos clínicos. Se aplicó método de significación estadística de la t de student y análisis de riesgo absoluto y relativo con media y desviación estándar. Se determinó que la PIA tiene un alto valor predictivo en la aparición de complicaciones de pacientes quirúrgicos, y su aumento estableció un pronóstico desfavorable en cuanto a complicaciones y riesgo de muerte, su elevación antecede a la aparición de signos clínicos como fiebre, taquicardia o taquipnea y el valor de su lectura se incrementa en la medida en que transcurre el tiempo de evoluciónA prospective and investigative study was made to determine the diagnostic and prognostic value in our environment of the measurement of intraabdominal pressure (IAP in surgical patients admitted in the Intensive Care Unit of the "Gustavo Aldereguia Lima" Clinical and Surgical Teaching Hospital from March 1st to December 3lst, 1998 (n:80. All the cases were measured and surveyed in order to determine values on admission and at 6, 12, 24, and 48 hours and at the end of their evolution. The complications and the appearance of clinical signs were also determined. The t of student method of statistical significance and the analysis of relative and absolute risk with mean and standard deviation were applied. It was observed that IAP has a high predictive value in the appearance of surgical

  10. Sonographically Assessed Intra-Abdominal Fat And Cardiometabolic Risk Factors in Adolescents with Extreme Obesity

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    Anja Moss

    2016-04-01

    Full Text Available Objective: The metabolic and cardiovascular risk of obesity is predominantly defined through the amount of intra-abdominal fat (IAF. Regarding this risk and the benefits of weight reduction gender-specific differences have been described. The aim of this study was to examine the gender-specific relationship between IAF assessed via ultrasound and the cardiometabolic risk profile in extremely obese adolescents before and after weight loss. Methods: In 107 consecutively admitted adolescents (n = 59 girls, mean age 15.4 ± 2.6 years boys and 15.1 ± 2.1 years girls, mean BMI z-score 3.2 ± 0.6 boys and 3.5 ± 0.6 girls anthropometric and fasting laboratory chemical parameters were measured before and after an in-patient long-term therapy (mean durance 5.6 ± 2.3 months. IAF was determined by measuring the intra-abdominal depth (IAD via ultrasound. Results: IAD was higher in boys as compared to girls (58.0 ± 22.4 mm vs. 51.3 ± 16.0 mm. IAD values were positively associated with BMI-z scores, waist circumferences, HOMA-IR and serum levels of γGT, hs-CRP and IL-6 in both genders. In boys, but not in girls, IAD was significantly correlated with systolic and diastolic blood pressure, serum levels of triglycerides, ALT as well as adiponectin and HDL-cholesterol. After a marked mean weight loss of -27.1 ± 16.2 kg (-20.1 ± 7.9% in boys and of -20.5 ± 11.5 kg (-17.3 ± 7.1% in girls, IAD decreased by -20.7 ± 16.2 mm (--32.4 ± 16.9% in boys and by -18.4 ± 12,7 mm (-34.3 ± 18.4% in girls, resulting in more pronounced ameliorations of cardiovascular risk factors in boys than in girls. Conclusions: The present study indicates that IAF assessed by ultrasound is a good indicator for the cardiometabolic risk factor profile in extremely obese adolescents. Associations between IAF and risk factors are more pronounced in boys than in girls.

  11. Effects of intra-abdominal pressure on liver function assessed with the LiMON in critically ill patients.

    Science.gov (United States)

    Inal, Mehmet Turan; Memis, Dilek; Sezer, Y Atakan; Atalay, Meltem; Karakoc, Abdullah; Sut, Necdet

    2011-06-01

    Intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) are associated with significant morbidity and mortality in critically ill patients. Our aim was to assess the effects of IAH on liver function using the noninvasive liver function monitoring system LiMON and to assess the prognostic value of IAP in critically ill patients. We conducted a retrospective analysis of critically ill patients who were treated in the intensive care unit (ICU). The IAP and indocyanine green plasma disappearance rate (ICG-PDR) measurements were made within 24 hours after admission to the ICU and repeated 12 hours later. Intra-abdominal pressure was measured via a Foley bladder catheter, and ICG elimination tests were conducted concurrently using the LiMON. We included 30 critically ill patients (17 women and 13 men aged 28-89 yr) in our analysis. Statistical analysis showed that the baseline IAP values were significantly higher among nonsurvivors than survivors (19.38 [standard deviation; SD 2.08] v. 13.07 [SD 0.99]). The twelfth-hour IAP values were higher than baseline measurements among nonsurvivors (21.50 [SD 1.96]) and lower than baseline measurements among survivors (11.71 [SD 1.54]); the difference between groups was significant (p LiMON is a good predictor of the effects of IAP on liver function and, thus, can be recommended for the evaluation of critically ill patients.

  12. Combined therapy of allantoin, metronidazole, dexamethasone on the prevention of intra-abdominal adhesion in dogs and its quantitative analysis

    Science.gov (United States)

    Wang, Xiao-Chen; Gui, Chang-Qing; Zheng, Qing-Shan

    2003-01-01

    AIM: To observe the preventive effects of combined therapy of AMD (allantoin, metronidazolem and dexamethasone in combination) on intra-abdominal adhesion in dogs. METHODS: 20 dogs of both sexes were used in this study. After laparotomy under anesthesia, 2 cm section of cecal end was clamped and ligated, then 1 cm cecum section was cut and another 1 cm was kept. The cecum stump was closed with purse-string suture. Both parietal and visceral peritonea were stripped for an area of about 3 × 4 cm2. Before the skin closure, the animals were divided into two groups randomly. The abdominal cavities in Group AMD (n = 10) were rinsed by 200 mL of AMD solution, and with 50 mL left, whereas the control (n = 10) received the equal volume of normal saline. After 7 d, the degree of intra-abdominal adhesions was evaluated by using the score method of ultrasonography and traditional dissection. RESULTS: Compared with the control, both the ultrasonography and traditional dissection scores in Group AMD were significantly decreased that marked as 2.0 ± 1.25 vs 3.3 ± 0.82 and 1.91 ± 0.83 vs 3.3 ± 0.82 respectively (P abdominal adhesion, and ultrasonography is an useful tool to diagnose intra-abdominal adhesion. PMID:12632520

  13. An Intra-Abdominal Desmoid Tumor, Embedded in the Pancreas, Preoperatively Diagnosed as an Extragastric Growing Gastrointestinal Stromal Tumor

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    Mari Mizuno

    2017-04-01

    Full Text Available A 45-year-old woman was found to have a pancreatic tumor by abdominal ultrasound performed for a medical check-up. Abdominal contrast-enhanced computed tomography showed a hypovascular tumor measuring 30 mm in diameter in the pancreatic tail. Endoscopic ultrasound-guided fine needle aspiration was performed. An extragastric growing gastrointestinal stromal tumor was thereby diagnosed preoperatively, and surgical resection was planned. Laparoscopic surgery was attempted but conversion to open surgery was necessitated by extensive adhesions, and distal pancreatectomy, splenectomy, and partial gastrectomy were performed. The histological diagnosis was an intra-abdominal desmoid tumor. A desmoid tumor is a fibrous soft tissue tumor arising in the fascia and musculoaponeurotic tissues. It usually occurs in the extremities and abdominal wall, and only rarely in the abdominal cavity. We experienced a case with an intra-abdominal desmoid tumor that was histologically diagnosed after laparotomy, which had been preoperatively diagnosed as an extragastric growing gastrointestinal stromal tumor. Although rare, desmoid tumors should be considered in the differential diagnosis of intra-abdominal tumors. Herein, we report this case with a literature review.

  14. Effect of exercise training on in vivo insulin-stimulated glucose uptake in intra-abdominal adipose tissue in rats

    DEFF Research Database (Denmark)

    Enevoldsen, L H; Stallknecht, B; Fluckey, J D

    2000-01-01

    Intra-abdominal obesity may be crucial in the pathogenesis of the insulin-resistance syndrome, and training may alleviate this condition. We compared insulin-mediated glucose uptake in vivo in three intra-abdominal adipose tissues (ATs; retroperitoneal, parametrial, and mesenteric) and in subcuta......Intra-abdominal obesity may be crucial in the pathogenesis of the insulin-resistance syndrome, and training may alleviate this condition. We compared insulin-mediated glucose uptake in vivo in three intra-abdominal adipose tissues (ATs; retroperitoneal, parametrial, and mesenteric......) and in subcutaneous AT and also studied the effect of training. Rats were either swim trained (15 wk, n = 9) or sedentary (n = 16). While the rats were under anesthesia, a hyperinsulinemic ( approximately 900 pM), euglycemic clamp was carried out and local glucose uptake was measured by both the 2-deoxy-D-[(3)H...... hyperinsulinemia, in part, reflecting an effect in muscle. During hyperinsulinemia, interstitial glucose concentrations were lower, glucose uptake per 100 g of tissue was higher in AT in trained compared with sedentary rats, and training influenced glucose uptake identically in all ATs. In conclusion, differences...

  15. Practical limitations of bioresorbable membranes in the prevention of intra-abdominal adhesions.

    Science.gov (United States)

    Lim, Rizal; Morrill, Jonathan M; Lynch, Ryan C; Reed, Karen L; Gower, Adam C; Leeman, Susan E; Stucchi, Arthur F; Becker, James M

    2009-01-01

    Intra-abdominal adhesions are a significant source of postoperative morbidity. Bioresorbable barriers composed of hyaluronic acid and carboxymethylcellulose (HA/CMC) reduce adhesion formation by physically separating injured or healing peritoneal surfaces. To assess whether the efficacy of a physical barrier can extend beyond the site of application, we evaluated the effectiveness of an HA/CMC barrier in preventing adhesions distal to the site of placement. Adhesions were induced in rats by creating peritoneal ischemic buttons on either side of a midline incision. An HA/CMC barrier (Seprafilm Genzyme) was intraoperatively placed either under the midline incision, unilaterally over half the ischemic buttons, or bilaterally over all ischemic buttons. Control buttons received no HA/CMC. On day 7 adhesions were scored. In similar experiments, peritoneal fluid was collected at 24 h to assess the effects of HA/CMC on tissue plasminogen activator activity. Placement of HA/CMC under the midline incision did not reduce adhesion formation to distal ischemic buttons (72 +/- 7%) compared to controls (80 +/- 8%). Unilateral placement of HA/CMC significantly (p CMC also significantly (p CMC did not affect peritoneal tPA activity. Effective adhesion reduction by the physical barrier HA/CMC appears to be limited to the site of application in this rat model. Despite the presence of a bioresorbable membrane at predicted sites of adhesion formation in the peritoneal cavity, adhesions readily form to distal unprotected sites.

  16. Laparoscopic Testicular Preservation in Adults with Intra-Abdominal Cryptorchidism: Is It Beneficial?

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    Fábio César Miranda Torricelli

    2012-01-01

    Full Text Available Purpose. To present the results in a midterm followup of laparoscopic testicular preservation in adults with intra-abdominal cryptorchidism. Methods. We analyzed 14 adult patients with cryptorchidism (19 testes submitted to transabdominal laparoscopic evaluation and treatment of the condition. Data was collected retrospectively from a prospective database from August 2005 to May 2010. It analyzed patient age, affected side, procedure, mean operative time, mean hospital stay, postoperative testis position, intra- and postoperative complications, presence of malignancy in the removed testis, and midterm outcomes: size of the testis, development of tumors, and fertility. Results. Mean patient age was 29 (18–54 years. Thirteen (68.4% testes were preserved. There were no intra- or postoperative complications. After a mean followup of 48.7 (20–64 months, all patients submitted to orchiopexy had the organs correctly positioned, although 2 testes were significantly smaller than before the procedure. No patient presented any signs of malignancy during the followup. Fertility was not preserved in bilateral cases. Conclusion. Laparoscopic testicular evaluation and eventual preservation are feasible and safe. In a midterm followup, testicular tumor is not a concern, and unfortunately, fertility may not be preserved in bilateral cases.

  17. Intra-Abdominal Hypertension Causes Bacterial Growth in Lungs: An Animal Study

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    Eleni Papakrivou

    2017-01-01

    Full Text Available To study the effect of intra-abdominal hypertension (IAH on the frequency of pneumonia with an experimental study, thirteen Sprague-Dawley rats were included. Eight out of thirteen animals were randomly assigned to receive 10 ml of benzalkonium chloride 0.2% (megacolon group and five animals received 10 ml NaCl 0.9% (controls. Animals were anaesthetized by intramuscular delivery of ketamine. The incidence of positivity for bacteria lung tissue cultures and mesenteric lymph node cultures was assessed at the 21st day after animals’ sacrification, or before in case of death. All megacolon group animals presented progressive increase of the abdomen and increased IAP (≥10 mmHg whereas the frequency of their evacuations was almost eliminated. Controls presented normal evacuations, no sign of abdominal distention, and normal IAP. In megacolon group animals, there was evidence of significant amount of bacteria in lung cultures. In contrast, no bacteria were found in control animals.

  18. Impact of Percutaneous Drainage on Outcome of Intra-abdominal Infection Associated With Pediatric Perforated Appendicitis.

    Science.gov (United States)

    Bonadio, William; Langer, Miriam; Cueva, Julie; Haaland, Astrid

    2017-10-01

    Perforated appendicitis can result in potentially serious complications requiring prolonged medical care. The optimal approach to successfully managing this condition is controversial. Review of 80 consecutive cases of pediatric acute perforated appendicitis with intra-abdominal infection (IAI) medically managed with parenteral antibiotics and percutaneous drainage (PD) during a 7-year period. All patients received broad spectrum parenteral antibiotic therapy. One-third were hospitalized for >2 weeks. IAI was identified on admission in 60% compared with developing during hospitalization in 40% of cases. Before performing PD, the mean duration of antibiotic therapy in those who developed IAI during hospitalization was 6 days. IAI cultures yielded 127 bacterial isolates; polymicrobial infection occurred in 65% of cases. Only 7% of aspirates were sterile. The most common pathogens were Escherichia coli (82%), of which 5 isolates exhibited extended-spectrum β-lactamase production, and streptococci (40%). At the time of PD, 60% were febrile (mean duration of in-hospital fever, 7.5 days); 67% defervesced within 24 hours after the procedure. Posthospitalization abdominal complications (recurrent IAI or appendicitis) occurred in one-third of patients. Children with perforated appendicitis and IAI often have a complicated and prolonged clinical course. Medical management consisting solely of parenteral antibiotic therapy is frequently ineffective in resolving IAI. Rapid clinical improvement commonly follows PD.

  19. Use of methylene blue in the prevention of recurrent intra-abdominal postoperative adhesions.

    Science.gov (United States)

    Neagoe, Octavian C; Ionica, Mihaela; Mazilu, Octavian

    2018-01-01

    Objective To evaluate the efficacy of methylene blue in preventing recurrent symptomatic postoperative adhesions. Methods Patients with a history of >2 surgeries for intra-abdominal adhesion-related complications were selected for this study. Adhesiolysis surgery was subsequently performed using administration of 1% methylene blue. The follow-up period was 28.5 ± 11.1 months. Results Data were available from 20 patients (seven men and 13 women) whose mean ± SD age was 51.2 ± 11.4 years. Adhesions took longer to become symptomatic after the first abdominal surgery when the initial pathology was malignant compared with benign. However, the recurrence of adhesions after a previous adhesiolysis surgery had a similar time onset regardless of the initial disease. Following adhesiolysis surgery with methylene blue, the majority of patients did not present with symptoms associated with adhesion complications (i.e., chronic abdominal pain, bowel obstruction) for the length of the follow-up period. Conclusions The use of methylene blue during adhesiolysis surgery appears to reduce the recurrence of adhesion-related symptoms, suggesting a beneficial effect in the prevention of adhesion formation.

  20. Large Gastric Teratoma: A Rare Intra-abdominal Mass of Infancy

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    Roumina Hasan

    2016-05-01

    Full Text Available Amongst the varied, diverse causes of intraabdominal masses in infancy and early childhood, gastric teratomas (GTs account for a very small proportion. A worldwide literature search reveals only around one hundred cases of GT and also supports the fact that its preoperative diagnosis remains elusive. Here we report the case of a two-month-old male who presented to the pediatric surgery outpatient department of Kasturba Medical College and Hospital, Karnataka, India, with progressive distension of abdomen since birth. Clinically, a large firm, non-mobile and non-tender mass involving all four quadrants of the abdomen was seen. Ultrasound revealed a large solid-cystic mass with internal septations extending from the epigastrium up to the pelvis. Computed tomography revealed a large intraperitoneal fat containing solid-cystic mass lesion showing curvilinear and chunky areas of calcification, with the mass focally indenting the posterior gastric wall and showing focal polypoidal intragastric extension. Exploratory laparotomy revealed a large cystic tumor with a solid component, arising from lesser curvature of the stomach, showing focal intraluminal extension across the posterior gastric wall, and occupying the whole lesser sac and abdominal cavity. The tumor was excised in toto along with the body of the stomach. Histopathological examination showed mature tissue derived from all three germ cell layers and confirmed the diagnosis of mature gastric teratoma. The patient was disease free at one-year follow-up.

  1. A soluble suppressor T cell factor protects against experimental intraabdominal abscesses.

    Science.gov (United States)

    Zaleznik, D F; Finberg, R W; Shapiro, M E; Onderdonk, A B; Kasper, D L

    1985-03-01

    This paper describes a suppressor T cell factor which protects mice against intraabdominal abscesses caused by Bacteroides fragilis. This soluble cell-free factor (ITF) is derived from splenic T cells from mice immunized with capsular polysaccharide (CP) of B. fragilis. Mice receiving ITF are protected from developing abscesses caused by B. fragilis to the same degree as animals receiving intact immune splenic T cells. The factor appears to be small in molecular size as protective activity is dialyzable through a 12,000-mol wt exclusion dialysis membrane and is present in fractions intermediate between the bed and void volumes of a P2 Biogel column. The protective effect of ITF is antigen-specific to B. fragilis alone. Mice given a complex inoculum of B. fragilis, enterococcus, and another anaerobe develop abscesses even after receiving column-purified ITF. The activity of ITF also is eliminated after adsorption with B. fragilis CP coupled to sheep erythrocytes but not with an unrelated CP coupled to sheep erythrocytes. ITF, therefore, appears to have a binding site for B. fragilis CP. ITF is heat-labile and loses efficacy after protease digestion, suggesting that the active material is a protein. These studies define a suppressor cell factor with activity in a model system resembling human disease and offer promise for increased understanding of the diversity of cell-mediated immune systems.

  2. Use of a model of intraabdominal sepsis for studies of the pathogenicity of Bacteroides fragilis.

    Science.gov (United States)

    Onderdonk, A B; Shapiro, M E; Finberg, R W; Zaleznik, D F; Kasper, D L

    1984-01-01

    Over the past eight years, a Wistar rat model for intraabdominal sepsis has been developed and used to document the role of obligate anaerobes in this infections. The ability of Bacteroides fragilis alone to provoke abscesses in this model system is due to a species-specific capsular polysaccharide. It has been shown that active immunization of rats with capsular polysaccharide of B. fragilis protects these animals against the development of abscesses after intraperitoneal challenge with this species. Passive transfer of hyperimmune globulin provided protection against B. fragilis bacteremia in nonimmune, challenged animals but did not confer protection against abscess development. Adoptive transfer of spleen cells from immunized to nonimmunized animals resulted in protection against abscess following challenge with B. fragilis, a finding suggesting that a T cell-dependent immune response was involved in protection. It has also been shown that inbred, congenitally athymic OLA/Rnu rats that were actively immunized developed abscesses despite the presence of capsular antibody, as did 100% of unimmunized athymic control rats. However, no phenotypically normal, littermate control rats that were actively immunized developed abscesses. These data suggest that a T cell-dependent immune response is an important part of immunity to B. fragilis. Additional experiments are being performed to better define the immunologic and chemical basis for the protection afforded by immunization.

  3. The Effect of Postoperative Hyperbaric Oxygen Treatment on Intra-Abdominal Adhesions in Rats

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    Yi-Chiang Hsu

    2012-09-01

    Full Text Available Abdominal adhesions, whether caused by peritoneal trauma, radiation, infection, or a congenital condition, are associated with a wide range of complications. These complications include chronic abdominal or pelvic pain, infertility, and adhesive small bowel obstruction. Such adhesions render re-operation difficult, with attendant risks of inadvertent enterostomy and increased operation time. The purpose of this study was to investigate the potential of hyperbaric oxygen (HBO therapy in the prevention of abdominal adhesions in an experimental animal study. A laparotomy was performed on Wistar rats to induce the formation of adhesions on the cecum and the intra-abdominal area (1 ´ 2 cm. A superficial layer of the underlying muscle from the right abdominal wall was also shaved and prepared for aseptic surgery. The rats were divided into four groups according to the duration of HBO therapy; five additional groups were designated according to the conditions of HBO therapy. When the rats were evaluated according to adhesion area and grade, a statistically significant difference was observed between the control and HBO treatment groups (p < 0.005. Results from this study suggest that HBO treatment could reduce adhesion formation; and further suggest that HBO therapy may have therapeutic potential in the treatment of postoperative peritoneal adhesion.

  4. Colonic mesenteric lymphatic malformation presenting as an intraabdominal abscess in an infant: A case report.

    Science.gov (United States)

    Sriram, Gonakoti; Zendejas, Benjamin; Vargas, Sara O; Chen, Catherine

    2017-08-05

    Lymphatic malformations are low-flow vascular malformations most commonly located in the head and neck; isolated intraabdominal involvement is rare. An 8-month-old previously healthy male presented with a 9-day history of fevers. On examination, right-sided abdominal tenderness was noted. Ultrasound revealed a large heterogeneous mass, and CT scan revealed a rim-enhancing cystic mass adjacent to the right colon. Laboratory investigation including blood cultures was normal. His fever resolved with broad-spectrum antibiotics. Diagnostic laparoscopy revealed a large, firm mass arising from the mesentery of the right colon. An open right hemicolectomy with ileocolonic anastomosis was performed. The infant tolerated the procedure well, and he was discharged home on postoperative day four, pathologic examination identified a mesenteric lymphatic malformation with secondary abscess formation. This atypical presentation of an uncommon entity was instructive in several ways, particularly illustrating the diagnostic pitfalls that can be introduced by superinfection. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. REDUÇÃO DE MEDIDAS ABDOMINAIS DE MULHERES JOVENS SUBMETIDAS Á UM TREINAMENTO FÍSICO POR MEIO DO MÉTODO PILATES®

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    Pâmela Camila Pereira

    2017-05-01

    Full Text Available Uma das principais preocupações de mulheres jovens é a lipodistrofia, e o método Pilates® ajuda a diminuir a adiposidade através de exercícios que priorizam o fortalecimento da musculatura do “power house”. Objetivo: Analisar a influência do treinamento físico por meio do Método Pilates® na redução de medidas abdominais de mulheres jovens. Metodologia: Trata-se de um estudo transversal, intervencional, quantitativo e de centro único, amostra foi composta por 3 mulheres saudáveis, entre 18 e 23 anos, que realizaram exercícios do Método Pilates®, avaliadas antes e após 10 sessões. Resultados: O método Pilates® foi eficaz na redução significativa das medidas abdominais. Discussão: O método Pilates® é considerado uma importante ferramenta para melhorar a aparência física pois há melhora da força abdominal, fortalecimento da musculatura e redução da lipodistrofia. Conclusão: O Método Pilates® é capaz de reduzir medidas abdominais por meio dos exercícios propostos.

  6. Comparison of intraabdominal abscess formation after laparoscopic and open appendicectomies in children.

    Science.gov (United States)

    Nataraja, Ramesh M; Teague, Warwick J; Galea, Julie; Moore, Lynette; Haddad, Munther J; Tsang, Thomas; Khurana, Sanjeev; Clarke, Simon A

    2012-02-01

    Although laparoscopic appendicectomy (LA) is an accepted alternative to the open appendicectomy (OA) approach, it has been suggested that there is a higher incidence of intraabdominal abscesses (IAAs). Our aim was to determine the incidence of IAA in 3 pediatric surgical centers routinely practicing both techniques. Data were collected retrospectively for pediatric patients undergoing LA or OA over an 8-year period. Analysis included IAA formation, appendicitis complexity, radiologic/histologic investigations, grade of surgeon, and wound infection. A total of 1267 appendicectomies were performed (514 LAs and 753 OAs). There was no difference between the incidences of IAA (LA, 3.9% [19/491] vs OA, 3.9% [28/714]; P = 1.0). The incidence of IAA was increased in those with complicated appendicitis (34/375 [9.1%] vs 13/830 [1.6%]; P ≤ .0001). There was an increased proportion of those with complicated appendicitis in the LA group (182/491 [37.1%] vs 193/714 [27.0%]; P = .0002). Surgical trainees were more likely to be the primary surgeon in the OA group (79% vs 63%; P = .0001), although the incidence of IAA did not correlate with grade of surgeon. There was no significant difference in incidence of wound infection between groups (LA, 4.6% [8/173] vs OA, 2.5% [18/377]; P = .93). This large retrospective study shows that the technique of appendicectomy does not appear to affect the incidence of IAAs. Patients with complicated appendicitis are more likely to develop an IAA regardless of technique. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  7. Prevalence of JAK29V617F) mutation in intra-abdominal venous thrombosis.

    Science.gov (United States)

    Deepak, Amarapurkar; Punamiya, Sundeep; Patel, Nikhil; Parekh, Sunil; Mehta, Shilpa; Shah, Nirali

    2011-01-01

    Myeloproliferative disorders (MPD) (like polycythemia vera, essential thrombocythemia and primary myelofibrosis) are responsible for 50% cases of Budd-Chiari syndrome (BCS) and 35% cases of portal venous thrombosis (PVT) in western series. A point mutation at Val617Phe of Janus kinase 2 tyrosine kinase gene (JAK2(V617F) mutation) occurs in high proportion with MPD. This may be useful in diagnosing overt and latent form of MPD in intra-abdominal venous thrombosis (IAVT), consisting of BCS and PVT. In a 4 year prospective study from 2006 to 2009, JAK2 mutations were assessed in all patients diagnosed with MPD and IAVT attending our institution. Twenty three healthy individuals and 31 patients with non-MPD hematological disorders served as controls. All patients of idiopathic IAVT were tested for the mutation. Test for JAK2(V617F) mutation was carried out by allele specific polymerase chain reaction. JAK2(V617F) mutation was significantly more common in MPD patients (76%) than in non-MPD hematological disorders (0%) and healthy controls (0%). There was no statistical difference in presence of JAK2(V617F) mutation in patients of MPD with or without thrombosis (80% vs. 74%). In 58 patients with IAVT, the JAK2(V617F) mutation was present in 40% with BCS, 14% with PVT and 100% combined BCS+PVT). The JAK2(V617F) mutation occurs at high frequency in patients with MPD and IAVT. All idiopathic IAVT patients must be screened for JAK2(V617F) mutation to detect latent MPD. Detection of latent MPD by JAK2(V61F) mutation in BCS may change treatment strategy and outcome.

  8. Evaluation of isoflurane and propofol anesthesia for intraabdominal transmitter placement in nesting female canvasback ducks.

    Science.gov (United States)

    Machin, K L; Caulkett, N A

    2000-04-01

    Heart rate, occurrence of apnea, body temperature, quality of anesthesia and nest abandonment were compared during either propofol or isoflurane anesthesia of nesting female canvasback ducks (Aythya valisineria) at 15 to 18 days of incubation. One hundred eighteen canvasbacks were assigned randomly to three treatments so that nest abandonment could be compared among treatments from May to July 1995 and 1996. Sterile dummy silicone implants were placed during an abdominal laparotomy while ducks were anesthetized with either propofol or isoflurane, or ducks were flushed from the nest but not captured (control). Propofol was delivered through an intravenous catheter, while isoflurane was delivered in oxygen. Propofol provided smooth, rapid induction and recovery, whereas ducks recovering from isoflurane tended to struggle. At the nest, ducks in the propofol group were given additional boluses until they were lightly anesthetized, whereas birds that received isoflurane were released. All birds survived surgery but one death occurred prior to surgery in 1995 using propofol during a period without ventilation and monitoring. Adequate artificial ventilation is recommended to prevent complications. Heart rate declined significantly in both years during isoflurane anesthesia and in 1995 during propofol anesthesia but not 1996. During both isoflurane and propofol anesthesia, body temperature declined significantly over time. Nest abandonment was significantly different among treatments and occurred in all treatment groups in both years, but propofol (15%) and control groups (8%) had lower than expected abandonment compared to isoflurane (28%). Propofol offers several advantages over isoflurane for field use; equipment is easily portable, lower anesthetic cost, and ambient temperature does not alter physical characteristics of the drug. Advantages over isoflurane, including lower nest abandonment following intraabdominal radio transmitter placement, make propofol a good

  9. Intra-abdominal fat. Part I. The images of the adipose tissue localized beyond organs

    Directory of Open Access Journals (Sweden)

    Andrzej Smereczyński

    2015-09-01

    Full Text Available Unaltered fat is a permanent component of the abdominal cavity, even in slim individuals. Visceral adiposity is one of the important factors contributing to diabetes, cardiovascular diseases and certain neoplasms. Moreover, the adipose tissue is an important endocrine and immune organ of complex function both when normal and pathological. Its role in plastic surgery, reconstruction and transplantology is a separate issue. The adipose tissue has recently drawn the attention of research institutes owing to being a rich source of stem cells. This review, however, does not include these issues. The identifi cation of fat is relatively easy using computed tomography and magnetic resonance imaging. It can be more diffi cult in an ultrasound examination for several reasons. The aim of this paper is to present various problems associated with US imaging of unaltered intra-abdominal fat located beyond organs. Based on the literature and experience, it has been demonstrated that the adipose tissue in the abdominal cavity has variable echogenicity, which primarily depends on the amount of extracellular fl uid and the number of connective tissue septa, i.e. elements that potentiate the number of areas that refl ect and scatter ultrasonic waves. The normal adipose tissue presents itself on a broad gray scale: from a hyperechoic area, through numerous structures of lower refl ection intensity, to nearly anechoic regions mimicking the presence of pathological fl uid collections. The features that facilitate proper identifi cation of this tissue are: sharp margins, homogeneous structure, high compressibility under transducer pressure, no signs of infi ltration of the surrounding structures and no signs of vascularization when examined with the color and power Doppler. The accumulation of fat tissue in the abdominal cavity can be generalized, regional or focal. The identifi cation of the adipose tissue in the abdominal cavity using ultrasonography is not always

  10. Optimal times above MICs of ceftibuten and cefaclor in experimental intra-abdominal infections.

    Science.gov (United States)

    Onyeji, C O; Nicolau, D P; Nightingale, C H; Quintiliani, R

    1994-05-01

    The duration of time that serum drug levels remain above the MIC (time above the MIC) for the pathogen has been shown to be the most significant parameter determining the efficacies of beta-lactam antibiotics. In the described study, we investigated the optimal time above the MIC of ceftibuten and cefaclor using a nonneutropenic mouse model of intra-abdominal infections caused by Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Streptococcus pneumoniae. The abilities of the drugs to protect mice against the organisms were determined in mouse protection tests, and the doses were fractionated to produce various dosing regimens with different times above the MIC. All drug-organism combinations showed a significant correlation (r > 0.9) between drug efficacy and the time above the MIC. Also, with ceftibuten treatment, the different dosing regimens that produced equal times above the MIC resulted in the same efficacy, whereas with cefaclor, an apparent dose-dependent effect was observed. These results showed that for a 100% recovery from K. pneumoniae and E. coli infections, the optimal times above the MIC with ceftibuten treatment were 2.2 and 1.6 h, respectively. Relatively high doses of both antibiotics were required to ensure recovery from S. pneumoniae infections. In vitro time-kill studies demonstrated that cefaclor exhibits a marked inoculum effect against the pathogens, and there was a concentration-dependent killing at a large inoculum size. On the other hand, ceftibuten showed no inoculum effect. It is suggested that optimization of both dose and time above the MIC appears to be necessary for the treatment of S. aureus infections with cefaclor, and this may apply to other beta-lactams tht exhibit marked inoculum effects.

  11. Evidence for T cell-dependent immunity to Bacteroides fragilis in an intraabdominal abscess model.

    Science.gov (United States)

    Onderdonk, A B; Markham, R B; Zaleznik, D F; Cisneros, R L; Kasper, D L

    1982-01-01

    It has been shown that active immunization of rats with the capsular polysaccharide of Bacteroides fragilis protects these animals against abscess development following intraperitoneal challenge with this species. Passive transfer of hyperimmune globulin from immunized animals to nonimmune recipients provided protection against B. fragilis bacteremia in challenged animals, but did not confer protection against abscess development. On the other hand, adoptive transfer of spleen cells from immunized animals to nonimmunized recipients resulted in protection against abscesses following challenge with B. fragilis. These data suggested that a T cell-dependent immune response was involved in protection against abscess development after immunization with B. fragilis capsular antigen. To determine the possible role of cell-mediated immunity prompted by the capsular antigen, inbred congenitally athymic OLA/Rnu rats and their phenotypically normal littermates were actively immunized. Despite the development of high titers of anti-B. fragilis capsular antibody, 100% of actively immunized athymic rats developed abscesses, as did 100% of unimmunized athymic control rats. However, no phenotypically normal littermate control rats that were actively immunized developed abscesses, while 100% of phenotypically normal unimmunized rats developed abscesses. Additional studies showed that adoptive transfer of T cell-enriched spleen cell preparations from Wistar/Lewis rats immunized with the capsular polysaccharide to nonimmune recipients also resulted in protection against B. fragilis-induced abscesses. We conclude that the protection afforded by immunization with B. fragilis capsule against intraabdominal abscesses caused by that organism is T cell-mediated and does not require the presence of serum antibody.

  12. Rapid non-contrast magnetic resonance imaging for post appendectomy intra-abdominal abscess in children

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Megan H. [Washington University School of Medicine in St. Louis, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Eutsler, Eric P.; Khanna, Geetika [Washington University School of Medicine in St. Louis, Pediatric Radiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Sheybani, Elizabeth F. [Mercy Hospital St. Louis, Department of Radiology, St. Louis, MO (United States)

    2017-07-15

    Acute appendicitis, especially if perforated at presentation, is often complicated by postoperative abscess formation. The detection of a postoperative abscess relies primarily on imaging. This has traditionally been done with contrast-enhanced computed tomography. Non-contrast magnetic resonance imaging (MRI) has the potential to accurately detect intra-abdominal abscesses, especially with the use of diffusion-weighted imaging (DWI). To evaluate our single-center experience with a rapid non-contrast MRI protocol evaluating post-appendectomy abscesses in children with persistent postsurgical symptoms. In this retrospective, institutional review board-approved study, all patients underwent a clinically indicated non-contrast 1.5- or 3-Tesla abdomen/pelvis MRI consisting of single-shot fast spin echo, inversion recovery and DWI sequences. All MRI studies were reviewed by two blinded pediatric radiologists to identify the presence of a drainable fluid collection. Each fluid collection was further characterized as accessible or not accessible for percutaneous or transrectal drainage. Imaging findings were compared to clinical outcome. Seven of the 15 patients had a clinically significant fluid collection, and 5 of these patients were treated with percutaneous drain placement or exploratory laparotomy. The other patients had a phlegmon or a clinically insignificant fluid collection and were discharged home within 48 h. Rapid non-contrast MRI utilizing fluid-sensitive and DWI sequences can be used to identify drainable fluid collections in post-appendectomy patients. This protocol can be used to triage patients between conservative management vs. abscess drainage without oral/intravenous contrast or exposure to ionizing radiation. (orig.)

  13. Intra-abdominal pressure and possible ways of its drug correction after emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Людмила Василівна Новицька-Усенко

    2015-11-01

    Full Text Available Introduction. Postoperative disorders of gastrointestinal tract (GIT motility are often after abdominal operations. Postoperative enteroparesis is usually accompanied by the raise of intra-abdominal pressure (IAP.Materials and methods. After approval of research by bioethics committee and informed consent 52 patients were prospectively divided in 2 groups depending on the type of postoperative intensive care. Patients underwent operations on abdominal cavity by laparotomy incision on the subject of peritonitis. Patient of the 1 (control group (n=27 after operation received stimulation of GIT with metoclopramide and simethicone.  In the 2 group (n=25 patients received metoclopramide and simethicone. Patients were comparable on age, sex, concomitant pathology, ASA class (IIE-IIIE and the type of operative intervention (laparotomy on the subject of peritonitis. IAP level was studied before operation and at 1,2,3 days after it. IAP was measured by indirect method trough the urinary bladder. The values recommended by the World society of abdominal compartment syndrome were considered as the normal IAP level.  Perfuse pressure (PP in abdominal cavity was calculated by formula: PP=MAP-ICP where MAP – mean arterial pressure. There were also studied indices of the central and peripheral hemodynamics, inflammation markers (leukocytes, fibrinogen level, IL-1α, TNFα, IL-10, leukocytic index of intoxication was calculated. The final point of research was 28 day after operation when we evaluated mortality and life quality on Rancho Los Amigos scale.Results and discussion. We registered the raise of IAP in 63.1% of patients. The value of intra-abdominal pressure exceeded an upper limit of the normal one by 58,5% (р <0,001. Among patients with high IAP 83% had intra-abdominal hypertension (IAH of 1 degree, 17% - of 2 degree.  The development of 3 and 4degree IAH were not observed before operation. PP remained within the normal.Correlative analysis

  14. Increased Resistin Levels in Intra-abdominal Sepsis: Correlation with proinflammatory cytokines & Acute Physiology & Chronic Health Evaluation II scores

    Directory of Open Access Journals (Sweden)

    Tonguç U. Yilmaz

    2014-10-01

    Full Text Available Objectives: Resistin, a hormone secreted from adipocytes and considered to be a likely cause of insulin resistance, has recently been accepted as a proinflammatory cytokine. This study aimed to determine the correlation between resistin levels in patients with intra-abdominal sepsis and mortality. Methods: Of 45 patients with intraabdominal sepsis, a total of 35 adult patients were included in the study. This study was undertaken from December 2011 to December 2012 and included patients who had no history of diabetes mellitus and who were admitted to the general surgery intensive care units of Gazi University and Bülent Ecevit University School of Medicine, Turkey. Evaluations were performed on 12 patients with sepsis, 10 patients with severe sepsis, 13 patients with septic shock and 15 healthy controls. The patients’ plasma resistin, interleukin-6 (IL-6, tumour necrosis factor alpha (TNF-α, interleukin-1 beta (IL-1β, procalcitonin, lactate and glucose levels and Acute Physiology and Chronic Health Evaluation (APACHE II scores were studied daily for the first five days after admission. A correlation analysis of serum resistin levels with cytokine levels and APACHE II scores was performed. Results: Serum resistin levels in patients with sepsis were significantly higher than in the healthy controls (P <0.001. A significant correlation was found between serum resistin levels and APACHE II scores, serum IL-6, IL-1β, TNF-α, procalcitonin, lactate and glucose levels. Furthermore, a significant correlation was found between serum resistin levels and all-cause mortality (P = 0.02. Conclusion: The levels of resistin were significantly positively correlated with the severity of disease and were a possible mediator of a prolonged inflammatory state in patients with intra-abdominal sepsis.

  15. Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial.

    Science.gov (United States)

    Irwin, Melinda L; Yasui, Yutaka; Ulrich, Cornelia M; Bowen, Deborah; Rudolph, Rebecca E; Schwartz, Robert S; Yukawa, Michi; Aiello, Erin; Potter, John D; McTiernan, Anne

    2003-01-15

    The increasing prevalence of obesity is a major public health concern. Physical activity may promote weight and body fat loss. To examine the effects of exercise on total and intra-abdominal body fat overall and by level of exercise. Randomized controlled trial conducted from 1997 to 2001. A total of 173 sedentary, overweight (body mass index > or =24.0 and >33% body fat), postmenopausal women aged 50 to 75 years who were living in the Seattle, Wash, area. Participants were randomly assigned to an intervention consisting of exercise facility and home-based moderate-intensity exercise (n = 87) or a stretching control group (n = 86). Changes in body weight and waist and hip circumferences at 3 and 12 months; total body, intra-abdominal, and subcutaneous abdominal fat at 12 months. Twelve-month data were available for 168 women. Women in the exercise group participated in moderate-intensity sports/recreational activity for a mean (SD) of 3.5 (1.2) d/wk for 176 (91) min/wk. Walking was the most frequently reported activity. Exercisers showed statistically significant differences from controls in baseline to 12-month changes in body weight (-1.4 kg; 95% confidence interval [CI], -2.5 to -0.3 kg), total body fat (-1.0%; 95% CI, -1.6% to -0.4%), intra-abdominal fat (-8.6 g/cm2; 95% CI, -17.8 to 0.9 g/cm2), and subcutaneous abdominal fat (-28.8 g/cm2); 95% CI, -47.5 to -10.0 g/cm2). A significant dose response for greater body fat loss was observed with increasing duration of exercise. Regular exercise such as brisk walking results in reduced body weight and body fat among overweight and obese postmenopausal women.

  16. Profile of ceftolozane/tazobactam and its potential in the treatment of complicated intra-abdominal infections

    Directory of Open Access Journals (Sweden)

    Skalweit MJ

    2015-06-01

    Full Text Available Marion J Skalweit1,2 1Department of Medicine, 2Department of Biochemistry, Louis Stokes Cleveland Department of Veterans Affairs and Case Western Reserve University School of Medicine, Cleveland, OH, USA Abstract: Drug-resistant pathogens have gained a foothold especially in the most vulnerable patient populations, hospitalized and immunocompromised individuals. Furthermore, extended-spectrum β-lactamase and carbapenemase-producing organisms are finding their way even into the community, with patients presenting to the hospital with established colonization and infection with resistant Enterobacteriaceae in particular. Recently, a novel antipseudomonal cephalosporin in combination with an established Class A β-lactamase inhibitor, ceftolozane/tazobactam has been approved by the FDA for use in the treatment of complicated urinary tract infections and complicated intra-abdominal infections. Ceftolozane is a uniquely potent antipseudomonal cephalosporin because of its high affinity for the penicillin-binding proteins of Pseudomonas aeruginosa, its low affinity for the intrinsic Class C β-lactamases of P. aeruginosa, its ability to enter P. aeruginosa through the outer membrane without the utilization of OprD protein, and the fact that it is not a substrate of the often upregulated MexAB/OprM efflux system of P. aeruginosa. The biological chemistry, pharmacokinetics/pharmacodynamics, microbiologic spectrum, and clinical trials that led to the approval of ceftolozane is reviewed. A discussion regarding its potential role in the treatment of complicated intra-abdominal infections and other infectious disease syndromes associated with drug-resistant pathogens follows. Keywords: ceftolozane/tazobactam, complicated intra-abdominal infections, Pseudomonas aeruginosa

  17. The Cause of Unexpected Acute Abdomen and Intra-Abdominal Hemorrhage in 24-Week Pregnant Woman: Bochdalek Hernia.

    Science.gov (United States)

    Koca, Yavuz Savas; Barut, Ibrahim; Yildiz, İhsan; Yazkan, Rasih

    2016-01-01

    Bochdalek hernia (BH) is the most common type of congenital diaphragm hernia and is rarely seen in adults. In adult patients, BH often remains asymptomatic or presents with nondiagnostic symptoms and may lead to complications, though rarely. The necrosis and perforations occurring in the hernia may lead to mortality. In this report, we present a 34-year-old pregnant woman at 24 gestational weeks who presented with Bochdalek hernia causing gastric volvulus associated with perforation and intra-abdominal hemorrhage associated with splenic rupture.

  18. The Cause of Unexpected Acute Abdomen and Intra-Abdominal Hemorrhage in 24-Week Pregnant Woman: Bochdalek Hernia

    Directory of Open Access Journals (Sweden)

    Yavuz Savas Koca

    2016-01-01

    Full Text Available Bochdalek hernia (BH is the most common type of congenital diaphragm hernia and is rarely seen in adults. In adult patients, BH often remains asymptomatic or presents with nondiagnostic symptoms and may lead to complications, though rarely. The necrosis and perforations occurring in the hernia may lead to mortality. In this report, we present a 34-year-old pregnant woman at 24 gestational weeks who presented with Bochdalek hernia causing gastric volvulus associated with perforation and intra-abdominal hemorrhage associated with splenic rupture.

  19. Jejunal diverticulitis: an unusual cause of an intra-abdominal abscess - coronal Computed Tomography reconstruction can aid the diagnosis

    Directory of Open Access Journals (Sweden)

    Jim Virjee

    2008-11-01

    Full Text Available Jejunal diverticulitis is a rare condition that can present with an acute abdomen and be referred for imaging.  We present the case of an elderly patient who at CT was diagnosed with an intra-abdominal abscess involving both jejunum and transverse colon. However, the underlying eitiology was not initially clear until small bowel barium follow-through.Pertinent points regarding CT findings in jejunal diverticulitis are discussed, and practical recommendations in small bowel diverticulum recognition and diagnosis are made. 

  20. Early experience: high-intensity focused ultrasound treatment for intra-abdominal aggressive fibromatosis of failure in surgery.

    Science.gov (United States)

    Zhao, Wen-Peng; Han, Zhi-Yu; Zhang, Jing; Yu, Xiao-Ling; Cheng, Zhi-Gang; Zhou, Xiang; Liang, Ping

    2016-06-01

    The study was conducted to describe ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation in the treatment of intra-abdominal aggressive fibromatosis in seven patients who had failed surgery. We retrospectively investigated seven patients with pathologically proven intra-abdominal aggressive fibromatosis and surgical failure, who were treated with USgHIFU between June 2013 and February 2015. The main causes for surgical failure were a large tumour size or adjacent tissue invasion by the tumour. All of the patients were treated with palliative intent, to reduce symptoms of the diseases. The medical records were reviewed during the follow-up period, and the patients were asked to compare the symptoms of their disease as improved, unchanged or worsened, based on their levels before treatment. In addition, contrast-enhanced MRI was conducted to follow the size of the tumours before and after therapy. The procedure was successfully accomplished in all of the patients without severe side effects. The median diameter of the tumours was 10.3 cm (range, 7.6-13.6 cm) and the mean ablation rate (the percentage rate of the non-perfused volume compared with the tumour volume on enhanced MRI after treatment) was 92.5 ± 3.7% (range, 86.5-96.8%). One patient underwent two treatments for a large tumour size, and other patients received single-visit therapy. All of the patient clinical symptoms remitted significantly after 6 months. The regression rates of the tumours were 34.8 ± 8.2% (range, 22.4-46.1%) and 58.2 ± 12.7% (range, 43.8-70.3%), respectively, at 6 and 12 months after treatment. USgHIFU ablation could be an effective alternative minimally invasive therapy for the achievement of local control of intra-abdominal aggressive fibromatosis. The conclusions indicate that USgHIFU ablation could be a promising alternative treatment for the achievement of local control of intra-abdominal aggressive fibromatosis.

  1. Spectrally selective UV bactericidal effect for curative treatment of post-surgical intra-abdominal abscesses and other infections

    Science.gov (United States)

    Dudelzak, Alexander E.; Miller, Mark A.; Babichenko, Sergey M.

    2004-07-01

    Results of in-vitro studies of bactericidal effects of ultraviolet (UV) irradiation on strains causing drug-resistant endo-cavital infections (Enterococcus, Staphylococcus aureus, Pseudomonas aeruginosa, and others) are presented. An original technique to measure effects of UV-irradiation on bacterial growth at different wavelengths has been developed. Spectral dependences of the bactericidal effect have been observed, and spectral maxima of bactericidal efficiency have been found. Applications to curative treatments of wounds, post-surgical intra-abdominal abscesses and other diseases are discussed.

  2. Hemodynamic and metabolic changes as a result of application of different degrees of non-pneumatic intra-abdominal compression in rats

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    Bin LIANG

    2012-05-01

    Full Text Available Objective  To assess effects of different degrees of non-pneumatic intra-abdominal high pressure on metabolism and hemodynamics for the purpose of selecting the safe range of intra-abdominal pressure in anesthetized rats. Methods  Twenty four male Wistar rats were anesthetized and randomly distributed into four groups (IAP0, IAP5, IAP10, IAP15 (n=6. All the rats underwent 30 minutes of intra-abdominal distension resulting in 0, 5, 10 or 15mmHg of intra-abdominal pressure with a non-pneumatic device. Arterial blood were collected at following 4 time points: baseline, end of insufflation, 20 and 40min after desufflation respectively for assaying arterial blood pH, PaO2, PaCO2, HCO3-, base excess (BE, lactic acid (LAC. At the end of experiment, serum alanine aminotransferase (ALT and creatinine (Cr were determined. Mean artery pressure (MAP and heart rate (HR were monitored via right carotid catheter throughout the experiment. Results  No death occurred in each group. MAP in IAP15 group decreased by 42 percent when compared with that in IAP0 group (P 0.05. The pH values at the period of insufflation and at 20min after desufflation in IAP15 group were significantly lower than those in other groups (P 0.05. Significantly higher LAC level and significantly lower HCO3- and BE level were seen in IAP15 group compared with those of IAP0, IAP5, IAP10 groups at the end of the insufflation and at 20 and 40min after desufflation (P 0.05. Conclusion Safe limit of intra-abdominal pressures is less than 10mmHg, and intra-abdominal pressure of 15mmHg should be avoided in spontaneously breathing anesthetized rats.

  3. Infecciones genitales por VPH tratadas por microinmunoterapia

    National Research Council Canada - National Science Library

    Jacques Grauwet, Diego

    2011-01-01

    ... genitales por VPH tratadas por microinmunoterapia Diego Jacques Grauwet Médico ginecólogo y homeópata, Madrid, España Recibido el 30 de mayo de 2010; aceptado el 10 de septiembre de 2011 Correo...

  4. Recognition and importance of forced exhalation on the measurement of intraabdominal pressure: a subgroup analysis from a prospective cohort study on the incidence of abdominal compartment syndrome in medical patients.

    Science.gov (United States)

    Hongyan Liang; Daugherty, Elizabeth L; Taichman, Darren; Hansen-Flaschen, John; Fuchs, Barry D

    2008-01-01

    Intraabdominal pressure is measured conventionally at end-expiration; however, the significance of forced exhalation on this measurement has not been evaluated previously. Using data from a previous prospective cohort study of the incidence of intraabdominal hypertension and abdominal compartment syndrome in medical intensive care unit patients, the authors evaluated 65 strip-chart recordings obtained from 28 patients who had measurements of intraabdominal pressure and airway pressures taken simultaneously. Forced exhalation was identified by a rise in intraabdominal pressure during exhalation. Forced exhalation was observed in 4 patients; with a mean intraabdominal pressure increase of 14.3 +/- 1.3 mm Hg at end-exhalation, compared with a decrease of -2.5 +/- 1.2 mm Hg in 24 patients without forced exhalation and absolute pressures of 28.0 +/- 6.6 versus 13.8 +/- 3.9 mm Hg (P abdominal compartment syndrome.

  5. Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage

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    Papavramidis Theodossis S

    2009-06-01

    Full Text Available Abstract Background Acute pancreatitis leads to abdominal hypertension and compartment syndrome. Weeks after the episodes pancreatic fluids sometimes organize to pseudocysts, fluid collections by or in the gland. Aims of the present study were to evaluate the intra-abdominal pressure (IAP induced by large pancreatic pseudocysts and to examine the effect of their transcutaneous drainage on IAP. Methods Twenty seven patients with a pancreatic pseudocyst were included. Nine patients with pseudocysts greater than 1l (group A had CT drainage and eighteen (volume less than 1l were the control group. The measurements of group A were taken 6 hours before and every morning after the drainage, while for group B, two measurements were performed, one at the day of the initial CT and one 7 days after. Abdominal compliance (Cabd was calculated. Data were analyzed using student's t-test. Results Baseline IAP for group A was 9.3 mmHg (S.D. 1.7 mmHg, while the first post-drainage day (PDD IAP was 5.1 mmHg (S.D. 0.7 mmHg. The second PDD IAP was 5.6 mmHg (S.D. 0.8 mmHg, the third 6.4 mmH (S.D. 1.2 mmHgg, the fourth 6.9 mmHg (S.D. 1.6 mmHg, the fifth 7.9 mmHg (S.D. 1.5 mmHg, the sixth 8.2 mmHg (S.D. 1.4 mmHg, and the seventh 8.2 mmHg (S.D. 1.5 mmHg. Group B had baseline IAP 8.0 mmHg (S.D. 1.2 mmHg and final 8.2 mmHg (S.D. 1.4 mmHg. Cabd after drainage was 185.6 ml/mmHg (SD 47.5 ml/mmHg. IAP values were reduced between the baseline and all the post-drainage measurements in group A. IAPs seem to stabilize after the 5th post-drainage day. Baseline IAP was higher in group A than in group B, while the two values, at day 7, were equivalent. Conclusion The drainage of large pancreatic pseudocyst reduces IAP. Moreover, the IAP seems to rise shortly after the drainage again, but in a way that it remains inferior to the initial value. More chronic changes to the IAP are related to abdominal cavity's properties and have to be further studied.

  6. Sclerosing epithelioid fibrosarcoma presenting as intraabdominal sarcomatosis with a novel EWSR1-CREB3L1 gene fusion.

    Science.gov (United States)

    Stockman, David L; Ali, Siraj M; He, Jie; Ross, Jeffrey S; Meis, Jeanne M

    2014-10-01

    We report a case of intraabdominal sclerosing epithelioid fibrosarcoma (SEF) with a t (11;22)(p11.2;q12.2) Ewing sarcoma breakpoint region 1-cAMP-responsive element-binding protein 3-like 1 translocation. A 43-year old man presented with massive ascites and shortness of breath. Imaging studies revealed a large mesenteric-based mass with extensive omental/peritoneal disease. After resection and cytoreductive surgery, the tumor recurred with metastasis to the lungs; the patient is still alive with disease. Histologically, there was a uniform population of epithelioid cells arranged in cords and nests, embedded in a dense collagenous matrix; no areas of low-grade fibromyxoid sarcoma were identified. All immunohistochemical markers were nonreactive. Fluorescence in situ hybridization studies showed rearrangement of Ewing sarcoma breakpoint region 1. Genomic profiling by clinical grade next-generation sequencing revealed a fusion gene between intron 11 of Ewing sarcoma breakpoint region 1 (22q12.2) and intron 5 of cAMP-responsive element-binding protein 3-like 1 (11p11.2). This is the first report of "pure" or true SEF presenting as intraabdominal sarcomatosis with confirmation of the recently described unique Ewing sarcoma breakpoint region 1-cAMP-responsive element-binding protein 3-like 1 gene fusion in SEF without areas of low-grade fibromyxoid sarcoma. Copyright © 2014. Published by Elsevier Inc.

  7. Focus on ceftazidime-avibactam for optimizing outcomes in complicated intra-abdominal and urinary tract infections.

    Science.gov (United States)

    Nicolau, David P

    2015-01-01

    Complicated intra-abdominal infections and urinary tract infections are frequently associated with Gram-negative bacteria and treatment can be hampered by the involvement of resistant organisms. A common resistance mechanism is β-lactamase production which confers resistance to β-lactam antibiotics. This article summarizes β-lactamases found among Gram-negative bacteria as well as providing an overview of complicated intra-abdominal infections and urinary tract infections and the impact inappropriate antibiotic therapy and antibiotic resistance has in their treatment. The author reviews the activity of ceftazidime-avibactam , including animal model data and microbiological data from Phase II clinical trials. This article also highlights Phase III clinical trials of ceftazidime-avibactam that are ongoing or completed and briefly discusses other β-lactamase inhibitor combinations currently in development. The increasing problem and complexity of β-lactamase resistance has been met by resurgence in the development of β-lactamase inhibitor combinations. These show promise in the treatment of resistant infections. One β-lactamase inhibitor in advanced development with a broad spectrum of activity is avibactam, covering class A, class C and some class D enzymes. Importantly, the activity of avibactam also includes carbapenemases such as the KPC and OXA-48. The combination of avibactam with the cephalosporin ceftazidime is attractive, given the spectrum of antimicrobial activity and the low toxicity of the cephalosporin class.

  8. Can selection of mechanical ventilation mode prevent increased intra-abdominal pressure in patients admitted to the intensive care unit?

    Science.gov (United States)

    Rafiei, Mohammad Reza; Aghadavoudi, Omid; Shekarchi, Babak; Sajjadi, Seyed Sajed; Masoudifar, Mehrdad

    2013-05-01

    Increased intra-abdominal pressure (IAP) results in dysfunction of vital organs. The aim of the present study was to evaluate the effect of mechanical ventilation mode on IAP. In a cohort study, a total of 60 patients aged 20-70 years who were admitted to the ICU and underwent mechanical ventilation were recruited. Mechanical ventilation included one of the three modes: Biphasic positive airway pressure (BIPAP) group, synchronize intermittent mandatory ventilation (SIMV) group, or continuous positive airway pressure (CPAP) group. For each patient, mechanical ventilation mode and its parameters, blood pressure, SpO2, and status of tube feeding and IAP were recorded. Our findings indicate that the study groups were not significantly different in terms of anthropometric characteristics including age (64.5 ± 4, P = 0.1), gender (male/female 31/29, P = 0.63), and body mass index (24 ± 1.2, P = 0.11). Increase IAP was related to the type of respiratory mode with the more increased IAP observed in SIMV mode, followed by BIPAP and CPAP modes (P = 0.01). There were significant correlations between increased IAP and respiratory variables including respiratory rate, pressure support ventilation, and inspiratory pressure (P mechanical ventilation like CPAP and BIPAP mode in patients who are prone to Intra-abdominal hypertension.

  9. Ultrasound guided fine needle aspiration cytology: a sensitive diagnostic tool for diagnosis of intra-abdominal lesions.

    Science.gov (United States)

    Islam, T; Hossain, F; Rumpa, A P; Sikder, N H; Bhuiyan, M A; Karim, E; Hossain, A

    2013-04-01

    Ultrasound guided fine needle aspiration cytology is widely accepted as a safe diagnostic procedure in various neoplastic and non-plastic disorders. This study was conducted to determine the usefulness and diagnostic accuracy of ultrasound guided fine needle aspiration cytology in the diagnosis of intraabdominal lesions. This cross sectional study was conducted in the Department of Radiology and Imaging, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh during the period of June 2007 to June 2009. A total 78 patients with intra abdominal lesions were included in this study. Fifty nine (75.6%) were males and 19 (24.4%) were females. Out of total aspirates 29 (37.2%) were categorized as benign, 41 (52.6%) were malignant and 8 (10.3%) were non-representative, as it contained only blood. Most of the benign lesions were liver abscess 19 (24.4%). A diagnosis of primary malignancy was established in 26 (33.3%) and that of secondary in 15 (19.2%). The results showed a sensitivity of 89.7%. Ultrasound guided fine needle aspiration cytology is a sensitive diagnostic tool in a wide spectrum of intra-abdominal neoplastic and non-neoplastic disorders. It is a simple, safe, rapidand inexpensive technique.

  10. Mesenteric rheumatoid nodules masquerading as an intra-abdominal malignancy: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Tomlinson James S

    2009-07-01

    Full Text Available Abstract Background Rheumatoid nodules are the most common extra-articular findings in patients with rheumatoid arthritis. They occur most commonly at pressure points such as the extensor surfaces of the forearms, fingers, and occiput, but have also been reported to occur in unusual locations including the central nervous system, pericardium, pleura, and sclera. We present the unusual case of rheumatoid nodules in the small bowel mesentery masquerading as an intra-abdominal malignancy. Case presentation A 65-year-old-male with a known history of longstanding erosive, nodular, seropositive rheumatoid arthritis was incidentally found to have a mesenteric mass on computed tomography (CT exam of the abdomen. This mass had not been present on prior imaging studies and was worrisome for a malignancy. Attempts at noninvasive biopsy were nondiagnostic but consistent with a "spindle" cell neoplasm. Laparotomy revealed extensive thickening and fibrosis of the small bowel mesentery along with large, firm nodules throughout the mesentery. A limited bowel resection including a large, partially obstructing, nodule was performed. Pathology was consistent with an unusual presentation of rheumatoid nodules in the mesentery of the small bowel. Conclusion Rheumatoid nodules should be considered in the differential diagnosis of a patient who presents with an intra-abdominal mass and a history of rheumatoid arthritis. Currently, no tests or imaging modality can discriminate with sufficient accuracy to rule out a malignancy in this difficult diagnostic delimma. Hopefully, this case will serve as impetus for further study and biomarker discovery to allow for improved diagnostic power.

  11. Medición de la presión intraabdominal para la vigilancia posoperatoria de la cirugía abdominal Measurement of intraabdominal pressure for the postoperative surveillance of abdominal surgery

    Directory of Open Access Journals (Sweden)

    Ernesto Medrano Montero

    2007-12-01

    Full Text Available Se realizó un estudio de serie de casos de 286 pacientes laparotomizados que ingresaron en la Unidad de Cuidados Intensivos del Hospital General «Vladimir Ilich Lenin» (Holguín, entre el 4 de marzo de 1999 y el 29 de enero del 2003. El objetivo fue describir el comportamiento de la edad, sexo, diagnóstico al ingreso, frecuencia de complicaciones intraabdominales posoperatorias y el resultado al egreso de estos pacientes. Según el APACHE II, la escala pronóstica de gravedad fue de 13,1. Las principales causas del ingreso fueron peritonitis (34,9 % y politraumatismos (19,52 %. Encontramos complicaciones posoperatorias en el 32,5 % de los pacientes. La presión intraabdominal en los pacientes complicados fue de 14,94 ± 4,88 cm H2O, mientras que en los pacientes que no tuvieron complicaciones fue de 11,67 ± 4,63 cm H2O (F = 31,4948; p A case series study that included 286 laparotomized patients that were admitted at the ICU of “Vladimir Ilich Lenin” General Hospital, in Holguin, between March 4, 1999 and January 29, 2003, was conducted. The objective was to describe the behavior of age, sex, diagnosis on admission, frequency of intraabdominal postoperative complications, and the result attained in these patients on discharge. According to APACHE II, the prognostic scale of severity was 13.1. The main cause of hospitalization were peritonitis (34.9 % and polytraumas (19.52 %. Postoperative complications were found in 32.5 % of the patients. Intraabdominal pressure in the complicated patients was 14.94 ± 4.88 cm H2O; whereas, in those patients without complications it was11.67 ± 4.63 cm H2O (F = 31.4948; p < 0.05. There were 94 deaths (32.8 % and their intrabdominal pressure was 14.22 ± 5.18 cm H2O. However, the survivors’ pressure was 12.07 ± 4.74 cm H2O (F = 12.2824; p < 0.05. The patients with postoperative complications and unfavorable results on discharge from the ICU had a higher intrabdominal pressure than those with a

  12. Effects of additional exercise training on epicardial, intra-abdominal and subcutaneous adipose tissue in major depressive disorder: A randomized pilot study.

    Science.gov (United States)

    Kahl, K G; Kerling, A; Tegtbur, U; Gützlaff, E; Herrmann, J; Borchert, L; Ates, Zeynep; Westhoff-Bleck, M; Hueper, K; Hartung, D

    2016-03-01

    Major depressive disorder (MDD) is associated with increased amounts of intra-abdominal and epicardial adipose tissue, risk factors for the development of cardio-metabolic disorders. Exercise has been shown to reduce intra-abdominal fat in different conditions such as obesity and diabetes mellitus, thereby reducing cardio-metabolic risks. Therefore we examined the effects of exercise on adipose tissue compartments in patients with MDD. Of thirty depressed patients included, twenty received supervised exercise training, and ten received no specific training. Volumes of subcutaneous, intra-abdominal and epicardial adipose tissue were measured using magnetic resonance imaging, and factors constituting the metabolic syndrome were determined. Significant effects of the training condition were observed on the amount of epicardial adipose tissue (P=0.017), subcutaneous adipose tissue (P=0.023), weight (P=0.047), body-mass index (P=0.04), high density lipoproteins (P=0.021) and the number of metabolic syndrome factors (P=0.018). The amount of intra-abdominal adipose tissue decreased slightly, although not significantly, in the exercise group. Exercise training reduces the amount of visceral, in particular epicardial adipose tissue, in patients with MDD, and ameliorates factors constituting the metabolic syndrome. Given the high prevalence of cardio-metabolic disorders in major depression, exercise training may be recommended as an additional treatment component. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. A Prospective Randomized Trial of Imipenem-Cilastatin Versus Clindamycin/Tobramycin in the Treatmentof Intra-Abdominal and Pelvic Infections

    Directory of Open Access Journals (Sweden)

    Lionel A Mandell

    1993-01-01

    Full Text Available Objective: A Canadian multicentre clinical trial in the treatment of intra-abdominal and pelvic infections to compare the efficacy and safety of monotherapy using imipenem-cilastatin (imipenem (500 mg intravenously every 6 h versus combination therapy with clindamycin/tobramycin (clindamycin 600 mg intravenously every 6 h and tobramycin 1.7 mg/kg intravenously every 8 h.

  14. Spontaneous non-traumatic massive intraabdominal spleen bleeding in young females: Importance of ATLS principles and trauma alarm.

    Science.gov (United States)

    Kazaryan, Airazat M; Wiborg, Joachim; Hauss, Kristin; Anundsen, Tommy K; Flemmen, Olav J; Holm, Thor Erik; Lauzikas, Giedrius

    2014-01-01

    Female, 28 FINAL DIAGNOSIS: Rupture of the splenic artery aneurysm Symptoms: Hypovolemic shock Medication: - Clinical Procedure: - Specialty: Surgery. Rare disease. ATLS principles have become a standard of care for trauma patients. However, there is poor documentation in regard to spontaneous non-traumatic life-threatening bleedings. Two women, a 21-year-old and a 28-year-old, presented to the admissions department in hemorrhagic shock. The latter woman was in her 26(th) week of pregnancy. The trauma alarm was raised and the patients received prompt, complex diagnostics including ultrasonography verifying massive intraabdominal fluid. Massive infusion therapy was initiated. The first patient was intubated in the emergency room and required cardiopulmonary rescue due to cardiopulmonary arrest. The patients were moved to the surgical theatre for life-saving operations at 30 and 60 minutes, respectively, after arrival in the emergency department. In the first case, we found 4 L of intraabdominal blood and a rupture in the lower pole of the splenic capsule. Splenectomy was performed. The patient developed disseminated intravascular coagulation syndrome and was transferred to a first-level trauma centre for further treatment. She survived with slight sequelae in the form of psychosocial maladjustment, and low-grade spasms and myoclonic twitches due to prolonged brain ischemia. She was steadily improving at 17 months of follow-up. Viral mononucleosis was established as the cause of the spontaneous rupture of the spleen. In the second case, we found 2.5 L of intraabdominal blood and persistent bleeding from an aneurism of the splenic artery. A splenectomy was performed. She was transferred to a first-level trauma centre for further treatment. She lost the fetus and underwent autotransplantation of the right kidney after 3 months, due to the finding of an aneurism of the right renal artery on the abdominal CT. We also found an ectasia in the ascending aorta, which will

  15. Single-center experience with intra-abdominal liposarcoma: Optimal minimum duration for postoperative remnant tumor screening.

    Science.gov (United States)

    Rhu, Jinsoo; Cho, Chan Woo; Lee, Kyo Won; Park, Hyojun; Park, Jae Berm; Choi, Yoon-La; Kim, Sung Joo

    2017-08-01

    This study sought to identify factors related to the prognosis of intra-abdominal liposarcoma and to determine the optimal minimum duration for remnant tumor screening. Intra-abdominal liposarcoma is associated with high rates of incomplete resection and recurrence requiring a sophisticated follow-up strategy.Patients who underwent surgery for intra-abdominal liposarcoma were included. Cox analyses were used to analyze factors related to recurrence and survival. To determine the optimal minimum duration for remnant tumor screening, patients with recurrence after surgery despite gross complete resection were grouped by a postoperative detection time of 1, 3, or 6 months. Their survivals were compared to the gross incomplete resection group.A total of 168 patients were included. Kaplan-Meier 5-year disease-free survival was 35.9% and overall survival was 66.5%. Multiplicity (HR=2.528, CI=1.585-4.033, P gross incomplete resection (HR = 4.368, CI = 1.890-10.097, P = .001), positive margin (HR = 2.766, CI = 1.367-5.600, P = .005), FNCLCC grade (G2,HR = 2.044, CI = 0.937-4.459; G3,HR = 4.470, CI = 1.893-10.557; P = .003), and RT (HR = 0.322, CI = 0.160-0.648, P = .001) were related to overall survival. Dividing patients into 1 month (P = .097) and 3 months (P = 0.063) did not yield significant differences in univariate analyses, whereas 6 months showed significant difference (P = .015) compared to the gross incomplete resection group. Patients with tumors detected within 6 months showed similar survival to the gross incomplete resection group (HR = 0.552, CI = 0.241-1.260, P = .158), whereas patients with tumor detection after 6 months showed better survival (HR = 0.325, CI = 0.149-0.708, P = .005).In conclusion, minimum duration of 6 months for remnant tumor screening using CT seems optimal.

  16. Adhesion formation of a polyvinylidenfluoride/polypropylene mesh for intra-abdominal placement in a rodent animal model.

    Science.gov (United States)

    Junge, Karsten; Binnebösel, Marcel; Rosch, Raphael; Jansen, Marc; Kämmer, Daniel; Otto, Jens; Schumpelick, Volker; Klinge, Uwe

    2009-02-01

    Effective laparoscopic ventral herniorrhaphy mandates the use of an intraperitoneal mesh. Visceral adhesions and shrinkage of prosthetics may complicate repairs. The aim of this study was to compare adhesion formation, mesh shrinkage and tissue ingrowth after intra-abdominal placement of a novel two-component monofilament mesh structure made of polypropylene (PP) and polyvinylidenfluoride (PVDF) with current alternatives. Forty Sprague-Dawley rats were used in this study. Mesh samples were fixed as intra-abdominal only mesh at the right lateral abdominal wall. The study groups were: PVDF+PP (polypropylene parietally and polyvinylidenfluoride viscerally), PP+Col (polypropylene with a collagenoxidized film), ePTFE (smooth surface viscerally and a textured surface parietally), and PP (a pure polypropylene mesh serving as control). The meshes were explanted after 30 days. Adhesions were scored as a percentage of explanted biomaterials' affected surface area; prosthetic shrinkage was calculated. Foreign-body reaction to mesh materials was measured by investigating the amount of inflammatory infiltrate and fibrotic tissue formation. In terms of adhesion score, the pure PP mesh showed the highest values followed by the ePTFE, PVDF+PP, and PP+Col meshes. Quantitative assessment of adhesion area revealed a significantly higher value of the pure PP mesh sample (62.0 +/- 22.1%) compared with the PP+Col (26.8 +/- 12.1%) and the PVDF+PP mesh (34.6 +/- 8.2%). Percentage of shrinkage showed a significantly higher value of the ePTFE mesh (52.4 +/- 13.9%) compared with all other mesh modifications (PP+Col 19.8 +/- 13.9%, PVDF+PP 19.9 +/- 7.0%, and PP 26.8 +/- 9.5%). Inflammatory infiltrate was significantly reduced in the PVDF+PP mesh group compared with all other mesh samples. The use of the novel two-component monofilament mesh structure made of polypropylene and polyvinylidenfluoride was found to be favorable regarding adhesion formation and mesh shrinkage compared to

  17. Validity and Reliability of an Instrumented Speculum Designed to Minimize the Effect of Intra-abdominal Pressure on the Measurement of Pelvic Floor Muscle Strength

    Science.gov (United States)

    Ashton-Miller, James A.; Zielinski, Ruth; Miller, Janis M.; DeLancey, John O.L.

    2015-01-01

    Background Existing clinical measurements of pelvic floor muscle strength are contaminated by crosstalk from intra-abdominal pressure. We tested an improved instrumented speculum designed to minimize this crosstalk. The hypotheses were that the speculum yields: 1) maximum vaginal closure forces unrelated to intra-abdominal pressure, 2) discriminatory validity between women who have strong vs. weak pelvic floor muscles, and 3) acceptable test-retest reliability. Methods Maximum voluntary vaginal closure force was measured in 40 incontinent women (20–77 years) using the improved instrumented speculum on two visits spaced one month apart. At the baseline visit, intra-abdominal pressure was also estimated via intra-vesical catheterization during the vaginal closure force measurement. Subjective estimate of pelvic floor muscle strength was also assessed using digital palpation by a skilled examiner to determine group placement as “strong” (n=31) or “weak” (n=9). Findings Vaginal closure force was not significantly correlated with intra-abdominal pressure (r = −.26, p = .109). The groups with subjectively scored strong and weak pelvic floor muscles differed significantly by mean [SD] maximum vaginal closure force (3.8 [1.7] vs. 1.9 [0.8] N respectively, p < .01.) Across both time points the mean vaginal closure force was 3.42 [1.67] N with a range of .68 to 9.05 N. Mean Visit 1 and Visit 2 vaginal closure force scores did not differ (3.41 [1.8] and 3.42 [1.6] N, respectively). The vaginal closure force repeatability coefficient was 3.1 N. Interpretation The improved speculum measured maximum vaginal closure force without evidence of crosstalk from intra-abdominal pressure, while retaining acceptable discriminant validity and repeatability. PMID:25307868

  18. Validity and reliability of an instrumented speculum designed to minimize the effect of intra-abdominal pressure on the measurement of pelvic floor muscle strength.

    Science.gov (United States)

    Ashton-Miller, James A; Zielinski, Ruth; DeLancey, John O L; Miller, Janis M

    2014-12-01

    Measurements of pelvic floor muscle strength are contaminated by crosstalk from intra-abdominal pressure. We tested an improved instrumented speculum designed to minimize this crosstalk. The hypotheses were that the speculum yields: 1) maximum vaginal closure forces unrelated to intra-abdominal pressure, 2) discriminatory validity between women with strong vs. weak pelvic floor muscles, and 3) acceptable test-retest reliability. Maximum voluntary vaginal closure force was measured in 40 incontinent women (20-77 years) on two visits spaced one month apart. At the baseline visit, intra-abdominal pressure was also estimated via intra-vesical catheterization during the vaginal closure force measurement. Subjective estimate of pelvic floor muscle strength was also assessed using digital palpation by a skilled examiner to determine group placement as "strong" (n=31) or "weak" (n=9). Vaginal closure force was not significantly correlated with intra-abdominal pressure (r=-.26, P=.109). The groups with subjectively scored strong and weak pelvic floor muscles differed significantly by mean [SD] maximum vaginal closure force (3.8 [1.7] vs. 1.9 [0.8] N respectively, P<.01.) Across both time points the mean vaginal closure force was 3.42 [1.67] N with a range of .68 to 9.05 N. Mean Visit 1 and Visit 2 vaginal closure force scores did not differ (3.41 [1.8] and 3.42 [1.6] N, respectively). The vaginal closure force repeatability coefficient was 3.1N. The improved speculum measured maximum vaginal closure force without evidence of crosstalk from intra-abdominal pressure, while retaining acceptable discriminant validity and repeatability. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. A case of multiple intra-abdominal splenosis with computed tomography and magnetic resonance imaging correlative findings

    Science.gov (United States)

    Imbriaco, Massimo; Camera, Luigi; Manciuria, Alessandra; Salvatore, Marco

    2008-01-01

    Hepatic splenosis refers to heterotopic auto-transplantation and implantation of splenic tissue resulting from the spillage of cells from the spleen after splenic trauma or splenectomy. The true incidence of splenosis is unknown, because this entity is usually an incidental finding at surgery. Splenic implants are usually multiple, and can be localized anywhere in the peritoneal cavity. Splenic implants in the peritoneal cavity may be confused with renal tumors, abdominal lymphomas and endometriosis. We describe computed tomography (CT) and magnetic resonance imaging (MRI) findings in a rare case of multiple intra-abdominal splenosis located along the hepatic surface and adjacent to the upper pole of the right kidney, mimicking a renal neoplasm. PMID:18322965

  20. Intra-abdominal hypertension complicating pancreatitis-induced acute respiratory distress syndrome in three patients on extracorporeal membrane oxygenation.

    Science.gov (United States)

    Feddy, Lee; Barker, Julian; Fawcett, Pete; Malagon, Ignacio

    2016-01-01

    Severe acute pancreatitis is associated with sever multiorgan failure from 15 to 50%, depending on the series. In some of these patients, conventional methods of ventilation and respiratory support will fail, demanding the use of extracorporeal membrane oxygenation (ECMO). Abdominal compartment syndrome is potentially harmful in this cohort of patients. We describe the successful treatment of three patients with severe acute pancreatitis who underwent respiratory ECMO and where intra abdominal pressure was monitored regularly. Retrospective review of case notes. Three patients with severe acute pancreatitis requiring ECMO suffered from increased intra abdominal pressure during their ICU stay. No surgical interventions were taken to relieve abdominal compartment syndrome. Survival to hospital discharge was 100%. Monitoring intraabdominal pressure is a valuable adjunct to decision making while caring for these high-risk critically ill patients.

  1. Unexpected natural death secondary to intra-abdominal bleeding: report of one idiopathic spontaneous intraperitoneal hemorrhage case.

    Science.gov (United States)

    Dedouit, Fabrice; Piercecchi-Marti, Marie-Dominique; Leonetti, Georges; Rougé, Daniel; Telmon, Norbert

    2012-01-10

    A 39-year-old woman was found dead at home. She was single, foreign national, chronic alcoholic, and had given shelter to a compatriot for three days. This man found the deceased in her bed, after a night of heavy drinking. The emergency medical team observed numerous recent blue ecchymoses of the upper limbs. Because of the unclear circumstances, a medicolegal autopsy was ordered by the public prosecutor. Massive hemoperitoneum was diagnosed with no visible internal traumatic injury. Autopsy revealed hepatic and pancreatic abnormalities secondary to chronic alcoholism, which were confirmed by pathological study. The source of the hemoperitoneum was not identified despite careful visceral and vascular examination. The authors concluded that death was secondary to idiopathic spontaneous hemoperitoneum or abdominal apoplexy. The forensic literature on unexpected death due to massive nontraumatic intra-abdominal hemorrhage in association with liver cirrhosis is sparse, with only five cases reported, including the present case. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  2. Comparison of the relative contributions of intra-abdominal and liver fat to components of the metabolic syndrome

    DEFF Research Database (Denmark)

    Kotronen, Anna; Yki-Järvinen, Hannele; Sevastianova, Ksenia

    2011-01-01

    Abdominally obese individuals with the metabolic syndrome often have excess fat deposition both intra-abdominally (IA) and in the liver, but the relative contribution of these two deposits to variation in components of the metabolic syndrome remains unclear. We determined the mutually independent...... that both fat depots are important predictors of these components of the metabolic syndrome....... quantitative contributions of IA and liver fat to components of the syndrome, fasting serum (fS) insulin, and liver enzymes and measures of hepatic insulin sensitivity in 356 subjects (mean age 42 years, mean BMI 29.7 kg/m²) in whom liver fat and abdominal fat volumes were measured. IA and liver fat contents...

  3. Carbapenem-resistant Lactobacillus intra-abdominal infection in a renal transplant recipient with a history of probiotic consumption.

    Science.gov (United States)

    Vanichanan, Jakapat; Chávez, Violeta; Wanger, Audrey; De Golovine, Aleksandra M; Vigil, Karen J

    2016-12-01

    Lactobacillus sp. is a low virulence bacterium, which rarely causes infection in immunocompetent individuals and usually is considered a contaminant. Normally this organism is susceptible to β-lactam antibiotics, yet resistant strains have been reported. Here, we report a case of a 60-year-old renal transplant recipient who developed an intra-abdominal abscess which grew a carbapenem-resistant Lactobacillus casei. This is significant since it is the first report of a clinical isolate of Lactobacillus sp. that demonstrated both microbiological and clinical resistance to carbapenem use. Moreover, the probiotic supplement that the patient had taken also grew a similar organism raising the concern of probiotic associated infection in immunocompromised individual.

  4. Ingestão calórica e relações entre ingestão proteica e variáveis de adiposidade em mulheres adultas
    Energy and protein intake and adiposity in women

    Directory of Open Access Journals (Sweden)

    E. A. ESTEVES

    2011-04-01

    Full Text Available

    A alta ingestão calórica favorece o acúmulo de gordura corporal. Adicionalmente, evidências sugerem que uma maior ingestão proteica pode auxiliar no controle do peso corporal. Assim, objetivou-se neste estudo avaliar a ingestão calórica e as relações entre ingestão proteica e variáveis de adiposidade em mulheres adultas. Determinou-se o Índice de Massa Corporal (IMC, a circunferência da cintura (CC e o percentual de gordura corporal (%GC. A ingestão calórica e proteica foi avaliada utilizando três recordatórios de 24 horas. Foram feitas correlações entre IMC, CC e %GC, e ingestão proteica. A ingestão média de calorias representou 88,36% das necessidades estimadas, mas os valores de IMC foram compatíveis com ingestão calórica excessiva em longo prazo para 42,8% das voluntárias. A ingestão proteica (g foi superior (p<0,05 nas eutróficas em comparação às com excesso de peso. Nenhuma diferença em calorias desse macronutriente foi observada entre as mesmas. Correlação signifi cativa não foi encontrada entre as variáveis analisadas. Portanto, sugere-se que, para haver efeito na adiposidade, a ingestão calórica de proteínas deve ser ≥ 25% da ingestão calórica diária, o que não foi verifi cado, já que a maioria consumiu menos de 20%. Erros inerentes ao método de avaliação da ingestão alimentar também podem explicar em parte esses resultados.

  5. Fast development of high intra-abdominal pressure when a trained participant is exposed to heavy, sudden trunk loads.

    Science.gov (United States)

    Essendrop, Morten; Trojel Hye-Knudsen, Christian; Skotte, Jørgen; Faber Hansen, Anne; Schibye, Bente

    2004-01-01

    This study focused on intra-abdominal pressure (IAP) during sudden trunk loads. Ten participants were exposed to heavy, sudden trunk loads as they might occur during patient handling. The aim was to study the development of intra-abdominal pressure when well-trained participants cope with heavy, sudden trunk loads. It is hypothesized that high IAP develops sufficiently fast to be present when the large torques act on the low-back structures. Well-trained sportsmen expose themselves to heavy sudden loads of the trunk without getting injured, but it is unknown how they cope with these loads. Do they use IAP? IAP is believed to play a significant role in spine stability, but this has only been documented in experimental studies with light trunk loads. Ten well-trained judo and jujitsu fighters were exposed to heavy sudden trunk loads through imitated patient handling situations in which the patient fell, and the fighters were to hold the patient and prevent the fall. IAP was measured with a catheter in the stomach. Along with the IAP measurement, the load on the low back during the patient falls was quantified by a three-dimensional dynamic biomechanical calculation of the torques and the compression at the L4/L5 joint. High IAP developed quickly and timed in relation to the external torque when the fighters were exposed to a sudden patient fall. When the trunk load was heavy and sudden, IAP was developed to be present at the time when low-back structures had to cope with the large load. High IAP was developed sufficiently fast to be present when the low-back structures had to cope with the large torques released from the sudden trunk loading.

  6. Effect of acute, slightly increased intra-abdominal pressure on intestinal permeability and oxidative stress in a rat model.

    Directory of Open Access Journals (Sweden)

    Yuxin Leng

    Full Text Available INTRODUCTION: Intra-abdominal hypertension (IAH is known as a common, serious complication in critically ill patients. Bacterial translocation and permeability changes are considered the pathophysiological bases for IAH-induced enterogenic endotoxemia and subsequent multiorgan failure. Nevertheless, the effects of slightly elevated intra-abdominal pressures (IAPs on the intestinal mucosa and the associated mechanisms remain unclear. METHODS: To investigate the acute effects of different nitrogen pneumoperitoneum grades on colonic mucosa, male Sprague-Dawley rats were assigned to six groups with different IAPs (0 [control], 4, 8, 12, 16, and 20 mmHg, n = 6/group. During 90 min of exposure, we dynamically monitored the heart rate and noninvasive hemodynamic parameters. After gradual decompression, arterial blood gas analyses were conducted. Thereafter, structural injuries to the colonic mucosa were identified using light microscopy. Colon permeability was determined using the expression of tight junction proteins, combined with fluorescein isothiocyanate dextran (FD-4 absorption. The pro-oxidant-antioxidant balance was determined based on the levels of malondialdehyde (MDA and antioxidant enzymes. RESULTS: IAH significantly affected the histological scores of the colonic mucosa, tight junction protein expression, mucosal permeability, and pro-oxidant-antioxidant balance. Interestingly, elevations of IAP that were lower than the threshold for IAH also showed a similar, undesirable effect. In the 8 mmHg group, mild hyponatremia, hypocalcemia, and hypoxemia occurred, accompanied by reduced blood and abdominal perfusion pressures. Mild microscopic inflammatory infiltration and increased MDA levels were also detected. Moreover, an 8-mm Hg IAP markedly inhibited the expression of tight junction proteins, although no significant differences in FD-4 permeability were observed between the 0- and 8-mmHg groups. CONCLUSIONS: Acute exposure to slightly

  7. Efeitos de dois tipos de treinamento de natação sobre a adiposidade e o perfil lipídico de ratos obesos exógenos Effects of two different types of swimming exercise on adiposity and lipid profile in rats with exogenous obesity

    Directory of Open Access Journals (Sweden)

    Lucimara Zambon

    2009-10-01

    Full Text Available OBJETIVO: Investigar os efeitos do exercício de natação intermitente em relação ao exercício contínuo e ao sedentarismo, em ratos Wistar, após o desenvolvimento de obesidade exógena pela administração de uma dieta hiperlipídica palatável sobre: evolução do peso corporal, ingestão alimentar, adiposidade, percentual de gordura dos tecidos e perfil lipídico. MÉTODOS: Foram utilizados ratos adultos, mantidos em gaiolas individuais, com livre acesso a água e comida. O protocolo experimental incluiu: 1 desenvolvimento da obesidade exógena (3 semanas, os animais foram divididos em: P: sedentários alimentados com dieta padrão Primor® (n=8 e H: sedentários alimentados com dieta hiperlipídica (n=32; 2 tratamentos (8 semanas subseqüentes, os animais (n=24 passaram a receber dieta padrão e foram divididos em: sedentário; treinado contínuo e treinado intermitente. Treinamentos (5x semana: Contínuo (90 minutos/dia e Intermitente (3x30min/dia. Os animais foram submetidos à eutanásia (3 e 8 semanas, sendo coletados os tecidos adiposos, o fígado e o sangue. Foram determinados a adiposidade e o percentual de gordura dos tecidos adiposos e do fígado, o ganho de peso corporal, o consumo alimentar e o perfil lipídico. RESULTADOS: A dieta hiperlipídica aumentou a adiposidade, o percentual de gordura acumulada no fígado e desenvolveu dislipidemias. A troca de dieta e os dois tipos de treinamento foram capazes de reverter o quadro de obesidade exógena. Contudo, o exercício intermitente foi mais eficiente na redução da adiposidade e de ganho de peso. CONCLUSÃO: Associados à dieta balanceada, os treinamentos aplicados neste estudo poderiam ser utilizados como estratégia no controle de peso e de dislipidemias, tanto em modelos experimentais quanto em seres humanos.OBJECTIVE: The objective was to look into the effects of intermittent swimming against continuous exercise and inactivity in Wistar rats after they developed exogenous

  8. Effects of increased intra-abdominal pressure on the healing process after surgical stapling of the stomach of dogs Efeitos da elevação da pressão intra-abdominal e de seu tempo de ação na cicatrização de suturas mecânicas no estômago de cães

    Directory of Open Access Journals (Sweden)

    Nilson Chaves Jr

    2007-10-01

    Full Text Available PURPOSE: To assess the initial healing after surgical stapling of the stomach using a linear cutting stapler and creating pneumoperitoneum (12-14 mmHg for 60 minutes or 120 minutes, and compare it with the healing of a staple line not submitted to increased pressure. METHODS: A total of 30 dogs were divided into three groups of 10 animals each: Group I (control group - surgical stapling, Group II (surgical stapling and increased intra-abdominal pressure for 60 minutes and Group III (surgical stapling and increased intra-abdominal pressure for 120 minutes. All dogs were maintained under general anesthesia for two hours after surgical stapling. Seven days after surgery, the area around the staple line was macroscopically and microscopically examined. RESULTS: The macroscopic examination of the samples (n = 30 did not show dehiscence, fistula or abscess. Adhesions between the omentum and the staple line were observed in all animals of Groups II and III (n = 20, which were significantly different from Group I (p = 0.008*. The histopathological analysis showed normal healing up to day 7 in the control animals (n = 10. When these results were compared with those of Groups II and III (n = 20, non-parametric tests revealed that there was a significant difference with regard to certain parameters of the early stages of healing, such as fibroblast migration (p = 0.011*, edema (p OBJETIVO: Avaliar os efeitos do pneumoperitônio com CO2 sobre a fase inicial da cicatrização (7º dia de uma sutura gástrica mecânica em cães, com diferentes tempos de aumento da pressão intra-abdominal. MÉTODOS: Trinta cães foram divididos em três grupos e submetidos à laparotomia mediana e realização de uma sutura vertical na grande curvatura gástrica com grampeador linear cortante. Após a síntese abdominal, nos animais dos grupos II e III instalou-se pneumoperitônio com CO2, permanecendo os animais com pressão intra-abdominal entre 12 e 14 mmHg durante 60

  9. Celulitis por citomegalovirus

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    A. Ruiz Lascano

    2002-12-01

    Full Text Available Las lesiones cutáneas por citomegalovirus (CMV son infrecuentes y a menudo una manifestación tardía de una enfermedad sistémica, que generalmente anuncia un curso fatal. Comunicamos un caso de celulitis por CMV: una mujer de 70 años con trasplante renal efectuado 1 mes antes de la consulta, terapia inmunosupresora con ciclosporina A y metilprednisona. La paciente ingresó por fiebre, dolor e impotencia funcional en pierna derecha. Comprobamos la existencia de una placa de 8 por 4 cm eritematoedematosa. La tratamos con antibióticos sin mejoría, por lo que realizamos un estudio histopatológico de piel que mostró cambios citopáticos compatibles con infección por CMV. Los cultivos bacteriológicos y micológicos fueron negativos. La inmunohistoquímica específica para CMV y el estudio de reacción en cadena de la polimerasa (PCR de la biopsia de piel fueron positivas, al igual que la antigenemia. El tratamiento con ganciclovir produjo la mejoría del cuadro clínico. En la literatura revisada no hemos encontrado la celulitis como manifestación de enfermedad cutánea por CMV.

  10. Fasting gall bladder volume and lithogenicity in relation to glucose tolerance, total and intra-abdominal fat masses in obese non-diabetic subjects

    DEFF Research Database (Denmark)

    Hendel, H W; Højgaard, L; Andersen, T

    1998-01-01

    with a specific radioimmunoassay. Insulin sensitivity was measured by the Minimal Model and glucose tolerance by an oral glucose tolerance test (OGTT). Serum lipid concentrations were measured by standard methods. RESULTS: The gallbladder volume in the fasting state increased with increasing intra-abdominal fat......OBJECTIVE: To investigate whether total body fat mass or fat distribution and associated metabolic disturbances in glucose and lipid metabolism influence the well known gallstone pathogenetic factors in obese subjects in order to explain why some obese subjects develop gallstones and some do not....... DESIGN: Cross sectional study of gallstone pathogenetic factors, body composition, fat distribution, glucose and lipid metabolism. SUBJECTS: 57 healthy overweight subjects (aged 26-64y, body mass index (BMI) 30-45 kg/m2). MEASUREMENTS: Total and intra-abdominal fat masses were measured by dual X...

  11. Endoscopic Ultrasound-Guided Drainage of Intra-Abdominal Abscess after Gastric Perforation in a Patient Receiving Ramucirumab and Paclitaxel for Advanced Gastric Cancer

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    Koichiro Mandai

    2017-01-01

    Full Text Available Gastrointestinal perforation is a serious adverse event that occurs in approximately 1% of patients receiving ramucirumab and paclitaxel. A 67-year-old man with unresectable advanced gastric cancer was admitted to our hospital and treated with ramucirumab and paclitaxel. Gastric perforation occurred during the second cycle of chemotherapy. Although the patient’s condition improved without surgery, an abscess developed in the intra-abdominal fluid collection resulting from the perforation. We performed endoscopic ultrasound-guided abscess drainage. The patient improved and was discharged in satisfactory condition. Endoscopic ultrasound-guided drainage is a treatment option for patients with intra-abdominal abscess following gastric perforation due to ramucirumab.

  12. Embolia pulmonar por polimetilmetacrilato

    OpenAIRE

    Héctor Gómez Santa María; Mauro García Aurelio; Yanina Castillo Costa; Víctor Mauro; Carlos Barrero

    2009-01-01

    Los primeros registros de embolia pulmonar por polimetilmetacrilato se publicaron recientemente (2003) y desde entonces se describieron no más de 15 casos. Se presenta el caso de un paciente joven a quien dos meses antes de la consulta se le había efectuado una vertebroplastia percutánea con polimetilmetacrilato. Por síntomas pleuríticos se le realizó una radiografía de tórax, que evidenció múltiples imágenes radioopacas en ambos campos pulmonares. La embolia pulmonar por polimetilmetacrilato...

  13. Pelvic drainage during removal of dialysis catheter decreases the risk of subsequent intra-abdominal complications in refractory peritoneal dialysis-related peritonitis.

    Science.gov (United States)

    Hsu, Chih-Yang; Huang, Wei-Chieh; Huang, Chun-Kai; Huang, Chien-Wei; Chou, Nan-Hua; Lee, Po-Tsang; Fang, Hua-Chang; Chou, Kang-Ju; Chen, Chien-Liang

    2015-11-01

    Some patients with refractory peritoneal dialysis-related peritonitis continue to develop intra-abdominal complications despite removal of the peritoneal catheter. Repeated percutaneous drainage or open laparotomy is often required, and mortality is not uncommon. The benefits of pelvic drainage placement during catheter removal in decreasing these complications and interventions remain unproven. Forty-six patients with refractory peritonitis who underwent removal of a Tenckhoff catheter between 1991 and 2013 were reviewed retrospectively. Twelve patients had pelvic drainage using closed active suction devices during catheter removal (drainage group). The remaining 34 patients underwent catheter removal without drainage (non-drainage group). The outcomes measured were the development of intra-abdominal complications and the requirement for repeated percutaneous drainage or open laparotomy within 90 days after the catheter removal. Baseline characteristics were similar with the exception of a higher median number of previous peritonitis episodes in the drainage group compared with the non-drainage group (2 vs 0, P = 0.02). During the follow-up period, intra-abdominal complications occurred in 15 (44%) of 34 patients in the non-drainage group, compared with one (8%) of 12 patients in the drainage group (P = 0.03). Twelve (35%) patients in the non-drainage group required repeated percutaneous drainage or open laparotomy for management, compared with zero (0%) patients in the drainage group (P = 0.02). Drain tubes were removed at a median of 6 days (inter-quartile range: 5-10) without complications. In the management of refractory peritonitis, pelvic drainage during removal of dialysis catheter decreases the risk of subsequent intra-abdominal complications and invasive interventions. © 2015 Asian Pacific Society of Nephrology.

  14. Biomarkers (Procalcitonin, C Reactive Protein, and Lactate) as Predictors of Mortality in Surgical Patients with Complicated Intra-Abdominal Infection.

    Science.gov (United States)

    Suarez-de-la-Rica, Alejandro; Maseda, Emilio; Anillo, Víctor; Tamayo, Eduardo; García-Bernedo, Carlos A; Ramasco, Fernando; Hernández-Gancedo, Carmen; López-Tofiño, Araceli; Gimenez, Maria-Jose; Granizo, Juan-Jose; Aguilar, Lorenzo; Gilsanz, Fernando

    2015-06-01

    An accurate and readily available biomarker for identifying patients with complicated intra-abdominal infection needing special attention in critical care units because of their greater risk of dying would be of value for intensivists. A multi-center, observational, retrospective study explored blood lactate, C-reactive protein (CRP), and procalcitonin (PCT) concentrations, and also Sequential Organ Failure Assessment (SOFA) and Simplified Acute Physiology Score (SAPS II) as mortality predictors in all adult patients with complicated intra-abdominal infection (cIAI) admitted to Surgical Critical Care Units (SCCUs) for ≥48 h in four Spanish hospitals (June 2012-June 2013). Logistic regression models (step-wise procedure) were constructed using as dependent variables "intra-SCCU mortality" or "overall mortality," and variables showing differences (p≤0.1) in bivariate analyses as independent variables. One hundred twenty-one cases were included. Mortality intra-SCCU (R(2)=0.189, p=0.001) was associated with SAPS II (categorized as high if ≥47) (OR=9.55; 95% CI, 1.09-83.85; p=0.042) and 24 h-lactate (≥5.87 categorized as high) (OR=6.90; 95% CI, 1.28-37.08). Overall mortality (R(2)=0.275, p=0.001) was associated with peak PCT (≥100 categorized as high) (OR=11.28; 95% CI, 1.80-70.20), peak lactate (≥1.8 categorized as high) (OR=8.86; 95% CI, 1.51-52.10) and SOFA at admission (≥7 categorized as high) (OR=8.14; 95% CI, 1.69-39.20), but was predicted better (R(2)=0.275, p=0.001) by a single dummy variable (high peak PCT-high peak lactate concentrations) (OR=99.11; 95% CI, 5.21-1885.97; p=0.002). In the present study, SAPS II and 24 h-lactate concentrations predicted intra-SCCU mortality whereas overall mortality was predicted better by concurrent high PCT and lactate peak concentrations than by clinical scores or by each biomarker separately.

  15. Doripenem in hospital infections: a focus on nosocomial pneumonia, complicated intra-abdominal infections, and complicated urinary tract infections

    Directory of Open Access Journals (Sweden)

    Tze Shien Lo

    2009-06-01

    Full Text Available Tze Shien Lo,1 Stephanie M Borchardt,2 Justin M Welch,3 Melissa A Rohrich,3 Augusto M Alonto,4 Anne V Alonto51Infectious Diseases Service, Veterans Administration Medical Center, Fargo, North Dakota, USA; 2Research Service, Veterans Administration Medical Center, Fargo, North Dakota, USA; 3Pharmacy Service, Veterans Administration Medical Center, Fargo, North Dakota, USA; 4Infectious Diseases Department, MeritCare Medical Center, Fargo, North Dakota, USA; 5Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USAAbstract: Doripenem is the latest carbapenem on the market to date. Although not an antibiotic in a new class, it offers a glimmer of hope in combating serious infections secondary to multidrug-resistant Gram-negative bacteria when we have not seen a new class of antibacterial, particularly for Gram-negative bacteria, for more than 10 years. In vitro, doripenem exhibits a broad spectrum of activity against Gram-positive and Gram-negative bacteria, including extended-spectrum β-lactamase (ESBL and Amp-C β-lactamase producing Enterobacteriaceae and anaerobes. Doripenem also exhibits better in vitro activity against Pseudomonas aeruginosa compared to other anti-pseudomonal carbapenems. It combines the desirable activities of both imipenem and meropenem. It has similar activity to imipenem against Gram-positive pathogens and has the antimicrobial spectrum of meropenem against Gram-negative organisms. Several randomized clinical trials have demonstrated that doripenem is non-inferior to meropenem, imipenem, piperacillin/tazobactam, or levofloxacin in its efficacy and safety profile in treating a wide range of serious bacterial infections including intra-abdominal infection, complicated urinary tract infection, and nosocomial pneumonia. Due to its wide spectrum of activity and good safety profile it is susceptible to misuse leading to increasing rates of resistance

  16. Alterações vasculares em ratos obesos por dieta rica em gordura: papel da Via L-arginina/NO Endotelial Alteraciones vasculares en ratones obesos por dieta rica en grasa: papel de la vía L-arginina/NO endotelial Vascular alterations in high-fat diet-obese rats: role of Endothelial L-arginine/NO Pathway

    Directory of Open Access Journals (Sweden)

    Thiago Bruder Nascimento

    2011-07-01

    Full Text Available FUNDAMENTO: Mecanismos subjacentes a anormalidades vasculares na obesidade ainda não estão completamente esclarecidos. OBJETIVO: Foi avaliada a via do óxido nítrico/L-arginina na resposta vascular de ratos obesos por dieta rica em gordura, enfocando as células endoteliais e do músculo liso. MÉTODOS: Ratos com 30 dias de vida foram divididos em 2 grupos: controle (C e obeso (OB, ratos sob dieta rica em gordura por 30 semanas. Após 30 semanas, foram registrados o peso corporal, índice de adiposidade, pressão arterial e perfis metabólicos e endócrinos dos animais. Foram obtidas curvas para noradrelanina na ausência e presença de inibidor de óxido nítrico sintase (L-NAME, 3x10-4M em aorta torácica intacta e com desnudamento em ratos C e OB. RESULTADOS: As medidas de peso corporal, índice de adiposidade, leptina e insulina aumentaram nos ratos OB, enquanto a pressão arterial permaneceu inalterada. A obesidade também produziu tolerância à glicose e resistência à insulina. A reatividade à noradrenalina da aorta intacta foi similar em ratos C e OB. A presença de L-NAME produziu um aumento similar nas respostas máximas, mas um desvio maior à esquerda das respostas nas aortas intactas dos ratos C em relação aos ratos OB [EC50 (x10-7M: C = 1,84 (0,83-4,07, O = 2,49 (1,41-4,38; presença de L-NAME C = 0,02 (0,01-0,04*, O = 0,21 (0,11-0,40*†,*p FUNDAMENTO: Los mecanismos subyacentes a las anormalidades vasculares en la obesidad todavía no están completamente aclarados. OBJETIVO: Se evaluó la vía del óxido nítrico/L-arginina en la respuesta vascular de ratones obesos por dieta rica en grasa, concentrándonos en las células endoteliales y en el músculo liso. MÉTODOS: Ratones con 30 días de vida que fueron divididos en 2 grupos: control (C y obeso (OB, ratones bajo dieta rica en grasa durante 30 semanas. Después de 30 semanas, fueron registrados el peso corporal, el índice de adiposidad, la presión arterial y los

  17. Embolia pulmonar por polimetilmetacrilato

    Directory of Open Access Journals (Sweden)

    Héctor Gómez Santa María

    2009-01-01

    Full Text Available Los primeros registros de embolia pulmonar por polimetilmetacrilato se publicaron recientemente (2003 y desde entonces se describieron no más de 15 casos. Se presenta el caso de un paciente joven a quien dos meses antes de la consulta se le había efectuado una vertebroplastia percutánea con polimetilmetacrilato. Por síntomas pleuríticos se le realizó una radiografía de tórax, que evidenció múltiples imágenes radioopacas en ambos campos pulmonares. La embolia pulmonar por polimetilmetacrilato es una complicación muy poco frecuente de ese procedimiento y un diagnóstico diferencial para tener en cuenta en pacientes con el antecedente y que consulten por dolor precordial o disnea.REV ARGENT CARDIOL 2009;77:129-130.

  18. A Challenging Case of Metastatic Intra-Abdominal Synovial Sarcoma with Unusual Immunophenotype and Its Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Yi-Che Changchien

    2012-01-01

    Full Text Available The primary and metastatic gastrointestinal synovial sarcoma is rare with a wide differential diagnosis. It usually expresses cytokeratins EMA, BCL2 with an occasional CD99, and S100 positivity but not desmin. We present a case of metastatic synovial sarcoma with unusual immunophenotype causing diagnostic challenges. The tumor cells showed focal cytokeratin, EMA, and, unexpectedly, desmin positivity. Additional intranuclear TLE-1 positivity and negativity for CD34 and DOG-1 were also identified. A diagnosis of monophasic synovial sarcoma was confirmed by using FISH break-apart probe. RT-PCR revealed the SYT-SSX1 fusion gene. Intra-abdominal synovial sarcoma, either primary or metastatic, with unusual desmin positivity raises the diagnostic challenge, since a wide range of differential diagnoses could show a similar immunophenotype (leiomyosarcoma, desmoid tumor, myofibroblastic tumor, and rarely GIST etc.. Typical morphology and focal cytokeratin/EMA positivity should alert to this tumor, and FISH and RT-PCR remain the gold standard for the confirmation.

  19. Correlation between procalcitonin and intra-abdominal pressure and their role in prediction of the severity of acute pancreatitis.

    Science.gov (United States)

    Bezmarevic, Mihailo; Mirkovic, Darko; Soldatovic, Ivan; Stamenkovic, Dusica; Mitrovic, Nikola; Perisic, Nenad; Marjanovic, Ivan; Mickovic, Sasa; Karanikolas, Menelaos

    2012-01-01

    Early assessment of disease severity and vigilant patient monitoring are key factors for adequate treatment of acute pancreatitis (AP). The aim of this study was to determine the correlation of procalcitonin (PCT) serum concentrations and intra-abdominal pressure (IAP) as prognostic markers in early stages of AP. This prospective observational study included 51 patients, of which 29 had severe AP (SAP). Patients were evaluated with the Acute Physiology And Chronic Health Evaluation (APACHE II) score, C-reactive protein (CRP) and PCT serum concentrations and IAP at 24 h from admission. PCT was measured three times in the 1st week of disease and three times afterward, while IAP was measured daily. PCT and IAP values correlated with each other, and also compared with APACHE II score and CRP values. PCT, IAP, CRP values and APACHE II score at 24 h after hospital admission were significantly elevated in patients with SAP. There was significant correlation between PCT and IAP values measured at 24 h of admission, and between maximal PCT and IAP values. Sensitivity/specificity for predicting AP severity at 24 h after admission was 89%/69% for APACHE II score, 75%/86% for CRP, 86%/63% for PCT and 75%/77% for IAP. Increased IAP was accompanied by increased PCT serum concentration in patients with AP. PCT and IAP can both be used as early markers of AP severity. Copyright © 2012 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  20. Role of moxifloxacin for the treatment of community-acquired [corrected] complicated intra-abdominal infections in Taiwan.

    Science.gov (United States)

    Lau, Yeu-Jun; Chen, Yen-Hsu; Huang, Ching-Tai; Lee, Wen-Sen; Liu, Cheng-Yi; Liu, Jien-Wei; Liu, Hsiao-Dong; Lee, Yuarn-Jang; Chen, Chao-Wen; Ko, Wen-Chien; Hsueh, Po-Ren

    2012-02-01

    Complicated intra-abdominal infections (cIAIs) are common yet serious infections that can potentially lead to substantial morbidity and morbidity. As an essential adjunct to source control, the goals of antimicrobial therapy are to promote patient recovery, reduce recurrence risk, and prevent antimicrobial resistance. The current international guidelines on the empirical treatment of community-acquired complicated IAIs were published by the Infectious Diseases Society of America (IDSA) and Surgical Infections Society (SIS) in 2010. These guidelines all recommend the use of a fluoroquinolone (ciprofloxacin or levofloxacin) plus metronidazole for mild-to-moderate- and high-severity cases. Moxifloxacin monotherapy is recommended by the current IDSA/SIS guidelines for the treatment of mild-to-moderate complicated IAIs. Moxifloxacin has demonstrated a broad spectrum coverage of both aerobic and anaerobic pathogens, good tissue penetration into the gastrointestinal tract, and a good tolerability profile. Clinical data have demonstrated that moxifloxacin is at least as effective as other standard therapeutic regimens recommended by current clinical guidelines. Due to the high rates of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and fluoroquinolone-resistant Enterobacteriaceae among isolates causing community-acquired IAIs in Asia, any fluoroquinolones (including moxifloxacin) are not recommended as drugs of choice for the empirical treatment of community-acquired IAIs, particularly in countries (China, India, Thailand, and Vietnam) with fluoroquinolone resistance rates among Escherichia coli isolates of >20%. Given the low rates of fluoroquinolone-resistant (country. Copyright © 2011. Published by Elsevier B.V.

  1. Massive Intra-Abdominal Imatinib-Resistant Gastrointestinal Stromal Tumor in a 21-Year-Old Male

    Directory of Open Access Journals (Sweden)

    Ann Falor

    2013-01-01

    Full Text Available Gastrointestinal stromal tumors (GISTs in adolescence are far less common than adult GISTs and have varied GIST genotypes that present diagnostic and therapeutic challenges. Here, we discuss a 21-year-old male with diagnosis of unresectable, imatinib-resistant GIST. At initial evaluation, a neoadjuvant treatment approach was recommended. As such, the patient received imatinib over the course of one year. Unfortunately, the GIST increased in size, and a subsequent attempt at surgical resection was aborted fearing infiltration of major vascular structures. The patient was then referred to our institution, at which time imatinib therapy was discontinued. Surgical intervention was again considered and the patient underwent successful resection of massive intra-abdominal GIST with total gastrectomy and Roux-en-Y esophagojejunostomy. Since pediatric GISTs are typically resistant to imatinib, we performed genotype analysis of the operative specimen that revealed KIT mutations associated with imatinib sensitivity and resistance. Given the sequencing data and operative findings, the patient was started postoperatively on sunitinib. This case illustrates the importance of understanding both adult and pediatric GISTs when implementing appropriate treatment regimens. Since the genotype of GISTs dictates phenotypic behavior, mutational analysis is an important component of care especially for adolescents whose disease may mirror the pediatric or adult population.

  2. Intra-Abdominal Localisation of a Buschke-Lowenstein Tumour: Case Presentation and Review of the Literature

    Directory of Open Access Journals (Sweden)

    N. E. Wester

    2013-01-01

    Full Text Available Giant condyloma acuminatum or Buschke-Lowenstein tumour is a very rare disease which usually is located in the genital, anorectal, and perianal regions. It is regarded as a type of verrucous carcinoma occurring on anogenital mucosal surfaces where it is locally invasive but displays a benign cytology. We describe a case of a 24-year-old woman with persisting condyloma acuminata progressing to a large intra-abdominal Buschke-Lowenstein tumour. To our knowledge such an advanced stage has only been reported once before. The severity and extent of the tumour both determine the treatment and patient outcome. Treatment was impeded by cachexia, an immunosuppressive state after kidney transplantation and difficulties in establishing a reliable diagnose. Interferon treatment was started which initially led to tumour reduction but was complicated by an interferon-induced pancreatitis, pneumonia, and fasciitis necroticans resulting in death. We present a literature overview on the treatment options for a Buschke-Lowenstein tumour, with emphasis on interferon therapy, with all the advantages and disadvantages.

  3. Influencia do tempo de exposicao a obesidade induzida por dieta hiperlipidica sobre os colagenos tipo I e III miocardico

    Directory of Open Access Journals (Sweden)

    Danielle Cristina Tomaz da Silva

    2014-03-01

    Full Text Available FUNDAMENTO: A obesidade é um fator de risco para muitas complicações médicas; a pesquisa médica demonstrou que as alterações hemodinâmicas, morfológicas e funcionais estão correlacionadas com a duração e gravidade da obesidade. OBJETIVO: O presente estudo determinou a influência do tempo de exposição à obesidade induzida por dieta com alto teor de gordura no colágenos tipo I e III miocárdico. MÉTODOS: Ratos machos com trinta dias de idade, da raça Wistar, foram distribuídos aleatoriamente em dois grupos: um grupo de controle (C alimentado com ração padrão e um grupo de ratos obesos (Ob alternadamente alimentados com uma de quatro dietas palatáveis ricas em gordura. Cada dieta foi mudada diariamente, e os ratos foram mantidos em suas respectivas dietas por 15 (C15 e Ob15 e 30 (C30 e Ob30 semanas consecutivas. A obesidade foi determinada pelo índice de adiposidade. RESULTADOS: O grupo Ob15 foi similar ao grupo C15 em relação à expressão de colágeno miocárdico tipo I; contudo, a expressão no grupo Ob30 foi menor do que no grupo C30. O tempo de exposição à obesidade foi associado com uma redução de colágeno do tipo I no grupo Ob30, quando comparado com o Ob15. A obesidade não afetou a expressão do colágeno tipo III. CONCLUSÃO: Este estudo mostrou que o tempo de exposição à obesidade por 30 semanas induzida por uma dieta rica em gordura insaturada causou uma redução na expressão do colágeno miocárdico tipo I em ratos obesos. No entanto, nenhum efeito foi observado em relação à expressão do colágeno miocárdico tipo III

  4. Asma inducido por ejercicio

    OpenAIRE

    Ramos Zabala, Mª Gracia

    1997-01-01

    Este trabajo consiste en una revisión de artículos y libros que tratan sobre el asma inducido por ejercicio. Principalmente me he basado en cinco artículos realizados en los últimos arios y en diferentes libros que me han servido de apoyo. Algunas consideraciones del asma inducido por el ejercicio son las siguientes: La probabilidad de presentar broncoespasmo, así como la intensidad del mismo, después de realizar ejercicio, se incrementa con la severidad del asma, aunque hay individuos en los...

  5. Razonamiento rebatible por casos

    OpenAIRE

    Bodanza, Gustavo A.

    1996-01-01

    Este trabajo constituye un estudio de las dificultades de la incorporación de información disyuntiva en un sistema conteniendo reglas rebatibles. Se presenta una ampliación del sistema MTDR a fin de aumentar la capacidad de éste, permitiendo el razonamiento por casos mediante argumentos. En un artículo anterior ([BS95]) se brindaba una aproximación al problema introduciendo una relación de inferencia rebatible que incluía la prueba por casos. Tal solución presenta limitaciones en determ...

  6. Plebiscito por la paz

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    Holmes Trujillo, Carlos; Cepeda, Iván

    2016-01-01

    Sin lugar a dudas, este tema podría permitir el cambio del rumbo de la historia en nuestro país, en tanto el próximo domingo 2 de octubre los colombianos podrán votar en un Plebiscito Nacional por el Sí o por el No a estos acuerdos de paz. En esta emisión, se darán los elementos para tomar la decisión no sólo de nuestro voto, sino nuestro compromiso como ciudadanos responsables.

  7. Absolute counts of peripheral blood leukocyte subpopulations in intraabdominal sepsis and pneumonia-derived sepsis: a pilot study Absolute counts of peripheral blood leukocyte subpopulations in intraabdominal sepsis and pneumonia-derived sepsis: a pilot study

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    Grazyna Anna Hoser

    2012-10-01

    Full Text Available The leading pathophysiological changes during sepsis include systemic abnormalities in the immune
    response. Due to the general character of these disturbances, sepsis is usually studied as a homogenous clinical
    condition. We aimed to compare the immune response in intraabdominal sepsis (IAS and pneumonia-derived
    sepsis (PDS. The following cell populations were examined: white blood cell count (WBC, monocytes, lymphocytes:
    CD3+, CD4+ and CD8+ T cells, B cells, and NK cells. In both studied groups (i.e. IAS and PDS, the
    WBC was elevated. However, it was significantly higher in the IAS group than in the PDS group. The difference
    was due to a lower granulocyte count, as well as a lower monocyte count in PDS. We found no significant
    correlation between the total lymphocyte number and CD3+CD8+ T cells in either form of sepsis. Similarly, we
    observed no correlation between the total lymphocyte number and the NK cells subset in IAS. However, the
    numbers of CD3+CD8+ and NK cells correlated similarly in both types of sepsis. Both studied types of sepsis
    induced profound lymphocytopenia, with marked loss of CD8+ T cells and the NK cells. However, the similar
    relation between them, which was independent of the infection type, suggests that the NK and CD3+CD8+ cells
    have shared mechanisms of regulation. The primary site of infection has an impact on the global immune reaction.
    These alternations include especially myeloid cells: granulocytes and monocytes which disappear from peripheral
    blood during PDS, but increase in IAS.
    The leading pathophysiological changes during sepsis include systemic abnormalities in the immune
    response. Due to the general character of these disturbances, sepsis is usually studied as a homogenous clinical
    condition. We aimed to compare the immune response in intraabdominal sepsis (IAS and pneumonia-derived
    sepsis (PDS. The following cell

  8. Modulação da pressão intracraniana em um modelo experimental de hipertensão abdominal e lesão pulmonar aguda Factors associated with variation in intracranial pressure in a model of intra-abdominal hypertension with acute lung injury

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    Fernando Godinho Zampieri

    2011-06-01

    Full Text Available OBJETIVO: Avaliar o efeito de alterações hemodinâmicas, respiratórias e metabólicas sobre a pressão intracraniana em um modelo de lesão pulmonar aguda e síndrome compartimental abdominal. MÉTODOS: Oito porcos Agroceres foram submetidos, após a instrumentação, a cinco cenários clínicos: 1 estado basal com baixa pressão intra-abdominal e pulmão sadio; 2 pneumoperitôneo, com pressão intra-abdominal de 20 mm Hg; 3 lesão pulmonar aguda induzida por lavagem pulmonar e desativação de surfactante; 4 pneumoperitôneo com pressão intra-abdominal de 20 mm Hg na vigência de lesão pulmonar aguda e com PEEP baixo; e 5 PEEP ajustado a 27 cm H2O na vigência de pneumoperitôneo e lesão pulmonar aguda. Variáveis respiratórias e hemodinâmicas foram coletadas. Análise multivariada foi realizada buscando as variáveis associadas com elevação da pressão intracraniana nos cinco cenários estudados. RESULTADOS: Após a análise multivariada, nas situações não associadas com lesão pulmonar aguda apenas a pressão de platô das vias aéreas se correlacionou positivamente com a pressão intracraniana. Nos modelos associados com lesão pulmonar aguda, a pressão de platô de vias aéreas, a pressão arterial de CO2, o CO2 no final da expiração e a pressão venosa central se correlacionaram positivamente com incrementos da pressão intracraniana. CONCLUSÃO: Em um modelo de disfunção orgânica múltipla com situações clínicas associadas com aumento da pressão torácica e abdominal, o incremento da pressão intracraniana desencadeado pela elevação da pressão abdominal parece ser decorrente da piora da complacência do sistema respiratório e da redução do gradiente para drenagem venosa cerebral ocasionado pela elevação da pressão venosa central.OBJECTIVE: To evaluate the effects of hemodynamic, respiratory and metabolic changes on intracranial pressure in a model of acute lung injury and abdominal compartment syndrome

  9. Laparoscopic Appendectomy Is Safe: Influence of Appendectomy Technique on Surgical-site Infections and Intra-abdominal Abscesses.

    Science.gov (United States)

    Sohn, Maximilian; Hoffmann, Maria; Hochrein, Alfred; Buhr, Heinz J; Lehmann, Kai S

    2015-06-01

    Surgical-site infections (SSIs) and intra-abdominal abscesses (IAAs) are the most frequent complications of appendectomy. The role of laparoscopy in the treatment of appendicitis remains controversial concerning the complication rate. The aim of this retrospective cohort study was to compare open and laparoscopic appendectomy for SSI and IAA. All patients undergoing appendectomy between January 1, 2007 and May 31, 2010 were included in the study. Perioperative data and data on postoperative complications were collected from patient files. A questionnaire was used to assess complications after discharge. Main outcome parameters were SSI and IAA. Open appendectomy (OAG) and laparoscopic appendectomy (LAG) were compared with univariate and multivariate analyses for the outcome parameters. Four hundred thirty patients were included in the study. SSI (all: 10.6%, OAG: 11.7%, LAG: 7.5%, P=0.293) and IAA (all: 2.8%, OAG: 2.4%, LAG: 3.8%, P=0.506) were not significantly different between OAG and LAG. Risk factors for SSI were age (P=0.003), body mass index (P=0.017), ASA score (P=0.001), the intraoperative grade of inflammation (P=0.004), and the histologic grade of inflammation (P=0.015). The only risk factor for IAA was the intraoperative grade of inflammation (P=0.028). ASA score (odds ratio: 1.992, P=0.032) and the intraoperative grade of inflammation (odds ratio: 1.573, P=0.006) remained significant in the multivariate analysis for SSI. A higher ASA score correlates with SSI. A higher grade of intraoperative inflammation correlates with SSI and IAA. Laparoscopy has no impact on SSI and IAA in appendectomy.

  10. Complicated intra-abdominal infections in Europe: preliminary data from the first three months of the CIAO Study

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    Sartelli Massimo

    2012-05-01

    Full Text Available Abstract The CIAO Study is a multicenter observational study currently underway in 66 European medical institutions over the course of a six-month study period (January-June 2012. This preliminary report overviews the findings of the first half of the study, which includes all data from the first three months of the six-month study period. Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs were included in the study. 912 patients with a mean age of 54.4 years (range 4–98 were enrolled in the study during the first three-month period. 47.7% of the patients were women and 52.3% were men. Among these patients, 83.3% were affected by community-acquired IAIs while the remaining 16.7% presented with healthcare-associated infections. Intraperitoneal specimens were collected from 64.2% of the enrolled patients, and from these samples, 825 microorganisms were collectively identified. The overall mortality rate was 6.4% (58/912. According to univariate statistical analysis of the data, critical clinical condition of the patient upon hospital admission (defined by severe sepsis and septic shock as well as healthcare-associated infections, non-appendicular origin, generalized peritonitis, and serious comorbidities such as malignancy and severe cardiovascular disease were all significant risk factors for patient mortality. White Blood Cell counts (WBCs greater than 12,000 or less than 4,000 and core body temperatures exceeding 38°C or less than 36°C by the third post-operative day were statistically significant indicators of patient mortality.

  11. Phase 2, Dose-Ranging Study of Relebactam with Imipenem-Cilastatin in Subjects with Complicated Intra-abdominal Infection.

    Science.gov (United States)

    Lucasti, Christopher; Vasile, Liviu; Sandesc, Dorel; Venskutonis, Donatas; McLeroth, Patrick; Lala, Mallika; Rizk, Matthew L; Brown, Michelle L; Losada, Maria C; Pedley, Alison; Kartsonis, Nicholas A; Paschke, Amanda

    2016-10-01

    Relebactam (REL [MK-7655]) is a novel class A/C β-lactamase inhibitor intended for use with imipenem for the treatment of Gram-negative bacterial infections. REL restores imipenem activity against some resistant strains of Klebsiella and Pseudomonas In this multicenter, double-blind, controlled trial (NCT01506271), subjects who were ≥18 years of age with complicated intra-abdominal infection were randomly assigned (1:1:1) to receive 250 mg REL, 125 mg REL, or placebo, each given intravenously (i.v.) with 500 mg imipenem-cilastatin (IMI) every 6 h (q6h) for 4 to 14 days. The primary efficacy endpoint was the proportion of microbiologically evaluable (ME) subjects with a favorable clinical response at discontinuation of i.v. therapy (DCIV). A total of 351 subjects were randomized, 347 (99%) were treated, and 255 (73%) were ME at DCIV (55% male; mean age, 49 years). The most common diagnoses were complicated appendicitis (53%) and complicated cholecystitis (17%). Thirty-six subjects (13%) had imipenem-resistant Gram-negative infections at baseline. Both REL doses plus IMI were generally well tolerated and demonstrated safety profiles similar to that of IMI alone. Clinical response rates at DCIV were similar in subjects who received 250 mg REL plus IMI (96.3%) or 125 mg REL plus IMI (98.8%), and both were noninferior to IMI alone (95.2%; one-sided P 90% of carbapenem-resistant bacterial strains. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  12. Compliance with an empirical antimicrobial protocol improves the outcome of complicated intra-abdominal infections: a prospective observational study

    Science.gov (United States)

    Guilbart, M.; Zogheib, E.; Ntouba, A.; Rebibo, L.; Régimbeau, J. M.; Mahjoub, Y.; Dupont, H.

    2016-01-01

    Background Despite improvements in medical and surgical care, mortality attributed to complicated intra-abdominal infections (cIAI) remains high. Appropriate initial antimicrobial therapy (ABT) is key to successful management. The main causes of non-compliance with empirical protocols have not been clearly described. Methods An empirical ABT protocol was designed according to guidelines, validated in the institution and widely disseminated. All patients with cIAI (2009–2011) were then prospectively studied to evaluate compliance with this protocol and its impact on outcome. Patients were classified into two groups according to whether or not they received ABT in compliance with the protocol. Results 310 patients were included: 223 (71.9%) with community-acquired and 87 (28.1%) with healthcare-associated cIAI [mean age 60(17–97) yr, mean SAPS II score 24(16)]. Empirical ABT complied with the protocol in 52.3% of patients. The appropriateness of empirical ABT to target the bacteria isolated was 80%. Independent factors associated with non-compliance with the protocol were the anaesthetist's age ≥36 yr [OR 2.1; 95%CI (1.3–3.4)] and the presence of risk factors for multidrug-resistant bacteria (MDRB) [OR 5.4; 95%CI (3.0–9.5)]. Non-compliance with the protocol was associated with higher mortality (14.9 vs 5.6%, P=0.011) and morbidity: relaparotomy (P=0.047), haemodynamic failure (P=0.001), postoperative pneumonia (P=0.025), longer duration of mechanical ventilation (Pnon-compliance with the ABT protocol was independently associated with mortality [OR 2.4; 95% CI (1.1–5.7), P=0.04]. Conclusions Non-compliance with empirical ABT guidelines in cIAI is associated with increased morbidity and mortality. Information campaigns should target older anaesthetists and risk factors for MDRB. PMID:27317705

  13. Bacteriology and antimicrobial susceptibility of ESBLs producers from pus in patients with abdominal trauma associated intra-abdominal infections.

    Science.gov (United States)

    Fan, S; Wang, J; Li, Y; Li, J

    2017-02-01

    Intra-abdominal infections (IAIs) caused by ESBLs producing bacteria have become a serious clinical concern worldwide as the prevalence of bacterial resistance to antibiotics continues to increase. The objective of this study was to analyze the bacteriology and antimicrobial susceptibility of ESBLs producers using pus samples from IAIs patients caused by abdominal trauma. A total of 113 pus samples aspirated from IAIs patients were collected. The BACTEC 9120 and Vitek 2 system were used for detecting positive pathogens and confirming ESBLs production. The results of susceptibility were determined following the Clinical Laboratory Standards Institute guidelines. Among the pathogens causing IAIs, Escherichia coli (E. coli) (29.1 %) was the most commonly isolated, followed by Klebsiella pneumoniae (K. pneumoniae) (22.5 %). The incidence rates of ESBLs production among E. coli, K. pneumoniae, and Klebsiella oxytoca were 69.6, 45.1, and 25.0 %, respectively. All pathogens had high resistance rates against studied antibiotics, with imipenem (88.7 %) and ertapenem (90.7 %) remaining the only practical options. Trend analysis documented an increase in ESBLs producing E. coli and K. pneumoniae, and a decrease in susceptibility for carbapenems among ESBLs producing E. coli and K. pneumoniae. Escherichia coli and K. pneumoniae were the major pathogens causing abdominal trauma associated IAIs. The most active agents against ESBLs producing E. coli and K. pneumoniae were ertapenem and imipenem. However, the ESBLs rates were alarmingly high and increasing among IAIs associated gram-negative bacilli infections in China, and most agents exhibited decreased susceptibility against ESBLs producing pathogens.

  14. Evaluation of surgical anti-adhesion products to reduce postsurgical intra-abdominal adhesion formation in a rat model.

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    Long-Xiang Lin

    Full Text Available Adhesions frequently occur after abdominal surgery. Many anti-adhesion products have been used in clinic. However, the evidences are short for surgeons to reasonably choose the suitable anti-adhesion produces in clinical practice. This study provided such evidence by comparing the efficiency of five products to prevent abdominal adhesion formation in a rat model.Fifty-six Sprague-Dawley rats were randomly divided into seven groups: sham-operation group, adhesion group, and five product groups (n = 8. The abdomens of rats were opened. The injuries were created on abdominal wall and cecum in the adhesion and product groups. The wounds on abdominal wall and cecum of rats in the adhesion group were not treated before the abdomens were closed. The wounds on abdominal wall and cecum of rats in the product groups were covered with anti-adhesion product: polylactic acid (PLA film, Seprafilm®, medical polyethylene glycol berberine liquid (PEG, medical sodium hyaluronate gel (HA, or medical chitosan (Chitosan. Fourteen days after surgery, the adhesions were evaluated by incidence, severity, adhesion area on abdominal wall and adhesion breaking strength.The application of PLA film and Seprafilm® significantly reduced the incidence, severity, adhesion area and breaking strength of cecum-abdomen adhesion (P0.05. The statistical significances in the incidence and severity of abdomen-adipose adhesion between adhesion group and the product groups were not achieved. However, Seprafilm® was more effective to reduce abdomen-adipose adhesion than PLA film. Furthermore, it was found that the products tested in this study did not effectively reduce cecum-adipose adhesion. The application of PEG could result in abdomen-small intestine adhesion.Based on the results of this study, the preference order of anti-adhesion products used to reduce postsurgical intra-abdominal adhesion formation is Seprafilm > PLA >> HA > Chitosan > PEG.

  15. The Effect of Ethanol Extract of Rose (Rosa damascena) on Intra-abdominal Adhesions After Laparotomy in Rats.

    Science.gov (United States)

    Karimi, Mehrdad; Yazdan Asadi, Sayyed; Parsaei, Pouya; Rafieian-Kopaei, Mahmoud; Ghaheri, Hafez; Ezzati, Sareh

    2016-05-01

    Abdominal adhesions are pathological connections in peritoneal surfaces that are created after abdominal surgery. The aim of this study was to evaluate the inhibitory effect of Rosa damascena extract on adhesions, considering the antioxidant properties of rose. Thirty healthy rats were divided into 3 groups: rats treated by 1% (A) and 5% (B) of R. damascena extract and the con- trol group (C). After administering anesthesia, the abdominal wall was opened and 3 shallow incisions (2 cm) were made on the right wall, and a 2 × 2 piece of peritoneal surface was removed on the left side of the abdominal wall. Then 3 mL of 1% (A) and 5% (B) R. damascena extract was administered into the abdominal cavity. The control group (C) received 3 mL of distilled water. The abdominal cavity was sutured, and a second laparotomy was carried out 14 days later to the created adhesions according to the Canbaz scale, and a histopathologic examination was also performed. All data was analyzed by SPSS volume 16 (Chicago, IL); P less than 0.05 was considered statistically significant. The amount of adhesion in group A was significantly lower than that of group C, 1.4 ± 1.265 versus 3 ± 0.816, (P = 0.007). The histological investigation also showed significant differences in the se- verity of fibrosis (P = 0.029) and inflammation (P = 0.009) between groups A and C; all rats in group B (5%) were found dead. This study indicated the use of R. damascena at a 1% level resulted in a remarkable decrease of intra-abdominal adhesions after laparotomy in rats. Further studies are necessary on this extract and its derivatives for treatment of such diseases in the human model.

  16. Retrospective evaluation of concurrent intra-abdominal injuries in dogs with traumatic pelvic fractures: 83 cases (2008-2013).

    Science.gov (United States)

    Hoffberg, Jamie E; Koenigshof, Amy M; Guiot, Laurent P

    2016-01-01

    To report the occurrence of intra-abdominal injury (IA) in dogs with pelvic fractures due to blunt trauma, to evaluate for association between characterization of pelvic fractures and the presence of IA, and to evaluate for association between IA and other specific clinical conditions. Retrospective case series (2008-2013). University teaching hospital. Eighty-three client-owned dogs with pelvic fractures due to blunt trauma. None. Pelvic injuries included pubic fractures (90.4%), ischial fractures (80.7%), sacroiliac luxations (57.8%), iliac fractures (43.4%), acetabular fractures (30.1%), and sacral fractures (13.3%). Thirty-one dogs (37%) had IA, which included hemoabdomen (27 dogs), uroabdomen (3), and septic abdomen (3); 2 dogs had 2 types of IA. Dogs with sacral fractures were significantly more likely to have IA than dogs without sacral fractures (P = 0.0162). Characterization of pelvic fractures included the direction of compression, presence of a weight-bearing bone fracture, and degree of pelvic narrowing, none of which had an association with IA (P > 0.05). Dogs were more likely to have IA if they had cardiac dysrhythmia (P = 0.0002) or hematuria (P = 0.0001), and were more likely to have a hemoabdomen if they had cardiac dysrhythmia (P = 0.0005). Dogs with hematochezia were more likely to have a septic abdomen (P = 0.0123). Dogs were more likely to receive a transfusion if they had AI (P = 0.033) or hemoabdomen specifically (P = 0.0033). Overall survival to discharge was 89%, which was significantly greater than survival in dogs with pelvic injury that also had septic abdomen (33%; P = 0.0299). IA is common in dogs with pelvic fractures, especially those with sacral fractures. Pelvic fracture characterization had no bearing on the presence of IA. © Veterinary Emergency and Critical Care Society 2016.

  17. [Effect of intra-abdominal pressure in pregnant women on level of spina block and frequency of hypotension during cesarean section].

    Science.gov (United States)

    Ronenson, A M; Sitkin, S I; Savel'eva, Iu V

    2014-01-01

    It is common knowledge that an increase of intra-abdomninal pressure (lAP) causes a decrease in the volume of cerebrospinal fluid in the lumbar and lower thoracic region, which may contribute to the development of more high spinal block. There is currently no research devoted to studying the impact of intra-abdominal pressure in pregnancy on the development of high spinal blockade. To investigate effects of intra-abdominal pressure in pregnancy on the development of spinal blockade and incidence of hypotension during cesarean section. 170 pregnant women with gestational age 38-40 weeks were included in the randomized, blinded, controlled study. All the women received elective cesarean section under spinal anesthesia (SA). Pregnant women w|,ere divided into two groups of 85 females each. In the first group, the anesthesiologist did not know the value of lAP and used the dose of local anesthetic focusing on height, weight, and according to his own experience. In the second group, an anesthesiologist corrected dose of local anesthetic depending on the lAP and also considered the height and weight of a woman. In 9.2% of women, lAP was less than 11 mmHg (physiologically normal), in 49%--from 12 to 15 mmHg (degree I of intra-abdominal hypertension (IAH)), in 40.3%--from 16 to 20 mmHg (degree II of IAH), in 1.5%--from 21 to 25 mmHg (degree III of IAH). In the first group, the incidence of high spinal block (above Th4) and incidence of arterial hypotension (systolic blood pressure under 90 mm.Hg) was two times higher than in the second group (phypotension. To prevent these complications, we recommend decreasing the dose of local anesthetic with use of the Scale of the Risk of developing high spinal block in pregnant.

  18. Apendicitis por Paracoccidioides brasiliensis

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    Ana Beatriz MUÑOZ URRIBARRI

    2006-01-01

    Full Text Available La paracoccidioidomicosis es la micosis más prevalente en Sudamérica. La forma aguda afecta el sistema fagocítico mononuclear de niños y personas inmunocomprometidas. El compromiso gastrointestinal es frecuente y su patogenia implica diseminación hematógena y linfática. La linfadenomegalia abdominal causa obstrucción intestinal y abdomen agudo. En este artículo damos a conocer el caso de un niño con compromiso gastrointestinal por apendicitis. Este es el primer caso reportado de apendicitis por esta patología. (Rev Med Hered 2006;17:58-60.

  19. Osteomielitis por salmonella

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    Alicia Velázquez Pérez

    2014-08-01

    Full Text Available Se presenta el caso de una paciente femenina de color blanco y dos años de edad, con diagnóstico prenatal de sicklemia, que desde edades tempranas tiene problemas de la enfermedad. Ingresó en esta ocasión por una de las complicaciones infecciosas que ocasiona este padecimiento, una osteomielitis del húmero izquierdo, aislándose el germen en el hemocultivo realizado, una salmonella. Necesitó de tratamiento enérgico y prolongado; se obtuvo un resultado satisfactorio en la evolución de la enfermedad y se sigue sistemáticamente por consulta externa en la actualidad

  20. Carcel por amor

    OpenAIRE

    Torres, Carlos Luis

    2014-01-01

    La novela de Álvaro Pineda-Botero “Carcel por Amor”, una historia ligera en apariencia, relata la vida de l pintor Aurelio Méndez Tovar, y como se afirma en la nota “al lector”, la novela se escribe a solicitud de su hermana Gabriela (muerta hace poco tiempo) para aclarar ante el público las circunstancias que llevaron al pintor a su reclusión (en un sanatorio) y posterior muerte.

  1. Antimicrobial Treatmdent of "Complicated" Intra-Abdominal Infections and The New IDSA Guidelines - A Commentary and an Alternative European Approach According to Clinical Definitions

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    Eckmann C

    2011-03-01

    Full Text Available Abstract Recently, an update of the IDSA guidelines for the treatment of complicated intraabdominal infections has been published. No guideline can cater for all variations in ecology, antimicrobial resistance patterns, patient characteristics and presentation, health care and reimbursement systems in many different countries. In the short time the IDSA guidelines have been available, a number of practical clinical issues have been raised by physicians regarding interpretation of the guidelines. The main debatable issues of the new IDSA guidelines are described as follows: The authors of the IDSA guidelines present recommendations for the following subgroups of "complicated" IAI: community-acquired intra-abdominal infections of mild-to-moderate and high severity and health care-associated intra-abdominal infections (no general treatment recommendations, only information about antimicrobial therapy of specific resistant bacterial isolates. From a clinical point of view, "complicated" IAI are better differentiated into primary, secondary (community-acquired and postoperative and tertiary peritonitis. Those are the clinical presentations of IAI as seen in the emergency room, the general ward and on ICU. Future antibiotic treatment studies of IAI would be more clinically relevant if they included patients in studies for the efficacy and safety of antibiotics for the treatment of the above mentioned forms of IAI, rather than conducting studies based on the vague term "complicated" intra-abdominal infections. The new IDSA guidelines for the treatment of resistant bacteria fail to mention many of new available drugs, although clinical data for the treatment of "complicated IAI" with new substances exist. Further-more, treatment recommendations for cIAI caused by VRE are not included. This group of diseases comprises enough patients (i.e. the entire group of postoperative and tertiary peritonitis, recurrent interventions in bile duct surgery or

  2. ULTRASONOGRAPHY AND COMPUTED TOMOGRAPHY GUIDED FINE NEEDLE ASPIRATION CYTOLOGY IN DIAGNOSING INTRA-ABDOMINAL LESIONS- A 6-YEAR RETROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL IN MANIPUR

    Directory of Open Access Journals (Sweden)

    Ratan Konjengbam

    2017-07-01

    Full Text Available BACKGROUND Fine-Needle Aspiration Cytology (FNAC is a widely used method, which is accurate and safe in a readily palpable masses. But, in those inaccessible lesions and deeper organs are safely aspirated using fine needle radiological procedure like ultrasound or computed tomography guided. The aim of the study is to assess the utility of FNAC in the diagnosis of intra-abdominal lesions and different pattern of lesions in particular to the sites. MATERIALS AND METHODS This retrospective study was done in the Department of Pathology, Regional Institute of Medical Sciences (RIMS, Imphal, between June 2010 and June 2016. The study included 128 intra-abdominal masses. Giemsa and Papanicolaou’s stains were used. The cytological diagnosis was correlated with clinical and radiological data to arrive at a final diagnosis. RESULTS Reports on FNAC smears were retrospectively analysed, which had been done in various anatomic sites- liver (70 cases, colon (19 cases, gallbladder (17 cases, mesenteric lymph nodes (12 cases, ovary (3 cases, adrenals (2 cases and 1 case each of pancreas, peritoneal wall, pelvic, suprapubic and flank masses. The mean age was 42.16 years with M:F of 1.3:1. The diagnostic yield was 85.2% in combination for Ultrasound Guided (USG and Computed Tomography (CT guided aspiration. The smears were classified as benign neoplastic, malignant neoplastic, non-neoplastic, inconclusive and unsatisfactory for interpretation. There were 79 (61.7% malignant neoplastic lesion, 5 (3.9% benign neoplastic lesion, 25 (19.5% non-neoplastic lesion, one (0.7% inconclusive lesions and 18 (14.1% unsatisfactory smears. The liver and the colon were the most common sites. Adenocarcinomas and Hepatocellular Carcinoma (HCC were the most common malignant lesions comprising of 35 (44.3% and 25 (31.6% of the total malignant lesions diagnosed. CONCLUSION Intra-abdominal FNA is a simple, economical and a safe procedure with high sensitivity, specificity and

  3. Comparative Population Plasma and Tissue Pharmacokinetics of Micafungin in Critically Ill Patients with Severe Burn Injuries and Patients with Complicated Intra-Abdominal Infection

    Science.gov (United States)

    García-de-Lorenzo, A.; Grau, S.; Agrifoglio, A.; Cachafeiro, L.; Herrero, E.; Asensio, M. J.; Sánchez, S. M.; Roberts, J. A.

    2016-01-01

    Severely burned patients have altered drug pharmacokinetics (PKs), but it is unclear how different they are from those in other critically ill patient groups. The aim of the present study was to compare the population pharmacokinetics of micafungin in the plasma and burn eschar of severely burned patients with those of micafungin in the plasma and peritoneal fluid of postsurgical critically ill patients with intra-abdominal infection. Fifteen burn patients were compared with 10 patients with intra-abdominal infection; all patients were treated with 100 to 150 mg/day of micafungin. Micafungin concentrations in serial blood, peritoneal fluid, and burn tissue samples were determined and were subjected to a population pharmacokinetic analysis. The probability of target attainment was calculated using area under the concentration-time curve from 0 to 24 h/MIC cutoffs of 285 for Candida parapsilosis and 3,000 for non-parapsilosis Candida spp. by Monte Carlo simulations. Twenty-five patients (18 males; median age, 50 years; age range, 38 to 67 years; median total body surface area burned, 50%; range of total body surface area burned, 35 to 65%) were included. A three-compartment model described the data, and only the rate constant for the drug distribution from the tissue fluid to the central compartment was statistically significantly different between the burn and intra-abdominal infection patients (0.47 ± 0.47 versus 0.15 ± 0.06 h−1, respectively; P patients would achieve plasma PK/pharmacodynamic (PD) targets of 90% for non-parapsilosis Candida spp. and C. parapsilosis with MICs of 0.008 and 0.064 mg/liter, respectively, for doses of 100 mg daily and 150 mg daily. The PKs of micafungin were not significantly different between burn patients and intra-abdominal infection patients. After the first dose, micafungin at 100 mg/day achieved the PK/PD targets in plasma for MIC values of ≤0.008 mg/liter and ≤0.064 mg/liter for non-parapsilosis Candida spp. and Candida

  4. Associação entre perfil lipídico e adiposidade corporal em mulheres com mais de 60 anos de idade Association between lipid profile and adiposity in women over age 60

    Directory of Open Access Journals (Sweden)

    Maressa Priscila Krause

    2007-09-01

    Full Text Available OBJETIVO: Verificar a associação entre perfil lipídico e medidas de obesidade corporal global e central em mulheres com idade superior a 60 anos. MÉTODOS: A amostra foi composta por 388 mulheres, com mais de 60 anos de idade (média, 69,0; desvio padrão, 5,9 anos. O perfil lipídico foi determinado por meio das dosagens de colesterol total (CT, colesterol de lipoproteína de alta densidade (HDL-colesterol, colesterol de lipoproteína de baixa densidade (LDL-colesterol e triglicerídeos (TG. A obesidade global foi mensurada pelo índice de massa corporal (IMC e pelas dobras cutâneas (DC, e a obesidade central foi mensurada pela circunferência da cintura (CC e pela relação cintura-quadril (RCQ. A análise estatística foi realizada por meio da correlação parcial ajustada para a idade e ANOVA one-way (p OBJECTIVE: To verify the association between lipid profiles and overall or central obesity in women over the age of 60. METHODS: The sample was comprised of 388 women over the age of 60 (mean 69; standard deviation 5.9 years. The lipid profile was determined using total cholesterol (TC, HDL cholesterol (HDL-C, LDL cholesterol (LDL-C and triglyceride (TG levels. Overall obesity was determined using the body mass index (BMI and skin fold (SF measurements. Central obesity was determined using the waist circumference (WC and waist - hip ratio (WHR. Statistical analysis was conducted using age adjusted partial correlation and one way ANOVA (p<0.05. RESULTS: The mean values found for the adiposity variables and lipid profile components indicate an elevated atherogenic risk. In addition, the indicators for overall and central obesity were directly related to TG levels and inversely related to HDL-C levels. CONLCUSION: The partial correlation analysis and the largest variance found for WC and WHR in comparison to the lipidogram components indicate that both methods could be useful in the early diagnosis of atherosclerosis.

  5. Hematoma subcapsular por Fasciolasis

    OpenAIRE

    MORALES G,JUAN L; ARRIAGADA H,RENATO; SALAS G,LUIS; MORALES A,CARLOS; FUENTES A,FELIPE; Santana, Roberto

    2009-01-01

    Presentamos el caso de una paciente de sexo femenino de 60 años de edad, ingresada en nuestro centro hospitalario por cuadro agudo de dolor abdominal en hipocondrio derecho asociado a vómitos y fiebre. Destaca la presencia de leucocitosis con eosinofilia de 56%. La tomografía computanzada abdominal muestra una colección subcapsular hepática. Durante su evolución presenta abdomen agudo, realizándose una laparoscopía exploratoria que confirma un hematoma subcapsular con presencia de hemopentone...

  6. Infecciones por citomegalovirus

    Directory of Open Access Journals (Sweden)

    Ana Gloria Díaz Martínez

    1998-06-01

    Full Text Available Se ofrece una revisión actualizada sobre la infección por citomegalovirus a partir de la consulta de artículos referidos de 1990 a 1996 en las bases de datos MEDLINE, LILACS, Literatura Cubana de Medicina y Noticias de Salud. Se revisaron 37 artículos. Se abordan los aspectos más importantes de las manifestaciones clínicas, el diagnóstico, el tratamiento, así como la prevención y los métodos de control para evitar las enfermedades citomegálicas

  7. Osteomielitis por salmonella

    OpenAIRE

    Alicia Velázquez Pérez; Teresa P. Rodríguez Torres; Orelvis Pérez Duerto

    2014-01-01

    Se presenta el caso de una paciente femenina de color blanco y dos años de edad, con diagnóstico prenatal de sicklemia, que desde edades tempranas tiene problemas de la enfermedad. Ingresó en esta ocasión por una de las complicaciones infecciosas que ocasiona este padecimiento, una osteomielitis del húmero izquierdo, aislándose el germen en el hemocultivo realizado, una salmonella. Necesitó de tratamiento enérgico y prolongado; se obtuvo un resultado satisfactorio en la evolución de la enferm...

  8. Combates por la historia

    OpenAIRE

    2015-01-01

    E.P.S. Huayco frente a Sarita Colonia. 1980. De izquierda a derecha: Charo Noriega, Mariela Zevallos, Herbert Rodríguez, María Luy y Francisco Mariotti flanqueado por sus hijas. No aparecen Juan Javier Salazar y Armando Williams.(Fotografía: ¿AW?). Diecinueve anos después. De izquierda a derecha: Armando Williams, Francisco Mariotti, Charo Noriega y Juan Javier Salazar. (Fotografía: GB). Correctamente asumida, sin embargo, esta cercanía personal puede ser favorable para la reconstrucción min...

  9. Por mil devaluados pesos

    Directory of Open Access Journals (Sweden)

    Annie Rodríguez Collázos

    2013-03-01

    Full Text Available El estudio de lo popular y lo urbano hasta ahora se ha centrado en el comportamiento y en algunas relaciones de los habitantes con su entorno. “Por mil devaluados pesos. Publicidad popular y urbana”, pretende explorar las formas de publicidad, dispersas en diferentes espacios populares y urbanos en Bogotá, identificando esquemas y formas características de sus propios códigos comunicativos; se centran en un objeto de estudio consistente en las estrategias publicitarias y los códigos comunicativos en los mensajes publicitarios populares en las subculturas de San Victorino, 7 de Agosto y Sanandresito de San José.

  10. Associação entre ganho de peso no primeiro ano de vida com excesso de peso e adiposidade abdominal na idade pré-escolar Asociación entre ganancia de peso en el primer año de vida con exceso de peso y de adiposidad abdominal en la edad pre-escolar Association between weight gain in the first year of life with excess weight and abdominal adiposity at preschool age

    OpenAIRE

    Mariane Leite Bertotto; Júlia Valmórbida; Mônica Cristina Broilo; Paula Dal B. Campagnolo; Márcia Regina Vitolo

    2012-01-01

    OBJETIVO: Avaliar se a mudança no escore Z do índice de massa corpórea por idade >0,67 no primeiro ano de vida se associou ao excesso de peso na idade pré-escolar. MÉTODOS: Estudo de coorte aninhado a ensaio de campo randomizado realizado na cidade de São Leopoldo, no Rio Grande do Sul. Foram coletados dados de peso e estatura das crianças ao nascimento, dos seis aos oito meses e dos 12 aos 16 meses. Aos três e aos quatro anos, além destes dados aferiu-se a circunferência da cintura. Calculou...

  11. Successful laparoscopic repair of an incarcerated Bochdalek hernia associated with increased intra-abdominal pressure during use of blow gun: A case report.

    Science.gov (United States)

    Harada, Manabu; Tsujimoto, Hironori; Nagata, Ken; Ito, Nozomi; Yamazaki, Kenji; Kanematsu, Kyohei; Horiguchi, Hiroyuki; Kajiwara, Yoshiki; Hiraki, Shuichi; Aosasa, Suefumi; Yamamoto, Junji; Hase, Kazuo

    2016-01-01

    Bochdalek hernia is a congenital diaphragmatic hernia, and adult cases are rare, with a reported frequency of 0.17%-6% among all diaphragmatic hernias. A 78-year-old man was referred to our hospital with a sudden onset of whole abdominal pain after playing with a blow gun. Chest radiography and computed tomography revealed diaphragmatic hernia with the small intestine. We therefore diagnosed him with an incarcerated Bochdalek hernia associated with increased intra-abdominal pressure during use of blow gun. Laparoscopic repair was performed. The omentum, transverse colon, and small intestine were located in the left thoracic cavity, without ischemic change. After placing the herniated organs into the abdominal cavity, we performed a primary closure of the diaphragmatic defect with interrupted non-absorbable sutures. It is generally recommended that all adult Bochdalek hernia patients undergo surgical repair to prevent life-threatening complications due to incarceration. Recently, laparoscopic techniques for repair the hernia have gained popularity, especially in elective cases. In our case, we could successfully perform emergency laparoscopic repair, as it is associated with a shorter inpatient hospitalization period. An incarcerated Bochdalek hernias associated with increased intra-abdominal pressure is an uncommon clinical finding in an adult, and laparoscopic repair of an incarcerated Bochdalek hernia is safe, feasible, and an excellent option as it is minimally invasive. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Re-operative abdominal predictive score: a prognostic model combining Acute Re-intervention Predictive Index and intra-abdominal pressure.

    Science.gov (United States)

    Soler-Morejón, Caridad de Dios; Lombardo-Vaillant, Tomás Ariel; Tamargo-Barbeito, Teddy Osmín; Wise, Robert; Malbrain, Manu L N G

    2017-11-22

    The decision to re-operate after abdominal surgery is still difficult, especially in the setting of intra-abdominal sepsis. Mathematical models provide a good aid to both diagnosis and decision-making. A prospective observational study was conducted with 300 patients consecutively admitted to the intensive care unit of an academic institution affiliated to Calixto García Medical Faculty following abdominal surgery from January 2008 to January 2010. The patients were randomly separated (2:1) into estimation and validation groups. Logistic regression analysis was used in the estimation group to develop three models for decision-making related to re-operation including related factors such as age, ARPI, IAP, type of surgery (elective or emergency), and the duration of surgery. The three models developed were validated on the other group. The acute re-operation predictive index-intra-abdominal pressure (ARPI-IAP) model was the best of the three models, with an excellent calibration, using the Hossmer-Lemeshow goodness-of-fit statistical test (C = 9.976, P = 0.267), as well as discrimination (AUC = 0.989; 95% CI: 0.976-1.000). The combination of IAP with ARPI in a mathematical model can add accuracy to the prediction of need for re-operation related to intra-abdominal infectious complications in patients following abdominal surgery. This may be useful in all medical settings, but especially those with limited resources.

  13. Nodo-colonic fistula caused by intra-abdominal tuberculous lymphadenitis during treatment with anti-tuberculous medication: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Kyung Sun; Bae, Kyung Eun; Jeong, Myeong Ja; Lee, Ji Hae; Kang, Mi Jin; Kim, Jae Hyung; Kim, Soo Hyun [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2016-08-15

    Recently, the overall incidence of tuberculosis has decreased, but the incidence of an extrapulmonary manifestation in patients with tuberculosis has increased in the Republic of Korea. Although intestinal tuberculosis is not infrequent, a fistula caused by tuberculosis is a rare condition. A 23-year-old man presented with fever, diarrhea and right lower quadrant pain. A computed tomography (CT) scan revealed a lobulated, peripherally enhancing, low density mass in the mesentery. The patient underwent laparoscopic biopsy for necrotic lymph node, and intra-abdominal tuberculous lymphadenitis was diagnosed. Four months after initiating treatment with anti-tuberculous medication, the patient developed fever together with lower abdominal pain. A follow-up CT scan revealed a fistulous tract that had developed between the initially noted lymphadenopathy and the proximal ascending colon. Laparoscopic right hemicolectomy was performed as a curative treatment. This case suggests that a nodo-colonic fistula may occur as a paradoxical response in patients with intra-abdominal tuberculous lymphadenitis during treatment with anti-tuberculous medication.

  14. Insatisfação com a imagem corporal e relação com estado nutricional, adiposidade corporal e sintomas de anorexia e bulimia em adolescentes Body image dissatisfaction and its relationship with nutritional status, body fat, and anorexia and bulimia symptoms in adolescents

    Directory of Open Access Journals (Sweden)

    Cilene Rebolho Martins

    2010-01-01

    Full Text Available Objetivos: Identificar a prevalência de insatisfação com a imagem corporal e de sintomas de anorexia e bulimia em adolescentes do sexo feminino da cidade de Santa Maria (RS e verificar a associação da insatisfação com a imagem corporal com estado nutricional, adiposidade corporal e sintomas de anorexia e bulimia. Método: Foram analisadas 258 adolescentes do sexo feminino (11 a 13 anos, estudantes de escolas públicas. Aplicou-se o Body Shape Questionnaire e o Teste de Atitudes Alimentares (EAT-26. Foram calculados o índice de massa corporal e o percentual de gordura. Foram utilizados o teste qui-quadrado e a regressão logística. Resultados: A prevalência de insatisfação com a imagem corporal foi de 25,3% e a de sintomas de anorexia e bulimia foi de 27,6%. A insatisfação com a imagem corporal apresentou associação com o estado nutricional, sendo que as adolescentes com excesso de peso apresentaram maior insatisfação (razão de chances = 2,64; IC95%= 1,02-6,83. Conclusão: As prevalências de insatisfação corporal e sintomas de anorexia e bulimia foram elevadas. O estado nutricional parece ser o melhor preditor da insatisfação corporal.Objectives: To identify the prevalence of body image dissatisfaction and anorexia and bulimia symptoms in adolescent girls from the city of Santa Maria, Brazil, and to determine the association of body image dissatisfaction with nutritional status, body fat, and anorexia and bulimia symptoms. Method: We investigated 258 adolescent girls (11 to 13 years from public schools. The Body Shape Questionnaire and the Eating Attitudes Test (EAT-26 were used. Body mass index and percent body fat were calculated. The chi-square test and logistic regression were used. Results: The prevalence of body image dissatisfaction was 25.3% and the prevalence of anorexia and bulimia symptoms was 27.6%. Body image dissatisfaction was associated with nutritional status, with overweight girls presenting higher

  15. Gasto energético e consumo calórico em adolescentes do sexo masculino com diferentes níveis de adiposidade corporal Energy expenditure and caloric intake among male adolescents with different levels of body adiposy

    Directory of Open Access Journals (Sweden)

    Diego Augusto Santos Silva

    2013-03-01

    Full Text Available Foram comparados o gasto energético e consumo calórico de adolescentes com diferentes níveis de gordura corporal. Estudo transversal com 40 adolescentes de 14 a 16 anos do sexo masculino. Os adolescentes foram divididos em dois grupos, cada um com 20 sujeitos, de acordo com o %G: baixo (%G 20%. O gasto energético foi mensurado por acelerômetros triaxiais e recordatório de atividades diárias. O consumo calórico foi avaliado pelo registro de 24 horas. Os jovens com baixo %G tiveram menor consumo calórico ( = 2408,1 ± 557,9 kcal.dia-1 em comparação aos jovens com alto %G ( = 2931,7 ± 679,2 kcal.dia-1, pEnergy expenditure and caloric intake were compared among adolescents with different levels of adiposity. A cross-sectional study was carried with 40 adolescent boys aged 14 to 16 years. The adolescents were divided into two groups of 20 subjects each, according to % body fat (%BF: low ( 20%. Energy expenditure was measured using accelerometer and daily activity diary. The dietary pattern was evaluated based on 24-h recall. Caloric intake was lower in adolescents with low %F ( = 2408.1 ± 557.9 kcal.day-1 compared to those with high %F ( = 2931.7 ± 679.2 kcal.day-1, p<0.05. In addition, they presented greater relative energy expenditure than adolescents with high %F (p<0.05. High %F adolescents showed larger caloric intake than expenditure, while the opposite was observed among low %F males.

  16. Sepsis por shigella flexneri

    Directory of Open Access Journals (Sweden)

    César Cabrera C

    2005-04-01

    Full Text Available Se presenta un caso raro de sepsis por Shigella flexneri en una paciente de 45 años de edad quien estando hospitalizada para el estudio de un tumor cerebral, requirió el uso de manitol y dosis altas de corticoides; luego de ello presenta deposiciones líquidas con moco y sangre, desarrolla síndrome de respuesta inflamatoria sistémica, luego se aísla Shigella flexneri en el hemocultivo; recibió tratamiento antibiótico con ciprofloxacina. Se describen las características del caso y se comenta de acuerdo con la revisión de literatura.

  17. Ojo por ojo

    OpenAIRE

    del Llano Ibáñez, Ramón

    2011-01-01

    Nuestro pan y café de la mañana se acompaña de noticias alrededor de ejecuciones, de fosas clandestinas, de batallas del ejército, de balaceras en las calles y civiles caídos por balas perdidas : la muerte acompaña nuestro desayuno. Las calaveras de azúcar del día de muertos hoy son calaveras reales y amargas : 40 000 muertos en cuatro años después que el Presidente Calderón declaró la guerra a los narcotraficantes. Se han apresado a varios e importantes miembros de los cárteles : pero han si...

  18. Portable exhausters POR-004 SKID B, POR-005 SKID C, POR-006 SKID D storage plan

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, O.D.

    1997-09-04

    This document provides a storage plan for portable exhausters POR-004 SKID B, POR-005 SKID C, AND POR-006 SKID D. The exhausters will be stored until they are needed by the TWRS (Tank Waste Remediation Systems) Saltwell Pumping Program. The storage plan provides criteria for portable exhauster storage, periodic inspections during storage, and retrieval from storage.

  19. Impact of intra-abdominal absorbable sutures on surgical site infection in gastrointestinal and hepato-biliary-pancreatic surgery: results of a multicenter, randomized, prospective, phase II clinical trial.

    Science.gov (United States)

    Maehara, Yoshihiko; Shirabe, Ken; Kohnoe, Shunji; Emi, Yasunori; Oki, Eiji; Kakeji, Yoshihiro; Baba, Hideo; Ikeda, Masataka; Kobayashi, Michiya; Takayama, Tadatoshi; Natsugoe, Shoji; Haraguchi, Masashi; Yoshida, Kazuhiro; Terashima, Masanori; Sasako, Mitsuru; Yamaue, Hiroki; Kokudo, Norihiro; Uesaka, Katsuhiko; Uemoto, Shinji; Kosuge, Tomoo; Sawa, Yoshiki; Shimada, Mitsuo; Doki, Yuichiro; Yamamoto, Masakazu; Taketomi, Akinobu; Takeuchi, Masahiro; Akazawa, Kouhei; Yamanaka, Takeharu; Shimokawa, Mototsugu

    2017-09-01

    The use of absorbable sutures in wound closure has been shown to reduce the incidence of surgical site infection (SSI); however, there is no evidence that the intra-abdominal use of absorbable rather than silk sutures reduces the incidence of SSI after gastrointestinal surgery. We report the findings of a phase II trial, designed to evaluate the impact of the intra-abdominal use of absorbable sutures on the incidence of SSI. At 19 Japanese hospitals, 1147 patients undergoing elective gastrectomy, colorectal surgery, hepatectomy, or pancreaticoduodenectomy (PD) were randomly assigned to absorbable or silk intra-abdominal suture groups. The primary efficacy endpoint was the incidence of SSI. The secondary efficacy endpoints were the locations of SSI, time to resolution of SSI, length of hospital stay, and the incidence of bile leakage in hepatectomy and pancreatic fistula. The incidence of SSI was 11.3%, 15.5%, 11.3%, and 36.9% after gastrectomy, colorectal surgery, hepatectomy, and PD, respectively. The incidence of SSI was higher in the absorbable suture group than in the silk suture group for all the surgical procedures, but the difference was not significant. The intra-abdominal use of absorbable sutures did not have enough of an effect on the reduction of SSI in this phase II trial to justify the planning of a large-scale phase III trial.

  20. Distribution of 3H within purine nucleotides of Ehrlich mouse ascites tumour cells after intraabdominal injection of myo-[2-3H]inositol

    DEFF Research Database (Denmark)

    Christensen, Søren; Klenow, H.; Overgaard-Hansen, Kay

    2000-01-01

    In Ehrlich mouse ascites tumour cells, exposed intra-abdominally to [2-3H]inositol, ATP and GTP presented enough aberrant 3H-label to cause potential interference in the chromatographic analysis of inositol phosphates involved in signal transduction. After acid extraction and charcoal adsorption...

  1. Control Multivariable por Desacoplo

    Directory of Open Access Journals (Sweden)

    Fernando Morilla

    2013-01-01

    Full Text Available Resumen: La interacción entre variables es una característica inherente de los procesos multivariables, que dificulta su operación y el diseño de sus sistemas de control. Bajo el paradigma de Control por desacoplo se agrupan un conjunto de metodologías, que tradicionalmente han estado orientadas a eliminar o reducir la interacción, y que recientemente algunos investigadores han reorientado con objetivos de solucionar un problema tan complejo como es el control multivariable. Parte del material descrito en este artículo es bien conocido en el campo del control de procesos, pero la mayor parte de él son resultados de varios años de investigación de los autores en los que han primado la generalización del problema, la búsqueda de soluciones de fácil implementación y la combinación de bloques elementales de control PID. Esta conjunción de intereses provoca que no siempre se pueda conseguir un desacoplo perfecto, pero que sí se pueda conseguir una considerable reducción de la interacción en el nivel básico de la pirámide de control, en beneficio de otros sistemas de control que ocupan niveles jerárquicos superiores. El artículo resume todos los aspectos básicos del Control por desacoplo y su aplicación a dos procesos representativos: una planta experimental de cuatro tanques acoplados y un modelo 4×4 de un sistema experimental de calefacción, ventilación y aire acondicionado. Abstract: The interaction between variables is inherent in multivariable processes and this fact may complicate their operation and control system design. Under the paradigm of decoupling control, several methodologies that traditionally have been addressed to cancel or reduce the interactions are gathered. Recently, this approach has been reoriented by several researchers with the aim to solve such a complex problem as the multivariable control. Parts of the material in this work are well known in the process control field; however, most of them are

  2. Intraabdominal Intravascular Papillary Endothelial Hyperplasia (Masson’s Tumor: A Rare and Novel Cause of Gastrointestinal Bleeding

    Directory of Open Access Journals (Sweden)

    Michael C. Meadows

    2010-03-01

    Full Text Available Intravascular papillary endothelial hyperplasia (IPEH, or Masson’s tumor, a rare benign vascular lesion, occurs mainly in the head, neck, and hands in the human population. Aberrant tumor locations have been rarely reported. We present a case of a patient with chronic abdominal pain and melena of variable severity due to a Masson’s tumor, with no apparent Masson’s tumor-associated comorbidities, along with a comprehensive review of the literature. Using PubMed, a search engine provided by the U.S. National Library of Medicine and the National Institutes of Health, we searched for all reports of Masson’s tumor limited within the abdominal cavity. Furthermore, keywords such as ‘intravascular papillary endothelial hyperplasia’, ‘renal’, ‘gastrointestinal’, ‘hepatic’ and ‘intraabdominal’ were used to facilitate the search. We thus found fourteen cases of intraabdominal Masson’s tumors published. Six (42.9% of these were located in the renal vein, 4 (28.6% were reported in the gastrointestinal tract, 1 (7.1% in the adrenal gland, 1 (7.1% in the liver, and 1 (7.1% instance with multiple lesion sites including the renal hilum and retroperitoneum. Among these patients, 9 (64.3% were female and 5 (35.7% male, with a mean age of 38.9 years (7–69. IPEH is a reactive process, having three subtypes, all involving the proliferation of epithelial cells around a thrombus in the setting of venous stasis. In its pure form, the organized thrombus is solely localized within the vascular lumen. Mixed-form IPEH is formed in preexisting vascular lesions (such as arteriovenous malformation, hemangioma, pyogenic granuloma, etc.. The rarest form is the extravascular variety, which arises in hematomas often from recent trauma to the area. In its pure form, IPEH has a zero recurrence rate when an R0 resection is performed; all mixed and extravascular forms show the highest recurrence rates. The exact histogenesis of these epithelial cells

  3. Sociedad por Acciones Simplificada

    Directory of Open Access Journals (Sweden)

    Carlos Andrés Arcila Salazar

    2009-06-01

    Full Text Available En Colombia, aspectos como la responsabilidad limitada; supresión de la llamada doctrina de ultra vires; duración ilimitada; eliminación de la regla, una acción, un voto; remedios al abuso de los derechos; posibilidad de eliminar prohibiciones a los administradores, libertad de establecer restricciones para la transferencia de acciones y la simplificación de los procedimientos de fusión; son inviables bajo nuestra legislación. Sin embargo, la Ley 1258 de 2008, ha incorporado al derecho societario colombiano un nuevo tipo societario híbrido, llamado “Sociedad por Acciones Simplificada”. Esta forma societaria híbrida se basa en un principio básico: garantizar amplia libertad a los empresarios en la estructuración de sus relaciones a través de disposiciones contractuales. La S.A.S. provee a los empresarios significativa flexibilidad contractual, a la vez que preserva beneficios como la limitación de la responsabilidad.

  4. Sociedad por Acciones Simplificada

    Directory of Open Access Journals (Sweden)

    Carlos Andrés Arcila Salazar

    2009-07-01

    Full Text Available En Colombia, aspectos como la responsabilidad limitada; supresión de la llamada doctrina de ultra vires; duración ilimitada; eliminación de la regla, una acción, un voto; remedios al abuso de los derechos; posibilidad de eliminar prohibiciones a los administradores, libertad de establecer restricciones para la transferencia de acciones y la simplificación de los procedimientos de fusión; son inviables bajo nuestra legislación. Sin embargo, la Ley 1258 de 2008, ha incorporado al derecho societario colombiano un nuevo tipo societario híbrido, llamado “Sociedad por Acciones Simplificada”. Esta forma societaria híbrida se basa en un principio básico: garantizar amplia libertad a los empresarios en la estructuración de sus relaciones a través de disposiciones contractuales. La S.A.S. provee a los empresarios significativa flexibilidad contractual, a la vez que preserva beneficios como la limitación de la responsabilidad.

  5. Fasting gall bladder volume and lithogenicity in relation to glucose tolerance, total and intra-abdominal fat masses in obese non-diabetic subjects

    DEFF Research Database (Denmark)

    Hendel, H W; Højgaard, L; Andersen, T

    1998-01-01

    OBJECTIVE: To investigate whether total body fat mass or fat distribution and associated metabolic disturbances in glucose and lipid metabolism influence the well known gallstone pathogenetic factors in obese subjects in order to explain why some obese subjects develop gallstones and some do not....... DESIGN: Cross sectional study of gallstone pathogenetic factors, body composition, fat distribution, glucose and lipid metabolism. SUBJECTS: 57 healthy overweight subjects (aged 26-64y, body mass index (BMI) 30-45 kg/m2). MEASUREMENTS: Total and intra-abdominal fat masses were measured by dual X......-ray absorptiometry and abdominal CT scanning, respectively. The lithogenic index was measured in aspirated bile. The gallbladder volume was determined by ultrasound and the gallbladder ejection fraction% by dynamic cholescintigraphy. Plasma cholecystokinin (CCK) concentrations during a meal were measured...

  6. Validation of surface EMG as a measure of intravaginal and intra-abdominal activity: implications for biofeedback-assisted Kegel exercises.

    Science.gov (United States)

    Workman, D E; Cassisi, J E; Dougherty, M C

    1993-01-01

    This study validates surface EMG as a measure of pelvic muscle and abdominal activity by showing its high correlation to internal pressure data. Using standardized scores, between-subjects correlation of perineal EMG and intravaginal pressure was r = .75, and the correlation of abdominal EMG and intra-abdominal pressure was r = .72. Discriminant validity was also demonstrated by showing low correlation between standardized abdominal and perineal EMG measurements (r = .10). A repeated measures multivariate analysis of variance demonstrated that visual and auditory biofeedback of EMG during pelvic floor contractions increases intravaginal pressure when compared with trials without biofeedback. Potential benefits of fabric electrodes include reduced invasiveness and risk and the ease with which patients can utilize this technology for home practice.

  7. Sobre el conocimiento por connaturalidad

    OpenAIRE

    Buzeta-Undurraga, S. (Sebastián)

    2013-01-01

    El conocimiento por connaturalidad es un tópico central en la filosofía y teología de Tomás de Aquino, no tanto por la cantidad de páginas que dedicó a su estudio, sino por su naturaleza y radicalidad para la vida humana; pues se trata de un conocimiento integral, es decir, se funda desde una armonía de todas las facultades para que el entendimiento humano juzgue verdaderamente, conforme a su naturaleza, desde su naturaleza. No consiste en un tipo de conocimiento por el perfecto uso de la fac...

  8. Assessment of the attenuation of an intra-abdominal vein by use of a silicone-polyacrylic acid gradual venous occlusion device in dogs and cats.

    Science.gov (United States)

    Wallace, Mandy L; Ellison, Gary W; Giglio, Robson F; Batich, Christopher D; Berry, Clifford R; Case, J Brad; Kim, Stanley E

    2016-06-01

    OBJECTIVE To evaluate the closure rate and completeness of closure for a silicone-polyacrylic acid gradual venous occlusion device placed around an intra-abdominal vein to simulate gradual occlusion of an extrahepatic portosystemic shunt. ANIMALS 3 purpose-bred cats and 2 purpose-bred dogs. PROCEDURES The device was surgically placed around an external (cats) or internal (dogs) iliac vein. Computed tomographic angiography was performed at the time of surgery and 2, 4, and 6 weeks after surgery. Ultrasonographic examinations of blood flow through the vein within the device were performed at the time of surgery and at weekly intervals thereafter. Dogs were euthanized 6 weeks after surgery, and the external iliac veins were harvested for histologic examination. RESULTS The prototype gradual venous occlusion device was successfully placed in all animals, and all animals recovered without complications following the placement procedure. The vessel was completely occluded in 2 cats by 6 weeks after surgery, as determined on the basis of results of CT and ultrasonography; there was incomplete occlusion with a luminal diameter of 1.5 mm in the other cat by 6 weeks after surgery. The vessel was completely occluded in both dogs by 6 weeks after surgery. Histologic examination of the external iliac veins obtained from the dogs revealed minimal inflammation of the vessel wall and no thrombus formation. CONCLUSIONS AND CLINICAL RELEVANCE The prototype device induced gradual attenuation of an intra-abdominal vessel over a 6-week period. This device may provide another option for gradual occlusion of extrahepatic portosystemic shunts.

  9. El recuerdo viaja por Italia

    Directory of Open Access Journals (Sweden)

    Néstor Madrid Malo

    1965-09-01

    Full Text Available Espero que mis lectores puedan acompañarme en este viaje del recuerdo por Italia, en esta travesía restrospectiva por el cuerpo duradero, por el dorso sustantivo - vertebrado dulcemente, ásperamente, por el vasto cinturón apenínico- de un país donde la vida tiene una manera tan suya de ser grata, de transcurrir en todo momento significativamente. Y donde cada instante, cada sitio, está signado de plenitudes inefables, de expresivos modos de mostrársenos e insinuársenos, hasta hacerse todos ellos, por siempre, memorables e insistentes habitantes de nuestros mejores sueños y vigilias.

  10. Relação entre sobrepeso, adiposidade e distribuição de gordura com a pressão arterial de adolescentes no município do Rio de Janeiro Relationship between overweight, fat mass and fat distribution with blood pressure among adolescents of the city of Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Rosana Salles da Costa

    1998-12-01

    Full Text Available Estudo elaborado com o objetivo de avaliar se o sobrepeso, a adiposidade e a distribuição de gordura seriam fatores explicativos para a associação entre o crescimento e o aumento de pressão arterial. Uma amostra probabilística dos adolescentes do município do Rio de Janeiro foi obtida com base em 2040 domicílios. Foram estimados 857 adolescentes de 12 a 19 anos, 86% participaram da pesquisa (646 adolescentes, sendo avaliados 646 adolescentes, em relação às medidas de pressão arterial sistólica e diastólica, peso, altura, dobras cutâneas triciptal e subescapular, circunferências de braço, cintura e quadril. Os meninos apresentaram maior prevalência de sobrepeso (22,9 ± 2,3 quando comparados com as meninas (12,5 ± 1,9, considerando o percentil 90 do Índice de Massa Corporal (IMC-Kg/m² da população brasileira, bem como maior prevalência de hipertensão arterial, considerando o percentil 95 da população americana. As variáveis antropométricas correlacionaram-se mais com a pressão arterial sistólica do que com a diastólica, em ambos os sexos. A área de gordura braquial permaneceu significativamente correlacionada com a pressão arterial, após o ajuste pela idade, pelo IMC e pela área muscular do braço (pThis study investigated if overweight, obesity and fat distribution would explain the relationship between growth and blood pressure increase. A representative sample of 2040 households from the city of Rio de Janeiro was assessed. Of 857 adolescents, with ages between 12 and 19 years, 86% were included in this study. Of these, 646 adolescents were evaluated for measurements such as weight, height, triceps and subescapular skinfolds, arm circumference, waist and hip circumferences, and blood pressure. The hypertension prevalence was higher in males, than females, according to the 95th percentile of the Second Task Force. Overweight prevalence was higher among males (22,9 ± 2,3 than among females (12,5 ± 1

  11. Responsabilidade civil por abandono afetivo

    OpenAIRE

    Fidélis, Maria de Lourdes

    2013-01-01

    Este estudo tem por objetivo a análise da responsabilidade civil por abandono afetivo na relação paterno-filial a partir de recentes decisões dos tribunais brasileiros. Inicialmente discorre sobre a evolução da família contemporânea. Examina os elementos da responsabilidade civil objetivando uma interseção entre o novo Direito de Família e as transformações no dever de indenizar. A partir de dois casos paradigmáticos escolhidos busca-se encontrar os fundamentos e finalidades das demandas por ...

  12. Colecistitis aguda por Streptococcus constellatus

    OpenAIRE

    M Sandra Gómez-Canosa; Cristina Lijó-Carballeda; Begoña Vázquez-Vázquez; M José Bello-Peón

    2016-01-01

    Presentamos el caso de una paciente de edad avanzada y significativa comorbilidad que se diagnosticó de colecistitis aguda por Streptococcus constellatus. El drenaje de la vesícula biliar por colecistostomía percutánea, asociado a penicilinas, ha conseguido una evolución favorable. We report the case of a patient of advanced age and significant comorbidity diagnosed acute cholecystitis by Streptococcus constellatus. Gallbladder drainage by percutaneous cholecystostomy associated ...

  13. Porøse materialer

    DEFF Research Database (Denmark)

    Hansen, Ernst Jan de Place

    2000-01-01

    Dette undervisningsnotat er en samling af noter, der refererer til den indledende del af kurset Materialmekanik og Porøse materailer på Insitut for Bærende Konstruktiner og Materialer (BKM).......Dette undervisningsnotat er en samling af noter, der refererer til den indledende del af kurset Materialmekanik og Porøse materailer på Insitut for Bærende Konstruktiner og Materialer (BKM)....

  14. Otitis externa por Demodex cati

    OpenAIRE

    Real, L.

    2010-01-01

    La demodicosis por Demodex cati es una enfermedad parasitaria poco común que se presenta bajo tres formas clínicas: generalizada, localizada y otitis externa ceruminosa u otodemodicosis. El objetivo de esta comunicación es presentar dos casos clínicos de otitis ceruminosa causada por D.cati sin la presencia de otros síntomas cutáneos.

  15. Positive end expiratory pressure titrated by transpulmonary pressure improved oxygenation and respiratory mechanics in acute respiratory distress syndrome patients with intra-abdominal hypertension.

    Science.gov (United States)

    Yang, Yi; Li, Yang; Liu, Song-Qiao; Liu, Ling; Huang, Ying-Zi; Guo, Feng-Mei; Qiu, Hai-Bo

    2013-01-01

    Intra-abdominal hypertension (IAH) is common in acute respiratory distress syndrome (ARDS) patients and when resulting in decrease of chest wall compliance will weaken the effect of positive end expiratory pressure (PEEP). We investigated the effect of PEEP titrated by transpulmonary pressure (Ptp) on oxygenation and respiratory mechanics in ARDS patients with IAH compared with PEEP titrated by ARDSnet protocol. ARDS patients admitted to the intensive care unit (ICU) of the Zhongda Hospital were enrolled. Patients were ventilated with volume control mode with tidal volume of 6 ml/kg under two different PEEP levels titrated by Ptp method and ARDSnet protocol. Respiratory mechanics, gas exchange and haemodynamics were measured after 30 minutes of ventilation in each round. IAH was defined as intra-abdominal pressure of 12 mmHg or more. Seven ARDS patients with IAH and 8 ARDS patients without IAH were enrolled. PEEP titrated by Ptp were significant higher than PEEP titrated by ARDSnet protocol in both ARDS patients with IAH ((17.3 ± 2.6) cmH2O vs. (6.3 ± 1.6) cmH2O and without IAH ((9.5 ± 2.1) cmH2O vs. (7.8 ± 1.9) cmH2O). Arterial pressure of O2/fraction of inspired oxygen (PaO2/FiO2) was much higher under PEEP titrated by Ptp when compared with PEEP titrated by ARDSnet protocol in ARDS patients with IAH ((27.2 ± 4.0) cmHg vs. (20.9 ± 5.0) cmHg. But no significant difference of PaO2/FiO2 between the two methods was found in ARDS patients without IAH. In ARDS patients with IAH, static compliance of lung and respiratory system were higher under PEEP titrated by Ptp than by ARDSnet protocol. In ARDS patients with IAH, central venous pressure (CVP) was higher during PEEP titrated by Ptp than by ARDSnet protocol. Positive end expiratory pressure titrated by transpulmonary pressure was higher than PEEP titrated by ARDSnet protocol and improved oxygenation and respiratory mechanics in ARDS patients with IAH.

  16. Early enteral nutrition prevents intra-abdominal hypertension and reduces the severity of severe acute pancreatitis compared with delayed enteral nutrition: a prospective pilot study.

    Science.gov (United States)

    Sun, Jia-Kui; Li, Wei-Qin; Ke, Lu; Tong, Zhi-Hui; Ni, Hai-Bin; Li, Gang; Zhang, Lu-Yao; Nie, Yao; Wang, Xin-Ying; Ye, Xiang-Hong; Li, Ning; Li, Jie-Shou

    2013-09-01

    To investigate the effects of early enteral nutrition (EEN) on intra-abdominal pressure (IAP) and disease severity in patients with severe acute pancreatitis (SAP). Enteral nutrition (EN) was started within 48 h after admission in the EEN group and from the 8th day in the delayed enteral nutrition (DEN) group. The IAP and intra-abdominal hypertension (IAH) incidence were recorded for 2 weeks. The caloric intake and feeding intolerance (FI) incidence were recorded daily after EN was started. The severity markers and clinical outcome variables were also recorded. Sixty patients were enrolled to this study. No difference about IAP was found. The IAH incidence of the EEN group was significantly lower than that of the DEN group from the 9th day (8/30 versus 18/30; P = 0.009) after admission. The FI incidence of the EEN group was higher than that of the DEN group during the initial 3 days of feeding (25/30 versus 12/30; P = 0.001; 22/30 versus 9/30; P = 0.001; 15/30 versus 4/30; P = 0.002). Patients with an IAP <15 mmHg had lower FI incidence than those with an IAP ≥15 mmHg on the 1st day (20/22 versus 17/38; P < 0.001), the 3rd day (11/13 versus 8/47; P < 0.001), and the 7th day (3/5 versus 3/55; P = 0.005) of feeding. The severity markers and clinical outcome variables of the EEN group were significantly improved. Early enteral nutrition did not increase IAP. In contrast, it might prevent the development of IAH. In addition, EEN might be not appropriate during the initial 3-4 days of SAP onset. Moreover, EN might be of benefit to patients with an IAP <15 mmHg. Early enteral nutrition could improve disease severity and clinical outcome, but did not decrease mortality of SAP.

  17. Hyperthermic chemotherapy intra-abdominal laparoscopic approach: development of a laparoscopic model using CO2 recirculation system and clinical translation in peritoneal carcinomatosis.

    Science.gov (United States)

    Sánchez-García, Susana; Padilla-Valverde, David; Villarejo-Campos, Pedro; García-Santos, Esther P; Martín-Fernández, Jesús

    2017-09-01

    Hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective treatment for peritoneal carcinomatosis (PC). Laparoscopic surgery is performed in the treatment of colorectal and appendiceal cancer, and PC from diverse origin in selected patients. HIPEC management by laparoscopic approach after cytoreductive surgery (CRS) completed locoregional treatment of PC, and may be feasible and safe after appropriate patient selection. Development of an experimental model of HIPEC by laparoscopic approach, with CO2 recirculation. Clinical translation in two patients with PC and low peritoneal cancer index. We performed CRS in a porcine model of 5 pigs (35-38 kg) by laparoscopic approach. Laparoscopic HIPEC by CO2 recirculation system was performed; laparoscopic access was used for catheter input and output placement (Paclitaxel 175 mg/m2 for 60 min at 42 °C). The experimental variables were: blood gases, haemodynamic and intra-abdominal and central temperature. Clinical model application was performed in three cases with PC from colorectal origin. No statistically significant differences was found in blood gases, haemodynamic or temperature in the experimental study. In clinical study, there were no technical complications during laparoscopic-HIPEC approach, and we observed no changes in haemodynamic variables during the procedure. CRS and HIPEC laparoscopic model by CO2 recirculation system is safe and feasible technique in selected patients, that include low PC index, local and accessible tumour recurrences or high-risk of PC tumours.

  18. Early Versus Delayed Source Control in Open Abdomen Management for Severe Intra-abdominal Infections: A Retrospective Analysis on 111 Cases.

    Science.gov (United States)

    Rausei, Stefano; Pappalardo, Vincenzo; Ruspi, Laura; Colella, Antonio; Giudici, Simone; Ardita, Vincenzo; Frattini, Francesco; Rovera, Francesca; Boni, Luigi; Dionigi, Gianlorenzo

    2018-03-01

    Time to source control plays a determinant prognostic role in patients having severe intra-abdominal infections (IAIs). Open abdomen (OA) management became an effective treatment option for peritonitis. Aim of this study was to analyze the correlation between time to source control and outcome in patients presenting with abdominal sepsis and treated by OA. We retrospectively analyzed 111 patients affected by abdominal sepsis and treated with OA from May 2007 to May 2015. Patients were classified according to time interval from first patient evaluation to source control. The end points were intra-hospital mortality and primary fascial closure rate. The in-hospital mortality rate was 21.6% (24/111), and the primary fascial closure rate was 90.9% (101/111). A time to source control ≥6 h resulted significantly associated with a poor prognosis and a lower fascial closure rate (mortality 27.0 vs 9.0%, p = 0.04; primary fascial closure 86 vs 100%, p = 0.02). We observed a direct increase in mortality (and a reduction in closure rate) for each 6-h delay in surgery to source control. Early source control using OA management significantly improves outcome of patients with severe IAIs. This damage control approach well fits to the treatment of time-related conditions, particularly in case of critically ill patients.

  19. Inclusion of Vancomycin as Part of Broad-Spectrum Coverage Does Not Improve Outcomes in Patients with Intra-Abdominal Infections: A Post Hoc Analysis.

    Science.gov (United States)

    Sanders, James M; Tessier, Jeffrey M; Sawyer, Robert G; Lipsett, Pam A; Miller, Preston R; Namias, Nicholas; O'Neill, Patrick J; Dellinger, E P; Coimbra, Raul; Guidry, Chris A; Cuschieri, Joseph; Banton, Kaysie L; Cook, Charles H; Moore, Billy J; Duane, Therese M

    2016-12-01

    Management of complicated intra-abdominal infections (cIAIs) includes broad-spectrum antimicrobial coverage and commonly includes vancomycin for the empiric coverage of methicillin-resistant Staphylococcus aureus (MRSA). Ideally, culture-guided de-escalation follows to promote robust antimicrobial stewardship. This study assessed the impact and necessity of vancomycin in cIAI treatment regimens. A post hoc analysis of the Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial was performed. Patients receiving piperacillin-tazobactam (P/T) and/or a carbapenem were included with categorization based on use of vancomycin. Univariate and multivariable analyses evaluated effects of including vancomycin on individual and the composite of undesirable outcomes (recurrent IAI, surgical site infection [SSI], or death). The study cohort included 344 patients with 110 (32%) patients receiving vancomycin. Isolation of MRSA occurred in only eight (2.3%) patients. Vancomycin use was associated with a similar composite outcome, 29.1%, vs. no vancomycin, 22.2% (p = 0.17). Patients receiving vancomycin had (mean [standard deviation]) higher Acute Physiology and Chronic Health Evaluation II scores (13.1 [6.6] vs. 9.4 [5.7], p post hoc analysis reveals that addition of vancomycin occurred in nearly one third of patients and more often in sicker patients. Despite this selection bias, no appreciable differences in undesired outcomes were demonstrated, suggesting limited utility for adding vancomycin to cIAI treatment regimens.

  20. Use of the surgical Apgar score to enhance Veterans Affairs Surgical Quality Improvement Program surgical risk assessment in veterans undergoing major intra-abdominal surgery.

    Science.gov (United States)

    Masi, Antonio; Amodeo, Salvatore; Hatzaras, Ioannis; Pinna, Antonio; Rosman, Alan S; Cohen, Steven; Saunders, John K; Berman, Russell; Newman, Elliot; Ballantyne, Garth H; Pachter, Leon H; Melis, Marcovalerio

    2017-04-01

    We investigated whether the surgical Apgar score (SAS) may enhance the Veterans Affairs Surgical Quality Improvement Program (VASQIP) risk assessment for prediction of early postoperative outcomes. We retrospectively evaluated demographics, medical history, procedure, SAS, VASQIP assessment, and postoperative data for patients undergoing major/extensive intra-abdominal surgery at the Manhattan Veterans Affairs between October 2006 and September 2011. End points were overall morbidity and 30-, 60- , and 90-day mortality. Pearson's chi-square, ANOVA, and multivariate regression modeling were employed. Six hundred twenty-nine patients were included. Apgar groups did not differ in age, sex, and race. Low SASs were associated with worse functional status, increased postoperative morbidity, and 30-, 60- , and 90-day mortality rates. SAS did not significantly enhance VASQIP prediction of postoperative outcomes, although a trend was detected. Multivariate analysis confirmed SAS as an independent predictor of morbidity and mortality. SAS effectively identifies veterans at high risk for poor postoperative outcome. Additional studies are necessary to evaluate the role of SAS in enhancing VASQIP risk prediction. Published by Elsevier Inc.

  1. Ceftazidime/avibactam: a novel cephalosporin/nonbeta-lactam beta-lactamase inhibitor for the treatment of complicated urinary tract infections and complicated intra-abdominal infections.

    Science.gov (United States)

    Hidalgo, Jose A; Vinluan, Celeste M; Antony, Nishaal

    2016-01-01

    There has been greater interest in developing additional antimicrobial agents due to the increasing health care costs and resistance resulting from bacterial pathogens to currently available treatment options. Gram-negative organisms including Enterobacteriaceae and Pseudomonas aeruginosa are some of the most concerning threats due to their resistance mechanisms: extended-spectrum beta-lactamase production and Klebsiella pneumoniae carbapenemase enzymes. Ceftazidime is a third-generation broad-spectrum cephalosporin with activity against P. aeruginosa and avibactam is a novel nonbeta-lactam beta-lactamase inhibitor. Avycaz(®), the trade name for this new combination antibiotic, restores the activity of ceftazidime against some of the previously resistant pathogens. Avycaz was approved in 2015 for the treatment of complicated urinary tract infections, including pyelonephritis, and complicated intra-abdominal infections with the addition of metronidazole in patients with little to no other treatment options. This review article assesses the clinical trials and data that led to the approval of this antibiotic, in addition to its spectrum of activity and limitations.

  2. Resistance among Gram-negative ESKAPE pathogens isolated from hospitalized patients with intra-abdominal and urinary tract infections in Latin American countries: SMART 2013-2015

    Directory of Open Access Journals (Sweden)

    James A. Karlowsky

    Full Text Available ABSTRACT Gram-negative ESKAPE pathogens (Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species are important etiologic agents of nosocomial infection that are frequently resistant to broad-spectrum antimicrobial agents. Gram-negative ESKAPE pathogens were collected from hospitalized patients in 11 Latin American countries from 2013 to 2015 as part of the Study for Monitoring Antimicrobial Resistance Trends (SMART global surveillance program. In total, 2113 isolates from intra-abdominal infections (IAI and 970 isolates from urinary tract infections (UTI were tested against antimicrobial agents using standardized CLSI broth microdilution methodology. Of the agents tested, amikacin demonstrated the highest rates of susceptibility (% for K. pneumoniae (92.2, 92.3, Enterobacter spp. (97.5, 92.1, and P. aeruginosa (85.3, 75.2 isolates from both IAI and UTI, respectively. Ertapenem (68.5, 62.6 and imipenem (79.2, 75.9 showed substantially higher rates of susceptibility (% than other β-lactams, including piperacillin-tazobactam (35.9, 37.4 against ESBL-positive isolates of K. pneumoniae from IAI and UTI, respectively. Rates of susceptibility to all agents tested against A. baumannii were ≤30.9%. Gram-negative ESKAPE pathogens isolated from Latin America demonstrated compromised in vitro susceptibility to commonly prescribed broad-spectrum, parenteral antimicrobial agents. Continued surveillance is warranted. New antimicrobial agents with potent activity against Gram-negative ESKAPE pathogens are urgently needed.

  3. Daily melatonin administration to middle-aged male rats suppresses body weight, intraabdominal adiposity, and plasma leptin and insulin independent of food intake and total body fat.

    Science.gov (United States)

    Wolden-Hanson, T; Mitton, D R; McCants, R L; Yellon, S M; Wilkinson, C W; Matsumoto, A M; Rasmussen, D D

    2000-02-01

    Pineal melatonin secretion declines with aging, whereas visceral fat, plasma insulin, and plasma leptin tend to increase. We have previously demonstrated that daily melatonin administration at middle age suppressed male rat intraabdominal visceral fat, plasma leptin, and plasma insulin to youthful levels; the current study was designed to begin investigating mechanisms that mediate these responses. Melatonin (0.4 microg/ml) or vehicle was administered in the drinking water of 10-month-old male Sprague Dawley rats (18/treatment) for 12 weeks. Half (9/treatment) were then killed, and the other half were submitted to cross-over treatment for an additional 12 weeks. Twelve weeks of melatonin treatment decreased (PFood intake and total body fat were not changed by melatonin treatment. Melatonin-treated rats that were then crossed over to control treatment for a further 12 weeks gained BW, whereas control rats that were crossed to melatonin treatment lost BW, but food intake did not change in either group. Feed efficiency (grams of BW change per g cumulative food intake), a measure of metabolic function, was negative in melatonin-treated rats and positive in control rats before cross-over (Pfood intake or total adiposity. These results suggest that the decrease in endogenous melatonin with aging may alter metabolism and physical activity, resulting in increased BW, visceral adiposity, and associated detrimental metabolic consequences.

  4. Resistance among Gram-negative ESKAPE pathogens isolated from hospitalized patients with intra-abdominal and urinary tract infections in Latin American countries: SMART 2013–2015

    Directory of Open Access Journals (Sweden)

    James A. Karlowsky

    2017-05-01

    Full Text Available Gram-negative ESKAPE pathogens (Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species are important etiologic agents of nosocomial infection that are frequently resistant to broad-spectrum antimicrobial agents. Gram-negative ESKAPE pathogens were collected from hospitalized patients in 11 Latin American countries from 2013 to 2015 as part of the Study for Monitoring Antimicrobial Resistance Trends (SMART global surveillance program. In total, 2113 isolates from intra-abdominal infections (IAI and 970 isolates from urinary tract infections (UTI were tested against antimicrobial agents using standardized CLSI broth microdilution methodology. Of the agents tested, amikacin demonstrated the highest rates of susceptibility (% for K. pneumoniae (92.2, 92.3, Enterobacter spp. (97.5, 92.1, and P. aeruginosa (85.3, 75.2 isolates from both IAI and UTI, respectively. Ertapenem (68.5, 62.6 and imipenem (79.2, 75.9 showed substantially higher rates of susceptibility (% than other β-lactams, including piperacillin-tazobactam (35.9, 37.4 against ESBL-positive isolates of K. pneumoniae from IAI and UTI, respectively. Rates of susceptibility to all agents tested against A. baumannii were ≤30.9%. Gram-negative ESKAPE pathogens isolated from Latin America demonstrated compromised in vitro susceptibility to commonly prescribed broad-spectrum, parenteral antimicrobial agents. Continued surveillance is warranted. New antimicrobial agents with potent activity against Gram-negative ESKAPE pathogens are urgently needed.

  5. Anaphylaxis, Intra-Abdominal Infections, Skin Lacerations, and Behavioral Emergencies: A Literature Review of Austere Analogs for a near Earth Asteroid Mission

    Science.gov (United States)

    Chough, Natacha G.; Watkins, Sharmi; Menon, Anil S.

    2012-01-01

    As space exploration is directed towards destinations beyond low-Earth orbit, the consequent new set of medical risks will drive requirements for new capabilities and more resources to ensure crew health. The Space Medicine Exploration Medical Conditions List (SMEMCL), developed by the Exploration Medical Capability element of the Human Research Program, addresses the risk of "unacceptable health and mission outcomes due to limitations of in-flight medical capabilities". It itemizes 85 evidence-based clinical requirements for eight different mission profiles and identifies conditions warranting further research and technology development. Each condition is given a clinical priority for each mission profile. Four conditions -- intra-abdominal infections, skin lacerations, anaphylaxis, and behavioral emergencies -- were selected as a starting point for analysis. A systematic literature review was performed to understand how these conditions are treated in austere, limited-resource, space-analog environments (i.e., high-altitude and mountain environments, submarines, military deployments, Antarctica, isolated wilderness environments, in-flight environments, and remote, resource-poor, rural environments). These environments serve as analogs to spaceflight because of their shared characteristics (limited medical resources, delay in communication, confined living quarters, difficulty with resupply, variable time to evacuation). Treatment of these four medical conditions in austere environments provides insight into medical equipment and training requirements for exploration-class missions.

  6. Ptose palpebral causada por Paquidermoperiostose

    Directory of Open Access Journals (Sweden)

    Patricia Regina de Pinho Tavares

    2014-08-01

    Full Text Available A paquidermoperiostose é uma síndrome caracterizada por acometimento cutâneo e ósseo, e em alguns casos ocorre comprometimento palpebral leve. É uma síndrome rara, idiopática ou hereditária, com provável herança autossômica dominante de penetrância variável. Descreve-se o caso de um paciente com ptose grave por paquidermoperiostose elucidando sua fisiopatologia e conduta cirúrgica aplicada.

  7. Colecistitis aguda por Streptococcus constellatus

    Directory of Open Access Journals (Sweden)

    M Sandra Gómez-Canosa

    2016-03-01

    Full Text Available Presentamos el caso de una paciente de edad avanzada y significativa comorbilidad que se diagnosticó de colecistitis aguda por Streptococcus constellatus. El drenaje de la vesícula biliar por colecistostomía percutánea, asociado a penicilinas, ha conseguido una evolución favorable. We report the case of a patient of advanced age and significant comorbidity diagnosed acute cholecystitis by Streptococcus constellatus. Gallbladder drainage by percutaneous cholecystostomy associated with penicillins has achieved a favorable outcome.

  8. Mortalidad intrahospitalaria por accidente cerebrovascular

    OpenAIRE

    Federico Rodríguez Lucci; Virginia Pujol Lereis; Sebastián Ameriso; Guillermo Povedano; MARÍA F DÍAZ; Alejandro Hlavnicka; Néstor A. Wainsztein; Ameriso, Sebastián F.

    2013-01-01

    La mortalidad global por accidente cerebrovascular (ACV) ha disminuido en las últimas tres décadas, probablemente debido a un mejor control de los factores de riesgo vascular. La mortalidad hospitalaria por ACV ha sido tradicionalmente estimada entre 6 y 14% en la mayoría de las series comunicadas. Sin embargo, los datos de ensayos clínicos recientes sugieren que esta cifra sería sustancialmente menor. Se revisaron datos de pacientes internados con diagnóstico de ACV del Banco de Datos de Str...

  9. Miasis cutanea por cordylobia anthropophaga

    OpenAIRE

    Alkorta Gurrutxaga Miriam; Beristain Rementeria Xabier; Cilla Eguiluz Gustavo; Tuneu Valls Anna; Zubizarreta Salvador José

    2001-01-01

    El incremento progresivo en el número de personas que viajan a países tropicales ha hecho que las enfermedades importadas adquieran una relevancia cada vez mayor. Las miasis (o infestaciones por larvas de moscas) cutáneas se encuentran entre este tipo de enfermedades siendo especialmente frecuentes en países tropicales. A propósito de la observación de un caso de miasis cutánea masiva por Cordylobia antropophaga, que ocurrió en una mujer de 34 años de edad al volver de un viaje a Senegal, se ...

  10. Hipoglucemia inducida por carcinoma adrenal

    OpenAIRE

    Jimena Soutelo; Melina Saban; Florencia Borghi Torzillo; Ruben Lutfi; Mariela Leal Reyna

    2013-01-01

    El carcinoma suprarrenal es una neoplasia maligna infrecuente y de mal pronóstico. La presentación clínica más común es originada por la producción hormonal excesiva, mientras que el desarrollo de hipoglucemia sintomática es excepcional. Presentamos el caso de una mujer de 37 años que ingresó al hospital por síntomas de hipoglucemias graves, hipertensión arterial, hipopotasemia y amenorrea secundaria. En el laboratorio se halló hipoglucemia con insulina inhibida y niveles de andrógenos en ran...

  11. DESAJUSTE EDUCATIVO POR REGIONES EN COLOMBIA: ¿COMPETENCIA POR SALARIOS O POR PUESTOS DE TRABAJO?

    Directory of Open Access Journals (Sweden)

    Maribel Castillo Caicedo

    2007-06-01

    Full Text Available Este trabajo aporta una perspectiva del fenómeno de la sobreeducación, entendida como un desajuste por exceso, entre el nivel educativo alcanzado por el individuo y el exigido por el puesto de trabajo en el cual se desempeña; esto se debe a que existe una demanda laboral estrecha de puestos de trabajo para personas calificadas en Colombia. Se analizan las contribuciones empíricas existentes y el debate sobre las mismas; se examinan las teorías que permiten explicar la existencia de un desajuste educativo y se realiza una revisión de la literatura internacional y nacional sobre el tema. Adicionalmente, se plantean una serie de hipótesis para desarrollar un esquema que permita determinar el comportamiento del individuo en el fenómeno de la sobreeducación.

  12. Por que leer a Maquiavelo?

    National Research Council Canada - National Science Library

    Castillo Cisneros, Mery; Molano Rojas, Andres

    2013-01-01

    ... a Maquiavelo. Para empezar, hay que leer a Maquiavelo porque Maquiavelo, y en particular El Principe, es un clasico. Y un clasico, dice Calvino, es un libro del cual "se suele oir decir: 'Estoy releyendo ...' y nunca 'Estoy leyendo ...'" (1). En efecto, ningun lector lee en realidad a Maquiavelo por primera vez (siempre se lo lee con ...

  13. Celulitis por citomegalovirus Cytomegalovirus cellulitis

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    A. Ruiz Lascano

    2002-12-01

    Full Text Available Las lesiones cutáneas por citomegalovirus (CMV son infrecuentes y a menudo una manifestación tardía de una enfermedad sistémica, que generalmente anuncia un curso fatal. Comunicamos un caso de celulitis por CMV: una mujer de 70 años con trasplante renal efectuado 1 mes antes de la consulta, terapia inmunosupresora con ciclosporina A y metilprednisona. La paciente ingresó por fiebre, dolor e impotencia funcional en pierna derecha. Comprobamos la existencia de una placa de 8 por 4 cm eritematoedematosa. La tratamos con antibióticos sin mejoría, por lo que realizamos un estudio histopatológico de piel que mostró cambios citopáticos compatibles con infección por CMV. Los cultivos bacteriológicos y micológicos fueron negativos. La inmunohistoquímica específica para CMV y el estudio de reacción en cadena de la polimerasa (PCR de la biopsia de piel fueron positivas, al igual que la antigenemia. El tratamiento con ganciclovir produjo la mejoría del cuadro clínico. En la literatura revisada no hemos encontrado la celulitis como manifestación de enfermedad cutánea por CMV.Cutaneous lesions in CMV infection are rare, often a late manifestation of systemic infection, and usually herald a fatal course. A 70 year-old woman received a kidney transplantation one month before consulting and immunosuppressive therapy that included cyclosporine A and methylprednisone. She complained of fever, local pain in her right leg, and an erythematous and swelling plaque. She was treated with intravenous antibiotics without improvement. A skin biopsy was performed and the tissue obtained was sent for bacterial and fungal cultures as well as for histological examination. Cultures were negative. The biopsy showed CMV cytopathic changes. Immunoperoxidase staining was positive for CMV and polymerase chain reaction (PCR testing revealed CMV DNA. She was treated with ganciclovir with resolution of the lesion. CMV cellulitis is a rare cutaneous manifestation

  14. Esporotricosis diagnosticada por el laboratorio

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    Nelly Ordóñez

    1989-06-01

    Full Text Available De 1976 a 1989 se han diagnosticado 40 casos de esporotricosis en el laboratorio de Micología del Instituto Nacional de Salud. La enfermedad se presentó en pacientes entre 4 y 52 años y tuvo predilección por el sexo masculino: 35 de 40 (87,5%; las formas clínicas más frecuentes fueron la cutánea fija, 18 de 40 (45%, y la linfocutánea, 17 de 40 (42,5%, con localización mayor en miembros superiores, 18 de 40 (45%. El diagnóstico se estableció por el aislamiento del Sporothrix schenckii en 35 de 38 pacientes (92%; los otros dos pacientes se diagnosticaron empleando otras técnicas: inmunofluorescencia directa, intradermorreacción y aglutinación en tubo.

  15. Associations of maximal voluntary isometric hip extension torque with muscle size of hamstring and gluteus maximus and intra-abdominal pressure.

    Science.gov (United States)

    Tayashiki, Kota; Hirata, Kosuke; Ishida, Kiraku; Kanehisa, Hiroaki; Miyamoto, Naokazu

    2017-06-01

    Muscle size of the hamstring and gluteus maximus (GM) as well as intra-abdominal pressure (IAP) are considered as factors affecting the torque development during hip extension. This study examined the associations of torque development during maximal voluntary isometric hip extension with IAP and muscle size of the hamstring and GM. Anatomical cross-sectional area (ACSA) of the hamstring and thickness of GM were determined in 20 healthy young males using an ultrasonography apparatus (Experiment 1). Torque and IAP were simultaneously measured while subjects performed maximal voluntary isometric hip extension. The IAP was measured using a pressure transducer placed in the rectum and determined at the time at which the developed torque reached to the maximal. In Experiment 2, torque and IAP were measured during maximal voluntary isometric hip flexion in 18 healthy young males. The maximal hip extension torque was significantly correlated with the IAP (r = 0.504, P = 0.024), not with the ACSA of the hamstring (r = 0.307, P = 0.188) or the thickness of GM (r = 0.405, P = 0.076). The relationship was still significant even when the ACSA of the hamstring and the thickness of GM were adjusted statistically (r = 0.486, P = 0.041). The maximal hip flexion torque was not significantly correlated with the IAP (r = -0.118, P = 0.642). The current results suggest that IAP can contribute independently of the muscle size of the agonists to maximal voluntary hip extension torque.

  16. Effects of pressure support and pressure-controlled ventilation on lung damage in a model of mild extrapulmonary acute lung injury with intra-abdominal hypertension.

    Science.gov (United States)

    Santos, Cintia L; Santos, Raquel S; Moraes, Lillian; Samary, Cynthia S; Felix, Nathane S; Silva, Johnatas D; Morales, Marcelo M; Huhle, Robert; Abreu, Marcelo G; Schanaider, Alberto; Silva, Pedro L; Pelosi, Paolo; Rocco, Patricia R M

    2017-01-01

    Intra-abdominal hypertension (IAH) may co-occur with the acute respiratory distress syndrome (ARDS), with significant impact on morbidity and mortality. Lung-protective controlled mechanical ventilation with low tidal volume and positive end-expiratory pressure (PEEP) has been recommended in ARDS. However, mechanical ventilation with spontaneous breathing activity may be beneficial to lung function and reduce lung damage in mild ARDS. We hypothesized that preserving spontaneous breathing activity during pressure support ventilation (PSV) would improve respiratory function and minimize ventilator-induced lung injury (VILI) compared to pressure-controlled ventilation (PCV) in mild extrapulmonary acute lung injury (ALI) with IAH. Thirty Wistar rats (334±55g) received Escherichia coli lipopolysaccharide intraperitoneally (1000μg) to induce mild extrapulmonary ALI. After 24h, animals were anesthetized and randomized to receive PCV or PSV. They were then further randomized into subgroups without or with IAH (15 mmHg) and ventilated with PCV or PSV (PEEP = 5cmH2O, driving pressure adjusted to achieve tidal volume = 6mL/kg) for 1h. Six of the 30 rats were used for molecular biology analysis and were not mechanically ventilated. The main outcome was the effect of PCV versus PSV on mRNA expression of interleukin (IL)-6 in lung tissue. Regardless of whether IAH was present, PSV resulted in lower mean airway pressure (with no differences in peak airway or peak and mean transpulmonary pressures) and less mRNA expression of biomarkers associated with lung inflammation (IL-6) and fibrogenesis (type III procollagen) than PCV. In the presence of IAH, PSV improved oxygenation; decreased alveolar collapse, interstitial edema, and diffuse alveolar damage; and increased expression of surfactant protein B as compared to PCV. In this experimental model of mild extrapulmonary ALI associated with IAH, PSV compared to PCV improved lung function and morphology and reduced type 2 epithelial

  17. Genetic variations in toll-like receptor 4 in Mexican-Mestizo patients with intra-abdominal infection and/or pneumonia.

    Science.gov (United States)

    Rodriguez-Osorio, Carlos A; Lima, Guadalupe; Herrera-Caceres, Jaime O; Villegas-Torres, Beatriz E; Zuñiga, Joaquin; Ponce-de-Leon, Sergio; Llorente, Luis; Sifuentes-Osornio, Jose

    2013-06-01

    Sepsis is a leading cause of death around the world, and 73-83% of all sepsis cases requiring attention in intensive care units are linked to intra-abdominal infection (IAI) or pneumonia. The activation of innate immunity is central to the manifestation of sepsis, and toll-like receptor (TLR) 4 plays an important role in this activation process. The 299G and 399I alleles of TLR4 have been linked with an increased risk of Gram-negative bacteria (GNB) infections and septic shock in some populations. This case-control study evaluated the prevalence of D299G/T399I polymorphisms in Mexican patients with IAI and/or pneumonia and in healthy controls. Genotyping revealed that 1 in 44 patients (2.3%; CI 95%: 0.05-12.0%) and 4 in 126 controls (3.2%; CI 95%: 0.9-7.9%) were heterozygous for both the D299G and T399l polymorphisms (OR: 0.71, CI 95%: 0.01-7.44, p = NS), confirming the co-segregation of these alleles in this population. Furthermore, the patients with a GNB infection and severe sepsis were not carriers of the risk alleles. In summary, this report shows that the frequency of the D299G and T399I polymorphisms in Mexican-Mestizos is lower than anticipated in comparison with other ethnic groups, emphasizing the variable distribution of TLR4 polymorphisms among different populations. Consequently, this study was not able to detect associations between TLR4 polymorphisms and sepsis in this population. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. The great roundleaf bat (Hipposideros armiger) as a good model for cold-induced browning of intra-abdominal white adipose tissue.

    Science.gov (United States)

    Wang, Yao; Zhu, Tengteng; Ke, Shanshan; Fang, Na; Irwin, David M; Lei, Ming; Zhang, Junpeng; Shi, Huizhen; Zhang, Shuyi; Wang, Zhe

    2014-01-01

    Inducing beige fat from white adipose tissue (WAT) is considered to be a shortcut to weight loss and increasingly becoming a key area in research into treatments for obesity and related diseases. However, currently, animal models of beige fat are restricted to rodents, where subcutaneous adipose tissue (sWAT, benign WAT) is more liable to develop into the beige fat under specific activators than the intra-abdominal adipose tissue (aWAT, malignant WAT) that is the major source of obesity related diseases in humans. Here we induced beige fat by cold exposure in two species of bats, the great roundleaf bat (Hipposideros armiger) and the rickett's big-footed bat (Myotis ricketti), and compared the molecular and morphological changes with those seen in the mouse. Expression of thermogenic genes (Ucp1 and Pgc1a) was measured by RT-qPCR and adipocyte morphology examined by HE staining at three adipose locations, sWAT, aWAT and iBAT (interscapular brown adipose tissue). Expression of Ucp1 and Pgc1a was significantly upregulated, by 729 and 23 fold, respectively, in aWAT of the great roundleaf bat after exposure to 10°C for 7 days. Adipocyte diameters of WATs became significantly reduced and the white adipocytes became brown-like in morphology. In mice, similar changes were found in the sWAT, but much lower amounts of changes in aWAT were seen. Interestingly, the rickett's big-footed bat did not show such a tendency in beige fat. The great roundleaf bat is potentially a good animal model for human aWAT browning research. Combined with rodent models, this model should be helpful for finding therapies for reducing harmful aWAT in humans.

  19. Time-course evaluation of intestinal structural disorders in a porcine model of intra-abdominal hypertension by mechanical intestinal obstruction.

    Science.gov (United States)

    Párraga Ros, Ester; Correa-Martín, Laura; Sánchez-Margallo, Francisco M; Candanosa-Aranda, Irma Eugenia; Malbrain, Manu L N G; Wise, Robert; Latorre, Rafael; López Albors, Octavio; Castellanos, Gregorio

    2018-01-01

    A mechanical intestinal obstruction (MIO) can generate intraabdominal hypertension (IAH) that is life threatening. The intestines are very sensitive to IAH since the low splanchnic perfusion causes intestinal hypoxia, local acidosis and bacterial translocations. This may lead to acute intestinal distress syndrome (AIDS). The identification of intestinal injuries during IAH and its correlation with clinical parameters as the abdominal perfusion pressure (APP), the gastric intramucosal pH (pHi) and lactic acid (Lc) are still unknown. This study aimed to evaluate the sequence of intestinal histopathological findings in an MIO model and to analyze potential relationships with parameters currently used in clinical practice (APP, pHi and Lc). Twenty pigs were divided into three groups: a control group (n = 5) and two experimental groups with 20 mmHg (G1, n = 10) and 30 mmHg (G2, n = 5) of IAH by MIO. The pressures were maintained for 3 hours, except in 5 animals in G1 where it was maintained for 5 hours. The APP, pHi and LA were recorded and biopsies of the terminal ileum were taken every 30 minutes in all groups. The intestinal damage was graded according to the Park Score. Intestinal injuries were found in 42.9% of pigs in the experimental groups. The lesions were independent of the level and duration of IAH. Although APP and pHi were slightly lower in injured animals (I +) of G1 and G2, there were no significant differences among those uninjured (I-). Lc was significantly increased in all I+ pigs from the onset of IAH. The IAH by MIO causes intestinal lesions from the first 30 minutes with concurrent decreases in APP and pHi and increases in Lc. Lc could be the best clinical parameter related to intestinal damages with a clear difference between I + and I- animals.

  20. Comparative pharmacoeconomics and efficacy analysis of a new antibiotic adjuvant entity and piperacillin-tazobactam for the management of intra-abdominal infections: A retrospective study

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    Sandip Jadhav

    2016-01-01

    Full Text Available Objective: To analyze the comparative efficacy of piperacillin-tazobactam (PIP-TAZ and ceftriaxone-sulbactam with adjuvant (CSA in the treatment of intra-abdominal infections (IAIs and to assess the costs associated with respective therapies. Methods: The present study analyzed the data collected from 94 IAI patients treated at a tertiary-care hospital. Patient characteristics, infection types, surgical procedures, antibiotic therapies, treatment durations were recorded and overall cost involved in the infections management was estimated in Indian rupee. Results: In total, 46 patients received PIP-TAZ and 48 patients received CSA. The clinical cure was seen in 39.13% patients of PIP-TAZ group and 62.50% patients of CSA group. The patients diagnosed with mixed culture (Gram-positive and negative infections, needed additional cover of clindamycin to achieve clinical success. The failure patients from PIP-TAZ group were shifted to meropenem therapy. For the patients where meropenem and CSA therapy failed, colistin was given as an additional cover. Comparative cost expenditure analysis of the two drug treatment groups revealed that, the overall treatment cost for patients cured with empirical PIP-TAZ group was 51.79% more than that of CSA therapy. The strongest predictor of the increase in treatment costs was clinical failure. Similar trends were maintained for the patients cured with clindamycin additional therapy and change of therapy, with PIP-TAZ group accounting 36.11% and 39.99% more expenditure than CSA group. Conclusions: This study demonstrates that CSA has comparatively higher efficacy as compared to PIP-TAZ when used along with metronidazole in patients with different types of IAIs. Pharmacoeconomic analysis clearly shows that starting appropriate empirical antibiotic therapy has a large impact on the cost of treatment in management of IAIs and selection of CSA, can significantly reduce the cost involved in the treatment.

  1. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome.

    Science.gov (United States)

    Carr, Darcy B; Utzschneider, Kristina M; Hull, Rebecca L; Kodama, Keiichi; Retzlaff, Barbara M; Brunzell, John D; Shofer, Jane B; Fish, Brian E; Knopp, Robert H; Kahn, Steven E

    2004-08-01

    The underlying pathophysiology of the metabolic syndrome is the subject of debate, with both insulin resistance and obesity considered as important factors. We evaluated the differential effects of insulin resistance and central body fat distribution in determining the metabolic syndrome as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III. In addition, we determined which NCEP criteria were associated with insulin resistance and central adiposity. The subjects, 218 healthy men (n = 89) and women (n = 129) with a broad range of age (26-75 years) and BMI (18.4-46.8 kg/m2), underwent quantification of the insulin sensitivity index (Si) and intra-abdominal fat (IAF) and subcutaneous fat (SCF) areas. The metabolic syndrome was present in 34 (15.6%) of subjects who had a lower Si [median: 3.13 vs. 6.09 x 10(-5) min(-1)/(pmol/l)] and higher IAF (166.3 vs. 79.1 cm2) and SCF (285.1 vs. 179.8 cm2) areas compared with subjects without the syndrome (P < 0.001). Multivariate models including Si, IAF, and SCF demonstrated that each parameter was associated with the syndrome. However, IAF was independently associated with all five of the metabolic syndrome criteria. In multivariable models containing the criteria as covariates, waist circumference and triglyceride levels were independently associated with Si and IAF and SCF areas (P < 0.001). Although insulin resistance and central body fat are both associated with the metabolic syndrome, IAF is independently associated with all of the criteria, suggesting that it may have a pathophysiological role. Of the NCEP criteria, waist circumference and triglycerides may best identify insulin resistance and visceral adiposity in individuals with a fasting plasma glucose <6.4 mmol/l.

  2. Clinical and economic consequences of failure of initial antibiotic therapy for patients with community-onset complicated intra-abdominal infections.

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    Yong Pil Chong

    Full Text Available Complicated intra-abdominal infection (cIAI is infection that extends beyond the hollow viscus of origin into the peritoneal space, and is associated with either abscess formation or peritonitis. There are few studies that have assessed the actual costs and outcomes associated with failure of initial antibiotic therapy for cIAI. The aims of this study were to evaluate risk factors and impact on costs and outcomes of failure of initial antibiotic therapy for community-onset cIAI.A retrospective study was performed at eleven tertiary-care hospitals. Hospitalized adults with community-onset cIAI who underwent an appropriate source control procedure between August 2008 and September 2011 were included. Failure of initial antibiotic therapy was defined as a change of antibiotics due to a lack of improvement of the clinical symptoms and signs associated with cIAI in the first week.A total of 514 patients hospitalized for community-onset cIAI were included in the analysis. The mean age of the patients was 53.3 ± 17.6 years, 72 patients (14% had health care-associated infection, and 48 (9% experienced failure of initial antibiotic therapy. Failure of initial antibiotic therapy was associated with increased costs and morbidity. After adjustment for covariates, patients with unsuccessful initial therapy received an additional 2.9 days of parenteral antibiotic therapy, were hospitalized for an additional 5.3 days, and incurred $3,287 in additional inpatient charges. Independent risk factors for failure of initial antibiotic therapy were health care-associated infection, solid cancer, and APACHE II ≥13.To improve outcomes and costs in patients with community-onset cIAI, rapid assessment of health care-associated risk factors and severity of disease, selection of an appropriate antibiotic regimen accordingly, and early infection source control should be performed.

  3. Association between source control and mortality in 258 patients with intra-abdominal candidiasis: a retrospective multi-centric analysis comparing intensive care versus surgical wards in Spain.

    Science.gov (United States)

    Lagunes, L; Rey-Pérez, A; Martín-Gómez, M T; Vena, A; de Egea, V; Muñoz, P; Bouza, E; Díaz-Martín, A; Palacios-García, I; Garnacho-Montero, J; Campins, M; Bassetti, M; Rello, J

    2017-01-01

    Early empiric therapy and adequate resuscitation have been identified as main predictors of outcome in patients with candidemia or bacteremia. Moreover, source control is a major determinant in infectious sites when feasible, as a main technique to reduce microbiological burden. A retrospective, multicenter, cohort study was performed at surgical wards and intensive care units (ICU) of three University Hospitals in Spain between 2010 and 2014, with the aim of improving understanding of the interaction between source control, early antifungal therapy, and use of vasoactives in patients with intra-abdominal candidiasis (IAC). Source control was defined as all physical actions taken to control a focus of infection and reduce the favorable conditions that promote microorganism growth or that maintain the impairment of host defenses. Two hundred and fifty-eight patients with IAC were identified. Sixty-one patients were at ICU for diagnosis. Mortality was higher in the ICU group compared to what was documented for the non-ICU group (35 % vs 19.5 %, p = 0011). Adequate source control within 48 h of diagnosis was achieved in 60 % of the cohort. In multivariate analysis, inadequate source control was identified as the only common risk factor for 30-day mortality in both groups (ICU group OR: 13.78 (95% CI: 2.60-72.9, p = 0.002) and non-ICU group OR: 6.53 (95% CI: 2.56-16.61, p = control and adequate antifungal treatment was the one associated with a higher survival rate, in both the ICU and surgical groups. Source control remains a key element in IAC, inside and outside the intensive care unit. Early antifungal treatment among ICU patients was associated with lower mortality.

  4. Inverted U-Shaped Relationship between Central Venous Pressure and Intra-Abdominal Pressure in the Early Phase of Severe Acute Pancreatitis: A Retrospective Study.

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    Chong Yang

    Full Text Available Many studies have indicated that intra-abdominal pressure (IAP is positively correlated with central venous pressure (CVP in severe cases. However, although elevated IAP is common in patients with severe acute pancreatitis (SAP, its relationship with CVP remains unclear. Our study aimed to investigate the association of IAP with CVP in early-phase SAP patients.In total, 116 SAP patients were included in this retrospective study. On the first day of hospitalization, blood samples were collected for biochemical examination and cytokine concentration monitoring. Additionally, a urinary catheter and right subclavian vein catheter were inserted for IAP and CVP measurement, respectively. Other routine clinical data were also recorded.Within 24 hours after hospitalization, CVP fluctuated and increased with increasing IAP up to 15.7 mmHg (P = 0.054 but decreased with increasing IAP when the IAP was > 15.7 mmHg (P < 0.001. After adjusting for abdominal perfusion pressure (APP and mean arterial pressure (MAP, a similar distribution was observed. An inverted U-shaped trend between IAP and CVP was also present in the groups classified according to the patient's sex, local complications, ascites, and serum amylase levels.CVP and IAP have an inverted U-shaped relationship, with a peak at an IAP of 15.7 mmHg in the early phase of SAP. After this peak, CVP decreases as IAP increases. These results have crucial implications for clinical fluid resuscitation in SAP patients. In particular, because one CVP value might be correlated with different IAP values in patients with the same CVP, the volume of fluid needed might be different.

  5. Miasis cutanea por cordylobia anthropophaga

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    Alkorta Gurrutxaga Miriam

    2001-01-01

    Full Text Available El incremento progresivo en el número de personas que viajan a países tropicales ha hecho que las enfermedades importadas adquieran una relevancia cada vez mayor. Las miasis (o infestaciones por larvas de moscas cutáneas se encuentran entre este tipo de enfermedades siendo especialmente frecuentes en países tropicales. A propósito de la observación de un caso de miasis cutánea masiva por Cordylobia antropophaga, que ocurrió en una mujer de 34 años de edad al volver de un viaje a Senegal, se ha efectuado una revisión de los casos de miasis cutáneas forunculoides importadas publicados en España, así como de la biología, patología, tratamiento y prevención de la miasis humana por Cordylobia anthropophaga. El caso referido, se caracterizó por la infestación con un número inusualmente elevado de larvas, no sospechándose su etiología hasta la fase final de la enfermedad. La emergencia continuada de larvas (se recogieron 91 generó en la paciente un estado de ansiedad importante. Finalmente, la eliminación de las larvas provocó una rápida mejoría de la paciente. Aunque los casos de miasis cutánea no tienen la gravedad de otras enfermedades importadas, su conocimiento es necesario desde el punto de vista preventivo, diagnóstico y terapeútico. Es importante proceder a la identificación morfológica de las larvas diferenciándolas de otro tipo de miasis con implicaciones terapéuticas diferentes.

  6. Abdome agudo por obstrução por ileobiliar

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    Márcia Cristina de Alencastro

    Full Text Available OBJETIVO: descrever a experiência na abordagem dos doentes com abdome agudo por obstrução por IB, desde o diagnóstico até o tratamento definitivo. MÉTODOS: estudo retrospectivo incluindo todos os casos de IB tratados em um período de 23 anos. De acordo com a abordagem cirúrgica realizada, os pacientes foram divididos em dois grupos (1 enterolitotomia com colecistectomia no segundo momento; e (2 enterolitotomia, colecistectomia e abordagem da fístula. RESULTADOS: Doze pacientes foram incluídos, sendo 11 mulheres (91,6%, com média de idade de 72,2 anos. Todos os pacientes apresentavam doenças associadas, principalmente hipertensão arterial sistêmica (75%. Dois pacientes não apresentavam sintomas significativos de obstrução intestinal. O diagnóstico de IB foi realizado em seis pacientes (50% antes da laparotomia. O grupo 1 foi constituído de oito pacientes e o grupo 2 de quatro, e a morbidade foi, respectivamente, 33,3% e 8,3%. A mortalidade foi 16,6% (um paciente de cada grupo. CONCLUSÃO: O manejo do IB deve ser individualizado. O tratamento da obstrução mediante remoção do cálculo biliar por enterotomia proximal é a escolha inicial para o tratamento do IB. A colecistectomia e a correção da fístula bilioentérica podem ser realizadas juntamente com a remoção do cálculo, no entanto, em pacientes com comorbidades significativas, esses procedimentos devem ser realizados posteriormente.

  7. Agujeros negros vistos por fuera y por dentro

    OpenAIRE

    Janssen, Bert

    2015-01-01

    La Relatividad General es la teoría moderna de la gravedad, que corrige los problemas que surgen con la gravedad descrita por Newton. Explicaremos porque la gravedad newtoniana es incompatible con la Relatividad Especial y cual es la solución que propone Einstein: la gravedad como una manifestación del espacio curvo. Hablaremos brevemente de los fenómenos que surgen de la Relatividad General, como los agujeros negros, las ondas gravitacionales y la cosmología. Universidad de Málaga. Campu...

  8. Desajuste educativo por regiones en Colombia: ¿competencia por salarios o por puestos de trabajo?

    Directory of Open Access Journals (Sweden)

    Castillo Caicedo Maribel

    2007-08-01

    Full Text Available Este trabajo aporta una perspectiva del fenómeno de la sobreeducación,
    entendida como un desajuste por exceso, entre el nivel educativo alcanzado
    por el individuo y el exigido por el puesto de trabajo en el cual se
    desempeña; esto se debe a que existe una demanda laboral estrecha de
    puestos de trabajo para personas calificadas en Colombia. Se analizan las
    contribuciones empíricas existentes y el debate sobre las mismas; se
    examinan las teorías que permiten explicar la existencia de un desajuste
    educativo y se realiza una revisión de la literatura internacional y
    nacional sobre el tema. Adicionalmente, se plantean una serie de hipótesis
    para desarrollar un esquema que permita determinar el comportamiento
    del individuo en el fenómeno de la sobreeducación.

  9. Surtos de enfermidades transmitidas por alimentos causados por Salmonella Enteritidis

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    Peresi Jacqueline T.M.

    1998-01-01

    Full Text Available OBJETIVO: São descritos surtos de salmonelose notificados no período de julho de 1993 a junho de 1997 na região Noroeste do Estado de São Paulo, Brasil, tendo em vista os vários surtos de veiculação alimentar ocasionados por Salmonella nessa região. MÉTODO: Foram obtidos 19 inquéritos epidemiológicos para análise de dados, 87 amostras de fezes e 38 amostras de alimentos, incluindo 12 de ovos para análise microbiológica. Cepas de Salmonella foram submetidas a sorotipagem, fagotipagem e teste de sensibilidade a 13 agentes antimicrobianos. RESULTADOS: Foram acometidas 906 pessoas com 295 hospitalizações. Cepas de Salmonella Enteritidis Fagotipo 4 foram isoladas de 80,5% das coproculturas, de todas amostras de alimentose de 41,7% dos ovos. Em 22 (95,7% surtos os a salmonela foi veiculada por alimentos contendo ovos crus ou semicrus. Os testes de sensibilidade a antimicrobianos revelaram sensibilidade à maioria das cepas. CONCLUSÕES: Considerando os resultados obtidos, torna-se necessária a implantação e intensificação de medidas de controle na produção e armazenamento dos ovos, além da orientação à população quanto aos riscos no consumo inadequado desse alimento.

  10. Muerte materna por malaria grave por Plasmodium vivax

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    Nancy Arróspide

    Full Text Available Se presenta el caso de una mujer de 19 años con 29 semanas de gestación, procedente de Llumpe (Ancash con antecedentes de viajes a las localidades de Chanchamayo (Junín y Rinconada (Ancash. Ingresó al Hospital de Chacas (Ancash por presentar mal estado general, deshidratación, dificultad respiratoria, ictericia, sensación de alza térmica y dolor abdominal, tuvo reporte de: hemoparásitos 60% en frotis sanguíneo. Fue transferida al Hospital Ramos Guardia (Huaraz donde presentó mayor dificultad respiratoria, coluria, hematuria, disminución del débito urinario y reporte de Plasmodium (+, luego fue transferida al Hospital Cayetano Heredia (Lima donde ingresó a la Unidad de Cuidados Intensivos (UCI, con evolución a falla multiorgánica, óbito fetal y muerte materna. Se confirmó infección por Plasmodium vivax. Destacamos la importancia de mejorar nuestras capacidades de diagnóstico y manejo para brindar un tratamiento adecuado y oportuno.

  11. Penfigoide ampolloso inducido por vildagliptina

    OpenAIRE

    Geraldine López-Sánchez; Eduardo Reyna-Villasmil

    2016-01-01

    Penfigoide ampolloso (PA) es una enfermedad crónica, poco común, autoinmune y sub-epidérmica. La etiología no es completamente comprendida. Puede estar asociado con fármacos, radiación ultravioleta y exposición de rayos X. Hay algunos informes sobre la PA inducidos por gliptinas (vildagliptina, sitagliptina, saxagliptina) o inhibidores de la dipeptidil peptidasa IV (DPP-IV). La enzima DPP-IV degrada péptido similar al glucagón 1, que es u...

  12. Sepsis neonatal por Estreptococos Pyogenes

    OpenAIRE

    Gilberto Rodríguez-Herrera; Cinthya Ramírez-Navarro

    2009-01-01

    Se presenta el caso de un paciente masculino, recién nacido a término adecuado para la edad gestacional, quien nace por parto vaginal, con el antecedente de fiebre en la madre durante el periodo de postparto inmediato. Los padres consultan a los 2 días de vida pues le notan dificultad respiratoria, hipoactividad y rechazo a la leche materna. El paciente se interna y se aborda como una sepsis. Durante su estancia en el servicio de neonatología del Hospital Nacional de Niños asocia fallo respir...

  13. Derrame pleural causado por Tiamazol

    OpenAIRE

    Silva, Filipa Castanheira Dinis Duarte

    2016-01-01

    Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016 Os fármacos anti-tiroideus estão associados a um número significativo de reacções adversas, nomeadamente febre, rash, artralgias, agranulocitose e hepatite. As complicações pleurais são muito raras. Na literatura estão descritos cinco casos de derrame pleural induzido por estes fármacos, dois associados ao propiltiouracilo e três casos induzidos pelo carbimazol. Apresenta-se o ...

  14. Miasis ocular por Oestrus ovis

    Directory of Open Access Journals (Sweden)

    María Beltrán F

    2006-01-01

    Full Text Available Se presentan tres casos de miasis ocular (dos adultos y un niñoprocedentes de zonas ganaderas de la provincia de Huaura,departamento de Lima,que acudieron al Hospital Regional de Huacho por presentar el ojo rojo,fotofobia, edema palpebral y sensación de cuerpo extraño;se extrajeron larvas adheridas al canto interno del ojo,las cuales se recibieron en el Instituto Nacional de Salud y fueron identificadas como Oestrus ovis .

  15. Ultrasound evaluation of extra- and intra-abdominal umbilical structures involution in healthy Nelore calves products of natural conception or in vitro fertilization

    OpenAIRE

    Tiago Torrecillas Sturion; Marco Aurélio Torrecillas Sturion; Domingos José Sturion; Júlio Augusto Naylor Lisboa

    2013-01-01

    Esse trabalho foi desenvolvido com o objetivo de caracterizar a involução das estruturas umbilicais em bezerros sadios da raça Nelore ao longo dos primeiros 35 dias de vida, e de comparar esse processo em bezerros concebidos por métodos naturais ou por fertilização in vitro (FIV). Quarenta bezerros foram distribuídos em dois grupos (n=20) de acordo com o método de concepção (natural ou FIV) e cada grupo foi composto por dez machos e dez fêmeas. A ultrassonografia (transdutor microconvexo de 7...

  16. Hiperalgesia induzida por opioides (HIO

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    Plínio da Cunha Leal

    2010-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Opioides são medicamentos frequentemente usados para o controle da dor que, contudo, podem causar hiperalgesia. A circunstância pela qual esse fenômeno pode ocorrer não está inteiramente esclarecida. O objetivo desta revisão foi descrever os mecanismos, os fatores implicados e a modulação por medicamentos. CONTEÚDO: Foram descritos os fatores implicados no desenvolvimento da hiperalgesia induzida por opioides (HIO, como duração de uso, dose e tipo de opioide. Os mecanismos incluem o sistema glutamatérgico e receptores N-metil-D-aspartato (NMDA, ativação de ciclo-oxigenase (COX espinal, aminoácidos excitatórios, dinorfina, citocinas e quimocinas; prostaglandinas e facilitação descendente. A modulação de hiperalgesia pode ser feita com antagonistas de receptores NMDA, agonistas adrenérgicos-alfa2 e inibidores de COX. CONCLUSÕES: O assunto é bastante complexo, envolvendo uma série de mecanismos fisiopatológicos que podem contribuir para a HIO e o desconforto do paciente, trazendo consequências que podem ser danosas.

  17. La curiosidad por la naturaleza

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    José Vicente Rodríguez

    2016-07-01

    Full Text Available Esta actitud es un instrumento estratégico para estimular procesos de desarrollo realmente sostenibles, donde se aproveche la admiración que nos embarga al conocer y apreciar lo que nos rodea para responsablemente utilizar y conservar nuestros recursos naturales. Con esta reflexión deseo resaltar esa motivación de escudriñar lo desconocido, que fue también la virtud que propició el desarrollo de la personalidad de Francisco José de Caldas y Tenorio, uno de nuestros primeros y connotados sabios colombianos, y en cuyo honor se constituyó la revista de divulgación científica más importante del país, que en estos momentos cumple 76 años de existencia. Caldas tuvo curiosidad por todo lo que existía en su entorno; inicialmente en su natal Popayán, donde se maravilló por lo natural, lo que lo motivó y llevó más allá de su tierra a formar parte de la mayor empresa de exploración científica adelantada en ese entonces en territorio americano: la primera Expedición Botánica al nuevo Reino de Granada, de José Celestino Mutis.

  18. Hipoglucemia inducida por carcinoma adrenal

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    Jimena Soutelo

    2013-08-01

    Full Text Available El carcinoma suprarrenal es una neoplasia maligna infrecuente y de mal pronóstico. La presentación clínica más común es originada por la producción hormonal excesiva, mientras que el desarrollo de hipoglucemia sintomática es excepcional. Presentamos el caso de una mujer de 37 años que ingresó al hospital por síntomas de hipoglucemias graves, hipertensión arterial, hipopotasemia y amenorrea secundaria. En el laboratorio se halló hipoglucemia con insulina inhibida y niveles de andrógenos en rango tumoral. La tomografía computarizada (TC de abdomen y pelvis mostró voluminosa formación heterogénea de aspecto sólido sin plano de clivaje con respecto al parénquima hepático e intenso realce con contraste. Luego de la extirpación de la masa retroperitoneal, evolucionó con valores de glucemia y potasemia normales, estabilizó la presión arterial y recuperó los ciclos menstruales.

  19. Paz por estatalización, Paz por Cortes de Justicia, Paz por tratado, Paz por soberanía,Paz por derecho penal?

    National Research Council Canada - National Science Library

    Bernd Marquardt

    2009-01-01

    .... El lector va a realizar un viaje a través del tiempo, pasando por grandes eventos de paz como la Paz Territorial de Maguncia de 1235, la Paz Eterna en la Tierra de 1495 y la Paz de Westfalia de 1648...

  20. Aferição simultânea da pressão abdominal na avaliação ultra-sonográfica de mulheres com incontinência urinária de esforço Intraabdominal pressure measurement during ultrasound assessment of female patients with stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Frederico Teixeira Brandt

    2006-04-01

    Full Text Available OBJETIVO: Determinar a influência da aferição da pressão intra-abdominal na avaliação ultra-sonográfica da junção uretrovesical (JUV e da uretra proximal (UP em pacientes com incontinência urinária de esforço (IUE. MATERIAIS E MÉTODOS: Estudo prospectivo de corte transversal realizado na Unidade de Pesquisa em Incontinência Urinária da Universidade Federal de Pernambuco, de janeiro de 2002 a janeiro de 2005. Trinta e seis pacientes com queixas de IUE foram submetidas a ultra-sonografia perineal para avaliação da JUV e da UP com a bexiga praticamente vazia (OBJECTIVE: To determine the influence of intraabdominal pressure in the ultrasonographic evaluation of the urethrovesical junction (UVJ and proximal urethra (PU in patients with stress urinary incontinence (SUI. MATERIALS AND METHODS: A prospective, cross-sectional study was conducted at the Urinary Incontinence Research Unit of "Universidade Federal de Pernambuco", Brazil, from January 2002 to January 2005. Perineal ultrasounds of the UVJ and PU were performed in thirty-six women complaining of SUI with the bladder virtually empty (< 50 ml; simultaneous measurement of the intraabdominal pressure was also performed. An ultrasound machine with a computer chip and a high-resolution photographic camera connected to a 7 MHz vaginal probe was used for the evaluation. In order to measure the intraabdominal pressure, an urodynamic equipment with a 10fr rectal catheter connected to a pressure sensitive balloon was used. RESULTS: The age of the patients ranged from 25 to 69 years (mean 46.4 ± 10.2 years. On Valsava maneuver, the intra-abdominal pressure ranged from 7 to 193 cmH2O (mean: 99.3 ± 51.8 cmH2O; median: 99.5 cmH2O. Eight out of 31 (25.8% patients with UVJ hypermobility had an intraabdominal pressure lower than 60 cmH2O. There was no statistically significant association between intraabdominal pressure and the ultrasound parameters studied. CONCLUSION: There is a specific

  1. La administración por objetivos

    OpenAIRE

    García Madariaga, Ricardo

    1988-01-01

    De la administración por objetivos puede esperarse dos clases de resultados diferentes pero complementarios. Por una parte, la administración por objetivos contribuye a crear o mantener las condiciones que aseguren la evolución permanente de la organización para que ésta no solamente pueda adaptarse a los cambios del entorno sino también crecer y desarrollarse. Por otra parte, mejora la productividad racionalizando el empleo de los recursos humanos.

  2. Comparison of Three-Dimensional (3D) Conformal Proton Radiotherapy (RT), 3D Conformal Photon RT, and Intensity-Modulated RT for Retroperitoneal and Intra-Abdominal Sarcomas

    Energy Technology Data Exchange (ETDEWEB)

    Swanson, Erika L. [Department of Radiation Oncology, University of Florida, Gainesville, Florida (United States); Indelicato, Daniel J., E-mail: dindelicato@floridaproton.org [Department of Radiation Oncology, University of Florida, Gainesville, Florida (United States); University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Louis, Debbie; Flampouri, Stella; Li, Zuofeng [University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Morris, Christopher G.; Paryani, Nitesh [Department of Radiation Oncology, University of Florida, Gainesville, Florida (United States); Slopsema, Roelf [University of Florida Proton Therapy Institute, Jacksonville, Florida (United States)

    2012-08-01

    Purpose: To compare three-dimensional conformal proton radiotherapy (3DCPT), intensity-modulated photon radiotherapy (IMRT), and 3D conformal photon radiotherapy (3DCRT) to predict the optimal RT technique for retroperitoneal sarcomas. Methods and Materials: 3DCRT, IMRT, and 3DCPT plans were created for treating eight patients with retroperitoneal or intra-abdominal sarcomas. The clinical target volume (CTV) included the gross tumor plus a 2-cm margin, limited by bone and intact fascial planes. For photon plans, the planning target volume (PTV) included a uniform expansion of 5 mm. For the proton plans, the PTV was nonuniform and beam-specific. The prescription dose was 50.4 Gy/Cobalt gray equivalent CGE. Plans were normalized so that >95% of the CTV received 100% of the dose. Results: The CTV was covered adequately by all techniques. The median conformity index was 0.69 for 3DCPT, 0.75 for IMRT, and 0.51 for 3DCRT. The median inhomogeneity coefficient was 0.062 for 3DCPT, 0.066 for IMRT, and 0.073 for 3DCRT. The bowel median volume receiving 15 Gy (V15) was 16.4% for 3DCPT, 52.2% for IMRT, and 66.1% for 3DCRT. The bowel median V45 was 6.3% for 3DCPT, 4.7% for IMRT, and 15.6% for 3DCRT. The median ipsilateral mean kidney dose was 22.5 CGE for 3DCPT, 34.1 Gy for IMRT, and 37.8 Gy for 3DCRT. The median contralateral mean kidney dose was 0 CGE for 3DCPT, 6.4 Gy for IMRT, and 11 Gy for 3DCRT. The median contralateral kidney V5 was 0% for 3DCPT, 49.9% for IMRT, and 99.7% for 3DCRT. Regardless of technique, the median mean liver dose was <30 Gy, and the median cord V50 was 0%. The median integral dose was 126 J for 3DCPT, 400 J for IMRT, and 432 J for 3DCRT. Conclusions: IMRT and 3DCPT result in plans that are more conformal and homogenous than 3DCRT. Based on Quantitative Analysis of Normal Tissue Effects in Clinic benchmarks, the dosimetric advantage of proton therapy may be less gastrointestinal and genitourinary toxicity.

  3. Association between the seat belt sign and intra-abdominal injuries in children with blunt torso trauma in motor vehicle collisions.

    Science.gov (United States)

    Borgialli, Dominic A; Ellison, Angela M; Ehrlich, Peter; Bonsu, Bema; Menaker, Jay; Wisner, David H; Atabaki, Shireen; Olsen, Cody S; Sokolove, Peter E; Lillis, Kathy; Kuppermann, Nathan; Holmes, James F

    2014-11-01

    The objective was to determine the association between the abdominal seat belt sign and intra-abdominal injuries (IAIs) in children presenting to emergency departments with blunt torso trauma after motor vehicle collisions (MVCs). This was a planned subgroup analysis of prospective data from a multicenter cohort study of children with blunt torso trauma after MVCs. Patient history and physical examination findings were documented before abdominal computed tomography (CT) or laparotomy. Seat belt sign was defined as a continuous area of erythema, ecchymosis, or abrasion across the abdomen secondary to a seat belt restraint. The relative risk (RR) of IAI with 95% confidence intervals (CIs) was calculated for children with seat belt signs compared to those without. The risk of IAI in those patients with seat belt sign who were without abdominal pain or tenderness, and with Glasgow Coma Scale (GCS) scores of 14 or 15, was also calculated. A total of 3,740 children with seat belt sign documentation after blunt torso trauma in MVCs were enrolled; 585 (16%) had seat belt signs. Among the 1,864 children undergoing definitive abdominal testing (CT, laparotomy/laparoscopy, or autopsy), IAIs were more common in patients with seat belt signs than those without (19% vs. 12%; RR = 1.6, 95% CI = 1.3 to 2.1). This difference was primarily due to a greater risk of gastrointestinal injuries (hollow viscous or associated mesentery) in those with seat belt signs (11% vs. 1%; RR = 9.4, 95% CI = 5.4 to 16.4). IAI was diagnosed in 11 of 194 patients (5.7%; 95% CI = 2.9% to 9.9%) with seat belt signs who did not have initial complaints of abdominal pain or tenderness and had GCS scores of 14 or 15. Patients with seat belt signs after MVCs are at greater risk of IAI than those without seat belt signs, predominately due to gastrointestinal injuries. Although IAIs are less common in alert patients with seat belt signs who do not have initial complaints of abdominal pain or tenderness, the

  4. Does moderate renal impairment affect clinical outcomes in complicated intra-abdominal and complicated urinary tract infections? Analysis of two randomized controlled trials with ceftolozane/tazobactam.

    Science.gov (United States)

    Kullar, Ravina; Wagenlehner, Florian M; Popejoy, Myra W; Long, Jianmin; Yu, Brian; Goldstein, Ellie J C

    2017-03-01

    For reasons not well understood, antibacterials can yield lower cure rates in renally impaired patients. We explored this subject for the novel antibacterial ceftolozane/tazobactam. ASPECT-complicated intra-abdominal infections (cIAIs) and ASPECT-complicated urinary tract infections (cUTIs) were randomized, double-blinded clinical trials. Analyses in moderate [creatinine clearance (CL CR ) 30-50 mL/min] and mild/no (CL CR  > 50 mL/min) renal impairment (RI) patients were pre-specified as exploratory endpoints in the statistical analysis plans. We also explored variables potentially impacting outcomes in these subgroups. Clinicaltrials.gov NCT01445665/NCT01445678 and NCT01345929/NCT01345955. At baseline, 4.5% (36/806) of cIAI patients and 7.3% (58/795) of cUTI patients had moderate RI. Moderate RI patients were older, had more comorbid conditions and had higher APACHE-II scores. In the cIAI microbiological intent-to-treat population, response rates were 48% and 69% in moderate RI patients receiving ceftolozane/tazobactam and meropenem, respectively; among moderate RI cIAI patients considered treatment failures, indeterminate responses were more frequent with ceftolozane/tazobactam (39%; 9/23) than meropenem (8%; 1/13). In the cUTI microbiological modified intent-to-treat population, response rates were 81% and 78% in moderate RI patients receiving ceftolozane/tazobactam and levofloxacin, respectively. In both studies, response rates in moderate RI patients were similar between treatment arms in microbiologically evaluable populations, which excluded indeterminate responses due to missing data/protocol deviations (cIAI: 72.7% ceftolozane/tazobactam versus 71.4% meropenem; cUTI: 87% ceftolozane/tazobactam versus 80% levofloxacin). Regardless of treatment, clinical cure rates in cIAI and cUTI were lower in moderate versus mild/no RI patients. In moderate RI cIAI patients, numerical differences in response rates between treatments were attributable to imbalances

  5. Update of incidence and antimicrobial susceptibility trends of Escherichia coli and Klebsiella pneumoniae isolates from Chinese intra-abdominal infection patients.

    Science.gov (United States)

    Zhang, Hui; Yang, Qiwen; Liao, Kang; Ni, Yuxing; Yu, Yunsong; Hu, Bijie; Sun, Ziyong; Huang, Wenxiang; Wang, Yong; Wu, Anhua; Feng, Xianju; Luo, Yanping; Chu, Yunzhuo; Chen, Shulan; Cao, Bin; Su, Jianrong; Duan, Qiong; Zhang, Shufang; Shao, Haifeng; Kong, Haishen; Gui, Bingdong; Hu, Zhidong; Badal, Robert; Xu, Yingchun

    2017-12-18

    To evaluate in vitro susceptibilities of aerobic and facultative Gram-negative bacterial (GNB) isolates from intra-abdominal infections (IAIs) to 12 selected antimicrobials in Chinese hospitals from 2012 to 2014. Hospital acquired (HA) and community acquired (CA) IAIs were collected from 21 centers in 16 Chinese cities. Extended spectrum beta-lactamase (ESBL) status and antimicrobial susceptibilities were determined at a central laboratory using CLSI broth microdilution and interpretive standards. From all isolated strains the Enterobacteriaceae (81.1%) Escherichia coli accounted for 45.4% and Klebsiella pneumoniae for 20.1%, followed by Enterobacter cloacae (5.2%), Proteus mirabilis (2.1%), Citrobacter freundii (1.8%), Enterobacter aerogenes (1.8%), Klebsiella oxytoca (1.4%), Morganella morganii (1.2%), Serratia marcescens (0.7%), Citrobacter koseri (0.3%), Proteus vulgaris (0.3%) and others (1.0%). Non- Enterobacteriaceae (18.9%) included Pseudomonas aeruginosa (9.8%), Acinetobacter baumannii (6.7%), Stenotrophomonas maltophilia (0.9%), Aeromonas hydrophila (0.4%) and others (1.1%). ESBL-screen positive Escherichia coli isolates (ESBL+) showed a decreasing trend from 67.5% in 2012 to 58.9% in 2014 of all Escherichia coli isolates and the percentage of ESBL+ Klebsiella pneumoniae isolates also decreased from 2012 through 2014 (40.4% to 26.6%), which was due to reduced percentages of ESBL+ isolates in HA IAIs for both bacteria. The overall susceptibilities of all 5160 IAI isolates were 87.53% to amikacin (AMK), 78.12% to piperacillin-tazobactam (TZP) 81.41% to imipenem (IMP) and 73.12% to ertapenem (ETP). The susceptibility of ESBL-screen positive Escherichia coli strains was 96.77%-98.8% to IPM, 91.26%-93.16% to ETP, 89.48%-92.75% to AMK and 84.86%-89.34% to TZP, while ESBL-screen positive Klebsiella pneumoniae strains were 70.56%-80.15% susceptible to ETP, 80.0%-87.5% to IPM, 83.82%-87.06% to AMK and 63.53%-68.38% to TZP within the three year study

  6. Mortalidad intrahospitalaria por accidente cerebrovascular

    Directory of Open Access Journals (Sweden)

    Federico Rodríguez Lucci

    2013-08-01

    Full Text Available La mortalidad global por accidente cerebrovascular (ACV ha disminuido en las últimas tres décadas, probablemente debido a un mejor control de los factores de riesgo vascular. La mortalidad hospitalaria por ACV ha sido tradicionalmente estimada entre 6 y 14% en la mayoría de las series comunicadas. Sin embargo, los datos de ensayos clínicos recientes sugieren que esta cifra sería sustancialmente menor. Se revisaron datos de pacientes internados con diagnóstico de ACV del Banco de Datos de Stroke de FLENI y los registros institucionales de mortalidad entre los años 2000 y 2010. Los subtipos de ACV isquémicos se clasificaron según criterios TOAST y los ACV hemorrágicos en hematomas intrapanquimatosos, hemorragias subaracnoideas aneurismáticas, malformaciones arteriovenosas y otros hematomas intraparenquimatosos. Se analizaron 1514 pacientes, 1079 (71% con ACV isquémico (grandes vasos 39%, cardioembólicos 27%, lacunares 9%, etiología indeterminada 14%, otras etiologías 11% y 435 (29% con ACV hemorrágico (intraparenquimatosos 27%, hemorragia subaracnoidea 30%, malformaciones arteriovenosas 25% y otros hematomas espontáneos 18%. Se registraron 38 muertes intrahospitalarias (17 ACV isquémicos y 21 ACV hemorrágicos, representando una mortalidad global del 2.5% (1.7% en ACV isquémicos y 4.8% en ACV hemorrágicos. No se registraron muertes asociadas al uso de fibrinolíticos endovenosos. La mortalidad intrahospitalaria en pacientes con ACV isquémico y hemorrágico en nuestro centro fue baja. El manejo en un centro dedicado a las enfermedades neurológicas y el enfoque multidisciplinario por personal médico y no médico entrenado en el cuidado de la enfermedad cerebrovascular podrían explicar, al menos en parte, estos resultados.

  7. GASTRITIS POR REFLUJO ALCALINO. TRATAMIENTO QUIRURGICO

    Directory of Open Access Journals (Sweden)

    Gonzalo López Escobar

    1985-12-01

    Full Text Available

    DEFINICION

    * Resumen del trabajo de ingreso a la Academia.

    Según Bockus "se considera la Gastritis como un proceso inflamatorio, de variable etiología, que afecta particularmente la mucosa". La GASTRITIS POR REFLUJO suele presentarse cuando hay una disfunción del esfínter pilórico, generalmente disminución de la presión. En pacientes con estómago completo existen factores predisponentes como colecisto, pancreato o colopatías, parasitismo intestinal; o puede estar asociada a úlcera péptica, esofagitis por reflujo, ingestión de medicamentos (corticoides, analgésicos, antirreumáticos o agentes tóxicos como el alcohol; pero es, sin duda, una complicación frecuente en gastrectomizados tipo Billroth II y tras vagotomía con piloroplastia. El síndrome ha recibido también los nombres de: Gastritis biliar, Gastritis por reflujo biliar, Gastritis alcalina, Gastritis post-operatoria por reflujo alcalino, o Gastritis por reflujo alcalino postoperatorio.

    Fue observada por primera vez por Beaumont, en 1833, en su paciente Alexis St. Martin; y por Anton Wolfler, en 1881, después de una gastroentero-anastomosis. Descrita por primera vez, en 1962, por DuPlessis; y más tarde, en 1968, por Bartlett y Burrinton.

    El término de Gastritis por reflujo alcalino, fue usado por Mix, en 1922; y por Van-Heerden y colaboradores, en la Clínica Mayo, en 1969. Después de una resección gástrica, la frecuencia varía entre 5 y 350/0, según diferentes autores...

  8. Evolution of NADPH-cytochrome P450 oxidoreductases (POR) in Apiales - POR 1 is missing

    DEFF Research Database (Denmark)

    Andersen, Trine Bundgaard; Hansen, Niels Bjørn; Laursen, Tomas

    2016-01-01

    to most other eudicotyledon orders that have both POR 1 and POR 2. This suggests that through gene duplications and one gene deletion, Apiales only contain members of the POR 2 clade. Three POR 2 isoforms from Thapsia garganica L., Apiaceae, were all full-length in an Illumina root transcriptome dataset...

  9. Miotoxicidade por organofosforados Organophosphate myotoxicity

    Directory of Open Access Journals (Sweden)

    Maria J. Cavaliere

    1996-06-01

    Full Text Available Os organofosforados são um grupo de compostos químicos amplamente utilizados em agropecuária como inseticidas, ocasionando intoxicações acidentais em animais e humanos, e mesmo sendo utilizados em tentativas de suicídio. A toxicidade desses produtos decorre sobretudo de insuficiência cárdio-respiratória por compromentimento do sistema nervoso autônomo. Sabe-se que alguns destes compostos induzem em animais de experimentação e em humanos, uma miopatia caracterizada por degeneração de células musculares, comprometendo sobretudo a musculatura respiratória. Baseado no fato de que este comprometimento contribui para a piora da função respiratória, propõe-se um protocolo de avaliação rotineira de miotoxicidade por compostos organofosforados, através de uma bateria mínima e suficiente de colorações e reações histoquímicas para quantificação da necrose muscular. Utilizaram-se como modelo experimental, grupos de ratos albinos (Wistar intoxicados com o organofosforado paraoxon, com e sem antídotos (atropina ou pralidoxima. Verificou-se nos grupos tratados com paraoxon e paraoxon mais atropina, necrose de fibras musculares no diafragma, que atingia em determinadas áreas até 15% das fibras. No grupo tratado com paraoxon mais pralidoxima, a necrose foi mínima, evidenciando o papel mioprotetor deste último antídoto.Organophosphates comprise a group of chemical compounds extensively used in farming as insecticides, which cause accidental poisoning in animals and men and are also used in suicide attempts. The toxicity of these compounds is due especially to the cardiac and respiratory impairment in consequence of autonomic nervous system disorders. However, it is known that some of these products induce a myopathy in experimental animals and humans. This myopathy is characterized by muscle cell degeneration, involving above all the respiratory muscles. Based on the fact that this involvement certainly enhances the

  10. por láser

    Directory of Open Access Journals (Sweden)

    Mayra Garcimuño

    2013-01-01

    Full Text Available En el presente trabajo, la técnica Espectroscopia de plasmas producidos por láser (Laser-induced breakdown spectroscopy –LIBS– se aplicó a la determinación cuan- titativa de Na en agua natural dulce, de interés en agricultura para el estudio de la alcalinidad de aguas de regadío. Para efectuar el análisis, se prepararon soluciones con concentraciones conocidas del analito, se mezclaron con óxido de calcio y se compactaron en pastillas sólidas. Los plasmas se produjeron en aire a presión atmos- férica utilizando un láser pulsado Nd:YAG. Se construyó una curva de calibración y se calculó el límite de detección. Se analizaron muestras de agua natural y los resultados se compararon con los obtenidos mediante espectroscopia de absorción atómica. Se demostró la factibilidad del método para la determinación de Na en agua natural dulce.

  11. Osteomalacia inducida por tumor: hemangiopericitoma rinosinusal

    Directory of Open Access Journals (Sweden)

    Enriqueta M. Serafini

    2013-02-01

    Full Text Available La osteomalacia inducida por tumor es una rara enfermedad del metabolismo óseo caracterizada por el aumento en la excreción de fosfato a nivel renal seguido de hipofosfatemia. Es causada por agentes fosfatúricos producidos por determinados tumores. La resección total del tumor resulta en la completa reversión de las anormalidades bioquímicas, la desaparición de las manifestaciones clínicas y los hallazgos en los estudios por imágenes. Presentamos el caso de un varón de 61 años con cuadro clínico y laboratorio compatibles con osteomalacia oncogénica inducida por tumor mesenquimático de localización rinosinusal. En nuestro caso el diagnóstico histológico correspondió a una neoplasia de tipo vascular: hemangiopericitoma.

  12. Analysis of patients with diabetes and complicated intra-abdominal infection or complicated urinary tract infection in phase 3 trials of ceftolozane/tazobactam.

    Science.gov (United States)

    Popejoy, Myra W; Long, Jianmin; Huntington, Jennifer A

    2017-05-02

    Diabetes mellitus and hyperglycemia are associated with increased susceptibility to bacterial infections and poor treatment outcomes. This post hoc evaluation of the treatment of complicated intra-abdominal infections (cIAI) and complicated urinary tract infections (cUTI) aimed to evaluate baseline characteristics, efficacy, and safety in patients with and without diabetes treated with ceftolozane/tazobactam and comparators. Ceftolozane/tazobactam is an antibacterial with potent activity against Gram-negative pathogens and is approved for the treatment of cIAI (with metronidazole) and cUTI (including pyelonephritis). Patients from the phase 3 ASPECT studies with (n = 245) and without (n = 1802) diabetes were compared to evaluate the baseline characteristics, efficacy, and safety of ceftolozane/tazobactam and active comparators. Significantly more patients with than without diabetes were 65 years of age or older; patients with diabetes were also more likely to weigh ≥75 kg at baseline (57.1% vs 44.5%), to have renal impairment (48.5% vs 30.2%), or to have APACHE II scores ≥10 (33.8% vs 17.0%). More patients with diabetes had comorbidities and an increased incidence of complicating factors in both cIAI and cUTI. Clinical cIAI and composite cure cUTI rates across study treatments were lower in patients with than without diabetes (cIAI, 75.4% vs 86.1%, P = 0.0196; cUTI, 62.4% vs 74.7%, P = 0.1299) but were generally similar between the ceftolozane/tazobactam and active comparator treatment groups. However, significantly higher composite cure rates were reported with ceftolozane/tazobactam than with levofloxacin in patients without diabetes with cUTI (79.5% vs 69.9%; P = 0.0048). Significantly higher rates of adverse events observed in patients with diabetes were likely due to comorbidities because treatment-related adverse events were similar between groups. In this post hoc analysis, patients with diabetes in general were older, heavier, and had a

  13. Controle de microgrids dirigido por modelos

    OpenAIRE

    Sampaio Junior, Adalberto Ribeiro

    2014-01-01

    O uso de engenharia de software dirigida por modelos (MDE) e de modelos em tempo de execução constitui uma ferramenta importante para desenvolver e controlar sistemas complexos. Neste trabalho utilizamos uma abordagem dirigida por modelos para controlar sistemas de distribuição de energia elétrica conhecidos como microgrids. Mostramos como uma abordagem dirigida por modelos pode ser utilizada para criar um gerente capaz de controlar os diversos componentes de uma microgrid, alé...

  14. Hepatitis colestásica por ibuprofeno

    National Research Council Canada - National Science Library

    Kutz Leoz, Marcos; Bolado Concejo, Federico; Urman Fernández, José María; Zozaya Urmeneta, José Manuel; Martínez Peñuela, Ana

    2011-01-01

    ... hepática. Se ha descrito daño hepático por Ibuprofeno, tanto por mecanismo idisincrático 3,4 como por sobredosis 5,6 y en el contexto de infección por el virus de la hepatitis C 7,8 . A continuación describimos un caso de hepatitis colestásica relacionada con dicho fármaco. Varón de 32 años sin alergias conocidas ni antecedentes personales de interés, f...

  15. Casipoemas por Navidad : (1969-2010)

    OpenAIRE

    Sena Medina, Guillermo

    2011-01-01

    PRESENTACIÓN AL AIRE DE LA POESÍA RELIGIOSA Y NAVIDEÑA DE GUILLERMO SENA MEDINA Constituye un gran honor hacer la presentación de Guillermo Sena Medina por un doble motivo; por la larga y sincera amistad que nos une desde hace muchos años al socaire de nuestra común afición por la Historia, como cronistas oficiales de nuestros municipios; y, sobre todo y particularmente, por su rica y profunda personalidad como hombre de letras, nacida de su aún más rica y profunda personalidad humana. A...

  16. Hematoquecia letal por angiostrongilosis abdominal

    Directory of Open Access Journals (Sweden)

    Gerzain Rodríguez

    2000-06-01

    Full Text Available Una niña indigena de 4 años de edad, procedente de Carurú, Vaupés, un municipio semiselvático de 2.000 habitantes, presentó hematoquecia repetida con sincope y muerte 4 días después, a pesar de recibir transfusiones sanguíneas. El estudio postmortem descubrió dos masas de 3-4 cm de diámetro en el ileon distal que, al microscopio, correspondieron a inflamación severa de toda la pared intestinal, rica en eosinofilos y en granulomas con células gigantes que circunscribian y fagocitaban huevos y larvas de Angiostrongylus costaricensis, helminto situado también dentro de las arterias de la submucosa, vasos que presentaban engrosamiento de la intima y focos con inflamación granulomatosa con eosinófilos. La niña no presentó leucocitosis ni eosinofilia. Este es el segundo caso de angiostrongilosis de esta región. El primero fue el de una mujer indigena de 34 años también con hematoquecia anemizante. La angiostrongilosis abdominal se diagnosticó por primera vez en Colombia en 1979, en un niño de 5 años, de Dagua, Valle. La niña aquí presentada es el sexto paciente con esta entidad en Colombia. La hematoquecia como manifestación predominante de la angiostrongilosis es extraordinaria para una enfermedad parasitaria; se ha registrado solamente en tres ocasiones anteriores. La abundancia de cristales de Charcot-Leyden, que se tiñen muy bien con la coloración de Ziehl-Neelsen o de Fite-Faraco, en los infiltrados de la pared intestinal. sugiere que su búsqueda en las heces puede ser una ayuda en el diagnóstico de casos sospechosos. pues, los huevos y las larvas no se eliminan en las heces y el diagnóstico definitivo de la angiostrongilosis es histopatológico. Revisamos las caracteristicas clinicas, parasitológicas e histopatológicas de esta parasitosis que será más prevalente en Colombia a medida que los médicos. especialmente los patólogos, la conozcan mejor.

  17. Ceftazidime-avibactam or best available therapy in patients with ceftazidime-resistant Enterobacteriaceae and Pseudomonas aeruginosa complicated urinary tract infections or complicated intra-abdominal infections (REPRISE): a randomised, pathogen-directed, phase 3 study.

    Science.gov (United States)

    Carmeli, Yehuda; Armstrong, Jon; Laud, Peter J; Newell, Paul; Stone, Greg; Wardman, Angela; Gasink, Leanne B

    2016-06-01

    Carbapenems are frequently the last line of defence in serious infections due to multidrug-resistant Gram-negative bacteria, but their use is threatened by the growing prevalence of carbapenemase-producing pathogens. Ceftazidime-avibactam is a potential new agent for use in such infections. We aimed to assess the efficacy, safety, and tolerability of ceftazidime-avibactam compared with best available therapy in patients with complicated urinary tract infection or complicated intra-abdominal infection due to ceftazidime-resistant Gram-negative pathogens. REPRISE was a pathogen-directed, international, randomised, open-label, phase 3 trial that recruited patients from hospitals across 16 countries worldwide. Eligible patients were aged 18-90 years with complicated urinary tract infection or complicated intra-abdominal infection caused by ceftazidime-resistant Enterobacteriaceae or Pseudomonas aeruginosa. Patients were randomised (1:1) to 5-21 days of treatment with either ceftazidime-avibactam (a combination of 2000 mg ceftazidime plus 500 mg avibactam, administered via a 2-h intravenous infusion every 8 h) or best available therapy. The primary endpoint was clinical response at the test-of-cure visit, 7-10 days after last infusion of study therapy, analysed in all patients who had at least one ceftazidime-resistant Gram-negative pathogen, as confirmed by the central laboratory, and who received at least one dose of study drug. Safety endpoints were assessed in all patients who received at least one dose of study drug. This study is registered with ClinicalTrials.gov, number NCT01644643. Between Jan 7, 2013, and Aug 29, 2014, 333 patients were randomly assigned, 165 to ceftazidime-avibactam and 168 to best available therapy. Of these, 154 assigned to ceftazidime-avibactam (144 with complicated urinary tract infection and ten with complicated intra-abdominal infection) and 148 assigned to best available therapy (137 with complicated urinary tract infection and 11 with

  18. ¿Por qué escribir?

    OpenAIRE

    Jean Paul Sartre

    2015-01-01

    En la sección Grandes periodistas, Jean Paul Sartre define por qué escribir? Dice que no es verdad que se escriba para uno mismo, porque la operación de escribir supone la de leer y estos dos actos necesitan de agentes distintos. Solo hay arte por y para los demás.

  19. L-lysine escinat, thiotriazolin, gordox and mydocalm influence on oxygen tension in the intestinal wall and acid-base balance and limited proteolysis in intestinal venous blood in terms of intraabdominal hypertension modeling

    Directory of Open Access Journals (Sweden)

    Sapegin V.I.

    2014-11-01

    Full Text Available In acute experiments on rabbits there were studied changes in oxygen tension in the intestinal wall tissues, acid-base balance and limited proteolysis and its inhibitors in intestinal venous blood, protective action of L-lysine escinat (0,15 mg/kg / single dose, thiotriazolin (25 mg/kg / single dose, aprotinin (gordox (10,000 units/kg / single dose in sequential modeling of standard levels increasing of intra-abdominal hypertension (IAH — 50, 100, 150, 200, 250, 300, 350 m H2O, and also of tolperison (mydocalm (5 mg/kg / single dose on modeling of stable 3-hour IAH 200 m H2O. The IAH modeling was performed by means of stand of our construction. Under the influence of IAH the compensated metabolic acidosis in intestinal venous blood with a compensative hyperpnoe develops, decline of oxygen tension in tissues and activating of a limited proteolysis as well as decline of its inhibitors activity in intestinal venous blood occur. By the degree of metabolic acidosis prevention investigational preparations were distributed as follows gordox > thiotriazolin = L-lysine escinat = mydocalm, and by prevention of decline of oxygen tension in tissues — thiotriazolin > L-lysine escinat > mydocalm > gordox, it is is connected with different rate of methabolic products excretion into the blood, due to the influence on blood circulation and transcapilary exchange. By the degree of prevention of proteolytic activity and inhibitory potential changes, investigational preparations were distributed as follows: gordox > mydocalm > thiotriazolin > L-lysine escinat, this is connected with inhibition of proteolysis in gordox, and in other ones – with reduction of ischemic damage of tissues. Owing to different mechanism of action thiotriazolin, L-lysine escinat and mydocalm may be simultaneously recommended for a conservative treatment of patients with intraabdominal hypertension syndrome.

  20. Verdad por definición

    Directory of Open Access Journals (Sweden)

    Garrido Garrido, Julián

    1997-07-01

    Full Text Available Not available.La verdad por definición es un tipo peculiar de verdad científica, distinguible de las verdades lógicas, matemáticas y empíricas. La definición, por su parte, designa diversos procedimientos de asignación de significado, cuyas diferencias exigen una adjetivación cuidadosa: definiciones ostensivas y operacionales, definiciones de diccionario y definiciones teóricas. Pero sólo las del último tipo son verdaderas por definición. En el presente artículo se precisa el concepto formal de definición teórica, se delimita la estructura de esos enunciados, se analiza la verdad por definición, y se comparan, por último, las definiciones teóricas con los otros tipos de definición.

  1. Portable exhauster POR-007/Skid E and POR-008/Skid F storage plan

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, O.D.

    1998-07-25

    This document provides storage requirements for 1,000 CFM portable exhausters POR-O07/Skid E and POR-008/Skid F. These requirements are presented in three parts: preparation for storage, storage maintenance and testing, and retrieval from storage. The exhauster component identification numbers listed in this document contain the prefix POR-007 or POR-008 depending on which exhauster is being used.

  2. Obesidad y síndrome metabólico en niños y adolescentes

    Directory of Open Access Journals (Sweden)

    Dr. Castillo-Durán Garlos

    2012-03-01

    Full Text Available La obesidad general y en niños es un problema de salud pública con claro aumento a nivel mundial y en Chile. En las edades pediátricas, aparte de sus consecuencias traumatológicas, metabólicas y psicológicas, ya tiene un impacto en el riesgo de enfermedades en las edades adultas. El concepto de síndrome metabólico está en uso hace algunos años en la edad adulta, para aunar factores de riesgo de llegar a desarrollar diabetes tipo II y enfermedad cardiovascular. En pediatría hay suficiente evidencia que son factores predictores de riesgo desde la edad escolar la mayoría de los componentes estudiados en adultos: aumento de circunferencia abdominal, de presión arterial sistólica y diastólica, de triglicéridos y disminución de colesterol HDL sérico. Están en estudio otros componentes del síndrome: resistencia insulínica, adiposidad intraabdominal, hiperuricemia, hiperleptinemia, grosor aumentado de íntimamedia arterial, signos sugerentes de hígado graso. Se justifica el estudio de estos factores en niños y adolescentes obesos y su manejo intensivo por un equipo profesional entrenado.

  3. Osteoporosis inducida por glucocorticoides Glucocorticoid induced osteoporosis

    OpenAIRE

    R. Gutiérrez-Polo

    2003-01-01

    Los glucocorticoides son un grupo de fármacos que se emplean muy frecuentemente en la práctica médica por su indiscutible utilidad. La osteoporosis inducida por éstos supone el principal efecto adverso derivado de su administración sistémica y prolongada, constituyendo la causa más frecuente de osteoporosis secundaria. Comporta además una importante repercusión sanitaria y socioeconómica como consecuencia de las complicaciones que ocasiona, como son las diferentes fracturas óseas por fragilid...

  4. Verdad por definición

    OpenAIRE

    Garrido Garrido, Julián

    1997-01-01

    Not available.La verdad por definición es un tipo peculiar de verdad científica, distinguible de las verdades lógicas, matemáticas y empíricas. La definición, por su parte, designa diversos procedimientos de asignación de significado, cuyas diferencias exigen una adjetivación cuidadosa: definiciones ostensivas y operacionales, definiciones de diccionario y definiciones teóricas. Pero sólo las del último tipo son verdaderas por definición. En el presente artículo se precisa el concepto formal ...

  5. Microscopia de varrimento por sonda (SPM)

    OpenAIRE

    Limão-Vieira, P.; Gonçalves, M. R.; Ribeiro, J. H. F.

    1995-01-01

    Gazeta da Física • VOL. 18 • Fascículo 4 A invenção do Microscópio de Efeito de Túnel (Scanning Tunneling Microscope) em 1981, por G. Binnig e H. Rohrer, seguida do aparecimento do Microscópio de Força Atómica, em 1986, conduziu ao desenvolvimento de um conjunto de novas técnicas de microscopia, genericamente designadas por Microscopias de Varrimento por Sonda (Scanning Probe Microscopy ou SPM). Os avanços conseguidos com este tipo de micróscopia, associada a outras técnicas...

  6. 14 Nobel, preocupados por el CERN

    CERN Multimedia

    Rivera, A

    2003-01-01

    "E l presidente del Consejo del CERN (Laboratorio Europeo de Fisica de Particulas, junto a Ginebra), Maurice Bourquin, ha recibido una carta firmada por un grupo de cientificos muy especiales: 14 premios Nobel de Fisica" (1 page).

  7. Micetoma por Nocardia brasiliensis: reporte de caso

    Directory of Open Access Journals (Sweden)

    Miriam Guevara R

    2003-07-01

    Full Text Available Se presenta el caso de un paciente peruano, agricultor, con una infección cutánea de origen traumático causada por Nocardia brasiliensis, que evolucionó hacia la amputación del miembro inferior afectado. El diagnóstico se realizó por examen directo y cultivo del espécimen.

  8. Tatuaje por amalgama. Reporte de un caso

    Directory of Open Access Journals (Sweden)

    Luis Fang Mercado

    2012-01-01

    Full Text Available El tatuaje por amalgama se origina por el depósito en el tejido conectivo subepitelial de fragmentos de amalgama resultado de procedimientos iatrogénicos por parte del operador. La profundidad a la que se encuentren albergados los residuos de este material influye en la presentación clínica de las lesiones. Radiográficamente se pueden identificar los fragmentos mientras tengan diámetros razonables; histológicamente se pueden observar las partículas de amalgama como gránulos oscuros, sólidos e irregulares dispuesto entre los haces de colágeno y vasos sanguíneos. Este artículo refiere el caso clínico de un paciente que presentó pigmentación por amalgama en mucosa vestibular, originada por una porción de amalgama usada como material obturador en una apicectomía del 11 realizada con anterioridad. Teniendo en cuenta las consideraciones clínicas y radiográficas se optó por realizar una segunda apicectomía con obturación retrógrada con MTA del 11. Durante el procedimiento quirúrgico se cureteó y adelgazó la cara interna del colgajo mucoperióstico para tratar de disminuir el grado de pigmentación.

  9. Linfoma de Burkitt: informe de un caso diagnosticado por laparotomía Burkitt's lymphoma: report of a case diagnosed by laparotomy

    Directory of Open Access Journals (Sweden)

    Rafael Pinilla González

    2008-12-01

    Full Text Available El linfoma de Burkitt no endémico es un tumor de frecuente localización abdominal, por lo que se debe tener presente ante cualquier masa intraabdominal. Aunque el tratamiento de elección es la quimioterapia, existe controversia respecto del papel que debe desempeñar la cirugía, especialmente en casos donde el diagnóstico se establece durante una laparotomía exploradora. Este fue el caso de una adolescente de 14 años que presentó una masa hipogástrica y otra menor en la fosa ilíaca derecha. Algunos autores no aceptan la cirugía y añaden que puede retrasar y complicar el tratamiento quimioterápeutico, mientras que otros autores defienden la cirugía reductora de masa tumoral asociada a la quimioterapia. Esta controversia es especialmente importante cuando el diagnóstico se establece en el curso de una laparotomía exploradora, durante la cual hay que decidir si extirpar la masa tumoral o no hacerlo. En nuestro caso decidimos extirpar todo el tumor macroscópico. La buena evolución de nuestra paciente y los resultados comunicados apoyan esta postura.Non-endemic Burkitt's lymphoma is a tumor of frequent abdominal localization that should be taken into consideration before any intraabdominal mass. Although chemotherapy is the election treatment, there is controversy as regards the role surgery should play, specially in those cases where the diagnosis is established by explorative laparotomy. This was the case of a 14-year-old adolescent that presented a hypogastric mass and another lower mass in the right iliac fossa. Some authors do not accept surgery and state that it may delay and complicate chemotherapy, whereas other authors defend the tumoral mass-reducing surgery associated with chemotherapy. This controversy is particularly important when the diagnosis is made in the course of an explorative laparotomy and it should be decided wether to remove the tumoral mass or not. In our case, it was decided to remove the whole macroscopic

  10. Structural Insights into the PorK and PorN Components of the Porphyromonas gingivalis Type IX Secretion System

    National Research Council Canada - National Science Library

    Gorasia, Dhana G; Veith, Paul D; Hanssen, Eric G; Glew, Michelle D; Sato, Keiko; Yukitake, Hideharu; Nakayama, Koji; Reynolds, Eric C

    2016-01-01

    ... to the cell surface via a sortase-like mechanism. At least 11 proteins have been identified as components of the T9SS including PorK, PorL, PorM, PorN and PorP, however the precise roles of most of these proteins have not been elucidated...

  11. Angiografia por tomografia computadorizada dos aneurismas intracranianos

    Directory of Open Access Journals (Sweden)

    Laureano Vinícius Santos

    2002-01-01

    Full Text Available Este trabalho foi realizado para avaliar os achados da angiografia por tomografia computadorizada, comparativamente à angiografia por subtração digital, em relação aos aneurismas intracranianos, e a possibilidade da maior utilização da angiografia por tomografia computadorizada no Brasil. Foram analisados oito pacientes que apresentavam um total de sete aneurismas não tratados e um aneurisma tratado. Houve subseqüente correlação com outros trabalhos publicados na literatura médica. Os exames foram realizados em uma clínica e em dois hospitais privados, na cidade do Rio de Janeiro, RJ. Foi demonstrada boa correlação entre os métodos estudados, em relação ao diagnóstico dos aneurismas, no acompanhamento e avaliação pré-terapêutica dessas lesões. A angiografia por tomografia computadorizada foi um exame menos invasivo, de menor custo e maior acessibilidade. Concluiu-se que a angiografia por tomografia computadorizada é um exame que deve ser utilizado com maior freqüência para avaliação nesta enfermidade.

  12. Mielopatia por histoplasmose: registro de um caso

    Directory of Open Access Journals (Sweden)

    Edymar Jardim

    1981-03-01

    Full Text Available É relatado um caso de síndrome mielítica aguda por histoplasmose. A paciente apresentou um quadro de paraparesia aguda, com alterações da sensibilidade superficial e profunda em nível de T11-T12, e perda do controle esfinctérico. O exame do LCR revelou bloqueio total, confirmado pela mielografia. A mielografia e a laminectomia mostraram tratar-se de uma paquimeningite no nível considerado, com intensa granulomatose da aracnóide. O exame histopatoló-gico revelou a presença de granulomas por H. capsulatam. A terapêutica pela anfotericina B utilizada por via intrarraquídea e parenteral, não condicionou resultados satisfatórios.

  13. Diseño asistido por computador

    OpenAIRE

    Rojas Lazo, Oswaldo; Universidad Nacional Mayor de San Marcos; Rojas Rojas, Luis; Universidad Nacional Mayor de San Marcos

    2014-01-01

    El diseño es una actividad que se proyecta hacia la solución de problemas planteados por el ser humano en su adaptación al medio que lo rodea, para la satisfacción de sus necesidades, para lo cual utiliza recursos como la tecnología CAD/CAE/CAM. Estas tecnologías se vienen aplicando a través de los métodos de la ingeniería concurrente. La técnica más desarrollada en la ingeniería asistida por computador (CAE), es la aplicación de los análisis por elementos finitos (FEA), que con la mejora de ...

  14. Projecto de hardware digital orientado por objectos

    OpenAIRE

    Fernandes, João M.; Machado, Ricardo J.

    1997-01-01

    Os limites entre os domínios do software e do hardware são cada vez mais ténues, pelo que técnicas inicialmente experimentadas no software têm vindo a ser gradualmente aplicadas no hardware. Este artigo pretende descrever o estado actual da utilização da tecnologia de programação orientada por objectos no projecto de hardware digital. São analisadas as vantagens e implicações quando se introduzem conceitos ligados à tecnologia orientada por objectos em projectos de hardware e é apresent...

  15. PANORAMA LATINOAMERICANO DEL PAGO POR SERVICIOS AMBIENTALES

    Directory of Open Access Journals (Sweden)

    González T. Ángela

    2008-07-01

    Full Text Available Este documento busca proveer al lector de algunos elementos para el análisis y reflexión en torno al pago por servicios ambientales. Para ello, en primera instancia, aborda algunos conceptos básicos relacionados con economía ambiental, seguido de temas como la valoración económica de servicios ambientales y la implementación de mecanismos de pago por algunos de ellos. Lo anterior esta enriquecido con experiencias o estudios de caso a nivel latinoamericano y colombiano.

  16. Acuerdo por la discreción

    Directory of Open Access Journals (Sweden)

    Yeny Serrano

    2006-01-01

    Full Text Available En este artículo se propone un análisis del texto del Acuerdo por la discreción firmado en 1999 por 32 directores de medios de comunicación para “elevar el nivel de calidad y responsabilidad en el cubrimiento y difusión de hechos violentos”. Se analizan los factores que impiden que este Acuerdo produzca cambios efectivos en la práctica profesional informativa y se presenta un modelo (Lemieux, 2000 que tiene en cuenta las variables que influyen en la producción del discurso informativo mediático.

  17. Microrganismos associados a poríferos

    OpenAIRE

    Turque, Aline da Silva; Silveira, Cynthia Barbosa da; Vieira, Ricardo Pilz; Muricy, Guilherme Ramos da Silva; Cardoso, Alexander Machado; Clementino, Maysa Beatriz Mandetta; Martins, Orlando Bonifácio

    2007-01-01

    Os Poríferos, também conhecidos como esponjas, são invertebrados que filtram grandes quantidades de água e adquirem seus nutrientes por fagocitose dos micróbios capturados durante a filtração (Fig.1). Habitam os oceanos tropicais, temperados e polares, com algumas espécies encontradas em água doce (Taylor et al., 2007). As esponjas formam uma das mais antigas radiações dos metazoários, cuja origem data do Período Pré-Cambriano há cerca de 500 milhões de anos (Hentschel, 2004...

  18. Conjuntivite presumível por Acanthamoeba

    OpenAIRE

    Ruthes,Ana Cristina de Carvalho; Wahab,Sâmia; Wahab,Najua; Moreira,Hamilton; Moreira,Luciane

    2004-01-01

    OBJETIVO: Abordar quatro casos de conjuntivite presumível por Acanthamoeba, descrevendo o diagnóstico, considerando sinais e sintomas e o tratamento instituído. MÉTODOS: Foram estudados casos de conjuntivite presumível por Acanthamoeba diagnosticados no Hospital de Olhos do Paraná (HOP), no período de setembro/1998 a janeiro/2002. Todos os olhos estudados foram submetidos a um protocolo de investigação que incluía exame oftalmológico completo, microbiologia e cultura de secreções conjuntivais...

  19. Alimentos industrializados mais consumidos por idosos hipertensos

    OpenAIRE

    Rockenbach, Aline; Blasi, Tereza Cristina; Blümke, Adriane Cervi

    2013-01-01

    Este estudo compreende a avaliação da quantidade de alimentos industrializados consumida por idosos hipertensos. Para tanto, 112 voluntários, de ambos os gêneros, residentes na área urbana de um município da região central do estado do Rio Grande do Sul, foram avaliados por meio de frequência alimentar e de um questionário socioeconômico, tendo a coleta se efetivado nos respectivos domicílios. Dentre os achados, verificou-se que 67% (n=75) eram do gênero feminino e 33% (n=37), do gênero mascu...

  20. Saneamiento por vicios ocultos: las acciones edilicias

    OpenAIRE

    Verda y Beamonte, José Ramón de

    2009-01-01

    ¿Una cosa que no cumple o cumple imperfectamente con su función es la cosa prometida en el contrato o es una cosa distinta ¿La función que debe cumplir una cosa hace parte de su definición contractualDe estas preguntas que, a primera vista, pueden parecer eminentemente teóricas se desprenden consecuencias prácticas de gran importancia: ¿Puede el comprador servirse de la acción por incumplimiento de la obligación de entrega o, más bien, debe reclamar por vicios ocultos o, incluso, solicitar la...

  1. Neumopericardio debido a herida por arma blanca

    Directory of Open Access Journals (Sweden)

    Samuel I. Merino Barrera

    2015-10-01

    Full Text Available Hombre de 24 años de edad que ingresó en el hospital debido a una herida por arma blanca penetrante en el hemitórax derecho. La herida, de 3 cm a nivel de la piel, se localizaba a nivel del segundo espacio intercostal derecho y la radiografía de tórax demostró un neumotórax del mismo lado y una colección radiotransparente, por debajo del pericardio parietal, desde el origen de los grandes vasos hasta la porción apical del ventrículo izquierdo.

  2. MIASIS CUTÁNEA POR CORDYLOBIA ANTHROPOPHAGA

    OpenAIRE

    Miriam Alkorta Gurrutxaga; Xabier Beristain Rementeria; Gustavo Cilla Eguiluz; Anna Tuneu Valls; José Zubizarreta Salvador

    2001-01-01

    El incremento progresivo en el número de personas que viajan a países tropicales ha hecho que las enfermedades importadas adquieran una relevancia cada vez mayor. Las miasis (o infestaciones por larvas de moscas) cutáneas se encuentran entre este tipo de enfermedades siendo especialmente frecuentes en países tropicales. A propósito de la observación de un caso de miasis cutánea masiva por Cordylobia antropophaga, que ocurrió en una mujer de 34 años de edad al volver de un...

  3. Dairy Foods in a Moderate Energy Restricted Diet Do Not Enhance Central Fat, Weight, and Intra-Abdominal Adipose Tissue Losses nor Reduce Adipocyte Size or Inflammatory Markers in Overweight and Obese Adults: A Controlled Feeding Study

    Directory of Open Access Journals (Sweden)

    Marta D. Van Loan

    2011-01-01

    Full Text Available Background. Research on dairy foods to enhance weight and fat loss when incorporated into a modest weight loss diet has had mixed results. Objective. A 15-week controlled feeding study to determine if dairy foods enhance central fat and weight loss when incorporated in a modest energy restricted diet of overweight and obese adults. Design. A 3-week run-in to establish energy needs; a 12-week 500 kcal/d energy reduction with 71 low-dairy-consuming overweight and obese adults randomly assigned to diets: ≤1 serving dairy/d (low dairy, LD or ≤4 servings dairy/d (adequate dairy, AD. All foods were weighed and provided by the metabolic kitchen. Weight, fat, intra-abdominal adipose tissue (IAAT, subcutaneous adipose tissue (SAT macrophage number, SAT inflammatory gene expression, and circulating cytokines were measured. Results. No diet differences were observed in weight, fat, or IAAT loss; nor SAT mRNA expression of inflammation, circulating cytokines, fasting lipids, glucose, or insulin. There was a significant increase (P=0.02 in serum 25-hydroxyvitamin D in the AD group. Conclusion. Whether increased dairy intake during weight loss results in greater weight and fat loss for individuals with metabolic syndrome deserves investigation. Assessment of appetite, hunger, and satiety with followup on weight regain should be considered.

  4. Meningoencefalitis por Criptococcus neoformans en escolares inmunocompetentes

    National Research Council Canada - National Science Library

    Guevara-Campos, Jose; Gonzalez-Guevara, Lucia; Urbaez-Cano, Jose; Fermin, Soledad

    2009-01-01

    ... que se encuentra en el suelo, en los excrementos de las aves, principalmente de las palomas. Hasta la fecha se aceptan dos especies: Cryptococcus neoformans y Cryptococcus gattii. Ambas especies se diferencian por la morfologia de las colonias, caracteristicas bioquimicas, serologia y su ecologia (8). El Cryptococcus neoformans es de distribucion universal y afect...

  5. Pedro Teixeira y su viaje por Mesopotamia

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    Fuente del Pilar, José Javier

    2005-04-01

    Full Text Available Pedro Teixeira es un integrante notable de la ilustre nómina de los viajeros portugueses que, a finales del s, XVI y principios del XVII, ensancharon para Occidente las fronteras del mundo. Su conocimiento en España se debe a la publicación en 1994 de su obra «Relaciones del Origen, Descendencia y Sucesión de los Reyes de Persia, y de Harmuz, y de un viaje hecho por el autor dende la India hasta Italia por tierra», en edición realizada por el profesor Eduardo Barajas Sala, lamentablemente fallecido en 1997. En este artículo se ofrece una reseña biográfica de Pedro Teixeira, y un análisis del viaje narrado por el autor en la última parte de sus «Relaciones »: el que desde Ormuz le conducirá, a través de Mesopotamia, hasta la costa del Mediterráneo.…

  6. Puede aterrizarse el Pacto por Mexico?

    National Research Council Canada - National Science Library

    Elizondo Mayer-Serra, Carlos

    2013-01-01

    ... tiene cinco grandes ejes que tratan de ordenar lo firmado. El segundo eje es promover el crecimiento economico, el empleo y la competitividad. El Pacto "pretende sentar las bases de un nuevo acuerdo politico, economico y social para impulsar el crecimiento economico que genere los empleos de calidad ...". Para ello, "Mexico debe crecer por encima...

  7. El turismo accesible visto por los usuarios

    OpenAIRE

    2016-01-01

    El turismo es un elemento básico de la vida cotidiana de nuestra sociedad. Constituye un derecho del que, sin embargo, numerosas personas, por motivos de discapacidad, edad u otras razones, no pueden disfrutar o lo hacen con grandes dificultades debido a que los establecimientos no cuentan con las condiciones de accesibilidad que necesitan.

  8. Endocardite infecciosa causada por Eikenella corrodens

    Directory of Open Access Journals (Sweden)

    Cardoso Juliano Novaes

    2005-01-01

    Full Text Available Os microorganismos do grupo HACEK (Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens e Kingella kingae são responsáveis por 3% dos casos de endocardites. Eles apresentam propriedades clínicas e microbiológicas semelhantes entre si: são bacilos gram-negativos, isolados mais facilmente em meios aeróbicos, suas culturas necessitam de tempo prolongado de incubação para crescimento (média 3,3 dias e podem ser considerados como parte da flora normal do trato respiratório superior e da orofaringe1,2. Algumas características foram identificadas nas endocardites por esses agentes, como o quadro clínico insidioso¹, diagnóstico difícil pela natureza fastidiosa e culturas negativas3,4. A endocardite por Eikenella corrodens foi descrita pela primeira vez em 1972(5 e continua sendo um agente etiológico raro. Relatamos o caso de uma paciente com valva nativa que apresentou endocardite infecciosa causada por Eikenella corrodens.

  9. MORTE POR EXAUSTÃO NO TRABALHO

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    Cândida da Costa

    Full Text Available Este artigo tem por objeto a morte por exaustão no trabalho, descrevendo e analisando condições de trabalho no setor sucroalcooleiro de Ribeirão Preto e região (SP. Como objetivos, busca-se relacionar jornada exaustiva de trabalho à exigência de produção por metas e as condições de trabalho análogas à escravidão, assim como se levanta a hipótese da ocorrência de mortes de trabalhadores por exaustão, pela combinação de péssimas condições de trabalho com exigências de alto desempenho. Como procedimentos metodológicos, são analisados os atestados de óbito de oito trabalhadores e as causae mortis de vinte trabalhadores mortos no corte de cana e investigam-se as causas declaradas (parada cardiorrespiratória, pancreatite, acidente cerebral hemorrágico, infarto do miocárdio, causas desconhecidas, entre outras. Foram realizadas entrevistas com familiares (pai, mãe, esposa ou viúva, irmão para se conhecerem as condições de saúde do(a trabalhador(a ao partir para o trabalho no corte de cana-de-açúcar. Com base nessa metodologia, os resultados alcançados permitem manter a hipótese de que a morte por exaustão está presente também no setor sucroalcooleiro.

  10. Control de la conducta inducida por programa por sus consecuencias ambientales

    OpenAIRE

    Ardoy Cuadros, Juan

    2008-01-01

    La presente Tesis Doctoral se ha desarrollado dentro de una de las líneas de investigación desarrollada por el Departamento de Psicología Básica I de la UNED y cuyo objetivo prioritario es el estudio de las características de la conducta inducida por programa, así como el control ambiental y farmacológico de la misma. El objetivo de esta investigación, en concreto, es determinar los factores implicados en la aparición de la polidipsia inducida por programa en ratas, así como en su mantenimi...

  11. Responsabilidad por violación de la buena fe en la sociedad por acciones simplificada

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    Nicolás Polanía Tello

    2012-12-01

    Full Text Available La sociedad por acciones simplificada –SAS–, como los demás esquemas societarios, se funda en y está informada por el principio de la buena fe. Pero a diferencia de los otros modelos, la SAS tiene concreciones particulares de la buena fe que permiten un amparo más efectivo y eficiente de los derechos de los socios y de los terceros, en la medida en que instituciones como el fraude a la ley, el perjuicio injusto a terceros, el abuso del derecho y el administrador de hecho, todos estructurados a partir de violaciones a la buena fe, permiten tramitar los eventos de responsabilidad por ilícitos atípicos y llegar incluso a desestimar por ello el atributo de la limitación de responsabilidad.

  12. Responsabilidad penal del empleador por delitos cometidos en la empresa por sus subordinados

    Directory of Open Access Journals (Sweden)

    Walter Jose Saavedra Troncoso

    2013-07-01

    Full Text Available En este trabajo se realiza un estudio sobre la responsabilidad penal del empresario por los actos al margen de la ley que cometen sus subordinados. Se busca aclarar si el empresario debe responder penalmente cuando el delito es cometido por un subordinado en ejercicio de sus funciones o cuando este actúa a nombre de la empresa ya sea valiéndose de la información que manejan, del grado de responsabilidad o de la confianza. Por esta razón concentraremos nuestra atención en analizar la responsabilidad penal por la omisión de controles del empresario hacia el subordinado, exponiendo la problemática que se deriva de la posición de garante del primero en las operaciones empresariales.

  13. Tratamiento para manchas por fluorosis dental por medio de micro abrasion sin instrumentos rotatorios

    National Research Council Canada - National Science Library

    Molina-Frechero, Nelly; Villegas-Ham, Julio; Nevarez-Rascon, Alfredo; Bologna-Molina, Ronell; Castaneda-Castaneira, Enrique; Nevarez-Rascon, Martina M

    2010-01-01

    ... llenar las expectativas esteticas del paciente. La microabrasion es uno de los tratamientos mas conservadores para tratar las pigmentaciones y defectos causados en el esmalte dental por la ingesta de fluor...

  14. Eumicetoma por Madurella grisea: relato de caso

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    Maria do Rosário Rodrigues Silva

    1991-03-01

    Full Text Available E relatado um caso de micetoma por Madurella grisea de localização podai em uma mulher do lar. A identificação da amostra foi feita através das características macro e microscópicas do agente em ágar Sabouraud e através da assimilação de açúcares. Este é o quinto caso de micetoma por Madurella grisea relatado no Brasil.One case of mycetoma produced by Madurella grisea localised on the foot of a house wife is reported. The identification of the strain was made through the following features: aspect of the grains, micro e macromorphology in Sabouraud agar and capacity of assimilation of the sugars. This is the fifth case of mycetoma by Madurella grisea reported from Brasil.

  15. NEGOCIACIÓN: COMPETENCIA GERENCIAL POR ANTONOMASIA

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    Jorge Ignacio Paz

    Full Text Available Los conflictos son inherentes al ser humano y surgen cuando las personas se relacionan e interactúan, cuando manejan posiciones contrarias, las sostienen y las defienden. Las buenas decisiones surgen de la creatividad por el desacuerdo. Negociar es redefinir el problema para generar la mejor opción que satisfaga los intereses de las partes y, en consecuencia, éstas puedan comprometerse en un acuerdo que puedan cumplir. Dentro de la nueva concepción de la gerencia como suministradora de conocimientos para generar resultados, la competencia de negociación ha venido adquiriendo un gran protagonismo e importancia, esencialmente por constituirse en la herramienta fundamental para la solución de conflictos y para el establecimiento y mantenimiento de relaciones perdurables.

  16. Mastite por Paracoccidioidomicose: Relato de Caso

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    Chambô Filho Antônio

    2000-01-01

    Full Text Available A paracoccidioidomicose é uma importante micose sistêmica, endêmica na América Latina. A infecção é usualmente adquirida por inalação das partículas do micélio. Na sua maioria são infecções assintomáticas e estão associadas a vários fatores do hospedeiro, como sexo, idade, fatores genéticos, bem como às características do agente infeccioso e sua virulência. Apresentamos um caso de mastite por paracoccidioidomicose, com o objetivo de demonstrar que pacientes idosas e com abcessos na mama devem ser submetidas à biópsia.

  17. Choque cardiogênico por dissulfiram

    OpenAIRE

    Jerónimo, Ana; Meira, Carla; Amaro,Augusta; Campello,Glória Cabral; Granja, Cristina

    2009-01-01

    A intoxicação medicamentosa por dissulfiram é uma situação rara, mas, que pode se apresentar com manifestações cardiovasculares graves e potencialmente fatais, como choque cardiogênico. É apresentado o caso de uma paciente com choque refratário, após intoxicação voluntária por dissulfiram. A avaliação clínica e bioquímica, junto à avaliação ecocardiográfica e à monitorização invasiva, confirmaram tratar-se de um choque cardiogênico associado a esse fármaco. São discutidos os mecanismos de açã...

  18. Celulitis por cuerpo extraño

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    Miguel B. Carrasco Guzmán

    2016-01-01

    Full Text Available Las infecciones de la piel y el tejido celular subcutáneo surgen como un grupo importante de afecciones con una alta morbilidad en edades pediátricas, generalmente relacionada con traumatismo y cuerpos extraños. Se presenta el caso de una escolar femenina de 6 años de edad, con síntomas y signos clínicos que sugieren celulitis en el muslo derecho,  por su evolución tórpida se le realizó el estudio ultrasonográfico que confirmó el diagnóstico etiológico de una celulitis secundaria a un traumatismo, provocada por la introducción de un gran cuerpo extraño, que pasó inadvertido para a familia de la menor.

  19. Todo comenzó por una cartera

    OpenAIRE

    Álvarez Capazzolo, Patricia

    2016-01-01

    El cambio climatico afecta a todas las personas del planeta, por lo que la accion debepartir desde el ambito individual. Este ensayo sigue los primeros contactos de la autora con diferentes acciones ciudadanas para enfrentar el cambio climatico y detalla la formacion de un medio de comunicacion en lnea que se dedica a difundir informacion sobre el tema y hacerlo diferente a otros medios que conoce, con la intencion de hacerlo atractivo.

  20. Amar por cartas - este inferno de amara

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    Matildes Demetrio dos Santos

    1999-10-01

    Full Text Available Este trabalho tem por objetivo estudar o amor nas Folhas caídas e nas Cartas de amor à Viscondessa da Luz, de Almeida Garrett.Seus poemas cheios de erotismo e sensua lidade, inspirados numa mulher casada, Rosa Montúrar Infante, escandalizaram a sociedade portuguesado sécu lo XIX. Suas cartas de amor, em segredo, criavam uma ficção de características místicas.

  1. MIASIS CUTÁNEA POR CORDYLOBIA ANTHROPOPHAGA

    Directory of Open Access Journals (Sweden)

    Miriam Alkorta Gurrutxaga

    2001-01-01

    Full Text Available El incremento progresivo en el número de personas que viajan a países tropicales ha hecho que las enfermedades importadas adquieran una relevancia cada vez mayor. Las miasis (o infestaciones por larvas de moscas cutáneas se encuentran entre este tipo de enfermedades siendo especialmente frecuentes en países tropicales. A propósito de la observación de un caso de miasis cutánea masiva por Cordylobia antropophaga, que ocurrió en una mujer de 34 años de edad al volver de un viaje a Senegal, se ha efectuado una revisión de los casos de miasis cutáneas forunculoides importadas publicados en España, así como de la biología, patología, tratamiento y prevención de la miasis humana por Cordylobia anthropophaga. El caso referido, se caracterizó por la infestación con un número inusualmente elevado de larvas, no sospechándose su etiología hasta la fase final de la enfermedad. La emergencia continuada de larvas (se recogieron 91 generó en la paciente un estado de ansiedad importante. Finalmente, la eliminación de las larvas provocó una rápida mejoría de la paciente. Aunque los casos de miasis cutánea no tienen la gravedad de otras enfermedades importadas, su conocimiento es necesario desde el punto de vista preventivo, diagnóstico y terapeútico. Es importante proceder a la identificación morfológica de las larvas diferenciándolas de otro tipo de miasis con implicaciones terapéuticas diferentes.

  2. Eritema multiforme mayor desencadenado por antimicrobianos

    Directory of Open Access Journals (Sweden)

    Ronaldo de Carvalho Raimundo

    2010-03-01

    Full Text Available El eritema multiforme, aparece como una enfermedad sistémica con la participación de la piel y las membranas mucosas en relación con varios factores como las infecciones bacterianas o virales, y en particular la administración de drogas, analgésicos y antibióticos en general. Se presenta un paciente masculino de 29 años de edad con eritema multiforme mayor desencadenado por antimicrobianos con la aparición de lesiones vesiculares-bulloso-ulcerosas en las regiones de los labios, encías, la lengua y la mucosa genital en tratamiento de una infección del tracto urinario con norfloxacino 400 mg por una semana. Fue realizado un tratamiento de soporte con el uso de colutorios para la higienización bucal y pomada a base de corticoide para protección de las úlceras, antihistamínicos y orientación nutricional de dieta líquida hipercalórica e hiperproteica. Este síndrome está caracterizado como un proceso eruptivo buloso agudo que compromete la calidad de vida del paciente y no hay pruebas de laboratorio específicas por lo que su diagnóstico debe estar basado en la revisión minuciosa de la anamnesis y en los hallazgos clínicos.

  3. Dos genios unidos por un alfabeto

    Directory of Open Access Journals (Sweden)

    Andrés Arias

    2016-12-01

    Full Text Available En 1953 el artista Sergio Trujillo Magnenat le pidió al arquitecto Victor Schmid que le hiciera una casa dónde vivir con su familia. La única condición que le puso fue que el diseño de la construcción nada tuviera que ver con el estilo suizo que ya identificaba las obras de Schmid. Le dijo que quería una casa de corte moderno, de líneas parecidas a las impuestas por el famoso Le Corbusier. Schmid ni lo pensó: de inmediato aceptó el reto y un año después entregó la obra (y toda su vida diría, medio en serio, medio en broma, que aquella casa le había quedado aun mejor y más bella que las hechas por el propio Le Corbusier, por cierto compatriota suyo. Allí vivieron durante décadas los Trujillo: el maestro, Sara (su esposa y sus hijos. La casa aún se mantiene en pie: ocupa una amplia esquina, en la calle 58 con carrera tercera, en el muy bogotano barrio de Chapinero. Es más, fue restaurada y bajo el nombre de Casa Trujillo es hoy un conjunto de apartamentos.

  4. Por un humor ético

    Directory of Open Access Journals (Sweden)

    Victor Paramo Valero

    2016-04-01

    Full Text Available Ética del humor es una obra original, abundantemente documentada, de contenido científico y filosófico, que aborda un problema de gran importancia en los actuales estudios de éticas aplicadas. La ética del humor es una nueva ética aplicada que pretende comprender el fenómeno del humor a la luz de sus implicaciones éticas. Como señala el autor, Juan Carlos Siurana, reputado experto en el ámbito de la filosofía práctica, el interés por el humor es un interés por la ética. En la obra no presenta una nueva teoría filosófica del humor –las cuales se han venido sucediendo, al menos, desde los Diálogos de Platón–, sino una nueva teoría ética, que toma al humor como objeto principal de análisis. Por tanto, la finalidad es realizar una aportación dentro del ámbito de la ética. Para ello se nutre de distintos estudios psicológicos, biológicos, fisiológicos y neurológicos sobre el humor, así como de clásicas obras de filosofía que han abordado esta cuestión.

  5. Intoxicación aguda por plaguicidas

    Directory of Open Access Journals (Sweden)

    Durán-Nah Jaime Jesús

    2000-01-01

    Full Text Available OBJETIVO: Describir la epidemiología de la intoxicación aguda por plaguicidas (IAP en el Hospital General O'Horán de Mérida, Yucatán, México. MATERIAL Y MÉTODOS: Se revisaron los expedientes de 33 pacientes superscript three 13 años, tratados en una unidad de cuidados intensivos (UCI, entre 1994 y 1998. Se recopilaron variables demográficas y clínicas relevantes, y se aplicó estadística descriptiva. RESULTADOS: En la población estudiada predominó el sexo masculino (82% del medio rural (70%, y la edad media fue de 34 ± 15.8 años. El intento de suicidio fue causa frecuente de IAP (79%, y en 33% de los casos la intoxicación se produjo por la utilización de organofosforados. La mortalidad fue de 12%. CONCLUSIONES: La IAP fue baja entre los sujetos del medio rural, por lo que los resultados de este estudio parecen no reflejar la realidad del problema. Es importante añadir que los plaguicidas son utilizados con relativa frecuencia para el intento de suicidio.

  6. ESTUDOS SOBRE A PSICOTERAPIA MEDIADA POR COMPUTADOR

    Directory of Open Access Journals (Sweden)

    AZEVEDO, B. B.

    2015-12-01

    Full Text Available Levando em consideração que o avanço tecnológico vem influindo em diversos setores, inclusive no campo da Psicologia, torna-se importante entender como tal inserção tem sido percebida pela sociedade. A mais atual regulamentação desenvolvida pelo Conselho Federal de Psicologia foi a Resolução 011 de junho de 2012. O Conselho determinou que são reconhecidos diferentes serviços psicológicos realizados por meios tecnológicos de comunicação, como as orientações psicológicas em até vinte encontros virtuais. O atendimento psicoterapêutico mediado por computador, por sua vez, apenas é permitido em caráter experimental. Um adendo que pode vir a somar a reflexão de tal forma de trabalho, é que alguns atendimentos realizados por Freud e Jung se deram através de textos. O presente trabalho objetiva refletir acerca da opinião de moradores da cidade de Campos dos Goytacazes, norte fluminense do Rio de Janeiro, sobre a questão dos serviços psicológicos mediados por computador. O trabalho iniciou-se com a elaboração de um questionário que foi aplicado a quarenta sujeitos, de ambos os gêneros, com formação superior completa e moradores de Campos, passando a uma análise quantitativa dos dados. Um levantamento bibliográfico embasou a pesquisa. Quase que a totalidade da amostra reconhece a relevância da Psicologia para a vida das pessoas. Seja pela pouca divulgação ou até pelo receio frente os rápidos avanços tecnológicos, concluiu-se haver uma certa resistência em relação a referida prática online. Em relação a análise acerca de ser possível ou não haver uma psicoterapia online, as respostas da amostra não foram homogêneas. Na questão que dizia respeito a percepção da confidencialidade de psicoterapias presenciais e de psicoterapias virtuais, sessenta por cento, ou seja, mais da metade, da amostra ainda percebe a psicoterapia presencial como a mais sigilosa. Isto permite a inferência sobre a predomin

  7. Empiric therapy for hospital-acquired, Gram-negative complicated intra-abdominal infection and complicated urinary tract infections: a systematic literature review of current and emerging treatment options.

    Science.gov (United States)

    Golan, Yoav

    2015-08-05

    Empiric therapy for healthcare-associated infections remains challenging, especially with the continued development of Gram-negative organisms producing extended-spectrum β-lactamases (ESBLs) and the threat of multi-drug-resistant organisms. Current treatment options for resistant Gram-negative infections include carbapenems, tigecycline, piperacillin-tazobactam, cefepime, ceftazidime, and two recently approved therapies, ceftolozane-tazobactam and ceftazidime-avibactam. This systematic literature review surveys the published clinical trial evidence available since 2000 in support of both current and emerging treatment options in the settings of complicated intra-abdominal infection (cIAI) and complicated urinary tract infection (cUTI). When available, clinical cure rates for patients with infections from ESBL-producing strains are provided, as is information about efficacy against Pseudomonas aeruginosa. Clinical trial evidence to guide selection of empiric antibiotic therapy in patients with complicated, hospital-acquired, Gram-negative IAIs and UTIs is limited. Though most of the clinical trials explored in this overview enrolled patients with complicated infections, often patients with severe infections and multiple comorbidities were excluded. Practitioners in the clinical setting who are treating patients with complicated, hospital-acquired, Gram-negative IAIs and UTIs need to consider the possibility of polymicrobial infections, antibiotic-resistant organisms, and/or severely ill patients with multiple comorbidities. There is a severe shortage of evidence-based research to guide the selection of empiric antibiotic therapy for many patients in this setting. New therapies recently approved or in late-stage development promise to expand the number of options available for empiric therapy of these hospital-acquired, Gram-negative infections.

  8. Ethnic influences on the relations between abdominal subcutaneous and visceral adiposity, liver fat, and cardiometabolic risk profile: the International Study of Prediction of Intra-Abdominal Adiposity and Its Relationship With Cardiometabolic Risk/Intra-Abdominal Adiposity.

    Science.gov (United States)

    Nazare, Julie-Anne; Smith, Jessica D; Borel, Anne-Laure; Haffner, Steven M; Balkau, Beverley; Ross, Robert; Massien, Christine; Alméras, Natalie; Després, Jean-Pierre

    2012-10-01

    Ethnic differences in cardiometabolic risk (CMR) may be related to patterns of ethnic-specific body fat distribution. We aimed to identify differences across ethnic groups in interrelations between BMI, abdominal adiposity, liver fat, and CMR profile. In the International Study of Prediction of Intra-Abdominal Adiposity and Its Relationship With Cardiometabolic Risk/Intra-Abdominal Adiposity, 297 physicians recruited 4504 patients (from 29 countries). In the current cross-sectional analyses, 2011 whites, 166 African Caribbean blacks, 381 Hispanics, 1192 East Asians, and 347 Southeast Asians were included. Computed tomography was used to assess abdominal fat distribution and to estimate liver fat content. Anthropometric variables and CMR profile were measured. Higher ranges of BMI were associated with higher levels of visceral [visceral adipose tissue (VAT)] and deep subcutaneous [deep subcutaneous adipose tissue (DSAT)] adiposity, with significant ethnic differences regarding the slope of these relations. Despite lower absolute BMI values, East Asians presented the largest accumulation of VAT but the lowest accumulation of DSAT with increasing adiposity. The association of BMI with liver fat did not differ between ethnic groups. Liver fat and DSAT were positively correlated with VAT with no ethnic variation. All ethnic groups had a similar association between a 1-SD increase in VAT, DSAT, or liver fat with hypertension, type 2 diabetes, hypertriglyceridemia, low HDL-cholesterol concentration, or high C-reactive protein concentration. Ethnicity significantly affects abdominal adiposity and liver fat partitioning, and East Asians have the most deleterious abdominal fat distribution. Irrespective of ethnicity, abdominal and hepatic fat depots are strongly interrelated and increased with obesity. Higher amounts of VAT or liver fat are associated with a more deteriorated CMR profile in all ethnic groups.

  9. Resistance Rates of Intra-Abdominal Isolates from Intensive Care Units and Non-Intensive Care Units in the United States: The Study for Monitoring Antimicrobial Resistance Trends 2010-2012.

    Science.gov (United States)

    Hackel, Meredith A; Badal, Robert E; Bouchillon, Samuel K; Biedenbach, Douglas J; Hoban, Daryl J

    2015-06-01

    Enterobacteriaceae (3,235 isolates), Pseudomonas aeruginosa (476 isolates), and Acinetobacter baumannii (106 isolates) from inpatient intra-abdominal infections (IAIs) were collected for the 2010-2012 Study for Monitoring Antimicrobial Resistance Trends (SMART) program in the United States. This report evaluates the in vitro activity of several antimicrobial agents recommended for treatment of IAIs and compares profiles of isolates from intensive care units (ICUs) and non-intensive care units (non-ICUs). Gram-negative bacilli from hospitalized patients with IAIs were obtained each year from 2010-2012 from hospitals in the United States and tested for susceptibility to 12 antibiotics according to 2012 Clinical and Laboratory Standards Institute (CLSI) guidelines. The most active agents against members of the Enterobacteriaceae family from both ICUs and non-ICUs were amikacin, ertapenem, and imipenem-cilastatin, whereas the least active agent was ampicillin-sulbactam. Amikacin was the only agent with good activity against P. aeruginosa, whereas none of the agents tested exhibited substantial activity against A. baumannii. Amikacin, ceftazidime, ceftriaxone, ciprofloxacin, levofloxacin, and imipenem-cilastatin were significantly less active against Enterobacteriaceae from ICU patients, whereas cefepime and ceftazidime were significantly less active against P. aeruginosa from ICU patients. Intensive care unit isolates were more likely to be multi-drug-resistant than non-ICU isolates, although there was no difference in extended-spectrum β-lactamase (ESBL) production rates between the two patient groups. Despite increasing resistance trends, in this study amikacin, ertapenem, and imipenem-cilastatin were shown to have good in vitro activity against the most frequently isolated gram-negative bacilli from IAIs in ICU and non-ICU settings.

  10. Structural Insights into the PorK and PorN Components of the Porphyromonas gingivalis Type IX Secretion System

    Science.gov (United States)

    Gorasia, Dhana G.; Veith, Paul D.; Hanssen, Eric G.; Glew, Michelle D.; Sato, Keiko; Yukitake, Hideharu; Nakayama, Koji; Reynolds, Eric C.

    2016-01-01

    The type IX secretion system (T9SS) has been recently discovered and is specific to Bacteroidetes species. Porphyromonas gingivalis, a keystone pathogen for periodontitis, utilizes the T9SS to transport many proteins including the gingipain virulence factors across the outer membrane and attach them to the cell surface via a sortase-like mechanism. At least 11 proteins have been identified as components of the T9SS including PorK, PorL, PorM, PorN and PorP, however the precise roles of most of these proteins have not been elucidated and the structural organization of these components is unknown. In this study, we purified PorK and PorN complexes from P. gingivalis and using electron microscopy we have shown that PorN and the PorK lipoprotein interact to form a 50 nm diameter ring-shaped structure containing approximately 32–36 subunits of each protein. The formation of these rings was dependent on both PorK and PorN, but was independent of PorL, PorM and PorP. PorL and PorM were found to form a separate stable complex. PorK and PorN were protected from proteinase K cleavage when present in undisrupted cells, but were rapidly degraded when the cells were lysed, which together with bioinformatic analyses suggests that these proteins are exposed in the periplasm and anchored to the outer membrane via the PorK lipid. Chemical cross-linking and mass spectrometry analyses confirmed the interaction between PorK and PorN and further revealed that they interact with the PG0189 outer membrane protein. Furthermore, we established that PorN was required for the stable expression of PorK, PorL and PorM. Collectively, these results suggest that the ring-shaped PorK/N complex may form part of the secretion channel of the T9SS. This is the first report showing the structural organization of any T9SS component. PMID:27509186

  11. Structural Insights into the PorK and PorN Components of the Porphyromonas gingivalis Type IX Secretion System.

    Science.gov (United States)

    Gorasia, Dhana G; Veith, Paul D; Hanssen, Eric G; Glew, Michelle D; Sato, Keiko; Yukitake, Hideharu; Nakayama, Koji; Reynolds, Eric C

    2016-08-01

    The type IX secretion system (T9SS) has been recently discovered and is specific to Bacteroidetes species. Porphyromonas gingivalis, a keystone pathogen for periodontitis, utilizes the T9SS to transport many proteins including the gingipain virulence factors across the outer membrane and attach them to the cell surface via a sortase-like mechanism. At least 11 proteins have been identified as components of the T9SS including PorK, PorL, PorM, PorN and PorP, however the precise roles of most of these proteins have not been elucidated and the structural organization of these components is unknown. In this study, we purified PorK and PorN complexes from P. gingivalis and using electron microscopy we have shown that PorN and the PorK lipoprotein interact to form a 50 nm diameter ring-shaped structure containing approximately 32-36 subunits of each protein. The formation of these rings was dependent on both PorK and PorN, but was independent of PorL, PorM and PorP. PorL and PorM were found to form a separate stable complex. PorK and PorN were protected from proteinase K cleavage when present in undisrupted cells, but were rapidly degraded when the cells were lysed, which together with bioinformatic analyses suggests that these proteins are exposed in the periplasm and anchored to the outer membrane via the PorK lipid. Chemical cross-linking and mass spectrometry analyses confirmed the interaction between PorK and PorN and further revealed that they interact with the PG0189 outer membrane protein. Furthermore, we established that PorN was required for the stable expression of PorK, PorL and PorM. Collectively, these results suggest that the ring-shaped PorK/N complex may form part of the secretion channel of the T9SS. This is the first report showing the structural organization of any T9SS component.

  12. Structural Insights into the PorK and PorN Components of the Porphyromonas gingivalis Type IX Secretion System.

    Directory of Open Access Journals (Sweden)

    Dhana G Gorasia

    2016-08-01

    Full Text Available The type IX secretion system (T9SS has been recently discovered and is specific to Bacteroidetes species. Porphyromonas gingivalis, a keystone pathogen for periodontitis, utilizes the T9SS to transport many proteins including the gingipain virulence factors across the outer membrane and attach them to the cell surface via a sortase-like mechanism. At least 11 proteins have been identified as components of the T9SS including PorK, PorL, PorM, PorN and PorP, however the precise roles of most of these proteins have not been elucidated and the structural organization of these components is unknown. In this study, we purified PorK and PorN complexes from P. gingivalis and using electron microscopy we have shown that PorN and the PorK lipoprotein interact to form a 50 nm diameter ring-shaped structure containing approximately 32-36 subunits of each protein. The formation of these rings was dependent on both PorK and PorN, but was independent of PorL, PorM and PorP. PorL and PorM were found to form a separate stable complex. PorK and PorN were protected from proteinase K cleavage when present in undisrupted cells, but were rapidly degraded when the cells were lysed, which together with bioinformatic analyses suggests that these proteins are exposed in the periplasm and anchored to the outer membrane via the PorK lipid. Chemical cross-linking and mass spectrometry analyses confirmed the interaction between PorK and PorN and further revealed that they interact with the PG0189 outer membrane protein. Furthermore, we established that PorN was required for the stable expression of PorK, PorL and PorM. Collectively, these results suggest that the ring-shaped PorK/N complex may form part of the secretion channel of the T9SS. This is the first report showing the structural organization of any T9SS component.

  13. Vasculitis inducida por metimazol: Reporte de caso

    Directory of Open Access Journals (Sweden)

    Miguel Pinto

    2011-07-01

    Full Text Available Se reporta el caso de una paciente con enfermedad de Graves, que presentó vasculitis asociada al uso de metimazol. Mujer de 14 años, que acudió a consulta por presentar intolerancia al calor, tremor distal y palpitaciones. El examen físico mostró bocio difuso, y el perfil tiroideo, TSH suprimida y hormonas tiroideas elevadas. Los anticuerpos antiperoxidasa tiroidea fueron positivos. Se inició tratamiento con metimazol y beta bloqueadores. Después de 20 días, la paciente regresó por presentar malestar general, fiebre, poliartralgia, lesiones cutáneas maculopapulares y edema de miembros inferiores. Los anticuerpos antinucleares fueron negativos y los anticuerpos anticitoplasma de los neutrófilos (ANCA, positivos. Se suspendió el metimazol y se inició prednisona. Después de 10 días de tratamiento, las molestias desaparecieron y la paciente recibió I 131.Las vasculitis asociadas al uso de tionamidas son poco frecuentes, no dependen de la dosis y están asociadas a la presencia de anticuerpos tipo ANCA. Clásicamente, afectan a los vasos pequeños de la piel; sin embargo, también pueden afectar los riñones y pulmones. El cuadro clínico se caracteriza por artralgias y mialgias. En algunos casos puede ocurrir insuficiencia renal de grado variable. En la mayoría de casos, el cuadro remite con la suspensión de la droga; pero, en algunos se requiere el uso de glucocorticoides o inmunosupresores.(Rev Med Hered 2011;22:147-150.

  14. Cefaleia por uso excessivo de medicamentos

    Directory of Open Access Journals (Sweden)

    Ariane Maria Fonseca MIRANDA

    2015-01-01

    Full Text Available Uma variante da cefaleia crônica diária, a cefaleia por uso excessivo de medicamentos é uma manifestação clínica de frequência ≥ 15 dias por mês, durante 3 meses. Possui um diagnóstico deficiente e um tratamento dividido em etapas, sendo a desintoxicação, a etapa de fundamental importância. Este artigo apresenta uma revisão sobre o tema, contribuindo para o esclarecimento das principais manifestações clínicas, principais teorias envolvendo sua fisiopatologia e a terapêutica farmacológica empregada. A metodologia utilizada foi uma revisão de publicações europeias e americanas, no período de 2001 a 2013, nos idiomas português, inglês e espanhol. Todos os medicamentos utilizados no tratamento sintomático das cefaleias são capazes de cronificar uma cefaleia preexistente, desde que sejam utilizados excessivamente, de forma regular e continuada. A suspensão de tais agentes terapêuticos resultará em melhoria na maioria dos pacientes, porém pode ser necessária a introdução de uma terapia de suporte de transição e/ou terapia profilática. Os tratamentos nao farmacológicos, quando associados ao farmacológico, ampliam a possibilidade de resultados satisfatórios, evitando recaídas.

  15. Diarrea recurrente por Cystoisopora belli en pacientes con infección por VIH con TARGA

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    Raúl Montalvo

    Full Text Available La Cystoisospora belli, antes denominada Isospora belli, es el agente etiológico de la cystoisosporiasis, una infección oportunista que afecta a pacientes inmunodeprimidos, caracterizada por diarrea crónica y pérdida ponderal. La incidencia de diarrea crónica por este agente, en pacientes infectados por el VIH, ha disminuido considerablemente. Ello gracias al advenimiento de la terapia antirretroviral de gran actividad (TARGA, con la que se ha logrado mejorar la respuesta inmunológica del paciente y disminuir su carga viral. Se presentan seis casos de cystoisosporiasis recurrente y refractaria en pacientes con infección por VIH, en quienes se diagnosticó cystoisosporiasis pese a que previamente se encontraban recibiendo profilaxis con trimetropin/sulfametoxazol (TMP/SMX. Cinco de ellos evolucionaron de manera tórpida y fallecieron, a pesar de una buena respuesta al TARGA (adecuado incremento de CD4 y disminución de la carga viral hasta rangos indetectables, y de tratamiento con TMP/SMX por vía oral y otros medicamentos de segunda línea.

  16. Toxicidad por óxido de etileno

    OpenAIRE

    Téllez M. Jairo A.

    1993-01-01

    El óxido de etileno, es un compuesto epóxido gaseoso, ampliamente utilizado en nuestro medio como agente esterilizante y de desinfección en instituciones hospitalarias. Los estudios realizados en varios países han demostrado efectos sobre la salud humana, caracterizados por  hipersensibilidad dérmica, irritación del tracto respiratorio, irritación ocular, excitación del S.N.C. y se asocia con presencia de abortos expontáneos, aberraciones cromosómicas e irritación crónica de laringe ...

  17. RUPTURA UTERINA ESPONTANEA POR PLACENTA PERCRETA

    OpenAIRE

    Bustos,Paola; Delgado, Jorge; Greibe,Daniella

    2003-01-01

    La rotura uterina en un útero sin cicatriz previa, y temprano en el tercer trimestre, es un evento raro. Se expone el caso clínico de una paciente que se presenta con abdomen agudo, cursando embarazo de aproximadamente 25 semanas, se realiza laparotomía exploradora encontrando hemoperitoneo, feto y placenta libres en la cavidad peritoneal y útero roto en el fondo invadido por la placenta, que compromete epiplón mayor. Se realiza histerectomía y se confirma el diagnóstico con biopsia

  18. Por uma arte no mundo da vida

    Directory of Open Access Journals (Sweden)

    Rachel Costa

    2016-12-01

    Full Text Available O artigo visa debater a análise colocada por Jacinto Lageira no texto “As razões do agir, contribuição a uma poética da ação”. O debate se estabelece no que concerne ao problema da autonomia da arte e suas consequências, tendo em vista a necessidade de pensar possibilidades contemporâneas para a experiência estética que pressuponham o mundo material. Isso é realizado a partir da teoria dos gestos do filósofo Vilém Flusser.

  19. CONTABILIDAD POR ÁREAS DE RESPONSABILIDAD

    OpenAIRE

    García, Natalia

    2014-01-01

    La notable evolución del mundo actual de los negocios ha obligado a las empresas a revisar constantemente sus técnicas de administración y de contabilidad. para que éstas aporten a sus directivos, elementos suficientes y oportunos para tomar decisiones. En México, desde hace un tiempo atrás, el Instituto Mexicano de Contadores Públicos A.C., recomienda a los contadores públicos y a los hombres de empres,as, el uso del sistema de Contabilidad por Áreas de Responsabilidad, que tiene como prop...

  20. Osteomielitis mandibular por actinomices: Reporte de caso

    OpenAIRE

    Moreno Villalobos, David; Facultad de Estomatología, Universidad Peruana Cayetano Heredia. Lima.; Paniura Rodríguez, Ditel; Facultad de Estomatología, Universidad Peruana Cayetano Heredia. Lima,; Huamaní Parra, Jaime; Facultad de Estomatología, Universidad Peruana Cayetano Heredia. Lima.; Barreto Almea, Ana; Facultad de Estomatología, Universidad Peruana Cayetano Heredia. Lima.

    2014-01-01

    Se reporta el caso de un paciente varón de 27 años con antecedente de exodoncia compleja de la tercera molar mandibular inferior derecha que presentaba una tumefacción circunscrita dolorosa en la región submandibular ipsilateral. En el estudio imaginológico, la radiografía panorámica presentaba un proceso osteolítico periapical e interradicular con un patrón osteogénico circundante por lo que se utilizó como complemento una tomografía cone beam, en donde se evidenció compromiso desde la rama ...

  1. Hipotiroidismo inducido por Amiodarona. Reporte de caso.

    OpenAIRE

    Salinas Arce, Jorge Luis; Instituto Nacional Cardiovascular (INCOR), EsSALUD. Lima. Servicio de Cardiología, Clínica El Golf. Lima.; Pinto Valdivia, Miguel; Servicio de Endocrinología, Hospital Nacional Cayetano Heredia. Lima, Perú. Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima.; Solórzano Altamirano, Paula; Servicio de Cardiología, Clínica El Golf. Lima.

    2012-01-01

    Se describe el caso de una mujer de 57 años de edad, con diagnóstico de síndrome de Wolf Parkinson White, en tratamiento con amiodarona 200 mg/día; que acudió por presentar palpitaciones, fatiga y aumento de sueño. Al examen físico no se encontró bocio, pero los reflejos osteotendinosos estaban prolongados. Los exámenes auxiliares mostraron TSH elevado, T4 libre disminuido y anticuerpos antiperoxidasa tiroidea negativos. Se suspendió la amiodarona y se inició levotiroxina. Después de dos mese...

  2. Pênfigo vegetante induzido por uso de enalapril

    OpenAIRE

    Adriano,André Ricardo; Gomes Neto,Antonio; Hamester,Gustavo R; Nunes,Daniel H; Di Giunta,Gabriella

    2011-01-01

    Pênfigo Vegetante foi primeiramente descrito como uma variante do pênfigo vulgar, em 1876, por Neumann. Em 1889, Hallopeau descreveu um paciente com pústulas e placas vegetantes, e sugeriu ser uma variante do Pênfigo Vegetante de Neumann. Ambos os tipos de pênfigo vegetante são caracterizados pelo desenvolvimento de placas vegetantes, especialmente, em dobras (axila, inguinal, perianal). Os autores apresentam e discutem um caso de Pênfigo Vegetante com uma clínica incomum, com ausência de aco...

  3. TELECENTROS COMUNITARIOS MANIZALES VISTOS POR SUS USUARIOS

    Directory of Open Access Journals (Sweden)

    JUlio César Meza Ramírez

    2015-09-01

    Full Text Available El artículo presenta un ejercicio de evaluación de los Telecentros Comunitarios de la ciudad de Manizales (Caldas, Colombia, con el fin de identificar la percepción que sobre ellos tienen sus usuarios. Para ello se encuestan a 597 usuarios que han cursado alguna de las capacitaciones ofrecidas por Manizales Vive Digital, que reflejan la alta aceptación del programa y su efecto positivo sobre el proceso de inclusión digital en la ciudad.

  4. Intoxicación ocupacional por mercurio

    OpenAIRE

    Augusto V. Ramírez

    2008-01-01

    El mercurio, metal pesado ampliamente utilizado por el hombre, es muy tóxico; produce daño al sistema nervioso central, perturbaciones del comportamiento y lesiones renales. Se acumula en todos los seres vivos y no es esencial para ningún proceso biológico. La toxicidad del mercurio está directamente relacionada con su estado químico. El metilmercurio es la forma más dañina, con efectos neurotóxicos en adultos y en fetos de madres expuestas. El mercurio metálico no es menos tóxico. Las sales ...

  5. Intoxicación aguda por plaguicidas

    OpenAIRE

    Durán-Nah Jaime Jesús; Collí-Quintal Julián

    2000-01-01

    OBJETIVO: Describir la epidemiología de la intoxicación aguda por plaguicidas (IAP) en el Hospital General O'Horán de Mérida, Yucatán, México. MATERIAL Y MÉTODOS: Se revisaron los expedientes de 33 pacientes superscript three 13 años, tratados en una unidad de cuidados intensivos (UCI), entre 1994 y 1998. Se recopilaron variables demográficas y clínicas relevantes, y se aplicó estadística descriptiva. RESULTADOS: En la población estudiada predominó el sexo masculino (82%) del medio rural (70%...

  6. Bacteremias por bacilos gram-negativos

    Directory of Open Access Journals (Sweden)

    Adrelírio J. R. Gonçalves

    1969-01-01

    Full Text Available São apresentados 31 casos de bacteremia por gram-negativos, assunto que vem merecendo muita atenção dos pesquisadores nos últimos anos. Os organismos etiológicos mais importantes que apareceram em igualdade de freqüência foram Escherichia coli e Klebsiella-Aerobacter, sendo responsáveis por 58% do total das infecções, seguidos por Pseudomonas. A porta de entrada mais freqüente foi o trato urinário em 61,3% dos casos. A infecção foi mais comum no sexo masculino e a faixa etária de 50 a 60 anos predominou. O uso prévio de antibióticos foi um fator predisponente muito importante, seguido pelo uso de esteróides e citostáticos. As principais doenças predisponentes foram diabetes mellitus e neoplasias malignas. Os principais fatores precipitantes foram a manipulação do aparelho urinário, com infecção prévia ou desencadeada, cirurgia do aparelho digestivo, uronatia obstrutiva e obstrução biliar. As principais manifestações clínicas foram a presença de febre, calafrios e hipotensão arterial. A complicação mais freqüente foi o choque bacteriano que incidiu em 58% dos casos, aproximadamente três vêzes aquela relatada na literatura. As outras foram a insuficiência renal aguda, superinfecção e infecção pulmonar metastática. Considerações terapêuticas gerais e esquemas de antibióticos são propostos para estes casos. A mortalidade da bacteremia simples foi de 30,7% e quando associada ao choque elevou-se para 72,2% . As infecções por Pseudomonas foram 100% fatais.

  7. Osteonecrosis de hueso maxilar inducida por bisfosfonatos

    OpenAIRE

    Vera Sempere, Francisco José

    2016-01-01

    Los bisfosfonatos son un grupo de fármacos, análogos de los pirofosfatos, utilizados en administración oral en el tratamiento de la osteoporosis, así como en formulaciones intravenosas para el tratamiento del dolor óseo y de la hipercalcemia ligada a la enfermedad tumoral metastasica (generalmente en el contexto de mieloma múltiple / cáncer de mama o próstata avanzados), actuando como un inhibidor de la reabsorción ósea, mediada por osteoclastos, así como de la apoptosis de los osteobl...

  8. Estenosis mitral por mixoma auricular izquierdo

    Directory of Open Access Journals (Sweden)

    Orlando D. Navarro

    2016-07-01

    Full Text Available Los tumores cardiacos representan el 0.2% y pueden ser primarios o metastásicos (secundarios, siendo estos últimos 20 a 40 veces más comunes que los primarios. De los tumores primarios, el 75% son benignos y aproximadamente el 50-85% de estos corresponden a mixomas, con una incidencia de 0.5-1 por 106 individuos por año. Se presenta el caso de un paciente de 56 años de edad, sin factores de riesgo cardiovascular ni antecedentes patológicos, con un mixoma auricular izquierdo de 4,6 × 4,5 cm, que prolapsaba hacia la válvula mitral en diástole provocando obstrucción intermitente de la misma y estenosis mitral severa. El diagnóstico se realizó mediante una ecocardiografía transtorácica, sin requerir de otras pruebas diagnósticas. Se realizó resección quirúrgica, lográndose la resección completa del tumor. La evolución posterior del paciente fue satisfactoria, siendo egresado a los 11 días de la intervención.

  9. Hipotiroidismo inducido por Amiodarona: Reporte de caso

    Directory of Open Access Journals (Sweden)

    Jorge Luis Salinas Arce

    2012-03-01

    Full Text Available Se describe el caso de una mujer de 57 años de edad, con diagnóstico de síndrome de Wolf Parkinson White, en tratamiento con amiodarona 200 mg/día; que acudió por presentar palpitaciones, fatiga y aumento de sueño. Al examen físico no se encontró bocio, pero los reflejos osteotendinosos estaban prolongados. Los exámenes auxiliares mostraron TSH elevado, T4 libre disminuido y anticuerpos antiperoxidasa tiroidea negativos. Se suspendió la amiodarona y se inició levotiroxina. Después de dos meses; los niveles de TSH y T4 libre eran normales y la paciente no presentaba molestias. La amiodarona está asociada a diversos efectos adversos que pueden limitar su uso. Entre estos efectos adversos, se describe el hipotiroidismo inducido, que se caracteriza por TSH elevado, T4 libre disminuido y síntomas inespecíficos como fatiga, intolerancia al frío y piel seca. El tratamiento de elección es la levotiroxina.

  10. Por um mundo de palavras vivas

    Directory of Open Access Journals (Sweden)

    Fernanda Cupolillo Miana de Faria

    2011-01-01

    Full Text Available

    O presente artigo pretende fazer uma reflexão, a partir de Gramsci e de Sartre, sobre como as práticas do intelectual e do jornalista, formados em um mesmo locus social, como “técnicos do saber prático”, distanciam-se em virtude dos diferentes compromissos assumidos socialmente. O artigo pretende expor, portanto, alguns dos motivos, a partir da prática do jornalista, que o levam a se afastar da noção de intelectual, embora, muitas vezes, ele reivindique esse status. Argumenta-se sobre como a incorporação da retórica da neutralidade pelos jornalistas, derivada do racionalismo de que a classe burguesa se tornou representante, constituiu um dos braços para a construção dos pressupostos jornalísticos da imparcialidade e da objetividade. Por fim, argumenta-se, a partir das revistas semanais de informação Época, Veja e Istoé, sobretudo nas reportagens de comportamento, sobre como essa retórica instaura uma falsa arena de discussão pluralista nesses semanários sustentada por uma visão naturalizadora das relações humanas, valores, práticas culturais e do próprio ser humano.   

  11. Meningitis neonatal por Neisseria meningitidis serogrupo B

    Directory of Open Access Journals (Sweden)

    Manuel Díaz Álvarez

    Full Text Available La meningitis meningocóccica es una infección poco frecuente en el período neonatal internacionalmente, y solo hay una publicación previa en la literatura médica cubana hace 25 años atrás, de recién nacidos con meningitis bacteriana causada por Neisseria meningitidis. Se presenta el caso de un recién nacido febril, con manifestaciones de toxicidad, fontanela abombada, y cuando se realizó punción lumbar, se encontró pleocitosis del líquido cefalorraquídeo y se aisló N. meningitidis serogrupo B, por lo que se diagnostica meningitis meningocóccica neonatal. Tuvo evolución favorable. Se describen algunas características de la infección meningocócica, y se destaca el diagnóstico y tratamiento recomendado para este tipo de infección, así como se hace referencia a reportes de casos publicados en la literatura internacional.

  12. Nodulose por Metotrexato Methotrexate Induced Nodulosis

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    Fernanda Guidolin

    2005-08-01

    Full Text Available A nodulose por metotrexato (MTX é um dos efeitos colaterais pouco conhecidos do uso desse medicamento em doses baixas. Embora classicamente descrita em casos de artrite reumatóide, tem aparecido, também, em outras doenças reumáticas. Descreve-se aqui um caso de nodulose por MTX em uma paciente com artrite reumatóide soropositiva, que utilizava esse medicamento há um ano, com bom controle do processo articular. Segue-se uma breve revisão sobre o assunto.Methotrexate-induced nodulosis is a rare side effect of this drug when it is used in low doses. Although classically described in rheumatoid arthritis patients, it may also appear in other rheumatic disorders. We describe a seropositive rheumatoid arthritis patient who developed methotrexate-induced nodulosis after using this drug for a year, with good control of articular symptoms. This case presentation is followed by a brief revision on the subject.

  13. Luchas por el control territorial en Colombia

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    Darío I. Restrepo

    2002-01-01

    Full Text Available La tesis central del artículo es que la concurrencia entre los impactos de la globalización, el proceso de descentralización y la crisis política debilitan gravemente el Estado-Nación, y particularmente tienden a romperse las bases mismas del centralismo polÌtico, administrativo y económico. Por otra parte, se exacerban las luchas locales por la apropiación de las riquezas materiales y el control de las instituciones. De esta manera, se acrecienta el poder de negociación política de las fuerzas locales frente al gobierno central, tanto respecto de las funciones descentralizadas como de aquellas que mantiene el Estado de manera centralizada. Neoliberales, reformadores políticos, clases políticas territoriales, nuevos movimientos sociales, narcotraficantes, guerrilleros y paramilitares se disputan abiertamente el poder local. Todos tienen una estrategia, o al menos un conjunto de intereses y prácticas respecto del proceso de descentralización, el cual en última instancia no puede ser entendido sino como el resultado de la complejidad de fuerzas que intervienen en él.

  14. (Mol. Stuntz por arrastre de vapor

    Directory of Open Access Journals (Sweden)

    Ximena Araneda

    2014-01-01

    Full Text Available El objetivo del presente estudio fue elaborar y evaluar jugo de maqui (Aristotelia chilensis(Mol. Stuntz, paraser considerado potencialmente como una bebida funcional de origen natural, sin aditivos químicos y mínimoprocesamiento, mediante la técnica de arrastre por vapor de tipo artesanal. Se utilizó fruto recolectado deforma manual en la Región de La Araucanía (Chile. Se elaboraron dos jugos concentrados, con azúcar y sinazúcar. Se realizaron análisis tales como: contenido de sólidos solubles, pH, acidez, contenido de humedad,materia seca (MS, cenizas totales, azúcares totales (AT, proteína cruda (PC, polifenoles totales (PFT ycarbohidratos totales (CHT, destacando el contenido de polifenoles para el jugo sin azúcar con 993,2 mg 100mL-1EAG y para el jugo con azúcar con 829,208 mg 100 mL-1EAG. Por lo tanto, la técnica permite extraerjugo de maqui con un mínimo procesamiento, presentando éste una alta concentración de polifenoles.

  15. Celulitis por Microascus trigonosporus(anamorfo Scopulariopsis trigonospora)

    National Research Council Canada - National Science Library

    DELIA CANLE CORTIÑAS; RICARDO FERNÁNDEZ RODRÍGUEZ; ANA CID LAMA; MARIA DOLORES DÍAZ LÓPEZ

    2013-01-01

    ... régimen de tratamiento para las infecciones por Scopulariopsis spp. Presentamos un caso excepcional de celulitis por Microascus trigonosporus en un paciente con tratamiento prolongado con corticoides. Abstract...

  16. Glaucoma bilateral por fechamento angular induzido por sulfametoxazol-trimetoprima: relato de caso

    OpenAIRE

    Spadoni,Viviane Souto; Pizzol,Melissa Manfroi Dal; Muniz,Carlos Henrique Gervini; Melamed,Jacobo; Fortes Filho,João Borges

    2007-01-01

    Sulfametoxazol e trimetoprima (cotrimoxazol) é uma combinação de drogas amplamente usada no tratamento e profilaxia de inúmeras infecções sistêmicas. Esta droga e outras derivadas da sulfa podem causar uma síndrome ocular rara caracterizada por efusão coroidal supracililar com miopização transitória e glaucoma por fechamento angular. A maioria dos autores atribui o glaucoma ao edema do corpo ciliar que leva ao deslocamento anterior do diafragma irido-cristaliniano causando fechamento do ângul...

  17. Glaucoma bilateral por fechamento angular induzido por sulfametoxazol-trimetoprima : relato de caso

    OpenAIRE

    Spadoni, Viviane Souto; Dal Pizzol, Melissa Manfroi; Muniz, Carlos Henrique; Melamed Cattan, Jacobo; Fortes Filho, João Borges

    2007-01-01

    Sulfametoxazol e trimetoprima (cotrimoxazol) é uma combinação de drogas amplamente usada no tratamento e profilaxia de inúmeras infecções sistêmicas. Esta droga e outras derivadas da sulfa podem causar uma síndrome ocular rara caracterizada por efusão coroidal supracililar com miopização transitória e glaucoma por fechamento angular. A maioria dos autores atribui o glaucoma ao edema do corpo ciliar que leva ao deslocamento anterior do diafragma irido-cristaliniano causando fechamento do ângul...

  18. Tema 6. Moldeo por compresión

    OpenAIRE

    Beltrán Rico, Maribel

    2011-01-01

    En este tema se describe la técnica de moldeo por compresión de termoestables y moldeo por transferencia, y se comparan estas técnicas frente al moldeo por inyección. Se explican las principales características de los materiales termoestables y su comportamiento durante el procesado. Para finalizar, se describen algunos equipos que se pueden utilizar para automatizar el moldeo por compresión.

  19. Servicio de referencia virtual por chat en bibliotecas universitarias

    OpenAIRE

    Borrell, Marina

    2008-01-01

    En este trabajo nos proponemos realizar un estudio sobre los servicios de referencia virtual por chat. Abordamos los distintos conceptos y su evolución a través del tiempo; analizamos los diferentes servicios ofrecidos por bibliotecas universitarias del mundo, y por último, planteamos una serie de recomendaciones para la implementación de un servicio de referencia virtual por chat en bibliotecas universitarias argentinas.

  20. Neutralizacion del efecto hemorragico inducido por veneno de Bothrops asper por extractos de plantas tropicales

    National Research Council Canada - National Science Library

    Castro, Oscar; Gutierrez, Jose Maria; Barrios, Mariano; Castro, Ian; Romero, Marjorie; Umana, Eduardo

    1999-01-01

    ... cuculmeca y Virola koschnyi. El analisis quimico de estos extractos permitio identificar catequinas, flavonas, antocianinas y taninos condensados, los cuales podrian jugar un papel en la inhibicion del efecto hemorragico debido a la capacidad de quelar el ion zinc requerido por las metaloproteinasas hemorragicas para su accion. Abstract: Organic extracts rep...

  1. Hepatitis autoinmune precedida por infección aguda por citomegalovirus en una mujer inmunocompetente

    Directory of Open Access Journals (Sweden)

    María Vares González

    2012-05-01

    Full Text Available El diagnóstico diferencial de las hepatitis es amplio y complejo, y con mucha frecuencia corresponde al médico internista filiar la etiología de la misma. De etiopatogenia no claramente establecida, lo que caracteriza a la hepatitis autoinmune (HAI es la pérdida de tolerancia inmune frente a los antígenos de los hepatocitos, conduciendo a la destrucción del parénquima hepático por linfocitos T autorreactivos. El papel de ciertos virus como factores favorecedores de la disregulación autoinmune ha sido propuesto previamente, en base a lo demostrado por los estudios de investigación y a la evidencia clínica. A continuación se expone un caso de HAI precedido por una infección aguda por CMV, lo que otorga al caso un interés particular, pues su incidencia es excepcional, existiendo sólo tres casos recogidos en la literatura (dos de ellos en pacientes sanos de 17 años, y otro en un varón inmunodeprimido trasplantado de médula ósea.

  2. Por qué las ciencias sociales son naturales, y por qué no pueden

    OpenAIRE

    Zamora Bonilla, Jesús Pedro

    2012-01-01

    En este artículo se argumenta que no existen diferencias ontológicas ni epistemológicas fundamentales entre las ciencias naturales y las ciencias sociales, aunque el ámbito de lo social es tan complejo e inestable que dificulta la emergencia (y por lo

  3. Batallas desde la cultura por la cultura

    Directory of Open Access Journals (Sweden)

    José Joaquín Flores Félix

    2012-11-01

    indígenas y afromexicanos. Así mismo, se creó un proceso de organización y lucha por los derechos de los pueblos que dejó sentadas las bases para procesos e instituciones nuevas, como la Coordinadora Regional de Autoridades Comunitarias (CRAC y su Sistema de Policía Comunitaria; la Universidad de los Pueblos del Sur (UNISUR Este ensayo narra la experiencia de UNISUR y su puesta en marcha como parte del sistema de universidades públicas, desde un modelo pedagógico intercultural. Esta iniciativa tiene como raíz una comunicación política ligada a la lucha de los pueblos indígenas y a la necesidad de contar con intelectuales propios. dígenas para fomentar la solidaridad y romper con los mecanismos mediáticos de reproducción del racismo.

  4. Diseño curricular por competencias

    OpenAIRE

    Candreva, Anna; Susacasa, Sandra

    2009-01-01

    En el marco de la Jornada de Educación Médica, realizada en la Facultad de Ciencias Médicas de la UNLP, el 29 de junio próximo pasado, se desarrolló el Taller de DISEÑO CURRICULAR POR COMPETENCIAS con la participación de docentes de distintas cátedras de la carrera de Medicina. En la introducción del taller se expuso el marco teórico de esta cuestión tan significativa para la Educación Médica. Se presentaron los aportes de la Pedagogía Médica con el objetivo de instalar el...

  5. Herida por arma de fuego Gunshot wounds

    OpenAIRE

    A. Sibón Olano; P. Martínez-García; E. Santiago Romero

    2003-01-01

    En el examen de las heridas por arma de fuego, hay que prestar especial interés al orifico de entrada. Un examen minucioso del mismo, nos permitirá conocer la distancia a la que se ha efectuado el disparo; así mismo, nos orientará sobe la trayectoria y etiología médico-legal. El tipo de arma puede modificar en alguna medida el orificio de entrada en los disparos a cañón tocante; como ocurre en las armas de dos cañones, en las que tiene situada su mira en la boca del cañón, o en las que están ...

  6. Toxicidad por óxido de etileno

    Directory of Open Access Journals (Sweden)

    Téllez M. Jairo A.

    1993-08-01

    Full Text Available

    El óxido de etileno, es un compuesto epóxido gaseoso, ampliamente utilizado en nuestro medio como agente esterilizante y de desinfección en instituciones hospitalarias. Los estudios realizados en varios países han demostrado efectos sobre la salud humana, caracterizados por  hipersensibilidad dérmica, irritación del tracto respiratorio, irritación ocular, excitación del S.N.C. y se asocia con presencia de abortos expontáneos, aberraciones cromosómicas e irritación crónica de laringe y tráquea en personal expuesto ocupacionalmente.

  7. CSCW-TRABALHO COOPERATIVO SUPORTADO POR COMPUTADOR

    Directory of Open Access Journals (Sweden)

    Eulina X. Botelho

    2007-12-01

    Full Text Available Neste artigo iremos tratar da área da computação que se preocupa com a evolução rápida da informação e dos potenciais novos para uma comunicação entre povos. Os aspectos chaves são a disponibilidade aumentada de redes de computador e a tendência para o trabalho cooperativo. Uma ênfase principal para sistemas aplicados na sustentação do computador para o trabalho da equipe. As atividades nesse domínio são sabidas pelas noções do groupware ou do trabalho cooperativo suportado por computador (CSCW. Palavras-chave: colaboração, cooperação, cscw, groupware.

  8. fluidizado por proceso autotérmico

    Directory of Open Access Journals (Sweden)

    ZULAMITA ZAPATA BENABITHE

    2005-01-01

    Full Text Available El presente trabajo se basa en el estudio de la producción de carbón activado a partir de carbón mineral subbituminoso en un reactor de lecho fluidizado por proceso autotérmico. El carbón utilizado provino de la región de Amagá (Antioquia - Colombia y fue activado en dos reactores de lecho fluidizado de diferente diámetro interno, 10 cm y 22 cm. Los valores del área superficial específica y el volumen de poro de las muestras activadas fueron determinados a partir de las isotermas de N2 y CO2. Los resultados experimentales mostraron que los valores de áreas superficiales BET y DR y del Índice de Yodo se encontraron alrededor de 460 m2/g (SBET, 490 m2/g (SDR y 460 mg I2/g carbón.

  9. Pneumonia por "Pneumocystis carinii": forma tumoral

    Directory of Open Access Journals (Sweden)

    BARRA LUIZ ALBERTO COSTA

    2000-01-01

    Full Text Available A pneumocistose é uma infecção oportunística freqüente em imunodeprimidos, principalmente naqueles com a síndrome da imunodeficiência adquirida (AIDS. Relata-se o caso de um paciente com quadro insidioso de febre, tosse e emagrecimento. Na radiografia de tórax observou-se imagem tumoral em seio costofrênico direito. Iniciou-se uso de prova terapêutica para tuberculose com rifampicina, isoniazida e pirazinamida (esquema I, sem resolução. Posteriormente, foi realizada biópsia pulmonar "a céu aberto" e o estudo histopatológico revelou pneumonia por Pneumocystis carinii. Houve melhora clínica e radiológica após o início do tratamento específico.

  10. La Violencia Latinoamericana vista por los Economistas

    Directory of Open Access Journals (Sweden)

    Salama Pierre

    2003-08-01

    Full Text Available

    Salama, Pierre. "La Violencia Lationoamericana vista por los Economistas", Cuadernos de Economía, V. XXII, n. 38, Bogotá, 2003 páginas 179-198.

    Este articulo sintetiza los estudios económicos publicados recientemente sobre la violencia en América Latina y analiza las causas suceptibles a acrecentarla: pobreza, desigualdad de los ingresos en nivel y variación, impunidad, diferencia entre la probabilidad de ser arrestado y la severidad de la pena impuesta, y narcotrafico. Sin embargo, la explicación de la violencia no se limitará a los factores económicos, puesto que el autor privilegia un enfoque inspirado en la antropología y la sociología.

  11. Síndrome cerebeloso por amiodarona

    Directory of Open Access Journals (Sweden)

    Neuda S. Garretto

    1994-12-01

    Full Text Available La amiodarona (AMD es una droga antiarritmica cuyos efectos adversos pueden comprometer el sistema nervioso central y periferico. La aparición de un síndrome cerebeloso es infrecuente. Se presenta un paciente masculino de 56 anos de edad que desarolla un síndrome pancerebeloso de 4 meses de evolución, que revierte luego de la suspension de la AMD. El cuadro reaparece meses mas tarde luego de un periodo de automedicacion con la droga. Los mecanismos tóxicos por los cuales la AMD afecta al cerebelo permanecen inciertos. Esta droga de amplia difusión en nuestro medio, como otros antiarritmicos, posee efectos sobre el sistema nervioso que deben ser tenidos en cuenta a fin de poder detectarlos precozmente.

  12. REDE MESH ALIMENTADA POR ENERGIA SOLAR

    OpenAIRE

    Saraiva, Carlos Vinicio Araujo; Centro Universitario de Belo Horizonte (UNI BH); Dutra, Fábio de Souza; Centro Universitario de Belo Horizonte (UNI BH); Albuquerque, Sílvia Calmon de; Centro Universitario de Belo Horizonte (UNI BH)

    2012-01-01

    Este trabalho apresenta um sistema autônomo de comunicação sem fio alimentada por energia solar fotovoltaica. Este sistema permite o acesso à Internet sem fio para dispositivos móveis em áreas ao ar livre. Tem como vantagens: a eliminação da infraestrutura de cabos elétricos para a instalação, a redução de custos com o projeto da rede sem fio, mão-de-obra para instalação elétrica e do próprio custo da eletricidade, devido a utilização de energia solar renovável.

  13. Distensión abdominal y edemas por quiste del cordón espermático Abdomina distention and edema due to spermatic cord cyst

    Directory of Open Access Journals (Sweden)

    Guillermo A. Keller

    2006-04-01

    Full Text Available La distensión abdominal es un síntoma común, siendo en general la presentación inicial de enfermedades sistémicas o desórdenes gastrointestinales. Otras causas son infrecuentes. Los quistes del cordón espermático son poco frecuentes, pero aún más su ubicación intraabdominal, su tamaño habitual es insuficiente para producir distensión. El paciente presentado en este caso es un varón con criptorquidia bilateral admitido por distensión abdominal, interpretada inicialmente como síndrome ascítico edematoso. La ecografía interpretó la distensión como ascitis tabicada, y la tomografía computada como debida a un gran quiste. En la exploración quirúrgica se diagnosticó un quiste gigante del cordón espermático de ubicación abdominal.Abdominal distention is a frequent symptom, being often the initial presentation of systemic diseases or gastrointestinal disorders. Other causes are uncommon. Spermatic cord cysts are infrequent, abdominal location is even rarer, and the size of the cysts is usually not enough to produce abdominal distention. In our case a man with bilateral cryptorchidism was admitted with abdominal distention and edema of the lower extremities initially interpreted as ascitic-edematous syndrome. Ultrasonography interpreted abdominal distention as septate ascites, computed tomography as a giant cyst. Exploratory surgery showed a giant spermatic cord cyst in the left spermatic cord.

  14. Consensus conference definitions and recommendations on intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS)--the long road to the final publications, how did we get there?

    Science.gov (United States)

    Malbrain, M L N G; De laet, I; Cheatham, M

    2007-01-01

    There has been an exponentially increasing interest in intraabdominal hypertension (IAH) and the abdominal compartment syndrome (ACS) over the last decade, and different definitions have been suggested. Nevertheless, there has been an impetus from experts in the field to modify these definitions to reflect our current understanding of the pathophysiology of these syndromes. An international multidisciplinary group of interested doctors met with the goal of agreeing on a set of definitions that could be applied to patients with IAH and ACS. The goal of this consensus group was to provide a conceptual and practical framework to further define ACS, a progressive injurious process that falls under the generalized term 'IAH' and that includes IAH-associated organ dysfunction. In total, 21 North American, Australasian and European surgical, trauma and critical care specialists agreed to standardize the current definitions for IAH, ACS and related conditions in preparation for the second World Congress on Abdominal Compartment Syndrome (WCACS). The WCACS-meeting was endorsed by the European Society of Intensive Care Medicine (ESICM) and the World Society on Abdominal Compartment Syndrome (WSACS). The consensus conference (Noosa, Australia; December 7, 2004) was attended by 21 specialists from Europe, Australasia and North America and approximately 70 other congress participants. In advance of the conference, a blueprint for the various definitions was suggested. After the conference the participants corresponded electronically with feedback. A writing committee was formed at the conference and developed the final manuscript based on executive summary documents generated by each participant. The final report of the 2004 International ACS Consensus Definitions Conference has recently been published. This article will describe the long road towards this final publication with the evolution of the different definitions and recommendations from the initial suggestions in 2004

  15. Consensus conference definitions and recommendations on intra-abdominal hypertension (iah) and the abdominal compartment syndrome (acs) - the long road to the final publications, how did we get there?

    Science.gov (United States)

    Malbrain, M L N G; De Laet, I; Cheatham, M

    2007-01-01

    There has been an exponentially increasing interest in intraabdominal hypertension (IAH) and the abdominal compartment syndrome (ACS) over the last decade, and different definitions have been suggested. Nevertheless, there has been an impetus from experts in the field to modify these definitions to reflect our current understanding of the pathophysiology of these syndromes. An international multidisciplinary group of interested doctors met with the goal of agreeing on a set of definitions that could be applied to patients with IAH and ACS. The goal of this consensus group was to provide a conceptual and practical framework to further define ACS, a progressive injurious process that falls under the generalized term 'IAH' and that includes IAH-associated organ dysfunction. In total, 21 North American, Australasian and European surgical, trauma and critical care specialists agreed to standardize the current definitions for IAH, ACS and related conditions in preparation for the second World Congress on Abdominal Compartment Syndrome (WCACS). The WCACS-meeting was endorsed by the European Society of Intensive Care Medicine (ESICM) and the World Society on Abdominal Compartment Syndrome (WSACS). The consensus conference (Noosa, Australia; December 7, 2004) was attended by 21 specialists from Europe, Australasia and North America and approximately 70 other congress participants. In advance of the conference, a blueprint for the various definitions was suggested. After the conference the participants corresponded electronically with feedback. A writing committee was formed at the conference and developed the final manuscript based on executive summary documents generated by each participant. The final report of the 2004 International ACS Consensus Definitions Conference has recently been published. This article will describe the long road towards this final publication with the evolution of the different definitions and recommendations from the initial suggestions in 2004

  16. Condición física, adiposidad y autoconcepto en adolescentes. Estudio piloto

    Directory of Open Access Journals (Sweden)

    Alejandro Garc\\u00EDa-S\\u00E1nchez

    2013-01-01

    Full Text Available Un alto índice de masa corporal y una baja capacidad aeróbica se asocia con un peor autoconcepto. Se ha observado también que personas obesas pero con buena forma física están físicamente sanos, fenómeno conocido como “fat but fit”. El presente estudio pretende: 1 determinar la relación entre cantidad de grasa corporal y principales componentes de la condición física con el autoconcepto en adolescentes; 2 testar si el fenómeno fat but fit se asocia con un mejor autoconcepto. Un total de 69 adolescentes (14.68 ± 1.36 años participaron en la evaluación de la composición corporal y la condición física (Batería ALPHA-Fitness. La capacidad aeróbica (forma vs. no en forma e índice de masa corporal (normo-peso vs. sobrepeso-obesidad fueron categorizadas usando criterios estándar. Cinco dimensiones del autoconcepto fueron evaluadas mediante el Cuestionario de Autoconcepto Forma 5. La grasa total y central se correlacionó negativamente con el autoconcepto físico, mientras que la condición física (fuerza, velocidad-agilidad y capacidad aeróbica se correlacionó positivamente (p .3. Los resultados confirman la paradoja fat but fit, el sobrepeso se asocia a un peor autoconcepto físico, pero si se tiene una buena forma física los valores de autoconcepto se igualan a los de los adolescentes con normo-peso.

  17. Condición física, adiposidad y autoconcepto en adolescentes. Estudio piloto

    OpenAIRE

    Alejandro Garc\\u00EDa-S\\u00E1nchez; Rafael Burgue\\u00F1o-Menjibar; David L\\u00F3pez-Blanco; Ortega, Francisco B

    2013-01-01

    Un alto índice de masa corporal y una baja capacidad aeróbica se asocia con un peor autoconcepto. Se ha observado también que personas obesas pero con buena forma física están físicamente sanos, fenómeno conocido como “fat but fit”. El presente estudio pretende: 1) determinar la relación entre cantidad de grasa corporal y principales componentes de la condición física con el autoconcepto en adolescentes; 2) testar si el fenómeno fat but fit se asocia con un mejor autoconcepto. Un total de 69 ...

  18. La enseñanza por competencias

    Directory of Open Access Journals (Sweden)

    Carolina España Chavarría

    2009-02-01

    Full Text Available La enseñanza por competencias, de manera semejante con el conjunto de actividades académicas que realizan los centros de educación superior, poseen una compleja estructura de atributos, tales como: conocimientos, actitudes, valores y habilidades. Bajo estas consideraciones, entendemos que los docentes de las universidades deberían de orientar entre otras, sus preocupaciones académicas, para impulsar el cambio de enfoque educativo que viabilice la construcción de puentes, para modificar favorablemente el desfase existente entre lo que demanda el sector productivo y la práctica cotidiana en los salones de clase de las universidades. Las universidades como entes responsables de la formación profesional de los(as ciudadanos(as de la sociedad, deben velar por coadyuvar a insertar al mercado laboral a sus graduados con una mentalidad flexible, dinámica, creativos, y con visión de futuros conocedores de las realidades de mercado, con una formación integral, plurifuncionales y versados en las herramientas tecnológicas de punta, con el propósito que sean competentes en sus labores específicas. Abstract Teaching through competencies as well as the academic activities carried out in universities, has complex structures as attributes such as: knowledge, values, and abilities. Based on this consideration, we understand that university professors should guide their academic interest towards a change on the teaching approach, allowing the building of bridges that can positively modify the existing gap between the demands of the productive sector on the current practice in the university classroom. The Universities are responsible for the professional education of the members of society and should watch over to help introduce graduates in the labor market. These graduates should characterized by a flexible, dynamic, and creative mind, capable of future projections, as acquainted with the characteristics of the real market, with a well rounded

  19. Autoagresión por quemaduras

    Directory of Open Access Journals (Sweden)

    Iris Montes de Oca

    1996-04-01

    Full Text Available Se realizó un estudio epidemiológico transversal en los casos de autoagresión por quemaduras, que acudieron al Cuerpo de Guardia del Servicio de Quemados del Hospital "Dr. Ernesto Guevara de la Serna", durante el período comprendido entre los meses de febrero de 1993 y febrero de 1994, con la finalidad de determinar el comportamiento de algunas variables de interés en estos casos. El universo de estudio lo constituyeron 57 casos, cuya información se recolectó de la gráfica general del paciente quemado (Modelo 71-05 y de los registros estadísticos del Servicio de Quemados del Hospital. Como fundamentales resultados y conclusiones se obtienen las siguientes: la mayor frecuencia de casos se encontró en las edades comprendidas entre 15 y 24 años; el sexo femenino resultó ser el más afectado en todos los grupos de edades. La cocina fue el lugar donde se efectuó el acto con mayor frecuencia. Se encontró un alto grado de asociación entre la supervivencia y la presencia de antecedentes de intentos suicidas. Presentaron la mayor incidencia por municipios los de Puerto Padre y Jobabo; el alcohol y el kerosene fueron los agentes causales más utilizados. En la casuística predominaron los grandes quemados.A transversal epidemiological study of the cases of self-aggression by burns, who received medical attention at the Emergency Department of the Burns Service of the "Dr. Ernesto Guevara de la Serna" Hospital from February, 1993 to February, 1994, was carried out aimed at determining the behaviour of some variables of interest in these cases. Fifty seven cases were studied and the information was collected from the general graph of the burn patient (Model 71-05, and from the statistical records of the Burns Service of the hospital. The main results and conclusions reached are the following: the highest frequency of cases was found in ages between 15 and 24; women were the most affected in all age groups; and kitchen was the place where the

  20. Consumo Voluntario de Forraje por Rumiantes en Pastoreo Consumo Voluntario de Forraje por Rumiantes en Pastoreo

    Directory of Open Access Journals (Sweden)

    José Mejía Haro

    2012-02-01

    Full Text Available The variation in voluntary forage intake is undoubtedly the major dietary factor determining level and efficiency of ruminant production. This variation is bigger and least predictable for grazing ruminants. Range ruminant productivity and efficiency is relatively low due, partly, to intake limitations; productivity could probably be increased most by increasing intake. Distension of the reticulo-rumen wall is the primary intake regulation mechanism of low-quality roughages in range ruminants, digestibility and rate of ingest passage also affect voluntary intake. Body size and metabolic bodysize as well affect intake of grazing animals. Kind and amount of supplementation, forage availability, and grazing intensity have been related to voluntary forage intake. La variación en el consumo voluntario de forraje es indudablemente el principal factor dietario que determina el nivel y eficiencia de producción en un rumiante. Esta variación es mayor y muy difícil de predecir bajo condiciones de pastoreo. La productividad y eficiencia de rumiantes en pastoreo es relativamente baja debido, en parte, a las limitaciones en el consumo; la productividad probablemente se podrá incrementar si se incrementa el consumo. La distensión de la pared del rumenretículo es el principal mecanismo de regulación del consumo de forrajes de baja calidad en rumiantes en pastoreo, aunque la digestibilidad y la tasa de pasaje también afectan el consumo voluntario. Igualmente, el consumo se ve afectado por el tamaño corporal y peso metabólico del animal, por la cantidad y tipo de suplemento ofrecido, por la disponibilidad de forraje y por la intensidad del pastoreo.