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Sample records for adiposidad intraabdominal por

  1. Adiposidad, resistencia a la insulina y dislipidemia

    Directory of Open Access Journals (Sweden)

    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.

  2. Adiposidad total y distribución segmentaria en niños toba y wichi

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    Mendez, Marta Graciela

    2005-01-01

    Full Text Available El período más crítico en la ontogenia humana es el de la infancia y aún quedan importantes interrogantes sobre si los cambios del desarrollo en adiposidad y composición corporal son los rasgos más importantes de la ontogenia funcional. La cantidad total de adiposidad es ecosensible no obstante su patrón de distribución se mantiene como característica individual y muestra gran influencia genética. Debido a que gran parte de la grasa corporal es subcutánea, su evaluación puede dar información valiosa sobre la cantidad total o porcentaje. Es más específica que el peso y, dado que su distribución varía regionalmente, es importante su medición tanto en el tronco como en las extremidades. En el presente trabajo se analiza la composición corporal y se evalúa la adiposidad corporal segmentaria en una muestra constituida por 127 niños de las etnias Toba y Wichi. Las variables relevadas fueron Peso, Estatura, Pliegue subescapular y Pliegue tricipital a partir de los cuales se calcularon el Índice de Masa Corporal y el Índice de Centralidad que representa la acumulación de grasa en el tronco y las extremidades. Los valores individuales fueron agrupados por edad y sexo, obteniéndose media y desvío estándar de cada índice para cada edad y por sexo. Se encuentra que en ambas etnias la adiposidad total varía con la edad y muestra dimorfismo sexual. También en ambas etnias hay un mayor grado de adiposidad en el sexo femenino. El análisis de la distribución corporal da cuenta del predominio de adiposidad en el tronco en el sexo femenino y en las extremidades en el sexo masculino.

  3. Índice de adiposidad corporal como predictor de obesidad y de síndrome metabólico en adultos de Bogotá, Colombia

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    González-Ruíz, Katherine; Ramírez-Vélez, Robinson; Correa Bautista, Jorge Enrique

    2015-01-01

    Recientemente, Bergman et al. desarrollaron el índice de adiposidad corporal (IAC), como un marcador de obesidad por exceso de grasa corporal en la práctica clínica. En este estudio se evaluó la validez del IAC como marcador de obesidad por exceso de adiposidad, además de examinar la capacidad predictiva del IAC con componentes e índices metabólicos asociados al SM en adultos de Bogotá, Colombia. Convocatoria FODEIN-USTA 2014 Nº 2013004

  4. 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

  5. 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

  6. 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...

  7. [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.

  8. 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

  9. [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...

  10. 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.

  11. 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.)

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

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    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.

  13. A focus on intra-abdominal infections

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    Sartelli Massimo

    2010-03-01

    Full Text Available Abstract Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with poor prognosis, particularly in higher risk patients. Well defined evidence-based recommendations for intra-abdominal infections treatment are partially lacking because of the limited number of randomized-controlled trials. Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection. Early prognostic evaluation of complicated intra-abdominal infections is important to select high-risk patients for more aggressive therapeutic procedures. The cornerstones in the management of complicated intra-abdominal infections are both source control and antibiotic therapy. The timing and the adequacy of source control are the most important issues in the management of intra-abdominal infections, because inadequate and late control of septic source may have a negative effect on the outcomes. Recent advances in interventional and more aggressive techniques could significantly decrease the morbidity and mortality of physiologically severe complicated intra-abdominal infections, even if these are still being debated and are yet not validated by limited prospective trials. Empiric antimicrobial therapy is nevertheless important in the overall management of intra-abdominal infections. Inappropriate antibiotic therapy may result in poor patient outcomes and in the appearance of bacterial resistance. Antimicrobial management is generally standardised and many regimens, either with monotherapy or combination therapy, have proven their efficacy. Routine coverage especially against Enterococci and candida spp is not always recommended, but can be useful in particular clinical conditions. A de escalation approach may be recommended in patients with specific risk factors for multidrug

  14. 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.

  15. 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

    OpenAIRE

    Hiara Miguel Stanciola Serrano; Gisele Queiroz Carvalho; Patrícia Feliciano Pereira; Maria do Carmo Gouveia Peluzio; Sylvia do Carmo Castro Franceschini; Silvia Eloiza Priore

    2010-01-01

    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 de...

  16. 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

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    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

  17. 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

  18. Intra-abdominal gout mimicking pelvic abscess

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    Chen, Chia-Hui; Chen, Clement Kuen-Huang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan); National Yang-Ming University, School of Medicine, Taipei (Taiwan); Yeh, Lee-Ren; Pan, Huay-Ban; Yang, Chien-Fang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan)

    2005-04-01

    Gout is the most common crystal-induced arthritis. Gouty tophi typically deposit in the extremities, especially toes and fingers. We present an unusual case of intrapelvic tophaceous gout in a patient suffering from chronic gouty arthritis. CT and MRI of the abdomen and pelvic cavity disclosed calcified gouty tophi around both hips, and a cystic lesion with peripheral enhancement in the pelvic cavity along the course of the iliopsoas muscle. The intra-abdominal tophus mimicked pelvic abscess. (orig.)

  19. Asociación del polimorfismo 3'UTR+62G>A en resistina con resistencia a la insulina, adiposidad y el índice adiponectina-resistina en población mexicana

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    Efraín Chavarria-Ávila

    2013-12-01

    Full Text Available Introducción: La resistencia a la insulina (RI se caracteriza por susceptibilidad genética, incremento en la adiposidad y distribución irregular de grasa corporal, con alteración en la producción de adipocinas. Objetivo: Investigar la asociación del polimorfismo 3'UTR+62G>A en resistina con RI, índice adiponectina-resistina (ARindex, adiposidad y marcadores inmuno-metabólicos. Métodos: En un estudio transversal a 260 mestizos-mexicanos, clasificados con peso normal, exceso de peso, sin y con RI, se les evaluó: composición corporal, distribución de masa grasa y marcadores inmuno-metabólicos. Los alelos del polimorfismo 3'UTR+62G>A en resistina se identificaron por PCR-RFLP. La concentración sérica de insulina, adiponectina total y resistina se midieron por la técnica de ELISA. Resultados: Las frecuencias del alelo +62G para los individuos con peso normal y exceso de peso, fueron (95.4% y 98.4%, respectivamente P= 0.0343. Los portadores del genotipo GA con peso normal mostraron valores menores del ARindex, adiposidad y marcadores inmuno-metabólicos comparados con los portadores del genotipo GG. Se observó diferencia entre los individuos sin y con RI en el ARindex (P = 0.002, concentración sérica de adiponectina (P = 0.002 y resistina (P = 0.033: 1.102 ± 0.03, 5.167 ± 0.36 μg/mL y 8.827 ± 0.42 ng/mL versus 1.336 ± 0.07, 3.577 ± 0.34 μg/mL y 10.480 ± 0.65 ng/mL, respectivamente. Los marcadores inmuno-metabólicos, reserva y distribución de grasa corporal correlacionan con ARindex 0.262 a 0.414, P A en los individuos mestizos-mexicanos con exceso de peso. El alelo +62A se asoció con incremento de adiponectina total, valores menores del ARindex, concentración de resistina, marcadores metabólicos y reserva de grasa corporal. El ARindex puede ser un indicador temprano de RI.

  20. Índice general de fuerza y adiposidad como medida de la condición física relacionada con la salud en niños y adolescentes de Bogotá, Colombia: estudio FUPRECOL

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    Javier Darío Pacheco-Herrera

    Full Text Available Objetivo: el presente estudio tuvo por objetivos: a determinar los valores de referencia de la condición muscular mediante el índice general de fuerza (IGF; y b estudiar si el IGF está asociado con indicadores de adiposidad en niños y adolescentes escolares de Bogotá, Colombia. Métodos: del total de 7.268 niños y adolescentes (9-17,9 años evaluados en el estudio FUPRECOL, 4.139 (57% fueron mujeres. Se evaluó el IGF como marcador del desempeño muscular a partir de la tipificación de las pruebas de fuerza prensil (FP y salto de longitud (SL. El IGF se recodificó en cuartiles (Q, siendo el Q4 la posición con mejor valor del IGF. El índice de masa corporal (IMC, la circunferencia de cintura (CC, el índice cintura/talla (ICT y el porcentaje de grasa corporal (% GC por bioimpedancia eléctrica se midieron como marcadores de adiposidad. Resultados: la edad media de los evaluados fue 12,8 ± 2,3 años. Se aprecia una tendencia hacia un incremento del nivel de condición física muscular en los varones conforme aumenta la edad, y hacia la estabilidad o un ligero aumento en el caso de las mujeres. El IGF se relacionó inversamente con el ICT y % GC en los varones (r = -0,280, r = -0,327, p < 0,01, respectivamente. Los escolares ubicados en el Q4 del IGF presentaron menores valores en marcadores de adiposidad IMC, CC, ICT y % GC, p < 0,01, que su contraparte del Q1. Conclusión: se presentan valores de referencia del IGF a partir de la estandarización de los resultados obtenidos en la FP y SL. La evaluación de la fuerza muscular en edades tempranas permitirá implementar programas de prevención de riesgo cardiovascular y metabólico futuro.

  1. 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

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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.FUNDAMENTO: Adolescentes con exceso de adiposidad y eutr

  2. Laparoscopy and Intra-Abdominal Sepsis

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    Coyne

    2015-06-01

    Full Text Available Context Intra-abdominal sepsis has significant morbidity and mortality. In the developed world, there are many common causes originating from the lower gastrointestinal tract including diverticular disease, appendicitis, perforated cancers, and inflammatory bowel disease. It has a high cost and is associated with high levels of significant morbidity and mortality. Management options include radiologic drainage and surgical options include resection for more widespread sepsis. Laparoscopic surgery has increased and has been useful in elective setting. Its use in the emergency setting is less evaluated. Evidence Acquisition Evidence was acquired by searching online medical databases including Pubmed, Medline and Embase. Results Laparoscopic surgery has been shown to have a role in the acute setting. Studies show it has become the gold standard in the appendicitis. High quality Randomized controlled trials are in short supply but observational and cohort studies have shown equivalence and with increasing experience complication rates are reduced. Evidence is also increasing in the management of diverticular disease, crohn’s and ulcerative colitis as well as post-operative complication management and acute presentations of colorectal cancer. Conclusions Laparoscopic surgery is feasible in the management of intra-abdominal sepsis. It has become the new accepted standard in the management of appendicitis, and is safe, feasible and increasing in the management of complex diverticular disease, acute IBD and colorectal cancer in the emergency and post-operative setting.

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

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    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

  4. Pressão intra-abdominal em cães

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    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.

  5. Evaluation and treatment of intraabdominal bilomas

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    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.

  6. [Desmoid tumors or intra-abdominal fibromatoses].

    Science.gov (United States)

    Lasser, P; Elias, D; Contesso, G; Genin, J; Mankarios, H; Rougier, P

    1993-01-01

    Intraabdominal desmoid tumour or fibromatosis, recurrent but non-metastatic, invasive, fibroblastic proliferations, are rare tumours. From 1968 to 1989, 16 patients were treated at Gustave Roussy Institute. They were associated with familial adenomatous polyposis in 10% of cases. These tumours, observed mainly in young women (70 to 85% of cases), are aggravated by pregnancy, and spontaneous regression can occur at menopause, proving their hormonal dependence. Although histologically benign, they are serious lesions due to their invasive character; their excision is complete in only 50% of cases. They recur in 30% to 75% of cases and cause death of the patient in 30% of cases. Treatment is surgical but due to their often very slow course, and their spontaneous stabilisation in some cases, a mutilating surgical treatment (extensive small intestine resection) does not seem to be justified. Radiotherapy is effective only at doses incompatible with the site of these tumours (35 to 60 Gy). Chemotherapy has never been shown to be effective.

  7. Composición corporal y adiposidad en adultos jujeños de distintos niveles altitudinales

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    Bejarano, Ignacio

    2013-12-01

    Full Text Available La obesidad constituye un problema de salud pública asociado a condiciones que afectan la morbimortalidad. El objetivo de este trabajo fue analizar la prevalencia del exceso de grasa corporal en la población adulta jujeña, localizada a diferentes niveles de altura geográfica, recurriendo a distintos parámetros e indicadores antropométricos de adiposidad. La muestra de 345 individuos de 20-40 años sanos fue seleccionada a través de un método aleatorio en 2 localidades: San Salvador de Jujuy (SSJ (1259 msnm y La Quiaca (LAQ (3442 msnm en un relevamiento realizado en el año 2010. En base a la Talla (T, Peso (P, Perímetro de la Cintura (PCI y Perímetro de la Cadera (PCA se determinaron los índices de Masa Corporal (IMC=P/T2, PCI/PCA y PCI/T y se establecieron prevalencias de exceso de adiposidad. Las variables continuas se compararon mediante ANOVA y las prevalencias con ?2 (SPSS y MEDCALC. Si bien los varones y mujeres de SSJ fueron más altos y pesados que los de LAQ, las diferencias sólo fueron estadísticamente significativas en mujeres. Se observaron diferencias poblacionales no significativas para PCI, PCA e IMC y significativas para PCI/PCA y PCI/T, presentando los varones de LAQ los valores más altos. No se observaron diferencias entre localidades para ninguno de los indicadores de obesidad. Independientemente del indicador utilizado se verificó que un elevado porcentaje de la población presentó un importante exceso de adiposidad. Se observó una alta correlación de todos los indicadores entre sí, especialmente del IMC, PCI, PCA y PCI/T. Las poblaciones jujeñas de altura presentan indicadores de adiposidad elevados, propios de poblaciones sobrealimentadas. Sin embargo, la interpretación de estos resultados debe ahondarse en las características metabólicas y de los hábitos alimentarios de estas poblaciones, aun insuficientemente explorados y comprendidos.

  8. [Changes of the intraabdominal pressure in patients with abdominal sepsis].

    Science.gov (United States)

    Kursov, S V

    2013-01-01

    64 patients with abdominal sepsis were included in the study of the intraabdominal pressure changes before and after the operation. The study demonstrated that the use of the crystalloids alone leads to the development of the capillary leak syndrome in comparison with the therapy regimen using colloids. The aggressive fluid resuscitation, associated with high numbers of central venous pressure, increasing 1177Pa (120 mm H2O), was connected with the increase of the intraabdominal pressure.

  9. 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

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    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

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

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    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.

  11. ABDOPRE: dispositivo de aplicação externa para redução da pressão intra-abdominal: Experiencia clínica preliminar ABDOPRE: dispositivo de aplicación externa para reducción de presión intraabdominal: Preliminary clinical experience ABDOPRE: an external device for the reduction of intra-abdominal pressure

    Directory of Open Access Journals (Sweden)

    Francisco Pracca

    2011-06-01

    Full Text Available São descritos os objetivos de redução da pressão intra-abdominal e o projeto de um dispositivo que os atenda. O ABDO-PRE compreende, pela primeira vez, um mecanismo de servo-controle de aplicação externa que mede a pressão intravesical como variável de controle. São apresentados os resultados da aplicação em 4 pacientes com hipertensão intra-abdominal, produzindo uma redução de 16% a 35% em três casos e um aumento paradoxal da pressão em um dos casos, devido a um desajuste entre a geometria da câmara de vácuo e a alteração anatômica acarretada pela obesidade da paciente. Estes resultados são promissores em relação ao possível uso do ABDOPRE na prática clínica para redução da hipertensão intra-abdominal.Se describen los objetivos de reducción de la presión intraabdominal y el proyecto de un dispositivo que los cumpla. ABDOPRE comprende por primera vez un mecanismo servcocontrolado de aplicación externa que toma la presión intravesical como variable de control. Se presenta el resultado de la aplicación en 4 pacientes afectados por hipertensión intraabdominal, con el resultado de una reducción de entre 16% y 35% en tres casos y de un aumento paradojal de presión en un caso debido a desajuste de la geometría de la campana de vacío a la anatomía obesa del paciente. Estos resultados prometen el posible uso de ABDOPRE para la reducción de la hipertensión intraabdominal en la práctica clínica.This article describes a device for the reduction of intra-abdominal pressure. The device (ABDOPRE includes a unique external servo-control mechanism, based on urinary bladder pressure measurement. The results of ABDOPRE use in the first four intra-abdominal hypertension patients are reported; the device resulted in a reduction of intra-abdominal pressure between 16% and 35% in 3 cases and in a paradoxical increase of the intra-abdominal pressure in an obese woman, likely due to inappropriate chamber size for the patient

  12. [Intraabdominal hypertension syndrome in patients with abdominal sepsis].

    Science.gov (United States)

    Kryvoruchko, I A; Ivanova, Iu V; Povelichenko, M S; Andreieshchev, S A

    2014-05-01

    Investigations were conducted in 53 patients, operated on in 2013 yr for abdominal sepsis (AS). The patients state severity was determined in accordance to the systemic inflammatory reaction and the polyorgan insufficiency severity. In 28 patients (group I) AS was diagnosed, in 14 (group II)--severe AS, in 11 (group III)--a septic shock. Tactics of surgical management of the patients have included two main measures: the infection origin control (source control), and control of the affected organ function and systemic defense mechanisms (damage control). In all the patients in AS the intraabdominal pressure rising was revealed. Syndrome of intraabdominal hypertension was noted in 10 (18.9%) patients (in 4--while presence of severe AS, and in 6--in septic shock). Lethality was the highest in intraabdominal hypertension degrees III and IV (11 of 25 patients have died).

  13. Negative pressure device for intra-abdominal pressure reduction

    Energy Technology Data Exchange (ETDEWEB)

    David, M; Geido, D; Pracca, F; Sanchez, G; Simini, F; Zoppolo, C [Nucleo de Ingenierfa Biomedica, Universidad de la Republica O. del Uruguay, Hospital de ClInicas, Av. Italia S/N, 11600, Montevideo (Uruguay)

    2007-11-15

    A device that generates negative extra-abdominal pressure (ABDOPRE) for treatment of patients with high intra-abdominal pressure was developed. It includes pressure sensors for transducing intra-abdominal pressure through an intra-vesical catheter and negative pressure in the vacuum bell which is placed over the abdomen. By means of a control system, a pattern for reducing IAP is set, according to a clinical protocol. The external negative pressure is generated using a vacuum pump connected to the bell. The system registers the values of interest for the medical history. The system is being tested over ICU patients, registering a satisfactory IAP reduction.

  14. Fournier's gangrene secondary to intra-abdominal processes.

    Science.gov (United States)

    Gerber, G S; Guss, S P; Pielet, R W

    1994-11-01

    We report 2 cases of necrotizing fasciitis of the perineum, perianal area, and male genitalia (Fournier's gangrene) that arose secondary to intra-abdominal infectious processes (ruptured appendicitis and diverticulitis). Management consisted of immediate debridement of necrotic tissue, exploratory laparotomy, and diverting colostomy. The presence of an acute abdominal process was not immediately evident on initial evaluation of either patient. This demonstrates the critical importance of considering intra-abdominal infection in patients with Fournier's gangrene when the more commonly seen urinary tract, perirectal, and traumatic causes are not readily apparent.

  15. Intraabdominal desmoplastic small round cell tumor - case report; Tumor de pequenas celulas redondas desmoplasico intra-abdominal - relato de caso

    Energy Technology Data Exchange (ETDEWEB)

    Westphalen, Antonio Carlos Anderson; Ferreira, Jose Hamilton Pinheiro [Hospital Moinhos de Vento, Porto Alegre, RS (Brazil). Moinhos Centro de Imagem]. E-mail: cpostal@zaz.com.br; Daudt, Alexander Welaussen [Centro de Oncologia Radioterapica do Rio Grande do Sul, Porto Alegre, RS (Brazil); Gaiger, Ana Maria [Pontificia Univ. Catolica do Rio Grande do Sul, Porto Alegre, RS (Brazil). Faculdade de Medicina. Dept. de Patologia

    2001-10-01

    The authors report a case of intraabdominal desmoplastic small round cell tumor in a 21-year-old male patient who presented with abdominal pain, right lower limb thrombosis and obstructive loss of renal function. Initial investigation showed a large lobulated intraabdominal soft tissue mass with internal cystic cavities, located posteriorly to the bladder and causing obstruction of ureteral flow, compression of the right iliac vein and partial occlusion of the rectum. Involvement of intraperitoneal and retroperitoneal nodes was also seen. Ultrasound, computed tomography and magnetic resonance imaging findings, as well as surgical and histopathology macroscopical, microscopical and immunohistochemistry findings are described. (author)

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

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    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.

  17. Pylephlebitis: An Uncommon Complication of Intra-Abdominal Infection

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    Salim R Surani

    2011-05-01

    Full Text Available We herein present a case of pylephlebitis, which is an infective suppurative thrombosis of the portal vein. Pylephlebitis is an uncommon complication of intra-abdominal infections and carries with it significant morbidity and mortality. [West J Emerg Med. 2011;12(4:575–576.

  18. Laparoscopic Fowler Stephens orchidopexy for intra-abdominal testis

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    Papparella A.

    2013-10-01

    Full Text Available The authors reported their experience in the laparoscopic orchidopexy for intra-abdominal testis (IAT. Since 2003, 173 laparoscopy for NPT were performed for a total of 181 testicular units. In 75 patients cord structures entering the inguinal ring were observed, and 43 had an inguinal exploration. In 34 patients a blind ending vas and vessels were observed and 8 showed testicular agenesis: these patients were managed by laparoscopy only. In 62 cases an intra-abdominal testes (IAT were found: 42 had a primary orchidopexy and 22, with high IAT, were managed by a laparoscopic Fowler-Stephens (FS procedure. In 12 testes we performed a two stage procedure while 10 had one stage. There were no differences in hospitalisation and early surgical complications were not recorded. Follow up ranged from 1 to 5 years. Of 22 patients who underwent FS orchidopexy, testicular atrophy developed in 4; the remaining are in scrotal position, with normal consistency and well perfused at color doppler ultrasound. Laparoscopy is essential in the surgical and therapeutic management of non-palpable testis. FS orchidopexy is reserved to high intra-abdominal testes that have a distance more than 3 cm from the internal inguinal ring. There were no differences between the group managed by one or two step FS. The minimal morbidity with an high success rate prove to be a significant contribution to the intra-abdominal testis management.

  19. Open abdomen management of intra-abdominal sepsis.

    Science.gov (United States)

    Adkins, Amy L; Robbins, James; Villalba, Mario; Bendick, Phillip; Shanley, Charles J

    2004-02-01

    Despite surgical advances, antimicrobial therapy, and intensive care, the morbidity and mortality of intra-abdominal sepsis remains high. The primary purpose of this study was to determine whether open abdomen management of intra-abdominal sepsis reduces intensive care unit (ICU) and hospital mortality. The records of 81 consecutive patients with open abdomen management for intra-abdominal sepsis admitted to the surgical ICU from January 1998 to April 2002 were retrospectively reviewed. Outcomes were compared to a historical control group with primary abdominal closure, also admitted to the surgical ICU with intra-abdominal sepsis and matched for sex, age, source of sepsis, and APACHE III score. ICU mortality for the open abdomen group was 25 per cent versus 17 per cent for the control group. Hospital mortality was 33 per cent and 25 per cent for the open abdomen patients and historical controls, respectively. Both ICU and hospital length of stay were significantly longer for the open abdomen group. An overall fistula rate of 14.8 per cent was demonstrated in the open abdomen patients. A significant difference in overall ICU and hospital mortality was not demonstrated between patients treated with open abdomen management and historical controls. A prospective randomized study accounting for extent of sepsis may define a role for open abdomen management in selected subgroups of patients.

  20. Case report: Filariasis presenting as an intra-abdominal cyst

    Directory of Open Access Journals (Sweden)

    Abhay K Kapoor

    2011-01-01

    Full Text Available Filariasis is an endemic infection seen in the tropical and subtropical regions of the world, presenting with lymphatic dysfunction in the form of lymphocele, hydrocele, chyluria, or groin lymphadenovarix. We report a rare presentation of filariasis as an intra-abdominal cystic mass.

  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. 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.

  3. 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

  4. Antimicrobial management of intra-abdominal infections:Literature's guidelines

    Institute of Scientific and Technical Information of China (English)

    Massimo Sartelli; Fausto Catena; Federico Coccolini; Antonio Daniele Pinna

    2012-01-01

    Antimicrobial management of severe intra-abdominal infections (IAIs) involves a delicate balance of optimizing empirical therapy,which has been shown to improve clinical outcomes,while simultaneously reducing unnecessary antimicrobial use.Two sets of guidelines for the management of intra-abdominal infections were recently published.In 2010,the Surgical Infection Society and the Infectious Diseases Society of America (SIS-IDSA)created guidelines for the diagnosis and management of complicated IAIs.The new SIS-IDSA guidelines replace those previously published in 2002 and 2003.The World Society of Emergency Surgery (WSES) guidelines represent additional contributions,made by specialists worldwide,to the debate regarding proper antimicrobial drug methodology.These guidelines represent the conclusions of the consensus conference held in Bologna,Italy,in July 2010 during the first congress of the WSES.

  5. La adiposidad como factor de riesgo del hígado graso no alcohólico: revisión sistemática

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    Arturo Jiménez-Cruz

    2014-04-01

    Full Text Available Introducción: Se ha descrito que la adiposidad es un factor de riesgo del hígado graso no alcohólico (HGNA. Objetivo: Realizar una revisión sistemática de estudios prospectivos que evaluaran la asociación de indicadores de adiposidad con el desarrollo del HGNA. Metodología: Se revisaron todos los artículos originales encontrados en inglés y en español publicados de enero de 2005 a diciembre de 2013, en la base de datos de MEDLINE/PubMed, de estudios prospectivos con una duración igual o mayor a un año de seguimiento. La calidad de los artículos fue evaluada mediante los criterios de GRADE. Resultados: La población total estudiada fue de 10.640 (6.394 hombres y 4.246 mujeres, y el rango de edad fue de 20-88 años. Cumplieron con los criterios de inclusión cinco estudios prospectivos, y el seguimiento osciló entre uno y siete años. Los criterios de diagnóstico utilizados fueron la ultrasonografía (4 y la tomografía computarizada (1. Los OR de IMC, circunferencia de cintura y ganancia de peso oscilaron entre 1,19 a 1,43, 1,04 a 2,15 y 1,21 a 1,57 respectivamente. Conclusión: Se observó una relación consistente entre los indicadores de adiposidad y el HGNA.

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

    Directory of Open Access Journals (Sweden)

    Arturo Jiménez Cruz

    2014-02-01

    Full Text Available 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 retrospectivos de cohorte registrados en la base de datos de Medline/Pubmed, de enero de 2011 a septiembre de 2013, que valoraran el efecto de la Diabetes Gestacional sobre los indicadores de adiposidad al nacimiento o después del nacimiento. Resultados: Once estudios cumplían con los criterios de inclusión. En total se estudiaron a 472.959 pares de madre e hijo. La edad del niño en el momento de la evaluación fue a partir del nacimiento hasta los 18 años. En nueve de once artículos se observó una asociación entre la diabetes gestacional e indicadores de obesidad. En siete de trabajos se realizaron ajustes para más de dos variables de confusión (IMC pre gestacional, edad de la madre, y en cinco de ellos se observó una asociación entre la diabetes gestacional con adiposidad. Conclusión: Los resultados de la revisión indican que la evidencia que demuestra que la diabetes gestacional aumenta el peso de los productos en períodos posteriores de la vida, es moderada.

  7. 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 algu- nos estudios contenían debilidades metodológicas. Objetivo: Analizar los resultados de estudios prospecti- vos 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 pros- pectivos o ret...

  8. 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 ...

  9. Intraabdominal foreign bodies: radiological aspects; Corpos estranhos intra-abdominais: aspectos radiologicos

    Energy Technology Data Exchange (ETDEWEB)

    Baena, Marcos Eduardo da Silva; Domenicis Junior, Osvaldo de; Costacurta, Marcos Antonio; Cerri, Giovanni Guido [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Servico de Diagnostico por Imagem

    1996-07-01

    The intraabdominal foreign bodies secondary to previous surgical interventions are relatively rare nowadays. In spite of this, it still remains a problem that a diagnostic imaging department have sometimes to face. In this article the authors report the evolution of five intraabdominal foreign bodies with clinical, radiological and preventive aspects. The medical literature is also reviewed. (author) 7 refs., 11 figs.

  10. Removal of an intraabdominal levonorgestrel-releasing intrauterine device during pregnancy.

    Science.gov (United States)

    Peleg, David; Latta, Richard

    2013-06-01

    A woman with a viable intrauterine 12-week pregnancy and an intraabdominal levonorgestrel-releasing intrauterine device had the device successfully removed under local anesthesia. The pregnancy continued without complication. The decision to remove an intraabdominal levonorgestrel-releasing intrauterine device during pregnancy remains controversial.

  11. Pre-eclampsia renamed and reframed: Intra-abdominal hypertension in pregnancy.

    Science.gov (United States)

    Sawchuck, Diane J; Wittmann, Bernd K

    2014-11-01

    This hypothesis proposes pre-eclampsia is caused by intra-abdominal hypertension in pregnancy. Sustained or increasing intra-abdominal pressure ⩾12mmHg causes impaired venous return to the heart, systemic vascular resistance, ischemia reperfusion injury, intestinal permeability, translocation of lipopolysaccharide endotoxin to the liver, cytotoxic immune response, systemic inflammatory response, pressure transmission to thoracic and intra-cranial compartments, and multi-organ dysfunction. This hypothesis is predicated on Pascal's law, evidence founded in the intra-abdominal hypertension literature, and the adapted equation ΔIAP-P=ΔIAVF/Cab, where ΔIAP-P=change in intra-abdominal pressure in pregnancy, ΔIAVF=change in intra-abdominal vector force (volume and force direction) and Cab=abdominal compliance. Factors causing increased intra-abdominal pressure in pregnancy include: progressive uterine expansion, obstetrical factors that increase intra-uterine volume excessively or acutely, maternal anthropometric measurements that affect intra-abdominal pressure thresholds, maternal postures that increase abdominal force direction, abdominal compliance that is decreased, diminished with advancing gestation, or has reached maximum expansion, habitation at high altitude, and rapid drops in barometric pressure. We postulate that the threshold for lipopolysaccharide translocation depends on the magnitude of intra-abdominal pressure, the intestinal microbiome complex, and the degree of intestinal permeability. We advance that delivery cures pre-eclampsia through the mechanism of abdominal decompression.

  12. 77 FR 59928 - Draft Guidance for Industry on Complicated Intra-Abdominal Infections: Developing Drugs for...

    Science.gov (United States)

    2012-10-01

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Complicated Intra-Abdominal... guidance for industry entitled ``Complicated Intra-Abdominal Infections: Developing Drugs for Treatment.'' The purpose of this guidance is to assist sponsors in the clinical development of drugs for...

  13. 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 pos

  14. 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.

  15. 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

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Luz Mª Adriana Balderas-Peña

    2013-08-01

    Full Text Available 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 inmunorreactividad. Se realizó el análisis de correlación entre el porcentaje de adiposidad, el IMC, la presencia de DM2 e hipertensión arterial con la expresión de receptores a estrógeno y progesterona y regresión logística con cálculo de Odds Ratio. Resultados: Se estudiaron 43 pacientes con cáncer de mama y se observó asociación entre el porcentaje de adiposidad y el índice de inmunoreactividad para los RE y RP (rP 0,470; p 0,003 y rP 0,328; p 0,042 respectivamente. El factor de riesgo más importante en cáncer positivo a receptores estrogénicos fue la obesidad (OR 19,1, IC 95% 2,1 a 169,1, p 0,008 y obesidad previa en cáncer positivo a receptores a progesterona (OR 20,7, IC 95% 2,3 a 185,9, p 0,007. Conclusión: El porcentaje de adiposidad es un factor de riesgo importante para desarrollar cáncer de mama positivo a receptores hormonales.

  18. 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.

  19. The Diagnostic Value of Intra-abdominal Pressure in Patients with Blunt Acute Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    Huseyin Narci

    2012-06-01

    Full Text Available Purpose:The objective of this study was to determine the diagnostic value of intra-abdominal pressure measurement in blunt abdominal trauma patients. Method: A prospective study was performed in 49 patients with blunt trauma in our university hospital for 1 years. Patients were randomly into two groups as intra-abdominal trauma (n=28 and extraabdominal trauma (n=21 groups. Intra-abdominal pressures was measured an classified as normal (10 cm H2O or less, elevated (more than 10 cm H2O determined indirectly. Results: No significant differences were found between abdominal trauma and extra-abdominal trauma groups from the point of intra-abdominal pressure (IAP. One the other hand, in abdominal trauma group; significant differences were observed between operated patients. Intra-abdominal bleeding was found in 10 patients and all of them elevated IAP values (exceeding 16 cm H2O. For determining the intra-abdominal injury, IAP had a sensitivity of 93%, specificity 38% in patients. Conclusion: IAP exceeding 16 cm H2O with blunt abdominal trauma patients abdominal trauma can be detected. It is thought that IAP, indirect monitoring of abdominal trauma patients is a reproducible, scientific guide and simple method.To determine the efficacy of the measurement of intra-abdominal pressure in blunt abdominal trauma patients, further studies should be done. [Cukurova Med J 2012; 37(3.000: 157-161

  20. 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.

  1. 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.

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

    DEFF Research Database (Denmark)

    Bak, Martin

    1996-01-01

    was undertaken in order to describe the entire spectrum of the disease including primary as well as secondary cases. Eleven patients are reported, nine of which had an associated colorectal disease in direct continuity with areas of intra-abdominal panniculitis. It is concluded that intra-abdominal panniculitis...... should not be regarded as a specific nosological entity but merely a result of injury to the fat cells. Intra-abdominal panniculitis is seen more often as a secondary local phenomenon than as a primary condition, and in both cases it is associated with considerable differential diagnostic problems...

  3. Estudios aleatorizados sobre el efecto del consumo de bebidas azucaradas sobre la adiposidad en adolescentes y adultos: revisión sistemática

    Directory of Open Access Journals (Sweden)

    Luis Mario Gómez-Miranda

    2013-12-01

    Full Text Available Introducción: Se ha observado una asociación entre el aumento del consumo de bebidas azucaradas y las enfermedades metabólicas. Objetivo: Analizar estudios aleatorizados (EA en > 13 años de edad, de 18 o más semanas de intervención, que valoren la reducción o el aumento 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 EA publicados hasta el 10 de abril de 2013. El término utilizado para la búsqueda fue "Sugar Sweetened Beverages". Se encontraron tres estudios enfocados a reducir y uno a aumentar12 el consumo de bebidas azucaradas. Resultados: En uno de los estudios dirigidos a reducir el consumo, se observó una ligera reducción del IMC en el grupo de intervención (p=0,045. En otro estudio se observó que la reducción de 355 ml/día se asoció a una pérdida de peso de 0.7 kg (IC 95%: 0,2-1,1, p=0,01. En el estudio para aumentar el consumo, se observó un aumento del cociente de la grasa visceral y la grasa subcutánea abdominal en el grupo que consumió Coca Cola regular y una disminución en el grupo que consumió leche descremada (p=0,01. Conclusión: Los resultados indican la tendencia hacía un efecto de la ingesta de bebidas azucaradas sobre la adiposidad.

  4. 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.

  5. Intra-Abdominal Testicular Seminoma in a Woman with Testicular Feminization Syndrome

    Directory of Open Access Journals (Sweden)

    Darshana D. Rasalkar

    2011-01-01

    Full Text Available We report a case of intra-abdominal testicular tumor in a 36-year-old married lady presenting with chief complaints of primary amenorrhea. The patient was later diagnosed with testicular feminization syndrome, a form of male pseudohermaphroditism. This testicular tumor was histologically proven as seminoma. Due to rarity, imaging findings in patients with testicular feminization syndrome and intraabdominal testicular tumor have been poorly documented. So far, only one case report had described the combined role of CT and MR imaging in intraabdominal testicular sex-cord stromal tumor. To our knowledge, this case is first to document USG and MR imaging in addition to MR spectroscopy features in intraabdominal testicular seminoma.

  6. Surgical Treatment of Intra-Abdominal Desmoid Tumors Resulting In Short Bowel Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Wheeler, Matthew; Mercer, David; Grant, Wendy; Botha, Jean; Langnas, Alan; Thompson, Jon, E-mail: jthompso@unmc.edu [Department of Surgery, University of Nebraska Medical Center, The Nebraska Medical Center 3280, Omaha, NE 68198 (United States)

    2012-01-19

    Advanced intra-abdominal desmoids tumors present with severe symptoms, complications or rapid growth, which lead to adverse outcomes. Our aim was to evaluate the treatment and outcome of patients with advanced intra-abdominal desmoids tumors, and develop guidelines for surgical management of these patients. We reviewed the clinical courses of 21 adult patients with advanced stage intra-abdominal desmoid tumors who presented to an intestinal rehabilitation and transplantation program. Patients with massive intestinal resection presented in two groups. The first group had a short small intestinal remnant after resection (<60 cm). These patients were poor rehabilitation candidates and eventually met criteria for transplant. The second had longer intestinal remnants and were more successfully rehabilitated and have not had complications that would lead to transplantation. Advanced intra-abdominal desmoid tumors have outcomes after resection that merit aggressive resection and planned intestinal rehabilitation and intestinal transplantation as indicated.

  7. 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)....

  8. Does an intraabdominally placed LNG-IUS have an adverse effect on fertility? A case report.

    Science.gov (United States)

    Doris, Nadine; Shabib, Gihad; Corbett, Shannon; Leader, Arthur; Black, Amanda

    2014-01-01

    This case of secondary infertility with an associated intraabdominal levonorgestrel intrauterine system (LNG-IUS) demonstrates the importance of adequate imaging in women with a missing intrauterine contraceptive device and the possible fertility implications of an extrauterine LNG-IUS.

  9. Adiposity In Childhood Cancer Survivors: Insights Into Obesity Physiopathology [adiposidade Em Pacientes Tratados Por Câncer Na Infância: Entendendo A Fisiopatologia Da Obesidade

    OpenAIRE

    Siviero-Miachon, Adriana Aparecida; Spinola-Castro, Angela Maria; Guerra-Junior,Gil

    2009-01-01

    As childhood cancer treatment has become more effective, survival rates have improved, and a number of complications have been described while many of these patients reach adulthood. Obesity is a well-recognized late effect, and its metabolic effects may lead to cardiovascular disease. Currently, studies concerning overweight have focused on acute lymphocytic leukemia and brain tumors, since they are at risk for hypothalamic-pituitary axis damage secondary to cancer therapies (cranial irradia...

  10. 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.

  11. 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.

  12. Percutaneous catheter drainage of intraabdominal abscesses and fluid

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Tae; Kwon, Tae Hee; Yoo, Hyung Sik; Suh, Jung Ho [Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Young Ho [Cheil General Hospital, Seoul (Korea, Republic of)

    1986-10-15

    Percutaneous catheter drainage has been reported to be an effective method in the management of selected patients with abscess and fluid collection. Its high success rate and relatively low complications make the procedure an alternative to surgery in the individual cases. During past two years percutaneous catheter drainage in 25 patients with intraabdominal abscesses and fluid collection was performed at the Department of Radiology, Yonsei University College of medicine. Here the technique and author's results were summarized. 1. The total 25 patients who had percutaneous catheter drainage are 10 liver abscesses, 3 subphrenic, one subhepatic, 4 renal and perirenal, 2 pelvic, one psoas, one anterior pararenal fluid from acute pancreatitis, one pancreas pseudocyst and 2 malignant tumor necrosis. 2. The modified Seldinger technique used for all cases of abscess and fluid drainage under guidance of ultrasound scan. The used catheters were 10F. Pigtail and 14F. Malecot (Cook c/o) catheters. 3. The abscesses and fluid of 17 patients among 25 were cured by the percutaneous catheter drainage and 4 patients were clinically improved. The catheter drainage was failed in 2 patients and 3 complication were developed. 4. The success rate of this procedure was 91.3%, failure rate was 8.7% and complication rate was 12%.

  13. Central adiposity in children born small and large for gestational age Adiposidad central en niños que nacieron con poco o con excesivo peso para su edad gestacional

    Directory of Open Access Journals (Sweden)

    M. Biosca

    2011-10-01

    Full Text Available Objective: To evaluate body composition differences between children that were born small (SGA or large for gestational age (LGA compared with their counterparts born adequate for gestational age (AGA. Methods: Body composition was assessed in 124 healthy Caucasian children (50% girls aged 6-10, classified according to their birth weight for gestational age as AGA, SGA and LGA. Fat mass (FM, percentage of FM, lean mass (LM, bone mineral content (BMC and bone mineral density were measured by dual-energy X-ray absorptiometry (DXA in the whole body and at different body regions. Results: LM (adjusted for age and sex and total BMC (adjusted for age, sex and weight were both significantly higher in LGA children and lower in SGA when compared with those born AGA. After adjustments for height, LM and BMC differences between groups were not significant. In SGA children, truncal (P Objetivo: Evaluar las diferencias que existen en la composición corporal de aquellos niños que nacieron pequeños (PEG o grandes para su edad gestacional (GEG en comparación con los que presentaban un peso adecuado al nacer (AEG. Métodos: La composición corporal se valoró en 124 niños caucásicos (50% niñas con edades entre 6 y 10 años, clasificados según su peso al nacer como AEG, PEG y GEG. La masa grasa (MG, el porcentaje de MG, la masa magra (MM, el contenido mineral óseo (CMO y la densidad mineral ósea se midieron mediante absorciometría dual de rayos X (DXA tanto globalmente como en las diferentes regiones corporales. Resultados: La MM (ajustada por edad y sexo y el CMO (ajustado por edad, sexo y peso fueron mayores en los GEG y menores en los PEG al compararlos con los AEG; al ajustar la MM el CMO por la altura, dichas diferencias ya no fueron significativas. En los PEG, la grasa abdominal (p < 0,01 y en el tronco (p < 0,05 eran mayores que en los AEG y que en los GEG tras ajustar por edad, sexo y altura. No existían diferencias en el porcentaje de MG

  14. 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.

  15. [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

    Introducción: la presión intraabdominal es el estado de equilibrio de la presión de la cavidad abdominal en reposo y puede presentar cambios durante la ventilación mecánica o espontánea. El objetivo fue determinar la presión intraabdominal como predictor de cirugía en el paciente con dolor abdominal agudo. Métodos: se llevó a cabo un estudio de casos y controles anidado en una cohorte de pacientes con dolor abdominal agudo en el servicio de urgencias de un hospital de segundo nivel, en el periodo comprendido entre abril y diciembre de 2013. Se incluyeron 37 pacientes, todos fueron intervenidos quirúrgicamente con previa toma de la presión intraabdominal. Se formaron los grupos con el resultado del estudio anatomopatológico: con evidencia de proceso inflamatorio abdominal agudo (n = 28) y sin evidencia de proceso inflamatorio abdominal agudo (n = 9). Resultados: en los casos el 100 % presentó presión intraabdominal alta con una p = 0.01, RM: 5 (IC 95 %: 2.578-9.699). En los casos la media de la presión intraabdominal fue de 11.46 y en los controles de 9.2 (p = 0.183). Conclusiones: el dolor abdominal que requiere cirugía para su resolución tiene relación directa con una presión intraabdominal > 5 mmHg.

  16. 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.

  17. [Pathogenetic aspects of intra-abdominal hypertension in patients with abdominal sepsis].

    Science.gov (United States)

    Veliev, N A; Gasanova, D N

    2011-09-01

    The authors had offered the original estimated system with the points calculation, basing on analysis of the examination and treatment results in 150 patients, suffering abdominal sepsis. The system, alike others, includes not only determination of the inflammation factors and indices of endotoxicosis, but as well as those, concerning intraabdominal pressure, the anterior abdominal wall rigidity and the tissues elasticity. Among the important indices, needed to determine, were considered those, which categorize the syndrome of intraabdominal, intrathoracic and microregional hypertension as well as the mechanisms of endotoxicosis pathogenesis. The authors recommend to use the indices of pathological consequences of this two factors while doing assessment of the abdominal sepsis severity.

  18. An unusual case of intra-abdominal testicular torsion: Role of laparoscopy

    Directory of Open Access Journals (Sweden)

    Alfonso Papparella

    2013-01-01

    Full Text Available The authors report a case of intra-abdominal testicular torsion, where laparoscopy has been useful for diagnosis and surgical management. A boy was presented with a left impalpable testis. Laparoscopy revealed a twisted spermatic cord at the inlet pelvis, which ended in a testicular remnant located in the sub-umbilical area. After orchiectomy, the pathologist confirmed testicular atrophy. Diagnosis of intra-abdominal testicular torsion should be considered in patients with impalpable testis and abdominal pain, but could not be excluded in those with no symptoms.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Complicated intra-abdominal infection caused by extended drug-resistant Achromobacter xylosoxidans.

    Science.gov (United States)

    Teng, Sing-On; Ou, Tsong-Yih; Hsieh, Yu-Chia; Lee, Wuan-Chan; Lin, Yi-Chun; Lee, Wen-Sen

    2009-04-01

    Achromobacter xylosoxidans (formerly Alcaligenes xylosoxidans) is a rare but important nosocomial pathogen. Antibiotic resistance has been increasing during the past decade. A. xylosoxidans may be confused with Pseudomonas spp. but, unlike Pseudomonas spp., this organism has peritrichous flagella. Complicated intra-abdominal infection with A. xylosoxidans has rarely been reported in the literature. This report is of an immunocompetent patient with acute cholecystitis complicated by an intra-abdominal abscess after surgery. Culture of both blood and ascites yielded extended drug-resistant A. xylosoxidans, which was only sensitive to colistin. The clinical and laboratory characteristics of A. xylosoxidans are presented.

  1. 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.

  2. Effect of increased intra-abdominal pressure due to pneumoperitoneum on liver functions and liver histopathology in a rat model with intra-abdominal sepsis.

    Science.gov (United States)

    Youssef, Youssef Farouk; Noseer, Mona

    2008-04-01

    Intra-abdominal sepsis was induced by open cecal ligation and puncture (OCLP) technique. Sixty rats were randomly divided into three equal groups each of 20. G1 was used as a control. G2 were subjected to laparotomy and closure after 12 hours from (OCLP) via the same incision. In G3, pneumoperitoneum was induced 12 hours after OCLP and maintained at 12 mmHg for about 30 minutes. Blood samples were taken for liver functions after 12 & 24 hours from OCLP procedure, and Liver biopsies were taken for histopathological examination after 24 hours. The results showed that liver functions were markedly increased in G3 after pneumoperitoneum, compared to Gs 1 & 2. The histopathological changes in liver biopsies due to sepsis were more marked in cases exposed to pneumoperitoneum than that exposed to conventional laparotomy. The intra-abdominal sepsis affected liver functions and caused pathogenesis. The increased intra-abdominal pressure induced more liver insults, compared to that gained after open surgery.

  3. A Single-Lumen Central Venous Catheter for Continuous and Direct Intra-abdominal Pressure Measurement

    NARCIS (Netherlands)

    O.J.F. van Waes (Oscar); J.B. Jaquet (Jean); W.C.J. Hop (Wim); M.J.M. Morak (Marjolein); J.N.M. IJzermans (Jan); J. Koning (Jan)

    2009-01-01

    textabstractBackground: Abdominal compartment syndrome (ACS) is associated with high morbidity and mortality rates. Therefore, the need for a good diagnostic tool to predict intra-abdominal hypertension (IAH) and progression to ACS is paramount. Bladder pressure (BP) has been used for several years

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

    DEFF Research Database (Denmark)

    Berentzen, Tina Landsvig; Angquist, 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...

  5. Ultrasound measurements of intraabdominal fat estimate the metabolic syndrome better than do measurements of waist circumference

    NARCIS (Netherlands)

    Stolk, RP; Meijer, Rudy; Mali, WPTM; Grobbee, DE; van der Graaf, Y

    2003-01-01

    Background: We recently developed an ultrasound technique to estimate intraabdominal fat (IAF). This method is more accurate than measurement of waist and hip circumferences and is simpler and less expensive than computed tomography or magnetic resonance imaging. Objective: We compared the associati

  6. 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...

  7. 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.)

  8. A standardised and reproducible model of intra-abdominal infection and abscess formation in rats

    NARCIS (Netherlands)

    Bosscha, K; Nieuwenhuijs, VB; Gooszen, AW; van Duijvenbode-Beumer, H; Visser, MR; Verweij, Willem; Akkermans, LMA

    2000-01-01

    Objective: To develop a standardised and reproducible model of intra-abdominal infection and abscess formation in rats. Design: Experimental study. Setting: University hospital, The Netherlands. Subjects: 36 adult male Wistar rats. Interventions: In 32 rats, peritonitis was produced using two differ

  9. A systematic review on intra-abdominal pressure in severely burned patients

    NARCIS (Netherlands)

    K.D. Strang; E.M.M. van Lieshout (Esther); R.S. Breederveld (Roelf S.); O.J.F. van Waes (Oscar)

    2014-01-01

    textabstractObjective Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are complications that may occur in severely burned patients. Evidenced based medicine for these patients is in its early development. The aim of this study was to provide an overview of literature rega

  10. 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.

    2016-01-01

    INTRODUCTION: 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

  11. 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.

    2016-01-01

    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 particula

  12. 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.

  13. Cirugía intraabdominal como causa de sepsis

    OpenAIRE

    2014-01-01

    Sepsis, sepsis grave y shock séptico son términos que se usan para describir las respuestas sistémicas del organismo a la infección. La sepsis y el shock séptico continúan siendo un capítulo de enorme interés y preocupación por su elevada frecuencia, y por no existir una disminución en las cifras de mortalidad a pesar de los nuevos conocimientos adquiridos en su fisiopatología y los avances surgidos en los diversos tratamientos aplicados. En 1992, un comité de consenso de ex...

  14. Change in Intra-Abdominal Fat Predicts the Risk of Hypertension in Japanese Americans.

    Science.gov (United States)

    Sullivan, Catherine A; Kahn, Steven E; Fujimoto, Wilfred Y; Hayashi, Tomoshige; Leonetti, Donna L; Boyko, Edward J

    2015-07-01

    In Japanese Americans, intra-abdominal fat area measured by computed tomography is positively associated with the prevalence and incidence of hypertension. Evidence in other populations suggests that other fat areas may be protective. We sought to determine whether a change in specific fat depots predicts the development of hypertension. We prospectively followed up 286 subjects (mean age, 49.5 years; 50.4% men) from the Japanese American Community Diabetes Study for 10 years. At baseline, subjects did not have hypertension (defined as blood pressure ≥140/90 mm Hg) and were not taking blood pressure or glucose-lowering medications. Mid-thigh subcutaneous fat area, abdominal subcutaneous fat area, and intra-abdominal fat area were directly measured by computed tomography at baseline and 5 years. Logistic regression was used to estimate odds of incident hypertension over 10 years in relation to a 5-year change in fat area. The relative odds of developing hypertension for a 5-year increase in intra-abdominal fat was 1.74 (95% confidence interval, 1.28-2.37), after adjusting for age, sex, body mass index, baseline intra-abdominal fat, alcohol use, smoking status, and weekly exercise energy expenditure. This relationship remained significant when adjusted for baseline fasting insulin and 2-hour glucose levels or for diabetes mellitus and pre-diabetes mellitus classification. There were no significant associations between baseline and change in thigh or abdominal subcutaneous fat areas and incident hypertension. In conclusion, in this cohort of Japanese Americans, the risk of developing hypertension is related to the accumulation of intra-abdominal fat rather than the accrual of subcutaneous fat in either the thigh or the abdominal areas.

  15. Tumor de pequenas células redondas desmoplásico intra-abdominal: relato de caso Intraabdominal desmoplastic small round cell tumor: case report

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    Antonio Carlos Andersson Westphalen

    2001-10-01

    Full Text Available Os autores relatam um caso de tumor de pequenas células redondas desmoplásico intra-abdominal acometendo paciente do sexo masculino, de 21 anos de idade, atendido com quadro de dor abdominal, trombose do membro inferior direito e perda da função renal, de causa obstrutiva. A investigação demonstrou volumosa lesão abdominopélvica, sólida, bocelada, com áreas císticas internas, situada posteriormente à bexiga, causando obstrução ureteral, compressão da veia ilíaca direita e oclusão parcial do reto, além de acometimento de linfonodos intra e retroperitoneais. São descritos os achados cirúrgicos, de ultra-sonografia, tomografia computadorizada e ressonância magnética, bem como aqueles do estudo macroscópico, microscopia e imuno-histoquímica.The authors report a case of intraabdominal desmoplastic small round cell tumor in a 21-year-old male patient who presented with abdominal pain, right lower limb thrombosis and obstructive loss of renal function. Initial investigation showed a large lobulated intraabdominal soft tissue mass with internal cystic cavities, located posteriorly to the bladder and causing obstruction of ureteral flow, compression of the right iliac vein and partial occlusion of the rectum. Involvement of intraperitoneal and retroperitoneal nodes was also seen. Ultrasound, computed tomography and magnetic resonance imaging findings, as well as surgical and histopathology macroscopical, microscopical and immunohistochemistry findings are described.

  16. Paniculitis mesentérica asociada con absceso intraabdominal

    OpenAIRE

    2008-01-01

    La paniculitis mesentérica es una enfermedad inflamatoria del tejido adiposo del mesenterio, de presentación infrecuente y que se caracteriza, por el engrasamiento, endurecimiento y nodularidad del mismo. Se pone en consideración un caso clínico en un varón joven, con una forma de presentación poco común que requirió de laparotomía exploradora para realizar el diagnóstico y tratamiento.

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

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    Qin Wu

    Full Text Available Studies on the incidence and risk factors of thrombocytopenia among intra-abdominal infection patients remain absent, hindering efficacy assessments regarding thrombocytopenia prevention strategies.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.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.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.

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

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    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.

  19. In vitro activity of moxifloxacin against 923 anaerobes isolated from human intra-abdominal infections.

    Science.gov (United States)

    Goldstein, Ellie J C; Citron, Diane M; Warren, Yumi A; Tyrrell, Kerin L; Merriam, C Vreni; Fernandez, Helen

    2006-01-01

    The in vitro activity of moxifloxacin against 923 recent anaerobic isolates obtained from pretreatment cultures in patients with complicated intra-abdominal infections was studied using the CLSI M11-A-6 agar dilution method. Moxifloxacin was active against 87% (96 of 110) Bacteroides fragilis strains at accounting for most of the resistant isolates; excluding the aforementioned four resistant species, 86% (303 of 363) of Bacteroides species isolates and 94% (417 of 450) of all other genera and species were susceptible to < or = 2 microg/ml of moxifloxacin. Overall, moxifloxacin was active against 763 of 923 (83%) of strains at < or = 2 microg/ml, supporting its use as a monotherapy for some community-acquired intra-abdominal infections.

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

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    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.

  1. Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma

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    Davood Farsi

    2014-01-01

    Full Text Available Background: Blunt abdominal injury is a leading cause of death in trauma patients. A reliable test predicting intra-abdominal hemorrhage would be a novel method. The study objective was to assess the diagnostic accuracy of plasma ammonia in detection of intra-abdominal bleeding in patients with blunt abdominal trauma (BAT. Materials and Methods: In this observational study, all patients suffering from BAT, referred to our university teaching hospital included. The levels of ammonia were measured at the time of emergency department admission and 1 h after initial treatment. Demographic data, vital signs, and venous blood gas reports were recorded. Findings of contrast-enhanced abdominopelvic computed tomography scan and laparotomy were assumed as a gold standard for abdominal injuries. Results: A total of 104 patients was enrolled in the study. 15 patients (14.4% had intra-abdominal hemorrhage and the mean plasma ammonia level in this group was significantly higher than the other patients on admission time (101.73 ± 5.41 μg/dL vs. 47.36 ± 26.31 μg/dL, P < 0.001. On receiver-operator characteristic curve analysis, in cutoff point of 89 μg/dL, the sensitivity, specificity, positive and negative likelihood ratios were 100% (95% confidence interval [CI], 79.6-100, 93.26% (95% CI, 86-96.8, 14.83 (95% CI, 6.84-32.12, and 0, respectively. Conclusion: The study findings suggest the measurement of ammonia level at the time of admission in the patients with BAT would be a useful test predicting intra-abdominal hemorrhage. Furthermore, decrease in the ammonia level could be a useful marker for monitoring response to treatment in these patients.

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

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    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.

  3. Adrenal gland volume, intra-abdominal and pericardial adipose tissue in major depressive disorder.

    Science.gov (United States)

    Kahl, Kai G; Schweiger, Ulrich; Pars, Kaweh; Kunikowska, Alicja; Deuschle, Michael; Gutberlet, Marcel; Lichtinghagen, Ralf; Bleich, Stefan; Hüper, Katja; Hartung, Dagmar

    2015-08-01

    Major depressive disorder (MDD) is associated with an increased risk for the development of cardio-metabolic diseases. Increased intra-abdominal (IAT) and pericardial adipose tissue (PAT) have been found in depression, and are discussed as potential mediating factors. IAT and PAT are thought to be the result of a dysregulation of the hypothalamus-pituitary-adrenal axis (HPAA) with subsequent hypercortisolism. Therefore we examined adrenal gland volume as proxy marker for HPAA activation, and IAT and PAT in depressed patients. Twenty-seven depressed patients and 19 comparison subjects were included in this case-control study. Adrenal gland volume, pericardial, intraabdominal and subcutaneous adipose tissue were measured by magnetic resonance imaging. Further parameters included factors of the metabolic syndrome, fasting cortisol, fasting insulin, and proinflammatory cytokines. Adrenal gland and pericardial adipose tissue volumes, serum concentrations of cortisol and insulin, and serum concentrations tumor-necrosis factor-α were increased in depressed patients. Adrenal gland volume was positively correlated with intra-abdominal and pericardial adipose tissue, but not with subcutaneous adipose tissue. Our findings point to the role of HPAA dysregulation and hypercortisolism as potential mediators of IAT and PAT enlargement. Further studies are warranted to examine whether certain subtypes of depression are more prone to cardio-metabolic diseases.

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

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    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.

  5. Exogenous pulmonary surfactant prevents the development of intra-abdominal adhesions in rats.

    Science.gov (United States)

    Schanaider, Alberto; Cotta-Pereira, Ricardo; Silva, Paulo C; Macedo-Ramos, Hugo; Silva, Johnatas D; Teixeira, Pedro A C; Pannain, Vera L N; Rocco, Patricia R M; Baetas-da-Cruz, Wagner

    2016-04-01

    Intra-abdominal adhesions are major post-operative complications for which no effective means of prevention is available. We aimed to evaluate the efficacy of exogenous pulmonary surfactant administration in the prevention of post-operative abdominal adhesions. Rats were randomly assigned to undergo laparotomy (L) or gastroenterostomy (GE) and then treated with surfactant (groups L-S and GE-S, respectively). Intra-abdominal adhesions, collagen fibre content, metalloproteinase (MMP)-9, expression of growth factors (TGF-β, KGF and VEGF), type III procollagen (PCIII) and pro-caspase 3, as well as isolectin B4 and ED1-positive cells expressing MMP-9, were evaluated. Groups treated with surfactant (GE-S and L-S) exhibited fewer adhesions. A significant reduction in collagen fibre content was observed in GE-S compared to GE animals (P abdominal adhesions triggered by laparotomy and gastrointestinal anastomosis, thus preventing fibrosis formation at the peritoneal surfaces. This preclinical study suggests an innovative treatment strategy for intra-abdominal adhesions with surfactant and to endorse its putative mechanism of action.

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

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    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

  7. 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

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    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

  8. Spinal epidural abscess presenting as intra-abdominal pathology: a case report and literature review.

    Science.gov (United States)

    Bremer, Andrew A; Darouiche, Rabih O

    2004-01-01

    Spinal epidural abscess is a rare infectious disease. However, if left unrecognized and untreated, the clinical outcome of spinal epidural abscess can be devastating. Correctly diagnosing a spinal epidural abscess in a timely fashion is often difficult, particularly if the clinician does not actively consider the diagnosis. The most common presenting symptoms of spinal epidural abscess include backache, radicular pain, weakness, and sensory deficits. However, early in its course, spinal epidural abscess can also present with vague and nondescript manifestations. In this report, we describe a case of spinal epidural abscess presenting as abdominal pain, and review the literature describing other cases of spinal epidural abscess presenting as intra-abdominal pathology.

  9. [Abdominal pregnancy: hormon concentrations during the postpartal period with placenta remaining intra-abdominal (author's transl)].

    Science.gov (United States)

    Gethmann, U; Mönkemeier, D

    1977-07-01

    It is reported of an abdominal pregnancy at term. The placenta was left in situ because of the high risk of intraabdominal bleedings. Thereby it was possible to measure hormon concentrations of the fetoplacental unit without the fetal compartment. Within 10 days after delivery we determined the plasma levels of estradiol-17 beta, estriol, progesterone, HCS, alpha1fetoprotein, and the excretion of the total estrogens in the urines. There was near the same decrease of hormon concentrations in the post partal time comparable with that of a normal pregnancy. Only the HCS concentrations didn't change in the first 9 days after delivery.

  10. [Intra-Abdominal Germ Cell Tumor in Persistent Mullerian Duct Syndrome].

    Science.gov (United States)

    Mishima, Takao; Harada, Jiro; Kawa, Gen; Sakurai, Takanori; Okada, Takuya

    2016-08-01

    A 46-year-old man was admitted to hospital presenting with a lower abdominal mass. The patient's testes were not palpable in the scrotum, and the levels of lactic dehydrogenase, α-fetoprotein and human chorionic gonadotropin were all elevated. Enhanced computed tomography revealed that the lumen of the mass had penetrated the prostate. Pathological analysis of biopsy tissue indicated that the mass was a seminoma. Residual tumor resection was performed after chemotherapy. On histological examination, the lumen proved to be a Mullerian structure. Our diagnosis was an intra-abdominal germ cell tumor and persistent Mullerian duct syndrome.

  11. Epidemiological study of community-and hospital-acquired intraabdominal infections

    Institute of Scientific and Technical Information of China (English)

    Shu Zhang; Wenxiang Huang

    2015-01-01

    Purpose: To investigate and analyze the clinical and etiological characteristics of community-acquired intraabdominal infections (CIAIs) and hospital-acquired or nosocomial intraabdominal infections (NIAls) in a comprehensive hospital, to understand the characteristics, pathogen composition, and drug resistance of CIAIs as well as NIAIs, and to provide a reference for clinical treatment.Methods: We collected the clinical data of patients with intraabdominal infections admitted to our hospital from June 2013 to June 2014.In vitro drug sensitivity tests were conducted to separate pathogens, and the data were analyzed using the WHONET 5.4 software and SPSS 13.0 software.Results: A total of 221 patients were enrolled in the study, including 144 with CIAIs (55 mild-moderate and 89 severe) and 77 with NIAIs.We isolated 322 pathogenic strains, including 234 strains of gramnegative bacteria, 82 strains of gram-positive bacteria, and 6 strains of fungi.Based on clinical features, NIAIs and severe CIAIs presented significantly higher values in age, length of hospital stay, mortality, and the incidence of severe intra-abdominal infection than mild-moderate CIAIs (p < 0.05).There was no significant difference in the prognosis between NIAIs and severe CIAIs.Primary diseases leading to CIAIs and NIAIs mostly were hepatobiliary diseases and gastrointestinal diseases respectively.Bacteria isolated from various types of IAIs mainly were Enterobacteriaceae;mild-moderate CIAIs mostly were mono-infection of gram-negative bacteria;NIAIs mostly were mixed infections of gram-negative and gram-positive bacteria;and severe CIAIs were from either type of infection.The rate of Extended Spectrum β-Lactamase-producing Escherichia coli and Klebsiella pneumoniae was much higher in NIAIs than in CIAls (p < 0.05).The antimicrobial drug sensitivity of gram-negative bacteria isolated from NIAIs was significantly lower than that of CIAIs.Conclusion: CIAIs and NIAls have their own unique clinical

  12. Treatment Modalities and Antimicrobial Stewardship Initiatives in the Management of Intra-Abdominal Infections

    Science.gov (United States)

    Hoffmann, Charles; Zak, Matthew; Avery, Lisa; Brown, Jack

    2016-01-01

    Antimicrobial stewardship programs (ASPs) focus on improving the utilization of broad spectrum antibiotics to decrease the incidence of multidrug-resistant Gram positive and Gram negative pathogens. Hospital admission for both medical and surgical intra-abdominal infections (IAIs) commonly results in the empiric use of broad spectrum antibiotics such as fluoroquinolones, beta-lactam beta-lactamase inhibitors, and carbapenems that can select for resistant organisms. This review will discuss the management of uncomplicated and complicated IAIs as well as highlight stewardship initiatives focusing on the proper use of broad spectrum antibiotics. PMID:27025526

  13. Treatment Modalities and Antimicrobial Stewardship Initiatives in the Management of Intra-Abdominal Infections

    Directory of Open Access Journals (Sweden)

    Charles Hoffmann

    2016-02-01

    Full Text Available Antimicrobial stewardship programs (ASPs focus on improving the utilization of broad spectrum antibiotics to decrease the incidence of multidrug-resistant Gram positive and Gram negative pathogens. Hospital admission for both medical and surgical intra-abdominal infections (IAIs commonly results in the empiric use of broad spectrum antibiotics such as fluoroquinolones, beta-lactam beta-lactamase inhibitors, and carbapenems that can select for resistant organisms. This review will discuss the management of uncomplicated and complicated IAIs as well as highlight stewardship initiatives focusing on the proper use of broad spectrum antibiotics.

  14. 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

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    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.

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

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    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.

  16. Basaloid (Cloacogenic Carcinoma Mimicking Intraabdominal Abscess: Report of a Case and Review of the Literature

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    Sami Akbulut

    2009-08-01

    Full Text Available Cloacogenic carcinoma (CC, basaloid carcinoma generally occurs around the dentate line, rarely it can arise from the other sides of the colon. There are only 5 cases of CC located outside the anal canal in the literature. The first occurrence of a CC presents as intraabdominal abscess. We describe a 23-year-old male patient who was admitted with fever and severe abdominal pain. Computed tomography imaging showed diffuse wall thickening about 10–11 cm above the rectosigmoid junction, intraabdominal abscess and a soft tissue lession covering the pelvis with a size of 8 × 8.5 cm including cystic necrotic areas. We performed Hartman procedure since the mass was nonresectable. Histopathological examination showed CC. In total, three times radiotherapy and a concurrent three-drug regimen of irinotecan, fluorouracil and folinic acid chemotherapy were administered for 6 weeks. As a result, the patient was lost because of multiple organ dysfunction syndrome that developed 3 months after radio-chemotherapy.

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

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    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.

  18. Effects of intra-abdominal pressure on adrenal gland function and morphology in rats.

    Science.gov (United States)

    Akkapulu, Nezih; Tirnaksiz, Mehmet Bulent; Kulac, Ibrahim; Tezel, Gaye Guler; Hayran, Mutlu; Dogrul, Ahmet Bulent; Cetinkaya, Erdinc; Yorganci, Kaya

    2015-01-01

    Intra-abdominal hypertension and abdominal compartment syndrome (IAH/ACS) are life-threatening conditions and caused by several clinical status. Although there is insufficient data regarding its effects on adrenal glands. This study aimed to identify whether elevated intra-abdominal pressure (IAP) caused any alteration on the morphology and function of adrenal glands in a rat model. Twenty four Sprague-Dawley male rats were included in the study. Animals were allocated into 4 groups. IAP was elevated to 15 mmHg for one hour and four hours in group 2 and 4. Group 1 and 3 were sham groups. Blood samples were taken for the assessment of plasma adrenaline, noradrenaline, and corticosterone levels and adrenalectomies were performed to evaluate apoptosis. Blood adrenaline, noradrenaline and corticosterone levels were significantly higher in the study groups compared with the sham groups. However, there were no significant changes in apoptotic index scores in the study groups as compared to sham groups. These results support that increased IAH leads to discharge of catecholamine and corticosterone from the adrenal glands. Failure to demonstrate similar changes in apoptotic index score may be concluded as apoptosis is not a leading pathway for impairment of adrenal glands during IAH period.

  19. Intra-abdominal Hypertension: An Important Consideration for Diuretic Resistance in Acute Decompensated Heart Failure.

    Science.gov (United States)

    Nguyen, Vinh Q; Gadiraju, Taraka V; Patel, Hiren; Park, Minnsun; Le Jemtel, Thierry H; Jaiswal, Abhishek

    2016-01-01

    Fluid accumulation is the hallmark of heart failure decompensation. Fluid overload and congestion are associated with recurrent hospitalizations, poor quality of life, and increased mortality in heart failure. Despite the use of high-dose intravenous loop diuretic therapy, acutely decompensated heart failure patients may develop diuretic resistance. Diuretic refractoriness can be a result of elevated intra-abdominal pressure (IAP) in acutely decompensated heart failure. Increased renal venous and interstitial pressures in patients with elevated IAP may lead to renal impairment and diuretic resistance. Routine approaches such as sequential nephron blockade with a combination of loop and thiazide or thiazide-like diuretics, continuous diuretic infusion, and ultrafiltration may not be sufficient. Presented here is a case illustrating the importance of recognizing intra-abdominal hypertension in patients with diuretic resistance. Lowering IAP improves renal perfusion, renal filtration, and diuresis. When elevated, IAP is an easily reversible cause of diuretic resistance. Additionally, abdominal perfusion pressure can be used to guide therapy to reverse end-organ damage and avoid permanent renal replacement therapy.

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

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    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.

  1. Pharmacokinetics of human recombinant tissue-type plasminogen activator, administered intra-abdominally, in a rat peritonitis model

    NARCIS (Netherlands)

    van Goor, Harry; Bom, VJJ; van der Meer, J; Sluiter, WJ; Geerards, S; de Graaf, JS; Bleichrodt, RP; van der Schaaf, W

    1996-01-01

    Human recombinant tissue-type plasminogen activator (rtPA), administered intraperitoneally, may promote intraabdominal fibrinolysis in peritonitis, thereby preventing adhesion and abscess formation. The pharmacokinetics of a single intraperitoneal dose of 0.5 or 2.0 mg/ml human rtPA were assessed in

  2. 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 adequa...

  3. The Epidemiology of Intra-Abdominal Flora in Critically III Patients with Secondary and Tertiary Abdominal Sepsis

    NARCIS (Netherlands)

    de Ruiter, J.; Weel, J.; Manusama, E.; Kingma, W. P.; van der Voort, P. H. J.

    2009-01-01

    Background: Different micro-organisms can be cultured from abdominal fluid obtained from patients with intra-abdominal infection resulting from a perforated digestive tract. We evaluated a cohort of patients with abdominal sepsis admitted to the intensive care with the aim of obtaining more insight

  4. 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

    2014-01-01

    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

  5. 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.

    2011-01-01

    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 su

  6. Prevention of intra-abdominal abscesses and adhesions using a hyaluronic acid solution in a rat peritonitis model

    NARCIS (Netherlands)

    Reijnen, MMPJ; Meis, JFGM; Postma, VA; van Goor, Harry

    1999-01-01

    Hypothesis: Hyaluronic acid (HA)-based bioresorbable membrane and 0.4% HA solution reduce intraabdominal adhesion and abscess formation in a rat peritonitis model. Design: Randomized laboratory experiment. Setting: A university hospital. Interventions: In 72 male Wistar rats, a bacterial peritonitis

  7. Obesity and central adiposity in Mexican adults: results from the Mexican National Health and Nutrition Survey 2006 Obesidad y adiposidad central en adultos mexicanos: resultados de la Encuesta Nacional de Salud y Nutrición 2006

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    Simón Barquera

    2009-01-01

    Full Text Available OBJECTIVE: To estimate the prevalence of overweight, obesity and central adiposity in Mexico, and to explore trends compared to the previous Mexican National Health Survey (ENSA 2000 and to Mexican-Americans. MATERIAL AND METHODS: The Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006 was used to describe overweight, obesity and central adiposity. Trends over time were assessed using the ENSA 2000 and by comparing the ENSANUT 2006 results to those of Mexican-Americans using the United States National Health and Nutrition Examination Survey (NHANES 1999-2000 and 2005-2006. RESULTS: A total of 33023 adults > 20 years old were included; 39.7% were found to be overweight and 29.9% were found to be obese; 75.9% of all adults had abdominal obesity. In Mexico between 2000 and 2006, the combined prevalence of overweight and obesity in adults increased approximately 12%. Mexican-Americans showed a higher prevalence of morbid obesity compared to native Mexicans. CONCLUSIONS: Mexico has experienced a rapid increase in the number of adults who have experienced excess weight gain between the years 2000 and 2006.OBJETIVO: Estimar la prevalencia de sobrepeso, obesidad y adiposidad central en México, y explorar las tendencias, comparándola con la Encuesta Nacional de Salud 2000 (ENSA 2000 y con los mexicano-americanos. MATERIAL Y MÉTODOS: La Encuesta Nacional de Salud y Nutrición 2006 (ENSANUT 2006 fue usada para describir la prevalencia de sobrepeso y obesidad, asi como de adiposidad central. Las tendencias a través del tiempo fueron obtenidas usando la ENSA 2000, y se compararon con datos de la ENSANUT 2006 y con mexicano-americanos participantes de las National Health and Nutrition Examination Survey (NHANES 1999-2000 y 2005-2006 de EUA. RESULTADOS: De un total de 33023 adultos > 20 años de edad, 39.7% tuvo sobrepeso y 29.9% obesidad. El 75.9% tuvo obesidad abdominal. En México, entre 2000 y 2006 la prevalencia combinada de sobrepeso y

  8. 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

    , 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......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......, a two-stage intravenous epinephrine infusion (60 min of 80 and 200 ng. kg(-1). min(-1), respectively) was carried out, and local interstitial glycerol concentration was measured by the microdialysis technique. Blood flow was measured by microspheres. Training increased blood flow in all ATs [on average...

  9. Intra-abdominal seminoma found incidentally during trauma workup in a man with bilateral cryptorchidism

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    Danielle Velez

    2015-01-01

    Full Text Available Bilateral cryptorchidism is a rare occurrence and seminoma is the most common germ cell tumor found in undescended testes when they occur. We present the case of a patient with bilateral cryptorchidism who presented to our trauma center after a motor vehicle collision and was found incidentally to have a 17-cm intra-abdominal mass. The mass was subsequently biopsied and proven to be seminoma. The patient completed three cycles of bleomycin/etoposide/cisplatin chemotherapy and successfully underwent a postchemo retroperitoneal lymph node dissection with no viable residual tumor or positive lymph nodes found in the surgical specimen. He also had an orchiopexy of the contralateral testicle. The patient recovered fully and has been found to be recurrence-free four months postoperatively. We highlight the importance of cisplatin-based chemotherapy and extensive tumor resection as the mainstay of initial cancer control.

  10. Effects of ovariohysterectomy on intra-abdominal pressure and abdominal perfusion pressure in cats.

    Science.gov (United States)

    Bosch, L; Rivera del Álamo, M M; Andaluz, A; Monreal, L; Torrente, C; García-Arnas, F; Fresno, L

    2012-12-15

    Intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) have shown clinical relevance in monitoring critically ill human beings submitted to abdominal surgery. Only a few studies have been performed in veterinary medicine. The aim of this study was to assess how pregnancy and abdominal surgery may affect IAP and APP in healthy cats. For this purpose, pregnant (n=10) and non-pregnant (n=11) queens undergoing elective spaying, and tomcats (n=20, used as controls) presented for neutering by scrotal orchidectomy were included in the study. IAP, mean arterial blood pressure (MAP), APP, heart rate and rectal temperature (RT) were determined before, immediately after, and four hours after surgery. IAP increased significantly immediately after abdominal surgery in both female groups when compared with baseline (PPregnancy did not seem to affect IAP in this population of cats, possibly due to subjects being in early stages of pregnancy.

  11. 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

    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......- and extraabdominal infectious complications as the outcome. RESULTS: Increased CRP levels on postoperative day (POD) 3 were associated with intraabdominal infections. The best cut-off value was 190 (sensitivity, 0.82; specificity, 0.73). The area under the ROC curve was 0.82. On POD 5 and 7, the diagnostic accuracy...

  12. Implanting intra-abdominal radiotransmitters with external whip antennas in ducks

    Science.gov (United States)

    Korschgen, C.E.; Kenow, K.P.; Gendron-Fitzpatrick, A.; Green, W.L.; Dein, F.J.

    1996-01-01

    We developed and evaluated a surgical procedure for implanting intra-abdominal radiotransmitters with external whip antennas in captive mallards (Anas platyrhynchos). Transmitters were implanted in the abdominal cavity and the antennas exited through the caudal abdominal wall and skin. Birds with implanted transmitters developed mild to moderate localized air sac reactions. These reactions involved adhesions of the right anterior abdominal air sac to the liver with contractions around the transmitters and antenna catheters. The adhesions were reinforced by a proliferation of connective tissue and lined by multinucleated giant cells (foreign body reaction). Casual observation indicated that neither behavior nor activity of the birds was altered by the histological reaction to the transmitter implant. No increase in systemic lesions (particularly liver or kidney) could be correlated with the histological reactions. Our evaluations indicate that the procedure is a reliable method for radiomarking ducks and the technique has been successfully used in 2 field studies.

  13. Is intra-abdominal hypertension a missing factor that drives multiple organ dysfunction syndrome?

    Science.gov (United States)

    Kirkpatrick, Andrew W; Roberts, Derek J; De Waele, Jan; Laupland, Kevin

    2014-03-19

    In a recent issue of Critical Care, Cheng and colleagues conducted a rabbit model study that demonstrated that intra-abdominal hypertension (IAH) may damage both gut anatomy and function. With only 6 hours of IAH at 25 mmHg, these authors observed an 80% reduction in mucosal blood flow, an exponential increase in mucosal permeability, and erosion and necrosis of the jejunal villi. Such dramatic findings should remind all caring for the critically ill that IAH may severely damage the normal gut barrier functions and thus may be reasonably expected to facilitate bacterial and mediator translocation. The potential contribution of IAH as a confounding factor in the efficacy of selective decontamination of the digestive tract should be considered.

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

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    Edivaldo Massazo Utiyama

    2015-02-01

    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. por valores

    Directory of Open Access Journals (Sweden)

    Jazmín Díaz-Barrios

    2005-01-01

    Full Text Available La era actual se caracteriza por una búsqueda de la identidad del hombre, donde el pivote del cambio organizacional es el individuo; cambiar en este entorno depende, en gran medida, de los valores que imperen en la cultura de la organización. Este trabajo documental intenta identificar aquellos valores, condición sine-qua-non, para el logro de los objetivos de cambio y analizarlos a fin de determinar sus indicadores, con el objeto de presentar una herramienta a las organizaciones que les facilite adaptarse a los nuevos tiempos. Se encontró que los valores: Delegación, Comunicación, Colaboración, Participación y Aprendizaje, son esenciales en los cambios integrales de esta era. Se determinaron 20 indicadores de su presencia. Se concluye que con esta información cada ente puede elaborar instrumentos que le permitan saber si los valores requeridos están presentes y en caso contrario tomar decisiones que alineen a la organización alrededor de los valores humanistas planteados, incrementando así las posibilidades de éxito en el proceso de cambio y por ende, las posibilidades de supervivencia en esta nueva época.

  16. Localized intra-abdominal fibromatosis of the small bowel mimicking a gastrointestinal stromal tumor:A case report

    Institute of Scientific and Technical Information of China (English)

    Piergiuseppe Colombo; Daoud Rahal; Fabio Grizzi; Vittorio Quagliuolo; Massimo Roncalli

    2005-01-01

    Intra-abdominal fibromatosis (IAF) is a benign mesenchymal lesion that can occur throughout the gastrointestinal tract. Although rare, it is the most common primary tumor of the mesentery and can develop at any age. We describe a rare case of primary IAF involving the mesentery and small bowel which clinically, macroscopically and histologically mimicked malignant gastrointestinal stromal tumor (GIST). This report highlights the fact that benign IAF can be misdiagnosed as a malignant GIST localized in the mesentery or arising from the intestinal wall. Their diagnostic discrimination is essential because of their very different biological behaviors and the fact that the introduction of effective therapies involving tyrosine kinase inhibitor STI571 (imatinib mesylate) has greatly changed the clinical approach to intra-abdominal stromal spindle cell tumors.

  17. 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

  18. 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.

  19. CT-guided percutaneous drainage of intra-abdominal abscesses: APACHE III score stratification of 1-year results

    Energy Technology Data Exchange (ETDEWEB)

    Betsch, Angelika; Belka, Claus [Department of Radiation Oncology, Eberhard Karls University, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Wiskirchen, Jakub; Truebenbach, Jochen; Claussen, Claus D.; Duda, Stephan H. [Department of Diagnostic Radiology, Eberhard Karls University, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Manncke, Klaus H. [Department of General Surgery, Eberhard Karls University, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany)

    2002-12-01

    Our objective was to evaluate the clinical success rates of percutaneously drained intra-abdominal abscesses using a risk stratification score for severely ill patients (APACHE III; Acute Physiology, Age, Chronic Health Evaluation). In 75 patients CT-guided percutaneous abscess drainage was performed to treat intra-abdominal abscesses. The clinical success rate based on a 1-year follow-up was correlated with abscess etiology, size, and structure, as well as with the initial APACHE III score. Clinical success, i.e., the complete removal of the abscess without surgical treatment, was observed in 62 of 75 patients (83%). Abscess size (<200 cm{sup 3}) and abscesses with a simple structure correlated with higher clinical success rates. Patients presenting with APACHE III scores below 30 were treated by percutaneous abscess drainages (PAD) alone significantly more often than patients presenting with higher APACHE scores. The percutaneous drainage of intra-abdominal abscesses shows good long-term results as long as abscesses are singular, small (<200 cm{sup 3}), and located in well accessible regions in combination with low APACHE scores (<30). (orig.)

  20. Patients with Risk Factors for Complications Do Not Require Longer Antimicrobial Therapy for Complicated Intra-Abdominal Infection.

    Science.gov (United States)

    Rattan, Rishi; Allen, Casey J; Sawyer, Robert G; Mazuski, John; Duane, Therese M; Askari, Reza; Banton, Kaysie L; Claridge, Jeffrey A; Coimbra, Raul; Cuschieri, Joseph; Dellinger, E Patchen; Evans, Heather L; Guidry, Christopher A; Miller, Preston R; O'Neill, Patrick J; Rotstein, Ori D; West, Michaela A; Popovsky, Kimberley; Namias, Nicholas

    2016-09-01

    A prospective, multicenter, randomized controlled trial found that four days of antibiotics for source-controlled complicated intra-abdominal infection resulted in similar outcomes when compared with a longer duration. We hypothesized that patients with specific risk factors for complications also had similar outcomes. Short-course patients with obesity, diabetes, or Acute Physiology and Chronic Health Evaluation II ≥15 from the STOP-IT trial were compared with longer duration patients. Outcomes included incidence of and days to infectious complications, mortality, and length of stay. Obese and diabetic patients had similar incidences of and days to surgical site infection, recurrent intra-abdominal infection, extra-abdominal infection, and Clostridium difficile infection. Short- and long-course patients had similar incidences of complications among patients with Acute Physiology and Chronic Health Evaluation II ≥15. However, there were fewer days to the diagnosis of surgical site infection (9.5 ± 3.4 vs 21.6 ± 6.2, P = 0.010) and extra-abdominal infection (12.4 ± 6.9 vs 21.8 ± 6.1, P = 0.029) in the short-course group. Mortality and length of stay was similar for all groups. A short course of antibiotics in complicated intra-abdominal infection with source control seems to have similar outcomes to a longer course in patients with diabetes, obesity, or increased severity of illness.

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

    Science.gov (United States)

    Papakrivou, Eleni; Manoulakas, Efstratios; Mitroudi, Magda; Tepetes, Konstantinos; Papazoglou, Konstantinos; Zakynthinos, Epaminondas

    2017-01-01

    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. PMID:28357400

  2. Deleterious Effects of Increased Intra-Abdominal Pressure on Kidney Function

    Directory of Open Access Journals (Sweden)

    Zaher Armaly

    2014-01-01

    Full Text Available Elevated intra-abdominal pressure (IAP occurs in many clinical settings, including sepsis, severe acute pancreatitis, acute decompensated heart failure, hepatorenal syndrome, resuscitation with large volume, mechanical ventilation with high intrathoracic pressure, major burns, and acidosis. Although increased IAP affects several vital organs, the kidney is very susceptible to the adverse effects of elevated IAP. Kidney dysfunction is among the earliest physiological consequences of increased IAP. In the last two decades, laparoscopic surgery is rapidly replacing the open approach in many areas of surgery. Although it is superior at many aspects, laparoscopic surgery involves elevation of IAP, due to abdominal insufflation with carbonic dioxide (pneumoperitoneum. The latter has been shown to cause several deleterious effects where the most recognized one is impairment of kidney function as expressed by oliguria and reduced glomerular filtration rate (GFR and renal blood flow (RBF. Despite much research in this field, the systemic physiologic consequences of elevated IAP of various etiologies and the mechanisms underlying its adverse effects on kidney excretory function and renal hemodynamics are not fully understood. The current review summarizes the reported adverse renal effects of increased IAP in edematous clinical settings and during laparoscopic surgery. In addition, it provides new insights into potential mechanisms underlying this phenomenon and therapeutic approaches to encounter renal complications of elevated IAP.

  3. Laparoscopic management of intra-abdominal infections:Systematic review of the literature

    Institute of Scientific and Technical Information of China (English)

    Federico; Coccolini; Cristian; Tranà; Massimo; Sartelli; Fausto; Catena; Salomone; Di; Saverio; Roberto; Manfredi; Giulia; Montori; Marco; Ceresoli; Chiara; Falcone; Luca; Ansaloni

    2015-01-01

    AIM: To investigate the role of laparoscopy in diagnosis and treatment of intra abdominal infections.METHODS: A systematic review of the literature was performed including studies where intra abdominal infections were treated laparoscopically.RESULTS: Early laparoscopic approaches have become the standard surgical technique for treating acute cholecystitis. The laparoscopic appendectomy has been demonstrated to be superior to open surgery in acute appendicitis. In the event of diverticulitis, laparoscopic resections have proven to be safe and effective procedures for experienced laparoscopic surgeons and may be performed without adversely affecting morbidity and mortality rates. However laparoscopic resection has not been accepted by the medical community as the primary treatment of choice. In high-risk patients, laparoscopic approach may be used for exploration or peritoneal lavage and drainage. The successful laparoscopic repair of perforated peptic ulcers for experienced surgeons, is demonstrated to be safe and effective. Regarding small bowel perforations, comparative studies contrasting open and laparoscopic surgeries have not yet been conducted. Successful laparoscopic resections addressing iatrogenic colonic perforation have been reported despite a lack of literature-based evidence supporting such procedures. In post-operative infections, laparoscopic approaches may be useful in preventing diagnostic delay and controllingthe source.CONCLUSION: Laparoscopy has a good diagnostic accuracy and enables to better identify the causative pathology; laparoscopy may be recommended for the treatment of many intra-abdominal infections.

  4. 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.

  5. INTRA-ABDOMINAL INFECTION AND ACUTE ABDOMEN-EPIDEMIOLOGY, DIAGNOSIS AND GENERAL PRINCIPLES OF SURGICAL MANAGEMENT

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    Jovanović Dušan

    2015-03-01

    Full Text Available Intra-abdominal infections are multifactorial and present an complex inflammatory response of the peritoneum to microorganisms followed by exudation in the abdominal cavity and systemic response Despite advances in management and critical care of patients with acute generalized peritonitis due to hollow viscus perforation, prognosis is still very poor, with high mortality rate. Early detection and adequate treatment is essential to minimize complications in the patient with acute abdomen. Prognostic evaluation of complicated IAI by modern scoring systems is important to assess the severity and the prognosis of the disease. Control of the septic source can be achieved either by nonoperative or operative means. Nonoperative interventional procedures include percutaneous drainages of abscesses. The management of primary peritonitis is non-surgical and antibiotic- treatment. The management of secondary peritonitis include surgery to control the source of infection, removal of toxins, bacteria, and necrotic tissue, antibiotic therapy, supportive therapy and nutrition. "Source control" is sine qua non of success and adequate surgical procedure involves closure or resection of any openings into the gastrointestinal tract, resection of inflamed tissue and drainage of all abdominal and pelivic collections.

  6. 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.

  7. 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.

  8. 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

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    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

  9. Effects of Altered Intra-abdominal Pressure on the Upper Airway Collapsibility in a Porcine Model

    Institute of Scientific and Technical Information of China (English)

    Shu-Lin Ren; Yan-Ru Li; Ji-Xiang Wu; Jing-Ying Ye; Rachel Jen

    2015-01-01

    Background: Obstructive sleep apnea is strongly associated with obesity, particularly abdominal obesity common in centrally obese males.Previous studies have demonstrated that intra-abdominal pressure (IAP) is increased in morbid obesity, and tracheal traction forces may influence pharyngeal airway collapsibility.This study aimed to investigate that whether IAP plays a role in the mechanism of upper airway (UA) collapsibility via IAP-related caudal tracheal traction.Methods: An abdominal wall lifting (AWL) system and graded CO2 pneumoperitoneum pressure was applied to four supine, anesthetized Guizhou miniature pigs and its effects on tracheal displacement (TD) and airflow dynamics of UA were studied.Individual run data in 3 min obtained before and after AWL and obtained before and after graded pneumoperitoneum pressure were analyzed.Differences between baseline and AWL/graded pneumoperitoneum pressure data of each pig were examined using a Student's t-test or analysis of variance.Results: Application of AWL resulted in decreased IAP and significant caudal TD.The average displacement amplitude was 0.44 mm (P < 0.001).There were three subjects showed increased tidal volume (TV) (P < 0.0l) and peak inspiratory airflow (P < 0.01);however, the change of flow limitation inspiratory UA resistance (Rua) was not significant.Experimental increased IAP by pneumoperitoneum resulted in significant cranial TD.The average displacement amplitude was 1.07 mm (P < 0.001) when IAP was 25 cmH20 compared to baseline.There were three subjects showed reduced Rua while the TV increased (P < 0.01).There was one subject had decreased TV and elevated Rua (P < 0.001).Conclusions: Decreased IAP significantly increased caudal TD, and elevated IAP significantly increased cranial TD.However, the mechanism of UA collapsibility appears primarily mediated by changes in lung volume rather than tracheal traction effect.TV plays an independent role in the mechanism of UA collapsibility.

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

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    Smereczyński, Andrzej; Kołaczyk, Katarzyna; Bernatowicz, Elżbieta

    2015-09-01

    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 identification of fat is relatively easy using computed tomography and magnetic resonance imaging. It can be more difficult 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 fluid and the number of connective tissue septa, i.e. elements that potentiate the number of areas that reflect and scatter ultrasonic waves. The normal adipose tissue presents itself on a broad gray scale: from a hyperechoic area, through numerous structures of lower reflection intensity, to nearly anechoic regions mimicking the presence of pathological fluid collections. The features that facilitate proper identification of this tissue are: sharp margins, homogeneous structure, high compressibility under transducer pressure, no signs of infiltration 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 identification of the adipose tissue in the abdominal cavity using ultrasonography is not always easy. When in doubt, the

  11. Two cases of monomicrobial intraabdominal abscesses due to KPC - 3 Klebsiella pneumoniae ST258 clone

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    Madonia Simona

    2011-09-01

    Full Text Available Abstract Background Knowledge of the etiology of pyogenic liver and pancreatic abscesses is an important factor in determining the success of combined surgical and antibiotic treatment. Literature shows geographical variations in the prevalence and distribution of causative organisms, and the spread of Klebsiella pneumoniae carbapenemase-producing bacteria is an emerging cause of abdominal infections. Case presentation We herein describe two cases of intra-abdominal abscesses due to monomicrobial infection by Klebsiella pneumoniae Sequence Type 258 producing K. pneumoniae carbapenemase 3 (KPC-Kp. In case 1, a 50-year-old HIV-negative Italian woman with chronic pancreatitis showed infection of a pancreatic pseudocystic lesion caused by KPC-Kp. In case 2, a 64-year-old HIV- negative Italian woman with pancreatic neoplasm and liver metastases developed a liver abscess due to KPC after surgery. Both women were admitted to our hospital but to different surgical units. The clonal relationship between the two isolates was investigated by pulsed-field gel electrophoresis (PFGE. In case 2, the patient was already colonized at admission and inter-hospital transmission of the pathogen was presumed. A long-term combination regimen of colistin with tigecycline and percutaneous drainage resulted in full recovery and clearance of the multidrug-resistant (MDR pathogen. Conclusions Timely microbiological diagnosis, the combined use of new and old antibiotics and radiological intervention appeared to be valuable in managing these serious conditions. The emergence and dissemination of MDR organisms is posing an increasing challenge for physicians to develop new therapeutic strategies and control and prevention frameworks.

  12. Synergistic Effect of Combined Hollow Viscus Injuries on Intra-Abdominal Abscess Formation.

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    Paulus, Elena M; Croce, Martin A; Shahan, Charles P; Zarzaur, Ben L; Sharpe, John P; Dileepan, Amirtha; Boyd, Brandon S; Fabian, Timothy C

    2015-07-01

    The strong association between penetrating colon injuries and intra-abdominal abscess (IAA) formation is well established and attributed to high colon bacterial counts. Since trauma patients are rarely fasting at injury, stomach and small bowel colony counts are also elevated. We hypothesized that there is a synergistic effect of increased IAA formation with concomitant stomach and/or colon injuries when compared to small bowel injuries alone. Consecutive patients at a level one trauma center with penetrating small bowel (SB), stomach (S), and/or colon (C) injuries from 1996 to 2012 were reviewed. Logistic regression determined associations with IAA, adjusting for age, gender, Injury Severity Score (ISS), admission Glasgow Coma Score, transfusions, and concurrent pancreas or liver injury. A total of 1518 patients (91% male, ISS = 15.9 ± 8.4) were identified: 496 (33%) SB, 231 (15%) S, 288 (19%) C, 40 (3%) S + SB, 69 (5%) S + C, 338 (22%) C + SB, and 56 (4%) S + C + SB. 148 (10%) patients developed IAA: 4 per cent SB, 9 per cent S, 10 per cent C, 5 per cent S + SB, 22 per cent S + C, 13 per cent C + SB, and 25 per cent S + C + SB. Multiple logistic regression demonstrated that ISS, 24 hour blood transfusions, and concomitant pancreatic or liver injuries were associated with IAA. Compared with reference SB, S or S + SB injuries were no more likely to develop IAA. However, S + C, SB + C, and S + C + SB injuries were significantly more likely to have IAA. In conclusion, combined stomach + colon, small bowel + colon, and stomach, colon, + small bowel injuries have a synergistic effect leading to increased IAA formation after penetrating injuries. Heightened clinical suspicion for IAA formation is necessary in these combined hollow viscus injury patients.

  13. Ceftolozane/Tazobactam: A Review in Complicated Intra-Abdominal and Urinary Tract Infections.

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    Scott, Lesley J

    2016-02-01

    Globally, the increasing prevalence of multidrug-resistant pathogens continues to pose major problems in healthcare systems and, at least in part, is driving an initiative to develop new antibacterials, such as ceftolozane (a cephalosporin β-lactam). Adding a β-lactamase inhibitor (e.g. tazobactam) to a β-lactam extends its spectrum of activity against β-lactamase-producing microorganisms (a key mechanism of resistance to β-lactams). Ceftolozane/tazobactam (Zerbaxa™), a β-lactam/β-lactamase inhibitor combination, is indicated for the treatment of adults with complicated intra-abdominal infections (cIAI) or complicated urinary tract infections (cUTI), including pyelonephritis. In multinational, phase 3 noninferiority trials, intravenous ceftolozane/tazobactam was an effective and generally well tolerated treatment in patients with cIAI or cUTI. In the ASPECT-cIAI trial, ceftolozane/tazobactam plus metronidazole was noninferior to meropenem in terms of clinical cure rates at the test-of-cure (TOC) visit, with clinical cure rates in subgroup analyses consistent with those in the primary analysis. In the ASPECT-cUTI trial, ceftolozane/tazobactam was superior to levofloxacin in terms of composite cure rates (clinical cure plus microbiological eradiation) at the TOC visit. Further clinical experience should help to more definitively position ceftolozane/tazobactam in the treatment of cIAI and cUTI, including in patients with renal impairment. In the meantime, given its very good in vitro activity against extended-spectrum β-lactamase-producing Enterobacteriaceae and drug-resistant Pseudomonas aeruginosa isolates, ceftolozane/tazobactam provides a potential alternative to currently approved antibacterials for empirical treatment of cIAI and cUTI in adults.

  14. Correlation study of intra-abdominal fat accumulation and ambulatory blood pressure

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    Li ZHANG

    2012-05-01

    Full Text Available Objective  To explore the influence of intra-abdominal fat (IAF accumulation on ambulatory blood pressure (ABP. Methods  Four hundred and forty-eight hospitalized patients with cardiovascular and metabolic diseases, including 235 males and 213 females, aged 20-85 (55±12 years old, were enrolled in this study. The abdominal fatty thickness was measured with B-mode ultrasound. Simultaneously the patient received 24hABP monitoring. The patients were divided into excessive IAF group, normal group, and quintile subgroups according to the cut-off points (male 38.5mm, female 34.7mm for observing the difference in indexes of ambulatory blood pressure between different groups/subgroups. Results  The 24h mean systolic BP (24hMSBP, 24h mean BP (24hMBP, 24h mean diastolic BP (24hMDBP, daytime MSBP (dMSBP, daytime MBP (dMBP, daytime MDBP (dMDBP, nighttime MSBP (nMSBP, nighttime MBP (nMBP, night MDBP (nMDBP were significantly higher in the excessive IAF group than in the normal group (P < 0.05. However, the elevation of ABP was not a simple gradual linear elevation corresponding to a gradual increase in IAF thickness, but manifested an approximately U-shaped trend. Pearson correlation analysis showed IAF thickness was positively correlated with all the indexes of 24hABP, while partial correlation analysis after adjustment for age and sex showed IAF thickness was positively correlated with 24hSBP, 24hMBP, dMBP and nMBP. Conclusion  The relationship between IAF thickness and ABP presents a U-shaped curve, which may provide an enlightenment in controlling blood pressure by weight loss in clinical work.

  15. Decreased Risk of Ventilator-Associated Pneumonia in Sepsis Due to Intra-Abdominal Infection.

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    François Philippart

    Full Text Available Experimental studies suggest that intra-abdominal infection (IAI induces biological alterations that may affect the risk of lung infection.To investigate the potential effect of IAI at ICU admission on the subsequent occurrence of ventilator-associated pneumonia (VAP.We used data entered into the French prospective multicenter Outcomerea database in 1997-2011. Consecutive patients who had severe sepsis and/or septic shock at ICU admission and required mechanical ventilation for more than 3 days were included. Patients with acute pancreatitis were not included.Of 2623 database patients meeting the inclusion criteria, 290 (11.1% had IAI and 2333 (88.9% had other infections. The IAI group had fewer patients with VAP (56 [19.3%] vs. 806 [34.5%], P<0.01 and longer time to VAP (5.0 vs.10.5 days; P<0.01. After adjustment on independent risk factors for VAP and previous antimicrobial use, IAI was associated with a decreased risk of VAP (hazard ratio, 0.62; 95% confidence interval, 0.46-0.83; P<0.0017. The pathogens responsible for VAP were not different between the groups with and without IAI (Pseudomonas aeruginosa, 345 [42.8%] and 24 [42.8%]; Enterobacteriaceae, 264 [32.8%] and 19 [34.0%]; and Staphylococcus aureus, 215 [26.7%] and 17 [30.4%], respectively. Crude ICU mortality was not different between the groups with and without IAI (81 [27.9%] and 747 [32.0%], P = 0.16.In our observational study of mechanically ventilated ICU patients with severe sepsis and/or septic shock, VAP occurred less often and later in the group with IAIs compared to the group with infections at other sites.

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

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    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

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

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    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.

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

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    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. 

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

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    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.

  20. 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.

  1. New scoring system for intra-abdominal injury diagnosis after blunt trauma

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    Shojaee Majid

    2014-02-01

    Full Text Available 【Abstract】Objective: An accurate scoring system for intra-abdominal injury (IAI based on clinical manifestation and examination may decrease unnecessary CT scans, save time, and reduce healthcare cost. This study is designed to provide a new scoring system for a better diagno- sis of IAI after blunt trauma. Methods: This prospective observational study was performed from April 2011 to October 2012 on patients aged above 18 years and suspected with blunt abdominal trauma (BAT admitted to the emergency department (ED of Imam Hussein Hospital and Shohadaye Hafte Tir Hospital. All patients were assessed and treated based on Advanced Trauma Life Support and ED protocol. Diagnosis was done according to CT scan findings, which was considered as the gold standard. Data were gathered based on patient's history, physical exam, ultrasound and CT scan findings by a general practitioner who was not blind to this study. Chisquare test and logistic regression were done. Factors with significant relationship with CT scan were imported in multivariate regression models, where a coefficient (β was given based on the contribution of each of them. Scoring system was developed based on the obtained total βof each factor. Results: Altogether 261 patients (80.1% male were enrolled (48 cases of IAI. A 24-point blunt abdominal trauma scoring system (BATSS was developed. Patients were divided into three groups including low (score<8, moderate (8≤score<12 and high risk (score≥12. In high risk group immediate laparotomy should be done, moderate group needs further assessments, and low risk group should be kept under observation. Low risk patients did not show positive CT-scans (specificity 100%. Conversely, all high risk patients had positive CT-scan findings (sensitivity 100%. The receiver operating characteristic curve indicated a close relationship between the results of CT scan and BATSS (sensitivity=99.3%. Conclusion: The present scoring system furnishes a

  2. 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.

  3. Effects of recombinant human growth hormone on rat septic shock with intraabdominal infection by E. coli

    Institute of Scientific and Technical Information of China (English)

    Ying Huang; Shu-Ren Wang; Cheng Yi; Ming-Ying Ying; Ying Lin; Mao-Hui Zhi

    2002-01-01

    AIM: To investigate the therapeutic effects of recombinant human growth hormone (rhGH) on rat septic shock with intraabdominal infection by E. coli and its possible mechanism. METHODS: 76 SD rats were divided into 3 groups randomly:control group (group C, n=16) without any special treatnent,of E. coli(1×1010 cfu@ L-1,15 ml@kg-1, ip), treated group (group by rhGH injection (2.25 U@kg-1@d-1, im). Group S and group T were further divided into 1d and 3d subgroups, respectively (n=15 each). Mean arterial pressure (MAP), levels of plasma TNFα and endotoxin and leukocyte count were determined on 1st day and 3rd day after E. coli injection. Another 39 SD rats were divided into groups C, S and T (n=13 each) just for observing survival rate within 1 week.RESULTS: (1) On 1st and 3rd day, MAP in group S decreased markedly, and MAP on 1st day lowered more than that of 3rd day (P<0.01), while MAP in group T just decreased slightly. The survival rate within 1 week was much higher in group T (84.6 %) than in group S (46.2 %) (P<0.01). (2)On 1st day, plasma TNFα and endotoxin elevated significantly in group S and group T (P<0.05), and endotoxin in group S had more increase (P<0.01). On 3rd day, TNFα in group S returned to the level of group C (P>0.05),while TNFα in group T went down below the level of group C(P<0.01). On 3rd day, endotoxin in group S declined, but was still higher than that of group C (P<0.01), endotoxin in group T returned to the level of group C (P>0.05). (3) On 1st day, neutrophil ratio in total leukocyte count in both group S and group T increased significantly (P<0.05 vs group C).CONCLUSION: rhGH showed beneficial effects on rat septic shock. The possible mechanisms may involve the attenuation of bacteria/endotoxin translocation and decreased systemic endotoxin level; inhibition of the production and release of TNFα; improved circulatory function; improved systemic host defenses and maintenance of intestinal mucosa barrier.

  4. 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.

  5. Influence of lumbar spine rhythms and intra-abdominal pressure on spinal loads and trunk muscle forces during upper body inclination.

    Science.gov (United States)

    Arshad, Rizwan; Zander, Thomas; Dreischarf, Marcel; Schmidt, Hendrik

    2016-04-01

    Improved knowledge on spinal loads and trunk muscle forces may clarify the mechanical causes of various spinal diseases and has the potential to improve the current treatment options. Using an inverse dynamic musculoskeletal model, this sensitivity analysis was aimed to investigate the influence of lumbar spine rhythms and intra-abdominal pressure on the compressive and shear forces in L4-L5 disc and the trunk muscle forces during upper body inclination. Based on in vivo data, three different spine rhythms (SRs) were used along with alternative settings (with/without) of intra-abdominal pressure (IAP). Compressive and shear forces in L4-L5 disc as well as trunk muscle forces were predicted by inverse static simulations from standing upright to 55° of intermediate trunk inclination. Alternate model settings of intra-abdominal pressure and different spine rhythms resulted in significant variation of compression (763 N) and shear forces (195 N) in the L4-L5 disc and in global (454 N) and local (156 N) trunk muscle forces at maximum flexed position. During upper body inclination, the compression forces at L4-L5 disc were mostly released by IAP and increased for larger intervertebral rotation in a lumbar spine rhythm. This study demonstrated that with various possible assumptions of lumbar spine rhythm and intra-abdominal pressure, variation in predicted loads and muscles forces increase with larger flexion. It is therefore, essential to adapt these model parameters for accurate prediction of spinal loads and trunk muscle forces.

  6. Treatment of intra-abdominal abscesses caused by Candida albicans with antifungal agents and recombinant murine granulocyte colony-stimulating factor.

    NARCIS (Netherlands)

    Vonk, A.G.; Netea, M.G.; Krieken, J.H.J.M. van; Verweij, P.E.; Meer, J.W.M. van der; Kullberg, B.J.

    2003-01-01

    The aim of the present study was to assess the influence of immunomodulation of host defense with recombinant murine granulocyte colony-stimulating factor (rmG-CSF) on intra-abdominal abscesses caused by Candida albicans. Mice received prophylaxis or therapy with 1 microg of rmG-CSF/day in the prese

  7. Current recognition and management of intra-abdominal hypertension and abdominal compartment syndrome among tertiary Chinese intensive care physicians

    Institute of Scientific and Technical Information of China (English)

    Jian-cang ZHOU; Hong-chen ZHAO; Kong-han PAN; Qiu-ping XU

    2011-01-01

    This survey was designed to clarify the current understanding and clinical management of intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) among intensive care physicians in tertiary Chinese hospitals. A postal twenty-question questionnaire was sent to 141 physicians in different intensive care units (ICUs). A total of 108 (76.6%) questionnaires were returned. Among these, three quarters worked in combined medical-surgical ICUs and nearly 80% had primary training in internal or emergency medicine. Average ICU beds, annual admission,ICU length of stay, acute physiology and chronic health evaluation (APACHE) Ⅱ score, and mortality were 18.2 beds,764.5 cases, 8.3 d, 19.4, and 21.1%, respectively. Of the respondents, 30.6% never measured intra-abdominal pressure (IAP). Although the vast majority of the ICUs adopted the exclusively transvesicular method, the over-whelming majority (88.0%) only measured IAP when there was a clinical suspicion of IAH/ACS and only 29.3% measured either often or routinely. Moreover, 84.0% used the wrong priming saline volume while 88.0% zeroed at reference points which were not in consistence with the standard method for IAP monitoring recommended by the World Society of Abdominal Compartment Syndrome. ACS was suspected mainly when there was a distended ab-domen (92%), worsening oliguria (80%), and increased ventilatory support requirement (68%). Common causes for IAH/ACS were "third-spacing from massive volume resuscitation in different settings" (88%), "intra-abdominal bleed-ing", and "liver failure with ascites" (52% for both). Though 60% respondents would recommend surgical decompres-sion when the IAP exceeded 25 mmHg, accompanied by signs of organ dysfunction, nearly three quarters of re-spondents preferred diuresis and dialysis. A total of 68% of respondents would recommend paracentesis in the treatment for ACS. In conclusion, urgent systematic education is absolutely necessary for most intensive care physi

  8. 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

  9. Prospective observational study of the frequency and features of intra-abdominal abscesses in patients with melioidosis in northeast Thailand.

    Science.gov (United States)

    Maude, Rapeephan R; Vatcharapreechasakul, Teerapon; Ariyaprasert, Pitchayanant; Maude, Richard J; Hongsuwan, Maliwan; Yuentrakul, Prayoon; Limmathurotsakul, Direk; Koh, Gavin C K W; Chaowagul, Wipada; Day, Nicholas P J; Peacock, Sharon J

    2012-10-01

    Retrospective case series from Thailand have reported the presence of intra-abdominal abscesses in around half of patients with melioidosis, a much higher rate than our clinical experience would suggest. We performed a prospective, observational study of 230 adult patients with culture-confirmed melioidosis in which all patients underwent abdominal ultrasound. One or more abscesses were detected in the liver and/or spleen in 77 (33%) cases. These were often multiple (70%, 31/44 in hepatic abscesses and 88%, 50/57 in splenic abscesses) and clinically silent (27% of cases with abscesses presenting with abdominal pain). The mortality rate at 4 weeks post-discharge was lower in patients who were abscess-positive vs abscess-negative (10%, 8/77 vs 20%, 31/153).

  10. The effect of exercise training on hormone-sensitive lipase in rat intra-abdominal adipose tissue and muscle

    DEFF Research Database (Denmark)

    Enevoldsen, L H; Stallknecht, B; Langfort, J

    2001-01-01

    1. Adrenaline-stimulated lipolysis in adipose tissue may increase with training. The rate-limiting step in adipose tissue lipolysis is catalysed by the enzyme hormone-sensitive lipase (HSL). We studied the effect of exercise training on the activity of the total and the activated form of HSL......, n = 12) or sedentary (S, n = 12). Then RE and ME adipose tissue and the EDL and soleus muscles were incubated for 20 min with 4.4 microM adrenaline. 3. HSL enzyme activities in adipose tissue were higher in T compared with S rats. Furthermore, in RE adipose tissue, training also doubled HSL protein...... not differ between T and S rats (P > 0.05). 4. In conclusion, training increased the amount of HSL and the sensitivity of HSL to stimulation by adrenaline in intra-abdominal adipose tissue, the extent of the change differing between anatomical locations. In contrast, in skeletal muscle the amount of HSL...

  11. 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

    ) 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......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......]glucose and microdialysis techniques. Blood flow was measured by microspheres. Upon insulin stimulation, blood flow generally decreased in AT. Flow was higher in mesenteric tissue than in other ATs, whereas insulin-mediated glucose uptake did not differ between ATs. Training doubled the glucose infusion rate during...

  12. 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...... 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...... were correlated (r = 0.65, P fat, liver fat or IA fat explained variation in fS-triglyceride (TG) and high-density lipoprotein (HDL) cholesterol, plasma glucose, insulin and liver enzyme concentrations, and hepatic...

  13. New drugs for the treatment of complicated intra-abdominal infections in the era of increasing antimicrobial resistance.

    Science.gov (United States)

    Syue, Ling-Shan; Chen, Yen-Hsu; Ko, Wen-Chien; Hsueh, Po-Ren

    2016-04-01

    The continuing increase in multidrug-resistant organisms (MDROs) worldwide has created new challenges in treating complicated intra-abdominal infections (cIAIs). A number of novel antimicrobial agents have been developed against resistant pathogens. To target extended-spectrum β-lactamase (ESBL)-producing pathogens, novel β-lactam antibiotics, such as ceftolozane/tazobactam, ceftazidime/avibactam, aztreonam/avibactam, imipenem/relebactam and S-649266, are antimicrobial alternatives for cIAIs. Two new drugs, eravacycline and plazomicin, have activity against Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae, carbapenem-resistant Acinetobacter baumannii and ESBL-producers. New lipoglycopeptides and oxazolidinones provide feasible options against resistant Gram-positive pathogens. These novel antimicrobials may play a role in improving the clinical outcomes of cIAIs caused by MDROs.

  14. [Mutual role of factors of endotoxicosis and intra-abdominal hypertension syndrome in pathogenesis of abdominal sepsis].

    Science.gov (United States)

    Veliev, N A; Gasanova, D N; Ismailov, V F

    2013-10-01

    The mutual role of the main factors of endotoxicosis and intraabdominal hypertension syndrome (IHS) were studied in pathogenesis of abdominal sepsis, basing on analysis of the treatment results in 156 patients, suffering this disease. The contents of neutrophils, macrophages, interleukins (IL-6, IL-10) were studied in peritoneal exudate as the indices of the source of inflammation in abdominal cavity. There was established the mutual strengthening of the endotoxicosis and IHS factors, what causes the clinical signs of the organ dysfunction, determines the course severity and outcome of pathological process in the organism. Such approach to pathogenesis of abdominal sepsis permits in time and adequately to elaborate the certain program of treatment in the patients.

  15. Efficacy of vitamin E and selenium for the prevention of intra-abdominal adhesions in rats: uterine horn models

    Directory of Open Access Journals (Sweden)

    Ali Said Durmus

    2011-01-01

    Full Text Available OBJECTIVE: This study compares the efficacies of vitamin E and selenium, both individually and in combination, for the prevention of postoperative intra-abdominal adhesions in rats. METHODS: Forty-seven female rats were divided into five groups. The sham animals (S group, n = 7 were given only laparotomies and intraperitoneally received 0.9% NaCl (2 ml. In the 40 other rats, abrasions of the left uterine horn were performed, followed by intraperitoneal administration of either 2 ml 0.9% NaCl (C group, 10 mg vitamin E (vitamin E group, 0.2 mg/kg selenium (Se group or 10 mg vitamin E with 0.2 mg/kg selenium (vitamin E + Se group, with 10 animals in each treatment group. RESULTS: Adhesion formation was significantly reduced in animals in the Se and vitamin E + Se groups (p<0.05. Tissue catalase and glutathione peroxidase activities did not significantly differ between the groups. However, catalase and glutathione peroxidase activities and reduced glutathione levels were slightly increased in the vitamin E, Se and vitamin E + Se groups. In the vitamin E group, malondialdehyde concentrations were significantly lower than in the C group (p<0.05, but no significant differences were present among the S, C, Se and vitamin E + Se groups. Levels of nitric oxide were significantly higher in the C group than in the other groups (p<0.01. CONCLUSION: Intraperitoneal administration of selenium or combined vitamin E and selenium appears to be effective in preventing intra-abdominal adhesion formation in rat models through the reduction of lipid peroxidation products.

  16. 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

  17. Análisis de las relaciones y efectos de los niveles de aptitud muscular sobre la coordinación motriz general y la adiposidad corporal en población escolar de 6 a 9 años

    OpenAIRE

    Casas, Ángel Adrián

    2017-01-01

    [Resumen] El desarrollo de inactividad física y obesidad es crítico durante la niñez, ya que la actividad física es esencial para el crecimiento, maduración y bienestar. El incremento de la aptitud muscular en los niños reduce la mortalidad, el riesgo cardio-metabólico y la adiposidad total. La evidencia señala que los niños han reducido su actividad física y sus niveles de fuerza y habilidades básicas. La escuela es el ámbito más idóneo para revertir esta tendencia que compromete a la sal...

  18. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  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......% was in ribose and 11% in guanine. This aberrant 3H labelling could be avoided using [1-3H]inositol. Copyright © 2000 John Wiley & Sons, Ltd....

  1. Activities of the Oxazolidinones Linezolid and Eperezolid in Experimental Intra-Abdominal Abscess Due to Enterococcus faecalis or Vancomycin-Resistant Enterococcus faecium

    OpenAIRE

    1999-01-01

    The in vivo effectiveness of oxazolidinones eperezolid (U-100592) and linezolid (U-100766) against one strain each of Enterococcus faecalis and vancomycin-resistant Enterococcus faecium was examined in a rat model of intra-abdominal abscess. MICs of both drugs were 2 μg/ml for each strain. At doses of 25 mg/kg of body weight twice daily intravenously or orally, linezolid produced small but statistically significant reductions in abscess bacterial density for E. faecalis. The reduction in viab...

  2. The use of body circumferences for the prediction of intra-abdominal fat in obese women with polycystic ovary syndrome El uso de circunferencias corporales para la predicción de la grasa intra-abdominal en mujeres obesas con el síndrome del ovario poliquístico

    Directory of Open Access Journals (Sweden)

    F. Rodrigues de Oliveira Penaforte

    2012-10-01

    Full Text Available Introduction: Computerizd tomography (CT is the gold standard for the evaluation of intra- (IAF and total (TAF abdominal fat; however, the high cost of the procedure and exposure to radiation limit its routine use. Objective: To develop equations that utilize anthropometric measures for the estimate of IAF and TAF in obese women with polycystic ovary syndrome (PCOS. Methods: The weight, height, BMI, and abdominal (AC, waist (WC, chest (CC, and neck (NC circumferences of thirty obese women with PCOS were measured, and their IAF and TAF were analyzed by CT. Results: The anthropometric variables AC, CC, and NC were chosen for the TAF linear regression model because they were better correlated with the fat deposited in this region. The model proposed for TAF (predicted was: 4.63725 + 0.01483 x AC - 0.00117 x NC - 0.00177 x CC (R² = 0.78; and the model proposed for IAF was: IAF (predicted = 1.88541 + 0.01878 x WC + 0.05687 x NC -0.01529 x CC (R²=0.51. AC was the only independent predictor of TAF (p Introducción: La tomografia computarizada (TC es el estándar de oro para la evaluación de la grasa intra-abdominal (GIA y abdominal total (GAT, pero los altos costos y la exposición a la radiación limitan su uso rutinario. Objetivo: Desarrollar ecuaciones para la estimación de la GIA y la GAT en mujeres obesas con el sindrome del ovario poliquistico, utilizando medidas antropométricas. Métodos: Se evaluó el peso, la altura, el IMC y las circunferencias abdominal (CA, cintura (CC, pecho (CP y cuello (Ccu de 30 mujeres obesas con SOP. La GIA y GAT fueron analizados por la TC. Resultados: El modelo propuesto fue: GAT = 4,63725 + 0,01483 x CA - 0.00117 x CCu - 0,00177 x CP (R² = 0,78; y para la GIA fue: GIA = 1, 88541 + 0, 01878 x CC + 0,05687 x CCu - 0,01529 x CP (R² = 0,51. La CA fue La única variable predictora independiente de la GAT (p < 0,01. Conclusión: Las equaciones propuestas correlacionaronse bien con el valor real, medido a trav

  3. Empiema por Fusobacterium necrophorum

    OpenAIRE

    ML. Valle Feijoo; M. Rodriguez Arias; A. Cobas Paz; J. De la Fuente Aguado

    2014-01-01

    Resumen La infección sistémica por Fusobacterium necrophorum se caracteriza por la tríada clásica de trombosis de la vena yugular interna, bacteriemia y focos metastásicos y se conoce como Síndrome de Lemierre (SL), sepsis post-angina o necrobacilosis. El compromiso pulmonar precipitado por la embolización séptica es extremadamente común en el SL, sin embargo el F. necrohorum raramente se asila en empiemas sin SL concurrente, por lo que hemos estimado oportuno comunicar un nuevo caso clíni...

  4. Celulitis por citomegalovirus

    OpenAIRE

    2002-01-01

    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 eritemato...

  5. T helper type 2-polarized invariant natural killer T cells reduce disease severity in acute intra-abdominal sepsis.

    Science.gov (United States)

    Anantha, R V; Mazzuca, D M; Xu, S X; Porcelli, S A; Fraser, D D; Martin, C M; Welch, I; Mele, T; Haeryfar, S M M; McCormick, J K

    2014-11-01

    Sepsis is characterized by a severe systemic inflammatory response to infection that is associated with high morbidity and mortality despite optimal care. Invariant natural killer T (iNK T) cells are potent regulatory lymphocytes that can produce pro- and/or anti-inflammatory cytokines, thus shaping the course and nature of immune responses; however, little is known about their role in sepsis. We demonstrate here that patients with sepsis/severe sepsis have significantly elevated proportions of iNK T cells in their peripheral blood (as a percentage of their circulating T cells) compared to non-septic patients. We therefore investigated the role of iNK T cells in a mouse model of intra-abdominal sepsis (IAS). Our data show that iNK T cells are pathogenic in IAS, and that T helper type 2 (Th2) polarization of iNK T cells using the synthetic glycolipid OCH significantly reduces mortality from IAS. This reduction in mortality is associated with the systemic elevation of the anti-inflammatory cytokine interleukin (IL)-13 and reduction of several proinflammatory cytokines within the spleen, notably interleukin (IL)-17. Finally, we show that treatment of sepsis with OCH in mice is accompanied by significantly reduced apoptosis of splenic T and B lymphocytes and macrophages, but not natural killer cells. We propose that modulation of iNK T cell responses towards a Th2 phenotype may be an effective therapeutic strategy in early sepsis.

  6. Not All Abdomens Are the Same: A Comparison of Damage Control Surgery for Intra-abdominal Sepsis versus Trauma.

    Science.gov (United States)

    Smith, Jason W; Nash, Nick; Procter, Levi; Benns, Matthew; Franklin, Glen A; Miller, Keith; Harbrecht, Brian G; Bernard, Andrew C

    2016-05-01

    Damage control surgery (DCS) was developed to manage exsanguinating trauma patients, but is increasingly applied to the management of peritoneal sepsis and abdominal catastrophes. Few manuscripts compare the outcomes of these surgeries on disparate patient populations. A multi-institutional three group propensity score matched case cohort study comparing penetrating trauma (PT-DCS), blunt trauma (BT-DCS), and intraperitoneal sepsis (IPS-DCS) was performed comparing patients treated with DSC between 2008 and 2013. Propensity scoring was performed using demographic and presenting physiologic data. Four hundred and twelve patients were treated with DCS across two institutions. Propensity matching for age, gender, and initial Acute Physiology and Chronic Health Evaluation II score 80 identified 80 patients per group for comparison. Rate of primary fascial closure was lowest in the IPS-DCS group, and highest in the penetrating trauma DCS group. Intra-abdominal complication rates were highest in the IPS-DCS group. IPS-DCS had increased time to definitive closure compared with the other two groups (RR 1.8; 1.3-2.2; P eight days were more than twice the risk of death at 90 days across all groups. (RR 2.15; 1.2-3.5; P abdominal closure at the earliest possible opportunity afforded the best outcome in patients managed via DCS.

  7. "EFFECTIVENESS OF ABDOMINAL WALL ELEVATOR IN REDUCING INTRA-ABDOMINAL PRESSURE AND CO2 VOLUME DURING LAPAROSCOPIC CHOLECYSTECTOMY"

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    A. Yaghoobi Notash

    2004-06-01

    Full Text Available Since CO2 pneumoperitoneum is the dominant method of laparoscopic exposure due to facility and good view, its physiologic effects are most relevant to the surgeons. CO2 pneumoperitoneum may affects hemodynamics by increased intra-abdominal pressure (IAP and the physiologic effects of absorbed CO2. The adverse effects of both mechanisms relate directly to the duration of the pneumoperitoneum and the elevation of IAP. Gasless laparoscopy involves obtaining exposure for laparoscopy by placing an internal retracting device through a small incision and lifting the anterior abdominal wall. We designed and made a mechanical wall elevator and used it in 24 patients, compared with a control group (52 cases using a conventional laparoscopic cholecystectomy. A prospective trial was undertaken in Sina Hospital, Tehran University of Medical Sciences from 1998 to 2000. The patients were assigned randomly to two groups. There was a significant decrease in IAP and CO2 consumption in the group using mechanical wall elevator as compared to conventional laparoscopic cholecystectomy, (mean IAP of 3.5 mmHg compared to 11.4 mmHg in the control group, mean CO2 volume 17 liters compared to 73 liters in the control group. We recommend this semigasless method in laparoscopy due to safety in performance and significant reduction in IAP through the surgery. This method provides a satisfactory view and easy performance without any increase in time or complications. The hospital stay and costs did not increase.

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

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    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.

  9. The Association between Self-Reported Energy Intake and Intra-Abdominal Adipose Tissue in Perimenopausal Women

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    Rasa Kazlauskaite

    2012-01-01

    Full Text Available We have previously shown that physical activity predicts intra-abdominal adipose tissue (IAT, but it is unknown whether energy intake predicts IAT independently of physical activity in a community-based, naturalistic environment. The association of energy intake with IAT was explored cross-sectionally in women, recruited between 2002 and 2005 for a study of fat patterning in midlife. IAT at L4-L5 vertebral interspace was assessed by computed tomography, energy intake by the Block Food Frequency Questionnaire, and physical activity by the Kaiser Physical Activity Survey. Linear regression models were used for the principal analyses. Among the 257 women, 48% were African American and 52% were Caucasian. Women were 52±3 years old, and 49% were postmenopausal. Every 500 kcal increase in energy intake was associated with a 6% higher IAT (P=0.02, independent of physical activity (P=0.02, after adjustment for ethnicity, menopausal status, age, smoking, income, and DXA-assessed percent body fat. Energy intake had a significant interaction with ethnicity (P=0.02, but not with physical activity. Models using the IAT to subcutaneous abdominal adipose tissue ratio as an outcome had similar associations. In conclusion, self-reported EI was associated with preferential IAT accumulation in midlife women, independent of physical activity. This association was significantly stronger in Caucasian than African American women. Future longitudinal studies are needed to explore lifestyle predictors of IAT accumulation during the menopausal transition.

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

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    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.

  11. An Intra-Abdominal Pseudocyst around a Ventriculoperitoneal Shunt due to Streptococcus Infection 7 Years after Shunt Surgery

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    Arata Tomiyama

    2014-01-01

    Full Text Available In 1999, a 50-year-old woman underwent ventriculoperitoneal (VP shunt surgery for hydrocephalus after subarachnoid hemorrhage. She was hospitalized for fever and recurrent systemic seizures in November 2006. Head computed tomography (CT showed only old changes. The seizures and fever were controlled by medicinal therapy. However, in December, her consciousness level suddenly decreased, and she showed progressive lower abdominal distension. Head CT showed marked ventriculomegaly, and abdominal CT showed a giant cystic mass at the shunt-tube tip in the lower abdominal cavity. Because thick pus was aspirated from the intra-abdominal mass, we diagnosed the patient with acute obstructive hydrocephalus due to an infected abdominal pseudocyst. Laparotomy and direct cyst drainage were performed, and antibiotic therapy against Streptococcus, the causative pathogen, was administered. The VP shunt tube was replaced. The postoperative course was uneventful, and postoperative CT showed hydrocephalus improvement and no pseudocyst recurrence. Abdominal pseudocysts, which are rare after VP shunt surgeries, usually occur after the subacute postoperative course in younger cerebral hemorrhagic cases. Our case was quite rare because the cyst developed in the chronic phase in an older patient and was caused by streptococcal infection. The cyst components should be examined before cyst drainage when choosing surgical strategies.

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

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    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.

  13. Impact of Abdominal Follow-Up Sonography in Trauma Patients Without Abdominal Parenchymal Organ Lesion or Free Intraabdominal Fluid in Whole-Body Computed Tomography.

    Science.gov (United States)

    Schneck, Emmanuel; Koch, Christian; Borgards, Mara; Reichert, Martin; Hecker, Andreas; Heiß, Christian; Padberg, Winfried; Alejandre-Lafont, Enrique; Röhrig, Rainer; Krombach, Gabriele Anja; Weigand, Markus; Bernhard, Michael; Roller, Fritz Christian

    2017-02-01

    Purpose Patients suffering from severe blunt abdominal trauma are challenging because of their need for accurate diagnostic imaging and fast therapeutic action. Whole-body computed tomography (WBCT) is highly sensitive and represents the gold standard in the trauma room diagnostic setting. The aim of our study was to investigate the impact and therapy relevance of abdominal follow-up sonography (AFS) as part of the tertiary trauma survey (TTS) in patients without abdominal parenchymal organ lesions or free abdominal fluid in initial WBCT. Materials and Methods All adult patients without abdominal parenchymal organ lesions or free intraabdominal fluid in the initial WBCT examination, who received AFS within 24 hours after trauma, were included in this retrospective analysis between January 2008 and December 2011. Results 316 patients were analyzed (ISS 10 ± 8, NISS 13 ± 11) according to the inclusion criteria. Overall, only small amounts of free intraabdominal fluid were detected in AFS in 3 patients (0.9 %) and remained without therapeutic consequence. None of the patients died due to intraabdominal bleeding. Conclusion AFS as part of the TTS did not show additional benefits and had no impact on further treatment in patients without abdominal parenchymal organ lesions or free intraabdominal fluid in the initial WBCT examination. We conclude that AFS is not routinely required but should be performed if indicated on a clinical or laboratory basis because of its fast and less invasive character. Key points  · Seriously injured patients are challenging for medical imaging and treatment.. · Whole-body computed tomography is known for its high accuracy in trauma patients.. · Nonetheless, missed injuries are a major challenge in trauma patients.. · Therefore, follow-up ultrasound is often performed within the tertiary trauma survey.. · Follow-up ultrasound in patients with an inconspicuous abdominal computed tomography scan did not show any

  14. 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

  15. 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.

  16. 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

  17. Antimicrobial susceptibility of Gram-negative bacteria causing intra-abdominal infections in China: SMART China 2011

    Institute of Scientific and Technical Information of China (English)

    Zhang Hui; Yang Qiwen; Xiao Meng; Chen Minjun; Robert E.Badal; Xu Yingchun

    2014-01-01

    Background The Study for Monitoring Antimicrobial Resistance Trends program monitors the activity of antibiotics against aerobic and facultative Gram-negative bacilli (GNBs) from intra-abdominal infections (IAIs) in patients worldwide.Methods In 2011,1 929 aerobic and facultative GNBs from 21 hospitals in 16 cities in China were collected.All isolates were tested using a panel of 12 antimicrobial agents,and susceptibility was determined following the Clinical Laboratory Standards Institute guidelines.Results Among the Gram-negative pathogens causing IAIs,Escherichia coli (47.3%) was the most commonly isolated,followed by Klebsiella pneumoniae (17.2%),Pseudomonas aeruginosa (10.1%),and Acinetobacter baumannii (8.3%).Enterobacteriaceae comprised 78.8% (1521/1929) of the total isolates.Among the antimicrobial agents tested,ertapenem and imipenem were the most active agents against Enterobacteriaceae,with susceptibility rates of 95.1% and 94.4%,followed by amikacin (93.9%) and piperacillin/tazobactam (87.7%).Susceptibility rates of ceftriaxone,cefotaxime,ceftazidime,and cefepime against Enterobacteriaceae were 38.3%,38.3%,61.1%,and 50.8%,respectively.The leastactive agent against Enterobacteriaceae was ampicillin/sulbactam (25.9%).The extended-spectrum β-lactamase (ESBL) rates among E.coli,K.pneumoniae,Klebsiella oxytoca,and Proteus mirabilis were 68.8%,38.1%,41.2%,and 57.7%,respectively.Conclusions Enterobacteriaceae were the major pathogens causing IAIs,and the most active agents against the study isolates (including those producing ESBLs) were ertapenem,imipenem,and amikacin.Including the carbapenems,most agents exhibited reduced susceptibility against ESBL-positive and multidrug-resistant isolates.

  18. An Umbilical/Paraumbilical Hernia as a Sign of an Intraabdominal Malignancy in the Elderly

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    Kenig Jakub

    2014-04-01

    Full Text Available The umbilical area can present with a variety of signs associated with an intra abdominal malignancy. An umbilical/paraumbilical hernia might itself be a sign of an internal malignancy. The correlation between the presence of an umbilical/paraumbilical hernia and an intra abdominal malignancy has been previously based only on case reports. The aim of the study was to evaluate the significance of an umbilical/paraumbilical hernia as a symptom of an intraabdominal malignancy. Material and methods. A retrospective analysis was performed; review of the medical records of 145 patients (113 female and 32 male; mean age 66.4±11.9 with an umbilical/paraumbilical hernia treated during the period of 2005-2013. Twenty-three patients (15.9% were diagnosed with an intra abdominal malignancy; 34% were in the age group over 75 years of age. Results. The most common malignancies were: colorectal cancer, followed by pancreatic cancer, and cancers of the adnexa and kidneys. The patients with a concomitant malignancy identified were significantly older than those without a malignancy. In 65% of patients, the diagnosis was made postoperatively. Logistic regression analysis demonstrated that age, the presence of preoperative symptoms, anemia, and weight loss were independent risk factors for concomitant abdominal cancer. Conclusion. The findings of this study support intensive preoperative diagnostic evaluation of elderly patients that are qualified for surgery for an umbilical/paraumbilical hernia. This is particularly important because most of these patients had a small/medium hernia orifice, which did not allow for accurate manual abdominal exploration. Currently, the routine preoperative diagnostic evaluation is often insufficient for an accurate diagnosis

  19. Modified Da-Cheng-Qi Decoction reduces intra-abdominal hypertension in severe acute pancreatitis: a pilot study

    Institute of Scientific and Technical Information of China (English)

    WAN Mei-hua; LI Juan; HUANG Wei; Rajarshi Mukherjee; GONG Han-lin; XIA Qing; ZHU Lin; CHENG Gui-lan; TANG Wen-fu

    2012-01-01

    Background Intra-abdominal hypertension (IAH) is a recognized prognostic marker for severity of severe acute pancreatitis (SAP) and has a strong impact on the clinical course of SAP.Previous studies indicate that a Da-Cheng-Qi Decoction (DCQD) is beneficial in the treatment of SAP.The purpose of this study was to evaluate the effect of modified DCQD on IAH in patients with SAP.Methods Between January 2008 and December 2008,42 patients from the West China Hospital were randomized into either the DCQD or control group (n=21 in each group).Mortality,intra-abdominal pressure (lAP),Acute Physiology and Chronic Health Evaluation II (APACHE II) score,C-reactive protein (CRP),oxygenation index,Balthazar CT score,rate of renal failure,decompression rate,intensive care unit (ICU) transfer rate,and length of hospital stay (LOS) were compared between the two groups.Results Compared to the control group,the modified DCQD treatment significantly decreased lAP (P <0.05) and APACHE Ⅱ (P <0.05) scores on days 4-8,CRP on day 8 (P <0.01 ),renal failure rate (P <0.05),and LOS (P <0.05).The oxygenation index was significantly improved in the DCQD group compared with the control group (P <0.05).No significant differences in the Balthazar CT score,shock rate,ICU transfer rate,or mortality occurred between the two groups.Conclusions The modified DCQD can effectively relieve IAH and decrease LOS for patients with SAP.Larger clinical trials are needed to confirm these findings.

  20. 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

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    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

  1. Factors associated with overweight and central adiposity in urban workers covered by the Workers Food Program of the Brazilian Amazon Region Fatores associados ao sobrepeso e adiposidade central em trabalhadores urbanos assistidos pelo Programa de Alimentação do Trabalhador da região amazônica do Brasil

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    Marília S. Araújo

    2010-09-01

    entre 18 e 74 anos, assistidos pelo Programa de Alimentação do Trabalhador na região metropolitana de Belém do Pará, na região norte do Brasil. Parâmetros relacionados à saúde e medidas antropométricas foram obtidas e amostra de sangue foram coletadas. RESULTADOS: A prevalência de sobrepeso foi de 38% nas mulheres e 50,4% nos homens. Dentre os indivíduos com sobrepeso, 6,1% das mulheres eram obesas e 10,7% dos homens tinham obesidade. Análise multivariada foi utilizada para identificar os fatores sociocomportamentais e clínico-bioquímicos associados com o aumento da adiposidade corporal (IMC > 25kg/m2 e circunferência de cintura > 80cm para mulheres e >94cm para homens. As variáveis e a razão de prevalência (PR associadas ao sobrepeso e adiposidade abdominal nos homens foram: idade (1,02, renda familiar alta (1,05, fumo (1,36, hipertensão (pressão arterial sistólica 1,41 e pressão arterial diastólica 1,85 e hipertrigliceridemia (2,29. Nas mulheres as razões de chance para sobrepeso e adiposidade abdominal foram: idade (1,02, consumo de álcool (1,42, hipertrigliceridemia (1,44, pressão arterial diastólilca (1,65 e hiperglicemia (1,71. CONCLUSÃO: A associação do sobrepeso e obesidade abdominal com parâmetros sociocomportamentais devem ser corrigidos com medidas educativas e preventivas. Além disso, a associação de sobrepeso e obesidade abdominal com parâmetros clínicos e bioquímicos coloca os trabalhadores de Belém do Pará, assistidos pelo Programa de Alimentação do Trabalhador, em possível risco de morbidades e mortalidade precoce pelo aumento de adiposidade corporal.

  2. Tigecycline: an evidence-based review of its antibacterial activity and effectiveness in complicated skin and soft tissue and intraabdominal infections

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    Christopher J. Dunn

    2006-03-01

    Full Text Available Christopher J. DunnCatalyst Communications Ltd, Auckland, New ZealandIntroduction: There is an urgent need for novel agents to manage serious bacterial infections, particularly those contracted in healthcare facilities. Tigecycline is a novel broad-spectrum glycylcycline with good activity against Gram-positive, many Gram-negative, anaerobic, and some atypical pathogens that has been developed to address this need.Aims: To review the evidence for the use of tigecycline in serious and complicated skin and soft tissue and intraabdominal infections.Evidence review: There is substantial evidence that tigecycline is as effective as vancomycin plus aztreonam in complicated skin and skin structure infections (SSSIs and as effective as imipenem plus cilastatin in intraabdominal infections. Limited evidence shows effectiveness in patients with resistant Acinetobacter infection in an intensive care unit, and the possibility that the use of tigecycline may reduce length of hospital stay. The drug is well tolerated, with nausea and vomiting as the major adverse effects.Outcomes summary: The introduction of tigecycline should be beneficial at a time of increasing problems with bacterial resistance, and evidence to date has been sufficient for regulatory approval for complicated SSSIs and intraabdominal infections. Research into tigecycline’s efficacy in other infectious diseases (notably pneumonia and bacteremia is ongoing. Further good quality studies and ongoing surveillance for any emerging bacterial resistance will be needed to determine outcomes with tigecycline relative to other novel antibacterial agents, and to explore the economic implications of its adoption.Key words: antibiotic resistance, bacterial infections, glycylcycline, nosocomial infections, review, tigecycline

  3. 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

  4. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 1: does the 'seatbelt sign' predict intra-abdominal injury after motor vehicle trauma in children?

    Science.gov (United States)

    Rentmeester, Landen

    2012-02-01

    A short cut review was carried out to establish whether the seat belt sign was a significant predictor of intra-abdominal injury in children involved in motor vehicle collisions. 51 papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that seatbelt sign appears to be associated with an increased risk of intra-abdominal injuries, especially gastrointestinal and pancreatic injuries.

  5. Ototoxicidad por medicamentos

    OpenAIRE

    Mercado M,Víctor; Burgos S,Rodolfo; Muñoz V,Claudio

    2007-01-01

    Se define ototoxicidad a las perturbaciones transitorias o definitivas de la función auditiva, vestibular, o de las dos a la vez, inducidas por sustancias de uso terapéutico¹. Son muchos los trabajos de investigación que se han dedicado ha este tema quedando aun dudas por resolver debido a las complejas consecuencias donde está envuelto el daño cocleovestibular. El propósito de esta revisión, es presentar las últimas teorías que tratan de explicar desde el punto de vista de la farmacociónétic...

  6. Electrocardiografo por computadora

    OpenAIRE

    Tinoco Hernandez, Rosanna; Paredes Bejarano, Margarita; Romero Chaglia, Norman; Yapur Auad, Miguel Eduardo

    2009-01-01

    El presente trabajo trata sobrees el diseño y la implementación de un graficador de señales cardiacas por computadora, para lo cual diseñamos un circuito electrónico capaz de recibir la senal analógica proveniente de la actividad electrica del corazón , amplificarla, y luego convertirla en una señal digital para ser procesada por software y finalmente ser graficada, siendo posible así observar la señal cardiaca en el monitor de un computador como un tren de pulsos. Cabe destacar que par...

  7. Blunt Abdominal Trauma Patients Are at Very Low Risk for Intra-Abdominal Injury after Emergency Department Observation

    Directory of Open Access Journals (Sweden)

    Jason S Haukoos

    2011-05-01

    Full Text Available Introduction: Patients are commonly admitted to the hospital for observation following blunt abdominal trauma (BAT, despite initially negative emergency department (ED evaluations. With the current use of screening technology, such as computed tomography (CT of the abdomen and pelvis, ultrasound, and laboratory evaluations, it is unclear which patients require observation. The objective of this study was to determine the prevalence of intra-abdominal injury (IAI and death in hemodynamically normal and stable BAT patients with initially negative ED evaluations admitted to an ED observation unit and to define a low-risk subgroup of patients and assess whether they may be discharged without abdominal/pelvic CT or observation. Methods: This was a retrospective cohort study performed at an urban level 1 trauma center and included all BAT patients admitted to an ED observation unit as part of a BAT key clinical pathway. All were observed for at least 8 hours as part of the key clinical pathway, and only minors and pregnant women were excluded. Outcomes included the presence of IAI or death during a 40-month follow-up period. Prior to data collection, low-risk criteria were defined as no intoxication, no hypotension or tachycardia, no abdominal pain or tenderness, no hematuria, and no distracting injury. To be considered low risk, patients needed to meet all low-risk criteria. Results: Of the 1,169 patients included over the 2-year study period, 29% received a CT of the abdomen and pelvis, 6% were admitted to the hospital from the observation unit for further management, 0.4% (95% confidence interval [CI], 0.1%–1% were diagnosed with IAI, and 0% (95% CI, 0%–0.3% died. Patients had a median combined ED and observation length of stay of 9.5 hours. Of the 237 (20% patients who met low-risk criteria, 7% had a CT of the abdomen and pelvis and 0% (95% CI, 0%–1.5% were diagnosed with IAI or died. Conclusion: Most BAT patients who have initially negative

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

    Directory of Open Access Journals (Sweden)

    Hidalgo JA

    2016-07-01

    Full Text Available Jose A Hidalgo,1,2 Celeste M Vinluan,1–3 Nishaal Antony3 1UTEP/UT Austin Cooperative Pharmacy Program, College of Health Sciences, University of Texas at El Paso, El Paso, 2Department of Pharmacy, College of Pharmacy, The University of Texas at Austin, Austin, 3Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA Abstract: 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. Keywords: ceftazidime/avibactam, Avycaz, complicated urinary tract infections, complicated intra-abdominal infections

  9. A prospective evaluation of CT features predictive of intra-abdominal hypertension and abdominal compartment syndrome in critically ill surgical patients

    Energy Technology Data Exchange (ETDEWEB)

    Al-Bahrani, A.Z. [Department of Surgery, Manchester Royal Infirmary, Manchester (United Kingdom); Abid, G.H. [Department of Surgery, Manchester Royal Infirmary, Manchester (United Kingdom); Sahgal, E. [Department of Surgery, Manchester Royal Infirmary, Manchester (United Kingdom); O' Shea, S. [Department of Radiology, Manchester Royal Infirmary, Manchester (United Kingdom); Lee, S. [Department of Surgery, Manchester Royal Infirmary, Manchester (United Kingdom); Ammori, B.J. [Department of Surgery, Manchester Royal Infirmary, Manchester (United Kingdom)]. E-mail: bammori@btinternet.com

    2007-07-15

    Aim: The aim of this study was to validate the computed tomography (CT) features of intra-abdominal hypertension (IAH) by relating them to the clinical measurement of intra-abdominal pressure (IAP) in critically ill surgical patients. Materials and methods: The intra-vesical pressure was measured to reflect IAP in 24 critically ill patients. CT examinations obtained within 24 h of IAP measurement were reviewed and scored independently by two consultant radiologists. Each CT examination was scored for the seven proposed features of IAH. Images obtained during the presence of IAH were compared with those obtained in the absence of IAH. Results: Forty-eight abdominal CT examinations were evaluated, of which 18 (38%) were obtained in the presence of IAH, whereas eight (17%) were obtained in the presence of abdominal compartment syndrome (ACS). At CT, the round belly sign (RBS) and bowel wall thickening with enhancement (BWTE) were significantly more frequently detected during the presence of IAH than when the IAP was less than 12 mmHg (78 versus 20% of examinations, p < 0.001 and 39 versus 3% of examinations, p = 0.003, respectively), but only BWTE was significantly associated with the presence of ACS (40 versus 11% of examinations, p = 0.047). Conclusion: The presence of RBS and BWTE on CT images of critically ill surgical patients should alert clinicians to the possibility of presence of IAH and ACS, and prompt measurement of the IAP and consideration of suitable interventions.

  10. 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.

  11. Osteomielitis por salmonella

    Directory of Open Access Journals (Sweden)

    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

  12. causada por Fusarium moniliforme

    Directory of Open Access Journals (Sweden)

    Mariano Mendoza Elos

    2006-01-01

    Full Text Available El objetivo de éste trabajo fue determinar la resistencia horizontal de 134 líneas S1 de maíz al hongo Fusarium moniliforme. La enfermedad fue inducida mediante inoculación en la etapa de floración masculina bajo condiciones de campo utilizando la técnica del palillo. Las líneas se evaluaron en México en 2002. La estimación de la enfermedad se hizo en dos ocasiones con una separación de 20 días. Las evaluaciones mostraron que las líneas Roque-801, 804, 1103 y 1405 fueron resistentes en la primera evaluación. Las tasas de incremento de la enfermedad variaron de 0,01 a 0,229 por unidad por día. Las líneas mostraron bajos niveles de enfermedad de 0 a 1 % en la primera evaluación. En la segunda evaluación, los niveles de enfermedad variaron de 49 a 100 %. En un programa de mejoramiento genético estas líneas pueden ser utilizadas para mejorar la resistencia horizontal del maíz a la pudrición del tallo causada por Fusarium moniliforme

  13. La lucha por Guayaquil

    Directory of Open Access Journals (Sweden)

    Felipe Burbano de Lara

    2009-01-01

    Full Text Available En el contexto del referendo constitucional del 2008 en Ecuador, este texto analiza la disputa entre Rafael Correa, presidente del Gobierno ecuatoriano y principal líder de Alianza País, y el alcalde la ciudad más grande del país, Jaime Nebot. Disputa que es examinada a partir de tres ejes: la lucha contra el neoliberalismo, la construcción de un proyecto estatal nacional y la búsqueda por una por una hegemonía política de Alianza País. Se profundiza en las nociones de autonomía y globalización que sirvieron de eje al discurso del alcalde, frente al modelo de autonomía propuesto por el Gobierno.In the context of Ecuador's 2008 Constitutional Referendum, this text analyses the dispute between Rafael Correa –the President of the Ecuadorian government and the figurehead of Alianza País– and the mayor of the largest city in the country, Jaime Nebot. The argument will be developed along three fronts: the battle against neoliberalism, the construction of a national state project, and the search for the political hegemony of Alianza País. The article examines the concepts of autonomy and globalization that were central to Nebot's discourse and contrasts them with the autonomous model put forward by the government.

  14. 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

    Directory of Open Access Journals (Sweden)

    V. Martín Moreno

    2003-12-01

    Full Text Available 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 longitud de las piernas e índice de masa corporal (IMC; porcentaje de grasa corporal; estimadores de la distribución de la grasa corporal: circunferencia de la cintura, cociente cintura-cadera y diámetro sagital; diversos parámetros bioquímicos con relevancia metabólica: glucosa, colesterol, HDL- colesterol y triglicéridos; y presión arterial. Menarquia, menopausia y nivel educativo también fueron analizados. Resultados: A diferencia del peso corporal, la correlación entre estatura e IMC, porcentaje de grasa corporal, estimadores de su distribución y presión arterial no alcanzó significación estadística. Estatura (r = - 0,395; p = 0,031 y longitud de las piernas (r = - 0,447; p = 0,013 se asociaron inversamente con la glucemia. El nivel educativo se asoció con la longitud de las piernas (r = 0,390; p = 0,037 e, inversamente, con la glucemia (r = - 0,517; p = 0,004. Conclusiones: Estos resultados apoyan la hipótesis de que el peso corporal condiciona la adiposidad y que la estatura está inversamente relacionada con el riesgo metabólico- cardiovascular en mujeres de 35-55 años, sugiriéndose que la longitud de las piernas condiciona este resultado y que el nivel socioeconómico influye en esta asociación. Parte de los factores que podrían explicar esta asociación permanecen sin determinar.Objective: To determine the relative importance of the components of height in the evaluation of the adiposity and the cardiovascular and

  15. 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

  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. 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

  18. A comparative study to validate the use of ultrasonography and computed tomography in patients with post-operative intra-abdominal sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Go, H.L.S. [Department of Radiology, Academic Medical Center, University of Amsterdam, C-1, P.O. Box 22660, 1100 DD Amsterdam (Netherlands); Department of Surgery, Academic Medical Center, University of Amsterdam, Room G4-111, P.O. Box 22700, 1100 DE Amsterdam (Netherlands); Baarslag, H.J. [Department of Radiology, Academic Medical Center, University of Amsterdam, C-1, P.O. Box 22660, 1100 DD Amsterdam (Netherlands); Vermeulen, H. [Department of Surgery, Academic Medical Center, University of Amsterdam, Room G4-111, P.O. Box 22700, 1100 DE Amsterdam (Netherlands); Lameris, J.S. [Department of Radiology, Academic Medical Center, University of Amsterdam, C-1, P.O. Box 22660, 1100 DD Amsterdam (Netherlands); Legemate, D.A. [Department of Surgery, Academic Medical Center, University of Amsterdam, Room G4-111, P.O. Box 22700, 1100 DE Amsterdam (Netherlands)]. E-mail: d.a.legemate@amc.uva.nl

    2005-06-01

    Purpose: To validate abdominal ultrasonography and helical computed tomography in detecting causes for sepsis in patients after abdominal surgery and to determine improved criteria for its use. Materials and methods: Eighty-five consecutive surgical patients primarily operated for non-infectious disease were included in this prospective study. Forty-one patients were admitted to the intensive care unit. All patients were suspected of an intra-abdominal sepsis after abdominal surgery. Both ultrasonography (US) and helical abdominal computed tomography (CT) were performed to investigate the origin of an intra-abdominal sepsis. The images of both US and CT were interpreted on a four-point scale by different radiologists or residents in radiology, the investigators were blinded of each other's test. Interpretations of US and CT were compared with a reference standard which was defined by the result of diagnostic aspiration of suspected fluid collections (re)laparotomy, clinical course or the opinion of an independent panel. Likelihood ratios and post-test probabilities were calculated and interobserver agreement was determined using {kappa} statistics. Results: The overall prevalence of an abdominal infection was 0.49. The likelihood ratio (LR) of a positive test-result for US was 1.33 (95% CI: 0.8-2.5) and for CT scan 2.53 (95% CI: 1.4-5.0); corresponding post-test probabilities for US 0.57 (95% CI: 0.42-0.70) and for CT 0.71 (95% CI: 0.57-0.83). The LR of a negative test-result was, respectively, 0.60 (95% CI: 0.3-1.3) and 0.18 (95% CI: 0.06-0.5); corresponding post-test probabilities for US 0.37 (95% CI: 0.20-0.57) and for CT 0.15 (95% CI: 0.06-0.32) were calculated. Conclusion: Computed tomography can be used as the imaging modality of choice in patients suspected of intra-abdominal sepsis after abdominal surgery. Because of the low discriminatory power ultrasonography should not be performed as initial diagnostic test.

  19. 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.

  20. Aprendizaje significativo por competencias

    OpenAIRE

    Acevedo Tovar, Luz Marina; Universidad Nacional Mayor de San Marcos

    2014-01-01

    Los cambios que desde hace un tiempo se han venido produciendo en educación, han dado lugar a la aparición de nuevos conceptos o a la modificación del significado de algunos térmi¬nos. Dos de estos conceptos, son los de aprendizaje significativo y competencias ¿Qué es realmente aprendizaje significativo?; ¿existe una oposición entre aprendizaje signifi¬cativo y aprendizaje repetitivo?- ¿el aprendizaje significativo es posible sólo por competen¬cias?.- Intentaré responder a estos interrogantes...

  1. Onicomicosis por hongos fuliginosos

    OpenAIRE

    Ingrid Salas-Campos; Norma T Gross-Martinez; Pedro J Carrillo-Dover

    2009-01-01

    Justificación y objetivo: Las infecciones de las uñas producidas por hongos son un problema de frecuente consulta dermatológica. Los dermatofitos son la mayor causa de estas infecciones, siendo Trichophyton rubrum el agente etiológico más importante. Sin embargo, los hongos no dermatofitos, tanto hialinos como fuliginosos, pueden ser también responsables de estos cuadros clínicos. Debido a que estos hongos tienden a ser resistentes a los antimicóticos comúnmente usados para tratar las onicomi...

  2. Activities of the oxazolidinones linezolid and eperezolid in experimental intra-abdominal abscess due to Enterococcus faecalis or vancomycin-resistant Enterococcus faecium.

    Science.gov (United States)

    Schülin, T; Thauvin-Eliopoulos, C; Moellering, R C; Eliopoulos, G M

    1999-12-01

    The in vivo effectiveness of oxazolidinones eperezolid (U-100592) and linezolid (U-100766) against one strain each of Enterococcus faecalis and vancomycin-resistant Enterococcus faecium was examined in a rat model of intra-abdominal abscess. MICs of both drugs were 2 microg/ml for each strain. At doses of 25 mg/kg of body weight twice daily intravenously or orally, linezolid produced small but statistically significant reductions in abscess bacterial density for E. faecalis. The reduction in viable cells observed would not likely be clinically relevant. Eperezolid was ineffective at this dose. At a dosage of 100 mg/kg/day, linezolid treatment led to an approximately 100-fold reduction in viable cells per gram of abscess. Against E. faecium infections, intravenous eperezolid and oral linezolid were effective, reducing densities approximately 2 log(10) CFU/g. Both oxazolidinones demonstrated activity against enterococci in this model. However, results were modest with the dosing regimens employed.

  3. Persistent Müllerian duct syndrome of mixed anatomical variant (combined male and female type with mixed germ cell tumor of left intra-abdominal testis

    Directory of Open Access Journals (Sweden)

    Manisha Mohapatra

    2016-01-01

    Full Text Available Persistent Müllerian duct syndrome (PMDS is a rare form of internal male pseudohermaphroditism characterized by retention of Müllerian duct derivatives in a phenotypically and karyotypically male patient. Deficiency of anti-Müllerian hormone (AMH secretion or resistance to AMH action due to defective AMH-II receptor is presumed to cause such syndrome in the majority of cases. About 158 PMDS cases have been reported so far, out of which 31 cases are associated with testicular neoplasms. Herein, we describe an interesting case of young male initially diagnosed and treated for inguinal hernia, but finally diagnosed as “PMDS of mixed anatomical variant (combined male and female type with mixed germ cell tumor of left intra-abdominal testis” comprising components of seminoma and yolk sac tumor and treated successfully.

  4. The effect of aqueous extract of gross and commercial yerba mate (Ilex paraguariensis) on intra-abdominal and epididymal fat and glucose levels in male Wistar rats.

    Science.gov (United States)

    Silva, Raquel D'Agostini; Bueno, Audrin Loss Scopel; Gallon, Carin Weirich; Gomes, Luana Ferreira; Kaiser, Samuel; Pavei, Cabral; Ortega, George González; Kucharski, Luiz Carlos; Jahn, Matheus Parmegiani

    2011-09-01

    This study analyzed the plasma lipid profile, glucose levels and fat deposits in male rats treated with aqueous extract of gross yerba mate, commercial yerba mate or water. Yerba mate treatment did not change body weight gain and lipid profile. The consumption of gross yerba mate significantly increased blood glucose (6.6 mmol/L) as compared to the water (4.8 mmol/L) and commercial group (5.2 mmol/L) and decreased epididymal and intra-abdominal deposits (10.1mg/g and 23.7 mg/g of weight) as compared to the water (15.4 mg/g and 36.9 mg/g of weight) and commercial group (12.5mg/g and 28 mg/g of weight). The results suggest that gross yerba mate reduces fat more efficiently but produces a greater increase in blood glucose when compared to commercial yerba mate and water groups.

  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. 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.

  7. Sepsis por shigella flexneri

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    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.

  8. Pasos por la salud

    OpenAIRE

    Fierro Rojas, Carlos

    2013-01-01

    Pasos por la Salud surge como un proyecto (mismo que derivara una estrategia de atención) que establece el Departamento de Educación Física Valle de México, para fortalecer la aplicación del programa de Educación Física en Educación Básica, fomentará la práctica del ejercicio físico hacia la promoción de la salud, brindará a los alumnos elementos teóricos y bases metodológicas que le ayuden a comprender los beneficios de salud que producen la práctica del ejercicio, concientizar al alumno de ...

  9. Onicomicosis por hongos fuliginosos

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    Ingrid Salas-Campos

    2009-12-01

    Full Text Available Justificación y objetivo: Las infecciones de las uñas producidas por hongos son un problema de frecuente consulta dermatológica. Los dermatofitos son la mayor causa de estas infecciones, siendo Trichophyton rubrum el agente etiológico más importante. Sin embargo, los hongos no dermatofitos, tanto hialinos como fuliginosos, pueden ser también responsables de estos cuadros clínicos. Debido a que estos hongos tienden a ser resistentes a los antimicóticos comúnmente usados para tratar las onicomicosis, es que se hace indispensable que el clínico se asegure por medio de un examen de laboratorio de la etiología de la infección. Métodos: Se estudiaron tres casos de pacientes con lesiones en uñas, que acudieron al laboratorio de Micología Médica, Facultad de Microbiología, Universidad de Costa Rica. Se realizaron los análisis de rutina para aislamiento e identificación de hongos patógenos. Resultados: En los tres casos estudiados se observó al examen directo micelio fuliginoso. En uno de los casos se aisló e identificó Scytalidium dimidiatum, hongo que presenta resistencia a los antifúngicos utilizados para tratar onicomicosis. Conclusión. El reporte de hongos diferentes a los dermatofitos como agentes etiológicos de onicomicosis es importante para que el médico pueda elegir el tratamiento más recomendado para este tipo de infección.

  10. Motivado por cirujanos

    Directory of Open Access Journals (Sweden)

    Carlos Salazar-Vargas

    2010-12-01

    Full Text Available Comenzaba la década de los 60 y nuestro grupo nerviosamente iniciaba lecciones en los hospitales de San José. En aquellos años, el estudiante de medicina empezaba su contacto con pacientes, por lo menos 1 ó 2 años después de iniciada la carrera. El estudio del ser humano normal que ya habíamos concluido, continuaba con el del enfermo, y más adelante aprenderíamos el tratamiento. La enfermedad descrita en el libro, de pronto se convertía en un enfermo, y es a este quien hoy veíamos, cohibido pero inquisidor, en la cama de un hospital. Los profesores nos enseñaban a interrogar y a examinar a los pacientes, y cada gesto suyo, cada pregunta, cada maniobra, eran celosamente guardados en la memoria de los educandos. Con claridad percibíamos, aun a temprana edad, las diferencias entre los especialistas, y casi de manera involuntaria, cada quien iba tomando partido y escogía su futuro camino. Fue durante esos tempranos años, cuando mi vida se cruzó con la de 7 maravillosas personas y excelentes cirujanos, que marcaron para siempre mi destino y, sin quererlo ellos, me hicieron inclinarme por la cirugía. Dos eran serios y profundamente académicos: el Dr. Manuel Aguilar Bonilla y el Dr. Vesalio Guzmán Calleja; 3, decididos, incansables y muy hábiles: el Dr. Longino Soto Pacheco, el Dr. Claudio Orlich Carranza y el Dr. Carlos Prada Díaz, y 2, abordables, prácticos, joviales y amistosos: el Dr. Fernando Valverde Soley y el Dr. Randall Ferris Iglesias….

  11. 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

  12. 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.

  13. 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.

  14. 分娩前后腹腔内压的测定%Determination of intra-abdominal pressure before and after delivery

    Institute of Scientific and Technical Information of China (English)

    王艳; 梁丽霞; 邓燕红

    2015-01-01

    ObjectiveTo compare the changes of intra-abdominal pressure (IAP) and hemodynamic differences before and after delivery in the normal pregnant women.Methods24 pregnant women,who were going to deliver in the Third Affiliated Hospital of Guangzhou Medical College from November 2011 to March 2012,were divided into a single pregnancy group (20 cases) and a twin pregnancy group (4 cases) according to the pregnant categories.Then the changes of intra-abdominal pressure before and after delivery were monitored by intravesical pressure measurement,in additional,the changes of blood pressure,abdominal perfusion pressure and heart rate were observed.Results(1) In the single pregnancy group,the systolic blood pressure and diastolic blood pressure of the pregnant women after delivery were (118.05±10.12)mm Hg and (70.95±7.65)mm Hg respectively,with no significant differences from those before delivery (P>0.05);While maternal heart rate after the delivery was(83.76±11.31)/min,which was significantly decreased compared with that before delivery of (95.29±14.11)/min,and abdominal perfusion pressure increased significantly than that before delivery,and the differences were significant (P<0.01).(2)The IAP range of women with singleton pregnancy was from 14.28 to 48.96mm Hg with an average of (35.13±8.81)mm Hg before delivery, so the incidence of intra-abdominal hypertension (IAP high 12mmHg) was 100%;While IAP range after delivery was from 8.84 to 25.84 mmHg with an average of(16.16±4.61)mm Hg,so the incidence of intra-abdominal hypertension was 85.7% (18/21),there was a significant difference before and after childbirth (P<0.01).(3)The IAP of women with twin pregnancy before delivery was (38.25±10.18)mm Hg,which was in the range of intra-abdominal hypertension;While that after delivery was (22.61±10.98)mm Hg,only 75% (3/4)of those were diagnosed intra-abdominal hypertension. In short,IAP decreased significantly after delivery (P<0.01). Conclusion The IAP of normal women

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

    Institute of Scientific and Technical Information of China (English)

    YANG Yi; LI Yang; LIU Song-qiao; LIU Ling; HUANG Ying-zi; GUO Feng-mei; QIU Hai-bo

    2013-01-01

    Background 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.Methods 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.Results 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 byARDSnet protocol.Conclusion 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. Simultaneous occurrence of hyperthyroidism and fistulizing Crohn’s disease complicated with intra-abdominal fistulas and abscess: a case report and review of the literature

    Science.gov (United States)

    Pachiadakis, Ioannis; Nakos, Andreas; Tatsi, Presvia; Moschos, John; Milias, Stefanos; Nikolopoulos, Panagiotis; Balaris, Christos; Apostolidis, Dimosthenis

    2009-01-01

    Introduction Fistula formation in patients with Crohn’s disease is a common complication during the course of the disease. Perianal and enteroenteric are the most common forms of fistulas, whereas the involvement of the upper gastrointestinal tract with gastrocolic and duodenocolic fistulas represents an extremely unusual condition. Moreover, hyperthyroidism in association with Crohn’s disease has been rarely described. Case presentation We present here a rare case of a 25-year-old male with simultaneous onset of hyperthyroidism and fistulizing Crohn’s disease. Crohn’s disease was complicated with intra-abdominal fistulas involving the upper gastrointestinal tract (duodenocolic, gastrocolic) and an intra-peritoneal abscess formation in the lesser sac. We describe the clinical presentation and therapeutic management of the patient including both medical treatment and surgical intervention. Despite intense medical treatment with total parenteral nutrition, antibiotics, aminosalicylates and corticosteroids the clinical course of the disease was suboptimal. Finally, the patient underwent laparotomy and right hemi-colectomy with ileo-transverse anastomosis performed, with simultaneous drainage of the abdominal abscess and primary closure of the upper gastrointestinal tract openings (gastric, duodenal and jejunal) at one stage operation. Although the surgical approach definitively cured the perforating complications of the disease (fistulas and abscess), the luminal disease in the colon remnant was still active and steroid-refractory. The subsequent successful treatment with infliximab, azathioprine and mesalazine resulted in the induction and maintenance of the disease remission. Thyrotoxicosis was successfully treated with methimazole and the hyperthyroidism has definitely subsided. Conclusion The management of intra-abdominal fistulas in Crohn’s disease is a complex issue, requiring a multi-disciplinary approach and ‘tailoring’ of the treatment to the

  17. Clinical evaluation of an air-capsule technique for the direct measurement of intra-abdominal pressure after elective abdominal surgery

    Directory of Open Access Journals (Sweden)

    Dembinski Rolf

    2008-10-01

    Full Text Available Abstract Background The gold standard for assessment of intraabdominal pressure (IAP is via intravesicular pressure measurement (IVP. This accepted technique has some inherent problems, e.g. indirectness. Aim of this clinical study was to assess direct IAP measurement using an air-capsule method (ACM regarding complications risks and agreement with IVP in patients undergoing abdominal surgery. Methods A prospective cohort study was performed in 30 patients undergoing elective colonic, hepatic, pancreatic and esophageal resection. For ACM a Probe 3 (Spiegelberg®, Germany was placed on the greater omentum. It was passed through the abdominal wall paralleling routine drainages. To compare ACM with IVP t-testing was performed and mean difference as well as limits of agreement were calculated. Results ACM did not lead to complications particularly with regard to organ lesion or surgical site infection. Mean insertion time of ACM was 4.4 days (min-max: 1–5 days. 168 pairwise measurements were made. Mean ACM value was 7.9 ± 2.7 mmHg while mean IVP was 8.4 ± 3.0 mmHg (n.s. Mean difference was 0.4 mmHg ± 2.2 mmHg. Limits of agreement were -4.1 mmHg to 5.1 mmHg. Conclusion Using ACM, direct IAP measurement is feasible and uncomplicated. Associated with relatively low pressure ranges (

  18. Clinical evaluation of an air-capsule technique for the direct measurement of intra-abdominal pressure after elective abdominal surgery

    Science.gov (United States)

    Otto, Jens; Kaemmer, Daniel; Biermann, Andreas; Jansen, Marc; Dembinski, Rolf; Schumpelick, Volker; Schachtrupp, Alexander

    2008-01-01

    Background The gold standard for assessment of intraabdominal pressure (IAP) is via intravesicular pressure measurement (IVP). This accepted technique has some inherent problems, e.g. indirectness. Aim of this clinical study was to assess direct IAP measurement using an air-capsule method (ACM) regarding complications risks and agreement with IVP in patients undergoing abdominal surgery. Methods A prospective cohort study was performed in 30 patients undergoing elective colonic, hepatic, pancreatic and esophageal resection. For ACM a Probe 3 (Spiegelberg®, Germany) was placed on the greater omentum. It was passed through the abdominal wall paralleling routine drainages. To compare ACM with IVP t-testing was performed and mean difference as well as limits of agreement were calculated. Results ACM did not lead to complications particularly with regard to organ lesion or surgical site infection. Mean insertion time of ACM was 4.4 days (min-max: 1–5 days). 168 pairwise measurements were made. Mean ACM value was 7.9 ± 2.7 mmHg while mean IVP was 8.4 ± 3.0 mmHg (n.s). Mean difference was 0.4 mmHg ± 2.2 mmHg. Limits of agreement were -4.1 mmHg to 5.1 mmHg. Conclusion Using ACM, direct IAP measurement is feasible and uncomplicated. Associated with relatively low pressure ranges (<17 mmHg), results are comparable to bladder pressure measurement. PMID:18925973

  19. Antimicrobial Susceptibilities of Aerobic and Facultative Gram-Negative Bacilli from Intra-abdominal Infections in Patients from Seven Regions in China in 2012 and 2013.

    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; Hu, Zhidong; Chu, Yunzhuo; Chen, Shulan; Cao, Bin; Su, Jianrong; Gui, Bingdong; Duan, Qiong; Zhang, Shufang; Shao, Haifeng; Kong, Haishen; Badal, Robert E; Xu, Yingchun

    2015-10-19

    To evaluate the antimicrobial susceptibility of Gram-negative bacilli that caused hospital-acquired and community-acquired intra-abdominal infections (IAIs) in China between 2012 and 2013, we determined the susceptibilities to 12 antimicrobials and the extended-spectrum β-lactamase (ESBL) statuses of 3,540 IAI isolates from seven geographic areas in China in a central laboratory using CLSI broth microdilution and interpretive standards. Most infections were caused by Escherichia coli (46.3%) and Klebsiella pneumoniae (19.7%). Rates of ESBL-producing E. coli (P = 0.031), K. pneumoniae (P = 0.017), and Proteus mirabilis (P = 0.004) were higher in hospital-acquired IAIs than in community-acquired IAIs. Susceptibilities of enterobacteriaceae to ertapenem, amikacin, piperacillin-tazobactam, and imipenem were 71.3% to 100%, 81.3% to 100%, 64.7% to 100%, and 83.1% to 100%, respectively, but imipenem was ineffective against P. mirabilis (Zhe) area where the rates of carbapenem resistance were also highest. Ertapenem, amikacin, piperacillin-tazobactam, and imipenem are the most efficacious antibiotics for treating IAIs in China, especially those caused by E. coli or K. pneumoniae. Resistance to cephalosporins and carbapenems is more common in the Jiang-Zhe area than in other regions in China.

  20. [First experience of a polyurethane foam composition "Locus" use to stop intra-abdominal hemorrhage as a result of liver damage of V degree. (An experimental study)].

    Science.gov (United States)

    Reva, V A; Litinskii, M A; Denisov, A V; Sokhranov, M V; Telitskii, S Yu; Samokhvalov, I M

    2015-04-01

    Today self-expanding polymers are considered as the most promising as means for intracavitary hemostasis in case of continuing bleeding after trauma. Testing of domestic open-cell polyurethane foam composition "Locus" was carried out on the developed experimental model simulating liver trauma of V degree. After damaging 6 experimental rabbits were injected intraperitoneally with 80 ml of the composition. 5 experimental rabbits were included into to control group (haemostatic agent was not given). Estimated blood loss was 111-124 ml. The two-hour survival rate didn't differ significantly: 3 animals survived in the experimental group; 2 animal survived in the control. Despite the 3-4-fold widening of the foam, due to open cells it absorbed 72.6 +/- 8.3 g of blood. Thus, open-cell polyurethane foam intraperitoneal administration of the composition didn't provide a temporary intra-abdominal hemostasis in liver. In order to enhance the hemostatic effect it requires changing the formulation of the polyurethane composition. For a more accurate assessment of the results it is neccessary to perform additional researches on larger animals.

  1. Correlation between carbapenem consumption and resistance to carbapenems among Enterobacteriaceae isolates collected from patients with intra-abdominal infections at five medical centers in Taiwan, 2006-2010.

    Science.gov (United States)

    Ho, Cheng-Mao; Ho, Mao-Wang; Liu, Yung-Ching; Toh, Han-Siong; Lee, Yu-Lin; Liu, Yuag-Meng; Huang, Chi-Chang; Lu, Po-Liang; Liu, Chun-Eng; Chen, Yen-Hsu; Ko, Wen-Chien; Tang, Hung-Jen; Yu, Kwok-Woon; Chen, Yao-Shen; Chuang, Yin-Ching; Wang, Jen-Hsien; Hsueh, Po-Ren

    2012-06-01

    We investigated the trend in resistance to carbapenems among isolates of Enterobacteriaceae that had been collected from patients with intra-abdominal infections at five medical centers in Taiwan from 2006 to 2010 and evaluated the correlation between resistance to carbapenems and consumption of said agents as part of the Study for Monitoring Antimicrobial Resistance Trends (SMART). During the study period, the usage of ertapenem and that of total carbapenems (ertapenem, imipenem, and meropenem) increased significantly from 6.13 to 13.38 defined daily doses per 1000 patient-days for ertapenem and from 20.43 to 34.25 defined daily doses per 1000 patient-days for total carbapenems. The most common species were Escherichia coli (n = 1095), Klebsiella spp. (n = 663), and Enterobacter spp. (n = 202). The susceptibility of all isolates to ertapenem and to imipenem varied during the study period. For ertapenem, the rates of nonsusceptibility ranged from 3.5% to 10.3% and those for imipenem ranged from 3.5% to 10.7%. Although the use of carbapenems increased during the study period, there was no marked increase in resistance to carbapenems. Continuous monitoring of resistance trends is necessary so that antimicrobial prescription policies can be adjusted and infection control intervention programs can be implemented.

  2. 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.

  3. Por que sou rondoniano

    Directory of Open Access Journals (Sweden)

    Mércio Pereira Gomes

    2009-01-01

    Full Text Available Numa revisão contextualizada no tempo e projetada pelos seus resultados, a obra do sertanista marechal Cândido Rondon (1867-1958 é avaliada positivamente pela dedicação à causa dos povos indígenas do Brasil, pela formação de uma ética de respeito do brasileiro para com os índios e pela institucionalização do dever do Estado brasileiro de proteger, assistir e ajudar os povos indígenas a manterem-se coesos e autônomos e ao mesmo tempo se projetarem no mundo mais amplo. A vida de Rondon é acompanhada desde a sua formação como cadete da Escola Militar, como membro da Igreja do Apostolado Positivista, como comandante da Expedição Rondon (1907-1930, que levou o telégrafo de Cuiabá a Porto Velho, e especialmente como criador e dirigente-mor do Serviço de Proteção aos Índios (SPI, 1910-1967. Rondon é o criador da expressão "Morrer se preciso for, matar nunca", que pautou a ação de indigenistas brasileiros que fizeram os primeiros contatos com muitos povos indígenas desde 1910. E muitos morreram seguindo essa norma, numa clara demonstração do novo espírito humanista criado pela atitude rondoniana. O indigenismo brasileiro implantado por Rondon teve altos e baixos ao longo de quase cem anos, que hoje prossegue pela Fundação Nacional do Índio (Funai. De fato, muitos povos indígenas perderam suas terras e muitos foram dizimados no século XX, mas os mais de 220 que sobreviveram vêm crescendo em número, obtendo suas terras (13% do território nacional e conquistando novos espaços político-culturais no Brasil.This paper reviews the life and work of Brazilian Indianist Marshall Cândido Rondon. Rondon's life is marked by a profound dedication to the Brazilian Indian cause and to instilling in Brazilians a respect for Indian peoples. He influenced the Brazilian government in shaping a policy of protecting, assisting, and helping Indian peoples retain cohesive, self-determined societies. He also encouraged Indians to

  4. One-stage laparoscopic orchiopexy for intra-abdominal testes%腹腔镜下高位隐睾Ⅰ期下降固定术的探讨

    Institute of Scientific and Technical Information of China (English)

    郝春生; 叶辉; 李龙; 白冬升; 李旭; 管考评

    2009-01-01

    目的 探讨高位隐睾腹腔镜I期固定术的应用.方法 回顾性研究2005年1月至2008年3月间所收治的35例高位隐睾患儿,年龄1~15岁,平均年龄2.6岁.左侧20例,右侧12例,双侧3例,总计38侧.根据睾丸位置高低,腹腔镜辅助下行精索松解I期睾丸固定或Fowler-Stephens(FS)I期睾丸固定手术.结果 在35例(38侧)患儿中,有33例(34侧)为低位腹腔内隐睾(89.5%),2例4侧(10.5%)为腹腔内高位隐睾.其中的34侧腹腔内低位睾丸及1侧高位睾丸经过松解精索血管或FSI期手术,将睾丸固定于患侧阴囊内;3侧高位睾丸经过松解精索血管I期将睾丸固定于外环口外与阴囊上极之间.手术成功率为92.1%.随访3~24个月(平均6个月),100%睾丸血运好无萎缩.结论 高位隐睾腹腔镜Ⅰ期固定手术效果良好,手术微创.%Objective The aim of this study was to explore the application in one-stage laparoscopic orchiopexy for intra-abdominal testes.Methods Between January of 2005 and January of 2008,35 patients with intra-abdominal testes were retrospectively analyzed.The mean age was 2.6 years (ranging from 1 to 15 years).Twenty cases were on the left side,12 on the right side and 3 on both sides.According to the position of testes in abdomen,one-stage laparoscopic orchiopexy or one-stage Fowler-Stephens orchiopexy was performed.Results Among 35 patients(38 testicular units),33 cases(34 testicular units)were diagnosed as low intra-abdominal testes(89.5%),4 testicular units (10.5%)as high.Twenty-four cases with lOW intra-abdominal testes and 1 with high intra-abdominal testes underwent one-stage orchiopexy(including 2 Fowler-Stephens procedures).Three intra-abdominal testes in high position were fixed in the area between external inguinal ring and upper scrotum..All patients were followed up for 1 to 30 months(mean 6 months),whose testes had good blood supply without atrophy.The testes of 35 patients(92.1%)were in an acceptable scrotal position

  5. 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)....

  6. 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 ...

  7. Otitis externa por Demodex cati

    OpenAIRE

    L. Real; Ortuñez, A.; Verde Arribas, Mª T.; Navarro, L.; Vilela, C

    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.

  8. [Influence of mydocalm on the degree of intra-abdominal hypertension and local blood circulation in the intestinal wall in experiment].

    Science.gov (United States)

    Sapegin, V I; Sapegin, I D; Il'chenko, F N

    2014-01-01

    The effect of mydocalm (tolperison, 5 mg/kg single dose) on the dynamics of intra-abdominal hypertension (IAH), blood circulation regulation, and oxygen balance in the tissues of intestinal wall were studied in acute experiments on rabbits. Using a special stand of original design, the initial IAH level was modeled at 200 mm H2O with the subsequent stopping of further receipt of liquid during 3 hours in an elastic container in the abdominal cavity. During 3-h observation without drug administration, no changes in IAH due to the tone of muscles of the frontal abdominal wall takes place, but there is progressive deceleration of local blood flow (-35.33 + 0.99%, p < 0.01), suppressed dilation (-20.02 + 0.54%, p < 0.01) and constriction (-60.45 + 1.17%, p < 0.01) reactivity of vessels, and decreased oxygen tension (-47.18 + 0.75%, p < 0.01) in the intestinal wall at the end of experiment. The introduction of mydocalm reduces the tone of muscles of the frontal abdominal wall, which leads to a decrease in IAH (maximum effect after 1.5 hours, -20.81 + 0.84%, p < 0.01) and prevents decrease in the local blood flow (-26.77 + 0.41%, p < 0.01), suppression of dilation (-16.51 + 0.34%, p < 0.01) and constriction (-37.85 + 0.61%, p < 0.01) reactivity of vessels, and reduction in oxygen tension (-36.60 + 1.18%, p < 0.01) at the end of experiment. The administration of mydocalm can extend the limits of application of a conservative therapy for patients with IAH and to improve the results.

  9. Perivascular epithelioid cell tumor (PEComa of the uterine cervix associated with intraabdominal "PEComatosis": A clinicopathological study with comparative genomic hybridization analysis

    Directory of Open Access Journals (Sweden)

    Ma Linglei

    2004-10-01

    Full Text Available Abstract Background The World Health Organization recently recognized a family of neoplasms showing at least partial morphological or immunohistochemical evidence of a putative perivascular epithelioid cell (PEC differentiation. These tumors include angiomyolipoma (AML, clear cell "sugar" tumors of the lung (CCST, lymphangioleiomyomatosis (LAM, clear cell myomelanocytic tumors of the falciform ligament and distinctive clear cell tumors at various other anatomic sites. Case presentation & methods A 41-year old gravida-1 para-1 with tuberous sclerosis presented with an incidentally identified 2.2 cm mass. The morphology and immunohistochemical profile was consistent with PEComa. Distinct aggregates of HMB-45 epithelioid cells were present in an occasionally distinctive perivascular distribution in the myometrium, small bowel lamina propria and ovarian hila. These distinctive aggregates, for which we propose the designation "PEComatosis" based on their intraabdominal distribution, did not display cytological atypia, mitotic activity or necrosis. CGH and DNA ploidy analysis showed a balanced chromosomal profile and diploid nuclei, respectively. There was no recurrence or metastases at 35 months' follow-up. Fifty-one previously reported cases of non-AML, LAM and CCST PEComas [perivascular epithelioid cell tumors- not otherwise specified (PEComa-NOS] are reviewed. Conclusions The lesions may be a reflection of tumor multicentricity, in which each may be a potential nidus for the development of future more well-developed tumors. Alternatively, they may be a manifestation of a poorly understood "field effect", in which there is an increased propensity to develop tumors of this type throughout the abdomen. Finally, and least likely in our opinion, they may represent tumor spread from its primary site.

  10. Surveillance of intra-abdominal pressure and intestinal barrier function in a rat model of acute necrotizing pancreatitis and its potential early therapeutic window.

    Directory of Open Access Journals (Sweden)

    Wei-Dong Li

    Full Text Available OBJECTIVES: To monitor intra-abdominal pressure (IAP and intestinal barrier function in a rat model of acute necrotizing pancreatitis (ANP to elucidate a potential relevant therapeutic window. METHODS: Sprague-Dawley rats were randomly divided into experimental or control groups. The ANP group (n = 40 was injected with 4.5% sodium taurocholate into the pancreatic duct to induce ANP. The controls received only abdominal opening surgery (sham-operated, SO; n = 40 or no treatment or surgery (baseline; 0 h, n = 20. The SO and ANP groups were then randomly subdivided into 3, 6, 12 and 24 h groups (n = 10 each. IAP was measured at each time point and the rats were sacrificed to measure the weight of accumulated ascites fluid and the amylase, endogenous creatinine (Cr, total bilirubin (TB, tumor necrosis factor- alpha (TNF-alpha, diamine oxidase (DAO, and D-lactate. Mortality and the development of pathological changes in the pancreas and intestines were also monitored. RESULTS: IAP showed a continuous upward trend in the ANP group, with values 2 to 3 times higher than those in the SO group at the corresponding time points and the rising rate was peaking at 6 h. The levels of plasma amylase, TNF-alpha, Cr, TB, DAO, and D-lactate also gradually increased in the ANP group over time and were significantly higher than in the SO group at 3, 6, 12 and 24 h (all P<0.05. Moreover, the rising rate of TNF-alpha, DAO, and D-lactate also peaked at 6 h. CONCLUSIONS: The ANP-induced changes in IAP, inflammatory factors and intestinal barrier that we observed in the rat model were especially obvious at 6 h post-induction, suggesting an early therapeutic window for the treatment of ANP in humans.

  11. Clinical and economic consequences of failure of initial antibiotic therapy for patients with community-onset complicated intra-abdominal infections.

    Directory of Open Access Journals (Sweden)

    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.

  12. Ptose palpebral causada por Paquidermoperiostose

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    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.

  13. Sepse por Serratia marcescens KPC

    OpenAIRE

    Del Peloso, Pedro Fernandez; Barros,Matheus Felipe Leal de; Santos,Fernanda Abreu dos

    2010-01-01

    A resistência aos carbapenems entre as bactérias não fermentadoras de glicose é comumente descrita. Porém, os relatos de resistência aos carbapenems em enterobactérias ainda são fatos isolados. Neste relato de caso, descrevemos um caso de infecção generalizada por Serratia marcescens carreadora de gene blaKPC. No Brasil, já foram relatados casos de isolados de Klebsiella pneumoniae e Escherichia coli carreando gene blaKPC, ficando evidente a emergência desse tipo de carbapenemase e sua dissem...

  14. 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.

  15. Asma inducida por el ejercicio.

    OpenAIRE

    Laurencena, Soledad

    2010-01-01

    El asma inducido por el ejercicio es una sensación de dificultad respiratoria, con la presencia de tos, sibilancias y opresión torácica tras realizar un esfuerzo físico. Sería el broncoespasmo transitorio que ocurre tras un ejercicio mantenido de tres a ocho minutos de duración al ochenta por ciento o más de la frecuencia cardíaca máxima. Se realizó un estudio transversal, descriptivo no experimental, tomando una muestra de 100 personas, entre 14 y 18 años, que estudian el ...

  16. Gall overflow and intra-abdominal flushing in laparoscopic cholicystectomy%腹腔镜胆囊切除术中胆汁外溢与腹腔冲洗

    Institute of Scientific and Technical Information of China (English)

    童铭武; 仇明

    2001-01-01

    Objective:To study the causes and preventive methods ofgallbladder breakage and flow of gall into abdomen in laparoscopic cholecystectomy(LC) and to analyze relevant intra-abdominal flushing.Methods:Eighteen cases with intra-abdominal flushing and 34 cases without intra-abdominal flushing among the 52 cases of flow of bile into abdomen were observed.Results:Five cases of fever or lower abdominal disorder appear in the flushing group and 2 cases in the non-flushing group(accounting for 27.78% and 5.88% respectively).Comparison of the two groups indicates that the proportion of adverse effects in the non-flushing group is lower that in the flushing group(P<0.05).There is no postoperative infection in the non-flushing group.Conclusions:The traditional indiscriminate choice of intra-abdominal flushing for bile overflow shall be abandoned and the flushing with small-amount liquid for many times and for different locations while changing the position of the body shall be adopted for the patients with infected bile,with flow of sand-like thick bile or with bleeding which affects visual field.%目的:探讨腹腔镜胆囊切除术(LC)中胆囊破损、胆汁溢入腹腔的原因和预防及腹腔冲洗的选择与方法。方法:52例胆汁外溢中,18例腹腔冲洗,34例不冲洗。结果:冲洗组术后出现发热或下腹不适5例(27.78%),非冲洗组2例(5.88%)。全组均无腹腔残余感染发生。结论:摒弃传统对所有胆汁外溢病例不加选择进行腹腔冲洗的做法,建议选择性地对感染性胆汁、泥沙状稠厚胆溢或伴有出血影响术野者,选用改变体位的少量、多次、多部位冲洗法。

  17. Efecto del cambio de posición de decúbito supino a decúbito prono en la presión intraabdominal y su relación con la función renal

    OpenAIRE

    Cuartero Sala, Mireia; Betbesé Roig, Antoni-Jordi

    2012-01-01

    Es tracta d'un estudi observacional prospectiu en 18 pacients afectats de la síndrome de destret respiratori agut que van requerir un canvi de posició de decúbit supí a decúbit pron per tal de millorar l'oxigenació. La hipòtesi de treball era que aquest canvi de posició podia augmentar la pressió intraabdominal i, en conseqüència, alterar la funció renal per causa prerrenal. Foren registrades variables hemodinàmiques, respiratòries i pressions intrabdominals, i valorada la funció renal. La po...

  18. 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.

  19. Celulitis por citomegalovirus Cytomegalovirus cellulitis

    Directory of Open Access Journals (Sweden)

    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

  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. (phoenicopterus roseus por intoxicación aguda por plomo

    Directory of Open Access Journals (Sweden)

    D Romero

    2007-01-01

    Full Text Available La presencia de plomo en el medio ambiente es un hecho indiscutible. Ello es objeto de gran interés sanitario pues repercute tanto en la salud de los animales como en la del ser humano. El plumbismo es una intoxicación que puede afectar a cualquier especie animal. En el ámbito de la fauna silvestre se asocia principalmente a la actividad cinegética en los humedales y a la ingestión de plomo metálico por parte de las aves que frecuentan estos ecosistemas. En España cada año mueren decenas de miles de aves acuáticas como consecuencia de la ingesta de perdigones de plomo. En los individuos capturados enfermos se pueden observar signos clínicos, mientras que a partir de muestras de cadáveres se obtienen datos sobre niveles tisulares de plomo. Sin embargo la evaluación de lesiones anatomopatológicas en animales de vida silvestre es difícil de realizar por la dificultad de encontrar animales recién muertos o afectados de un cuadro agudo mortal. La reproducción de esta patología en animales de experimentación se suele realizar en cisnes, palomas o patos, pero no en flamencos, por lo que no es usual disponer de datos histológicos en esta especie. En este trabajo presentamos la clínica, analítica y estudio microscópico de diferentes tejidos de un flamenco común (Phoenicopterus roseus muerto por plumbismo.

  2. Role of permissive hypotension, hypertonic resuscitation and the global increased permeability syndrome in patients with severe hemorrhage: adjuncts to damage control resuscitation to prevent intra-abdominal hypertension.

    Science.gov (United States)

    Duchesne, Juan C; Kaplan, Lewis J; Balogh, Zsolt J; Malbrain, Manu L N G

    2015-01-01

    Secondary intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are closely related to fluid resuscitation. IAH causes major deterioration of the cardiac function by affecting preload, contractility and afterload. The aim of this review is to discuss the different interactions between IAH, ACS and resuscitation, and to explore a new hypothesis with regard to damage control resuscitation, permissive hypotension and global increased permeability syndrome. Review of the relevant literature via PubMed search. The recognition of the association between the development of ACS and resuscitation urged the need for new approach in traumatic shock management. Over a decade after wide spread application of damage control surgery damage control resuscitation was developed. DCR differs from previous resuscitation approaches by attempting an earlier and more aggressive correction of coagulopathy, as well as metabolic derangements like acidosis and hypothermia, often referred to as the 'deadly triad' or the 'bloody vicious cycle'. Permissive hypotension involves keeping the blood pressure low enough to avoid exacerbating uncontrolled haemorrhage while maintaining perfusion to vital end organs. The potential detrimental mechanisms of early, aggressive crystalloid resuscitation have been described. Limitation of fluid intake by using colloids, hypertonic saline (HTS) or hyperoncotic albumin solutions have been associated with favourable effects. HTS allows not only for rapid restoration of circulating intravascular volume with less administered fluid, but also attenuates post-injury oedema at the microcirculatory level and may improve microvascular perfusion. Capillary leak represents the maladaptive, often excessive, and undesirable loss of fluid and electrolytes with or without protein into the interstitium that generates oedema. The global increased permeability syndrome (GIPS) has been articulated in patients with persistent systemic inflammation failing

  3. Ovariectomy and overeating palatable, energy-dense food increase subcutaneous adipose tissue more than intra-abdominal adipose tissue in rats

    Directory of Open Access Journals (Sweden)

    Gloy Viktoria

    2011-05-01

    Full Text Available Abstract Background Menopause is associated with increased adiposity, especially increased deposition of intra-abdominal (IA adipose tissue (AT. This differs from common or 'dietary' obesity, i.e., obesity apparently due to environmentally stimulated overeating, in which IAAT and subcutaneous (S AT increase in similar proportions. The effect of menopause on adiposity is thought to be due to the decreased secretion of ovarian estrogens. Ovariectomy in rats and other animals is a commonly used model of menopause. It is well known that ovariectomy increases adiposity and that this can be reversed by estradiol treatment, but whether ovariectomy selectively increases IAAT has not been measured directly. Therefore, we used micro-computed tomography (microCT to investigate this question in both chow-fed and dietary-obese rats. Methods Ovariectomized, ovariectomized and estradiol treated, and sham-operated (intact rats were fed chow or chow plus Ensure (Abbott Nutrition; n = 7/group. Total (T AT, IAAT and SAT were measured periodically by microCT. Regional distribution of AT was expressed as IAAT as a percentage of TAT (%IAAT. Excesses in these measures were calculated with respect to chow-fed intact rats to control for normal maturational changes. Chemical analysis of fat was done in chow-fed intact and ovariectomized rats at study end. Data were analyzed by t-tests and planned comparisons. Results Body mass, TAT, total fat mass, fat-free body mass, and %IAAT all increased in chow-fed intact rats during the 41 d study. In chow-fed rats, ovariectomy increased excess body mass, TAT, fat mass, fat-free body mass, and SAT, but had little effect on IAAT, in chow-fed rats, leading to a decrease in %IAAT. Ensure feeding markedly increased SAT, IAAT and TAT and did not significantly affect %IAAT. Ovariectomy had similar effects in Ensure-fed rats as in chow-fed rats, although less statistically reliable. Estradiol treatment prevented all the effects of

  4. 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.

  5. Prevalence and diagnosis rate of intra-abdominal hypertension in critically ill adult patients: A single-center cross-sectional study

    Institute of Scientific and Technical Information of China (English)

    Hua-Yu Zhang; Dong Liu; Hao Tang; Shi-Jin Sun; Shan-Mu Ai; Wen-Qun Yang; Dong-Po Jiang

    2015-01-01

    Purpose: To investigate the prevalence and diagnosis rate of intra-abdominal hypertension (IAH) in a mixed-population intensive care unit (ICU), and to investigate the knowledge of ICU staff regarding the guidelines published by the World Society of Abdominal Compartment Syndrome (WSACS) in 2013.Methods: A one-day cross-sectional study based on the WSACS 2013 guidelines was conducted in the general ICU of a tertiary teaching hospital in Chongqing, China.The included patients were divided into intravesical pressure (IVP) measured group and IVP unmeasured group.The epidemiologic data were recorded, and potential IAH risk factors (RFs) were collected based on the guidelines.IVP measurements were conducted by investigators every 4 h and the result was compared to that measured by the ICU staff to evaluate the diagnosis rate.Besides, a questionnaire was used to investigate the understanding of the guidelines among ICU staff.Results: Thirty-two patients were included, 14 in the IVP measured group and 18 in the IVP unmeasured group.The prevalence of IAH during the survey was 15.63% (5/32), 35.71% (5/14) in IVP measured group.Only one case of IAH had been diagnosed by the ICU physician and the diagnosis rate was as low as 20.00%.Logistic regression analysis showed that sequential organ failure assessment (SOFA) score was an independent RF for IAH (OR: 1.532, 95% CI: 1.029-2.282, p =0.036.Fourteen doctors and 5 nurses were investigated and the response rate was 67.86%.The average scores of the doctors and nurses were 27.14 ± 20.16 and 16.00 ± 8.94 respectively.None of them had studied the WSACS 2013 guidelines thoroughly.Conclusion: Patients with a higher SOFA score has a higher incidence of IAH.The IAH prevalence in 14 ICU patients with indwelling catheter was 35.71%.Strengthening the wide and rational use of WSACS guideline is important to improve the diagnosis of IAH.

  6. Research study of the impact of intra-abdominal hypertension on central nervous system%腹腔高压症对中枢神经系统影响的研究进展

    Institute of Scientific and Technical Information of China (English)

    张宏光; 刘冬; 张连阳

    2014-01-01

    Intra-abdominal hypertension, a kind of disease of continuous or repeated increase of intra-abdominal pressure reaching more than 12 mmHg, not only brings abnormality to enterocoelia organs, but causes injuries of the heart, lung and central nervous system. Morbidity and mortality rate is high among severely injured patients. This study tries to clarify the images, pathologies, molecular level changes and the respective mechanisms for the central nervous system injuries, saving more patients with a craniocerebral injury.%腹腔高压症是腹腔内压持续或反复病理性升高并>12 mmHg的病理状态,不仅可以引起腹腔脏器的变化,而且会损害心、肺及中枢神经系统功能,在危重患者中发病率和死亡率高。阐明其对中枢神经系统损害的影像表现、具体病理表现、分子水平变化和引起这些变化的具体机制,可进一步提高合并有颅脑损伤患者的治愈率。

  7. Association between intra-abdominal fat volume and waist circumference measured at the umbilicus level%经脐水平测定腹围与腹内脂肪体积关系的研究

    Institute of Scientific and Technical Information of China (English)

    林寰东; 颜红梅; 饶圣祥; 姚秀忠; 高鑫

    2012-01-01

    目的 比较临床常用的3种腹围测量方法与CT测定的腹内脂肪体积的关系,探讨最能反映腹内脂肪堆积程度的腹围测量方法和临床应用价值.方法 对147例18岁以上经年龄和性别匹配的成年人进行身高、体重和臀围测量,分别采用髂嵴上缘水平(WC1)、肋骨下缘和髂嵴上缘连线中点水平(WC2)和脐水平( WC3)测量腹围,与CT测量的腹内脂肪体积进行比较.结果 男性腹内脂肪体积高于女性[(1 236.0±608.4对931.0±665.0)cm3,P<0.01].相关性分析显示WC1 (r=0.634),WC2(r =0.677)和WC3(r=0.712)均与腹内脂肪体积呈正相关(均P<0.01),经性别、体重或体重指数校正后,WC3(r分别为0.488和0.432)与腹内脂肪体积的相关性优于WC1(r分别为0.347和0.293)和WC2(r分别为0.424和0.365).多元逐步线性回归分析显示WC2和WC3均与腹内脂肪体积独立相关,其中以WC3相关性最强(β=0.270,R2C=0.504,P<0.01).结论 经髂嵴上缘水平、肋骨下缘与髂嵴上缘连线中点水平以及经脐水平腹围均能反映腹内脂肪含量,其中经脐水平测量腹围是简便易行、更好地反映腹内脂肪体积的方法.%Objective To explore the best measurement of waist circumference related with intra-abdominal fat volume evaluated by CT scan.Methods Height,weight,and hip circumference were measured among 147 subjects aged over 18 years old.Waist circumference was measured at 3 different levels:the upper brim of the iliac crest ( WC1 ),the midpoint between costal brim and iliac crest ( WC2 ),and the umbilicus ( WC3 ).The intra-abdominal fat volume was evaluated by CT scan.Results Intra-abdominal fat volume was significantly higher in men than in women [ ( 1 236.0±608.4 vs 931.0±665.0)cm3,P<0.01 ].Correlation analysis showed that WC1 ( r =0.634),WC2( r=0.677),and WC3 (r =0.712)were positively correlated with intra-abdominal fat volume ( all P<0.01 ).Partial correlation analysis adjusted by gender,weight,or body mass index

  8. Se los por se lo

    Directory of Open Access Journals (Sweden)

    José Luis Rivarola

    1985-12-01

    Full Text Available El sistema de la conjugación "objetiva" plantea interesantesproblemas que fueron tratados en parte por K. Heger (1966 en suestudio comparativo del francés y del español. De la comparaciónse desprende, por ejemplo, que en español hay un cierto número deambigüedades que no permiten establecer un "paradigma tan completo y unívoco" como en el caso del francés. Dentro de estas ambigüedades se encuentran las que propicia el gramema se: "El morfema [gramema] se funciona no sólo como pronombre reflexivo, sinotambién como variante combinatoria del pronombre personal complemento indirecto de la tercera persona.

  9. por el Tribunal Constitucional chileno

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    Marisol Peña Torres

    2008-01-01

    Full Text Available La modificación introducida por la reforma constitucional de agosto de 1989 al artículo 5º de la Constitución chilena sentó un criterio decisivo en la incorporación del derecho internacional de los derechos humanos al ordenamiento jurídico interno. El artículo examina la jurisprudencia del Tribunal Constitucional antes y después de esa reforma distinguiendo entre la aplicación del Derecho Internacional de los Derechos Humanos por haberse invocado en la acción deducida y la aplicación de principios y criterios hermenéuticos extraídos del mismo.

  10. Sepsis neonatal por Estreptococos Pyogenes

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    Gilberto Rodríguez-Herrera

    2009-09-01

    Full Text Available 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 respiratorio que amerita ventilación mecánica asistida por varios días en diferentes ocasiones, derrame pleural exudativo, convulsiones de origen hipóxico isquémico. Con reporte de hemocultivos positivos por Estreptococos pyogenes. El Estreptococos pyogenes o estreptococo β-hemolνtico del grupo A, fue un problema en los comienzos del siglo pasado, siendo frecuente en las infecciones puerperales y del reciιn nacido. En la actualidad es un germen sumamente raro en los procesos de sepsis neonatal.2 La gravedad de la enfermedad causada por este microorganismo en el periodo neonatal varνa desde una onfalitis crónica de bajo grado a una septicemia, una meningitis fulminante y la muerte.1 El presente artículo pretende hacer un resumen del paciente, con su evolución clínica, radiológica y además ejemplificar todas las complicaciones que tuvimos con este germen tan poco frecuente en la actualidad en sepsis neonatal.

  11. posteriori por el Tribunal Constitucional

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    Teodoro Ribera Neumann

    2007-01-01

    Full Text Available Este trabajo clarifica la posición de los tratados internacionales en el orden jurídico chileno y analiza los argumentos a favor y en contra de la procedencia del control de constitucionalidad a posteriori de los tratados internacionales por el Tribunal Constitucional, concluyendo que dicha herramienta jurídica es procedente sobre la base de la reforma a la Constitución de 2005.

  12. Muerte materna por malaria grave por Plasmodium vivax

    OpenAIRE

    Arróspide, Nancy; Espinoza, Máximo Manuel; Miranda Choque, Edwin; Mayta Tristán, Percy; Legua, Pedro; Cabezas,César

    2015-01-01

    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 ...

  13. 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...

  14. Desajuste educativo por regiones en Colombia: ¿competencia por salarios o por puestos de trabajo?

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    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.

  15. 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.

  16. 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.

  17. Medidor de distancias por ultrasonidos

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    Sánchez Blanco, Oliver

    2011-01-01

    El proyecto consiste en la realización de un medidor de distancias, para ello se ha utilizado un sensor de ultrasonidos y un microcontrolador. El sensor nos proporciona la señal que necesitamos para medir la distancia y con el microcontrolador trabajamos dicha señal para poder obtener los datos que nos interesa y poder visualizarlos a través de un módulo LCD. Este proyecto consta de tres fases: - Diseño del prototipo por software y posterior simulación. - Verificaci...

  18. Once mil metros por segundo

    OpenAIRE

    2012-01-01

    Esta exposición es una ventana hacia el mundo de la Ciencia Ficción. Los sueños de escritores extraordinarios, personajes, lugares, máquinas y robots que cada día están más cerca de nuestra cotidianidad gracias a los avances de la ciencia y la tecnología hacen parte de la muestra itinerante por las sedes de la Universidad Nacional. El visitante puede recorrer los diferentes géneros que constituyen este género literario, además de conocer sus principales representantes. Así mismo se explor...

  19. Miasis ocular por Oestrus ovis

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    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 .

  20. Clonagem de canistel por estaquia

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    Fernando Marcelo Chiamolera

    2014-09-01

    Full Text Available O canistel é nativo do sul do México e América Central e seus frutos apresentam elevado teor de carotenoides e vitamina A. Sua propagação é feita via sementes, resultando em considerável variabilidade genética entre os indivíduos, sendo a propagação vegetativa preferível, a fim de fixar características desejáveis. Assim, o objetivo deste trabalho foi avaliar a propagação vegetativa por estaquia de ramos semi-herbáceos de canistel, em função de quatro genótipos e quatro concentrações de AIB. Foram utilizadas estacas semiherbáceas apicais, mantidas com um par de folhas, sob nebulização intermitente, por 120 dias. O delineamento experimental foi o inteiramente casualizado, em esquema fatorial 4×4 (genótipos de canistel × concentrações de AIB, com quatro repetições e dez estacas por parcela. Foram avaliados a porcentagem de sobrevivência, a retenção foliar, o enraizamento, o calejamento, o número e o comprimento médio de raízes por estaca. O genótipo PC-1 foi superior aos demais, em todas as variáveis avaliadas, com destaque para o enraizamento das estacas, superior a 60%. As concentrações de AIB (0; 1.000; 3.000 e 5.000 mg L-1 não influenciaram na sobrevivência, retenção foliar e enraizamento das estacas, mas aumentaram o número e o comprimento de raízes em relação ao tratamento-controle (sem AIB. Há diferença na capacidade de enraizamento das estacas entre os genótipos de canistel, sendo a melhor resposta obtida com PC-1. A concentração de 3.000 mg L-1 de AIB resulta em maior número e comprimento de raízes nas estacas de canistel.

  1. Por um hospital mais urbano

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    Figueiredo, Ana Teresa

    2013-01-01

    Dissertação de Mestrado Integrado em Arquitectura, apresentada ao Departamento de Arquitectura da F. C. T. da Univ. de Coimbra. A partir do século XX, uma nova linguagem, proveniente da revolução industrial, torna-se transversal a todo o discurso arquitectónico. O hospital pavilhonar é substituído por uma nova tipologia – o hospital vertical. Com o acelerado crescimento urbano proveniente do processo de industrialização das cidades, as novas construções hospitalares tendem a oc...

  2. A Vida por Outros Lados

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    Maria Berenice da Costa Machado

    2003-06-01

    Full Text Available Diálogo entre a imagem e o slogan do anúncio publicitário “A vida por todos os lados”, do jornal Zero Hora (ZH, com as características da Modernidade e da Pós-modernidade. A intenção é a refletir sobre a complexidade da comunicação institucional deste diário e sua ligação com as tendências contemporâneas.

  3. Polioencefalomalacia experimental em bovinos induzida por toxicose por enxofre

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    Paulo H.J. Cunha

    2011-01-01

    Full Text Available O presente trabalho teve como objetivos avaliar os sinais clínicos, as concentrações do sulfeto de hidrogênio ruminal e as alterações anatomopatológicas associadas à intoxicação experimental por enxofre em bovinos. Foram utilizados dez bezerros mestiços leiteiros, sendo que quatro bovinos ingeriram ração sem sulfato de sódio (G1 e seis consumiram ração com sulfato de sódio (G2. Exames clínicos (temperatura retal, frequência cardíaca e respiratória e motricidade ruminal e laboratoriais (hemograma, fibrinogênio, proteína plasmática, pH do fluido ruminal, concentração do sulfeto de hidrogênio ruminal, líquido cerebrospinal e histopatológico foram realizados. A temperatura retal, frequência cardíaca, hemograma, fibrinogênio, proteína plasmática, pH do fluido ruminal e os valores do líquido cerebrospinal estavam dentro dos valores de referência para a espécie. Taquipnéia, hipomotricidade ruminal e elevados valores de sulfeto de hidrogênio ruminal foram observados nos bezerros do grupo G2. Um bezerro do grupo G2 apresentou sinais neurológicos e lesões histopatológicas de PEM. Dois animais de cada grupo foram eutanasiados. Lesões microscópicas foram observadas nos bezerros do G2. Histologicamente as alterações observadas foram necrose neuronal cortical e lesões hemorrágicas nos núcleos basais, tálamo, mesencéfalo, ponte e bulbo. O protocolo experimental constituído por uma dieta rica em carboidrato de alta fermentação, baixa quantidade de fibra efetiva e altos níveis de enxofre (0,52% ocasionou alterações clinicas e histológicas e elevadas concentrações de sulfeto de hidrogênio ruminal compatíveis com quadro de intoxicação por enxofre.

  4. 腹腔高压病人腹腔开放的术式选择及评价%Open abdomen for intra-abdominal hypertension,procedures and evaluation

    Institute of Scientific and Technical Information of China (English)

    朱维铭

    2012-01-01

    腹腔开放是损伤控制外科的重要组成部分,不但用于腹部外伤和感染等普外科疾病的救治,也用于救治烧伤或液体复苏过程中产生的腹腔高压.腹腔开放包括两大要素:开放腹腔和暂时性腹腔关闭,二者缺一不可.开放腹腔的主要目的是降低腹内压,暂时性腹腔关闭技术能够保护腹内脏器、引流腹腔液体,减少或避免腹壁回缩和并发症的发生.暂时性腹腔关闭方法分三类,分别为关闭皮肤法,关闭筋膜法和负压辅助关腹法.关闭皮肤法简单方便,但后期修复腹壁困难较大.负压辅助关腹技术并发症少,早期确定性腹腔关闭成功率高,应用越来越广泛.%Open abdomen plays an important role in damage control surgery, it is used not only in the treatment of intra-abdoniinal sepsis and trauma, but also in intra-abdominal hypertension refractory to medical treatment. Open abdomen consists of two elements: open the abdomen and temporary abdominal closure. Open the abdomen reduces intra-abdominal pressure, temporary abdominal closure protect the viscera, drain the intra-abdominal fluid, and prevent fascial retraction. Temporary abdominal closure is classified into skin closure technique, fascia closure technique, and vacuum assist closure technique. Skin closure technique is simple, but often lead to ventral hernia, and vacuum assist closure technique facilitate early definite closure, and is approved widely.

  5. Study of direct percutaneous Pig-tail drainage tube for intra-abdominal abscess under CT guidance%CT引导下应用直接穿刺型猪尾巴导管组引流腹腔脓肿

    Institute of Scientific and Technical Information of China (English)

    孟宪平; 朱建新; 顾娅婷; 谢旭刚; 陈则君; 王林

    2013-01-01

    Objective To evaluate the safety and efficacy of direct percutaneous Pig-tail drainage tube for intra-abdominal abscess under CT guidance.Methods Seven cases of postoperative secondary intra-abdominal abscess were implanted with direct percutaneous Pig-tail drainage tube under CT guidance.Results Nine drainage tubes were placed.Two abscesses were deep-positioned and near the spleen,pancreas,colon and other important organs,so that trocar,guide wire and dilator were used before Pig-tail drainage tube.The other 5 cases were administered direct percutaneous pig-tail drainage tube.One postoperative patient with colon cancer was operated after 3days drainage due to a large fistulae.The other 6 cases were drained for 5-14 days with an average of 9 days.Body temperatures got normal within 2 days.Six patients were healed.Conclusion The usage of CT guided direct percutaneous Pig-tail drainage tube for postoperative secondary intra-abdominal abscess is safe,minimal invasive,accurate and efficient.%目的 探讨CT引导下应用直接穿刺型猪尾巴导管组引流腹腔脓肿的疗效及安全性.方法 对7例术后继发腹腔脓肿的患者行CT引导下直接穿刺型猪尾巴导管组置管引流.结果 7例患者均一次性置管成功,共放置引流管9根.2例因脓肿位置较深,置管路径邻近脾脏、胰腺和结肠等重要器官,于应用套管针、导丝、逐步扩张器后,再置下猪尾巴导管引流;余5例应用直接穿刺型猪尾巴导管组引流.1例结肠癌术后瘘口较大,引流3d后行再次手术治疗.其余6例引流时间为5~14d,平均9d,体温在2d内恢复正常,均治愈出院.结论 CT引导下应用直接穿刺型猪尾巴导管组引流术后继发腹腔脓肿安全、微创、精确,疗效确切.

  6. toxicidad neuroendocrina inducida por cadmio

    Directory of Open Access Journals (Sweden)

    A Romero

    2008-01-01

    Full Text Available El cadmio es un agente químico tóxico importante debido a su creciente nivel en el medio ambiente como resultado de prácticas industriales y agrícolas. Como perturbador endocrino, el cadmio modifica la secreción de hormonas hipofisarias. Los efectos indirectos del cadmio provocan la generación de especies reactivas de oxígeno y reducen la actividad de las proteínas implicadas en las defensas antioxidantes. La melatonina es conocida como un potente antioxidante, scavenger de radicales libres y quelante de metales sintetizada en la glándula pineal. De esta manera, las acciones antioxidantes de esta indolamina protegen frente a la peroxidación lipídica y el daño oxidativo de los radicales y de sus productos tóxicos. Los trabajos recopilados en esta revisión ponen de manifiesto la capacidad antioxidante de la melatonina y, por lo tanto, su posible papel protector frente a la toxicidad del cadmio en lo que se refiere al estrés oxidativo y peroxidación lipídica inducidos por la exposición a este metal.

  7. Pneumonia grave por "Chlamydia psittaci"

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    MOSCHIONI CRISTIANE

    2001-01-01

    Full Text Available A psitacose, também conhecida como ornitose, é causada pela Chlamydia psittaci; caracteriza-se por doença de início insidioso, sintomas brandos e inespecíficos, lembrando infecção de vias aéreas superiores. Acomete principalmente o pulmão, sendo raramente doença sistêmica e fatal. Descreve-se um caso raro de pneumonia por Chlamydia psittaci que evoluiu para insuficiência respiratória aguda, necessitando de ventilação mecânica. Destaca-se a importância em considerar o diagnóstico, especialmente em casos de pneumonia comunitária que evolui de modo insatisfatório, que não responde à terapia antimicrobiana e cuja epidemiologia é positiva para exposição às aves. O diagnóstico precoce é fundamental devido à excelente resposta terapêutica. O diagnóstico tardio pode levar a curso grave e fatal da doença.

  8. Por amor a los libros

    Directory of Open Access Journals (Sweden)

    Ismael Diadié Haidara

    2015-06-01

    Full Text Available Crecí entre libros. Muy joven, de noche, mi padre me dormía recitando poemas de románticos franceses como Lamartine, Vigny, Musset o Victor Hugo. Los aprendí de memoria y le escuchaba sin entender gran cosa aunque dormía mecido por el ritmo de sus versos. A diario, me mandaba traerle un Montaigne, un Marco Aurelio, un Marx, yo obedecía, uniendo los nombres a formatos y colores de los libros. Eran tiempos de encanto y siempre veo las manos de mi padre prolongadas por un libro. No hay encanto que dure toda la vida y en 1968, con once años, presencié cómo después del golpe de estado que arrebató a su amigo, Modibo Keita, la presidencia de Mali, como militares llegaron y se fueron con cajas de libros en un camión verde. Se llevaron todo, los libros y la máquina de escribir. Sólo quedaron en el salón estanterías vacías y mucho dolor.

  9. Hipoglucemia inducida por carcinoma adrenal

    Directory of Open Access Journals (Sweden)

    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.

  10. Hiperalgesia induzida por opioides (HIO

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. Surtos de enfermidades transmitidas por alimentos causados por Salmonella Enteritidis

    OpenAIRE

    Peresi Jacqueline T.M.; Almeida Ivete A Z.C.; Lima Sonia I.; Marques Denise F.; Rodrigues Elisabete C.A.; Fernandes Sueli A.; Gelli Dilma S.; Irino Kinue

    1998-01-01

    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 d...

  13. 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.

  14. Variation in immune state of mesenteric lymph node induced by intra-abdominal infection in sepsis rats%脓毒症大鼠肠系膜淋巴结细胞免疫功能的变化

    Institute of Scientific and Technical Information of China (English)

    喻文立; 崔乃强; 杜洪印; 傅强; 刘洪斌; 李东华

    2009-01-01

    Objective To investigate the variation in the immune state of mesenteric lymph node (MLN) during intra-abdominal infection in sepsis rats. Methods Ninety-six male Wistar rats weighing 200-250 g were randomly divided into 2 groups (n = 48 each): sham operation group and intra-abdominal infection group. Intra-abdominal infection was induced by cecum ligation and puncture (CLP). Eight rats in each group were killed after collection of blood and MLN samples at 0 (T_0), 6 (T_1), 12 (T_2), 24 (T_3),48 (T_4) and 72 h (T_5) after CLP. Plasma concentrations of endotoxin were detected. The ratio of T helper cells 1/T helper cells 2 (Th1/Th2) and the percentage of regulatory T cells (Treg) in CD4~+ T cells in MLN were determined by flow cytometry. Results The levels of endotoxin were significantly higher at T_2, T_3, T_4 and T_5 in group CLP than in sham operation group. The ratios of Th1/Th2 were significantly higher at T_1 and lower at T_2,T_3,T_4 and T_5 in group CLP than in sham operation group, while the percentage of Treg in CD4~+ T cells was significantly lower at T_1 and higher at T_2, T_3, T_4 and T_5 in group CLP than in sham operation group. There was a negative correlation between the ratio of Th1/Th2 and the percentage of Treg (r=-0.87, P<0.05). Conclusion Cellular immune function of MLN is suppressed during intra-abdominal infection by increasing the percentage of Treg in MLN.%目的 探讨脓毒症大鼠肠系膜淋巴结细胞免疫功能的变化.方法 雄性Wistar大鼠96只,体重200~250 g,随机分为假手术组(S组)和盲肠结扎穿孔致脓毒症组(CLP组),每组48只.分别于CLP后即刻、6、12、24、48、72 h(T_(1~5))时随机取8只大鼠抽取腹主动脉血,采用鲎试剂偶氮显色法测定血浆内毒素水平;取肠系膜淋巴结组织,流式细胞仪测定肠系膜淋巴结组织Th1/Th2比值和调节性T淋巴细胞(Treg)占CD4~+细胞的比例(Treg比例).结果 与S组比较,CLP组T_(2~5)时血浆内毒素水平升高,T_1

  15. In Vitro Activity of Ceftazidime-Avibactam against Isolates in a Phase 3 Open-Label Clinical Trial for Complicated Intra-Abdominal and Urinary Tract Infections Caused by Ceftazidime-Nonsusceptible Gram-Negative Pathogens.

    Science.gov (United States)

    Stone, Gregory G; Bradford, Patricia A; Newell, Paul; Wardman, Angela

    2017-02-01

    The in vitro activity of ceftazidime-avibactam was evaluated against 341 Gram-negative isolates from 333 patients in a randomized, phase 3 clinical trial of patients with complicated urinary tract or intra-abdominal infections caused by ceftazidime-nonsusceptible pathogens (NCT01644643). Ceftazidime-avibactam MIC90 values against Enterobacteriaceae and Pseudomonas aeruginosa (including several class B or D enzyme producers that avibactam does not inhibit) were 1 and 64 μg/ml, respectively. Overall, the ceftazidime-avibactam activity against ceftazidime-nonsusceptible isolates was comparable to the activity of ceftazidime-avibactam previously reported against ceftazidime-susceptible isolates. (This study has been registered at ClinicalTrials.gov under identifier NCT01644643.).

  16. Diagnosis and treatment of liver trauma complicated with intra-abdominal infections%肝脏外伤并发腹腔感染的分析及诊治

    Institute of Scientific and Technical Information of China (English)

    张雯雯; 何蕾; 万涛; 吕少诚; 徐明月; 刘同友; 路辉; 史宪杰

    2013-01-01

    OBJECTIVE To explore the measures for diagnosis and treatment of liver trauma complicated with intraabdominal infections so as to guide the prevention and treatment of intra-abdominal infections.METHODS We retrospectively analyzed the clinical data of 64 patients with liver trauma between Jan 2000 and Sep 2012,including 7 cases of conservative treatment and 57 cases of surgical treatment,and all the cases were treated with prevention of infections,liver protection,and nutritional support.RESULTS Of the 64 cases of patients,there were 23 cases of peritoneal infections with the infection rate of 35.9 %.No simple liver trauma patients suffered from complicating intrabdominal infection,while among the patients with gastrointestinal trauma the incidence of peritoneal infections was 85.7%,and the incidence of the patients with the AAST grading Ⅳ was 51.5%.Totally 41 strains of pathogens were isolated,among which there were 15 (36.6%) strains of Escherichia coli,10 (24.4%) strains of Enterococcus faecalis,and 8 (19.5%) strains of Enterococcus faecium,which ranked the top three species of the pathogens.Of totally 23 cases of patients with peritoneal infections,22 cases were cured with the cure rate of 95.65 %.CONCLUSION The incidence of intraabdominal infections is high in the patients with complex liver trauma,especially the patients with multi-organ trauma.The integrated treatment with micro-invasive operations on the basis of trauma-control surgery idea can effectively cure the intraabdominal infections and decrease the mortality.%目的 探讨肝脏外伤并发腹腔感染的诊治方法,以期为肝脏外伤并发腹腔感染的预防治疗起到指导作用.方法 回顾性分析医院2000年1月-2012年9月64例肝脏外伤患者的临床资料,其中7例行保守治疗,57例行手术治疗,均予预防性抗感染、保肝、营养等治疗方法.结果 64例患者中23例出现腹腔感染,感染率为35.9%,其中单纯性肝脏外伤患者无

  17. Clinical characteristics of tumor patients with complicated intra-abdominal infections%肿瘤患者腹腔复杂感染的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    章宝云; 赵擎宇; 方翼; 徐大志; 顾葆春; 王慧

    2015-01-01

    目的 分析肿瘤患者腹腔复杂感染的特点 ,为医院感染预防控制提供参考依据.方法 回顾性分析2009年1月-2014年12月144例肿瘤患者腹腔感染的临床资料 ,用SPSS19 .0统计软件进行数据录入和分析.结果 144例腹腔复杂感染肿瘤患者中有114例行手术治疗 ,其余30例为化疗或放疗等非手术治疗 ;共有102例患者发展为脓毒症 ,发生率为70 .8% ,20例发展为严重脓毒症 ,发生率为13 .9% ,22例发展为脓毒症休克 ,发生率为15 .3% ,死亡25例病死率为17 .4% ;所有患者感染标本共检出病原菌253株 ,检出革兰阴性菌最高占46 .1% ,其次革兰阳性菌占29 .5% 、真菌占24 .4% .结论 肿瘤患者腹腔复杂感染以术后吻合口瘘导致的感染常见 ,且易发展为严重的腹腔感染 ,预后较差 ;感染多由肠道混合菌群感染所致 ,其耐药率较高.%OBJECTIVE To investigate the characteristics of the tumor patients with complicated intra-abdominal in-fections so as to provide guidance for control and prevention of the nosocomial infections .METHODS The clinical data of 144 tumor patients with intra-abdominal infections who were treated from Jan 2009 to Dec 2014 were retro-spectively analyzed , and the statistical analysis of data was performed with the use of SPSS 19 .0 software . RESULTS Of the 144 tumor patients with complicated intra-abdominal infections ,114 received the postoperarive treatment and the rest of 30 cases received the non-surgical procedures such as chemotherapy and radiotherapy ;102 cases developed to sepsis ,with the incidence rate of 70 .8% ;20 cases developed to severe sepsis ,with the in-cidence rate of 13 .9% ;22 cases developed to septic shock ,with the incidence rate of 15 .3% ,and 25 cases died , with the mortality rate of 17 .4% .A total of 253 strains of pathogens were isolated from all of the specimens ,of which 46 .1% were gram-negative bacteria , 29 .5% were gram-positive bacteria , and 24 .4% were

  18. Detector de movimiento por infrarrojos

    OpenAIRE

    Fuertes Araque, Joaquin

    2007-01-01

    En las sucesivas paginas hablaremos del espectro electromagnético, de como un cuerpo negro absorbe o emite toda la energía sin reflejar nada. Verá como es la distribución de energía de un cuerpo, donde apreciará que a mayor temperatura el máximo de radiación se obtiene a longitudes de onda más pequeñas. Hablaremos de un sensor PIR, de como esta constituido por dos cristales piroeléctricos, que crean un campo magnético cuando reciben radicación infrarroja. Verá que tipo de le...

  19. 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

  20. GESTIÓN POR PROCESOS

    Directory of Open Access Journals (Sweden)

    Alejandro Hernández Lugo

    2003-04-01

    Full Text Available

    La gestión por procesos en una organización encierra un significado diferente a lo que podría ser un simple enfoque, o una aproximación para mejorar una tarea o varias, implica la planificación,organización, control y dirección de las actividades. La RAE define este vocablo como:

     

    gestión: acción de administrar algo. Los procesos se deben administrar.

  1. 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.

  2. Absceso epidural cervical por peptostreptococcus anaerobius

    OpenAIRE

    Fernandez Garcia, L.; Machado Baldasano, A.; Villanueva Pareja, F.; García de Quevedo Puerta, D.; Marfil Romero, M.

    1996-01-01

    Se presenta 1 caso de infección con absceso epidural a nivel cervical producido por un Peplostreptococcus anaerobius en 1 paciente en el que se realizó previamente una artrodesis C6-C7 por una hernia discal cervical. En la literatura no se han encontrado referencias bibliográficas de casos similares, por la etiología y la localización. Se discute la importancia de las infecciones por bacterias anaerobias en patología osteoarticular, métodos diagnósticos, así como su abordaje te...

  3. ¿paz por estatalización, paz por cortes de justicia, paz por tratado, paz por soberanía,paz por derecho penal?

    OpenAIRE

    Marquardt, Bernd

    2012-01-01

    Con este artículo se pretende introducir la historia de la paz en Europa, teniendo en cuenta los enfoques de la ciencia de la Historia del Derecho y de las investigaciones propias sobre la Historia Universal del Estado. Se quiere presentar los desarrollos y transformaciones de la paz en el milenio entre 800 y 1800 d.C. 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 Et...

  4. Concordancia entre los porcentajes de grasa corporal estimados mediante el área adiposa del brazo, el pliegue del tríceps y por impedanciometría brazo-brazo

    Directory of Open Access Journals (Sweden)

    Martín Moreno Vicente

    2003-01-01

    Full Text Available Fundamento: La valoración del estado nutricional a partir de los miembros superiores es útil a nivel clínico. El objetivo de este trabajo es analizar el grado de acuerdo entre los porcentajes de grasa corporal (%GC estimados mediante el área adiposa del brazo (%GC BRAZO, la ecuación de Siri para el pliegue del tríceps (%GC TRÍCEPS y por bioimpedanciometría brazo-brazo (%GC BIA, así como con la ecuación de Siri para cuatro pliegues (%GC SIRI. Métodos: Estudio descriptivo transversal. Se valoró antropométricamente y por impedanciometría (Omron BF 300© a 145 personas (83 varones, 62 mujeres. La concordancia entre métodos se analizó mediante el coeficiente de correlación intraclase (CCI y el método de Bland-Altman. Resultados: el CCI entre %GC BRAZO-%GC TRÍCEPS fue de 0,8322 (intervalo de confianza al 95% 0,7672-0,8791; entre %GCB RAZO-%GC BIA de 0,7337 (0,6305-0,8080 y entre %GC TRICEPS-%GC BIA de 0,9290 (0,9015; 0,9488. Con el método de Bland-Altman el intervalo de concordancia entre %GC BRAZO-%GC TRÍCEPS (-11,2; 16,96 y entre %GC BRAZO-%GC BIA (-13,04; 21,76 superó el punto de corte (±10%, pero no entre %G CTRICEPS-%GC BIA (-6,64; 9,6, %GC SIRI-%GC TRÍCEPS (-5,27; 4,52 y %GC SIRI-%GC BIA (-6,31; 8,52. El IMC no influyó en el resultado. Conclusiones: El método utilizado influye en la valoración nutricional realizada a partir de los miembros superiores. El área adiposa del brazo sobreestima el %GC con relación a la ecuación de Siri para el pliegue del tríceps o para cuatro pliegues y a la impedanciometría, y aunque este resultado sugiere que el área adiposa del brazo puede no ser un indicador válido de la adiposidad global, este extremo deberá ser confirmado frente a una técnica patrón.

  5. Concordancia entre los porcentajes de grasa corporal estimados mediante el área adiposa del brazo, el pliegue del tríceps y por impedanciometría brazo-brazo

    Directory of Open Access Journals (Sweden)

    Juan Benito Gómez Gandoy

    2003-01-01

    Full Text Available Fundamento: La valoración del estado nutricional a partir de los miembros superiores es útil a nivel clínico. El objetivo de este trabajo es analizar el grado de acuerdo entre los porcentajes de grasa corporal (%GC estimados mediante el área adiposa del brazo (%GCBRAZO, la ecuación de Siri para el pliegue del tríceps (%GCTRÍ- CEPS y por bioimpedanciometría brazo-brazo (%GCBIA, así como con la ecuación de Siri para cuatro pliegues (%GCSIRI. Métodos: Estudio descriptivo transversal. Se valoró antropométricamente y por impedanciometría (Omron BF 300© a 145 personas (83 varones, 62 mujeres. La concordancia entre métodos se analizó mediante el coeficiente de correlación intraclase (CCI y el método de Bland-Altman. Resultados: el CCI entre %GCBRAZO-%GCTRÍCEPS fue de 0,8322 (intervalo de confianza al 95% 0,7672-0,8791; entre %GCBRAZO- %GCBIA de 0,7337 (0,6305-0,8080 y entre %GCTRICEPS-%GCBIA de 0,9290 (0,9015; 0,9488. Con el método de Bland-Altman el intervalo de concordancia entre %GCBRAZO-%GCTRÍCEPS (-11,2; 16,96 y entre %GCBRAZO-%GCBIA (–13,04; 21,76 superó el punto de corte (±10%, pero no entre %GCTRICEPS-%GCBIA (-6,64; 9,6, %GCSIRI- %GCTRÍCEPS (-5,27; 4,52 y %GCSIRI-%GCBIA (-6,31; 8,52. El IMC no influyó en el resultado. Conclusiones: El método utilizado influye en la valoración nutricional realizada a partir de los miembros superiores. El área adiposa del brazo sobreestima el %GC con relación a la ecuación de Siri para el pliegue del tríceps o para cuatro pliegues y a la impedanciometría, y aunque este resultado sugiere que el área adiposa del brazo puede no ser un indicador válido de la adiposidad global, este extremo deberá ser confirmado frente a una técnica patrón.

  6. La inconstitucionalidad por omisión

    Directory of Open Access Journals (Sweden)

    Luz Bulnes Aldunate

    2006-01-01

    Full Text Available El artículo analiza la facultad de los tribunales constitucionales para determinar la inconstitucionalidad por omisión, en virtud del silencio u omisión de la autoridad de normar un principio o regla constitucional dispuesto por la Constitución explícita o implícitamente.

  7. Risk factors for intra-abdominal hypertension in children with sepsis%小儿脓毒症并腹内高压的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    张笃飞; 冯小伟; 林涛; 吴开芳

    2013-01-01

    Objective To study risk factors for the occurrence of intra-abdominal hypertension (IAH) in children with sepsis.Methods A nest case-control study was employed.According to intra-abdominal pressures (IAP) measured by cystometry,119 children with sepsis were classified into normal IAP (control,n =80) and IAH groups (n =39).Risk factors for the occurrence of IAH were investigated by monovariable and multivariable logistic regression analysis.Results Monovariable analysis showed that there were significant differences in pediatric critical illness score (PCIS),procalcitonin (PCT) level,PaCO2,blood lactate level,rates of intestinal or intra-abdominal infection,ascites,gastrointestinal dysfunction,mechanical ventilation,shock and multiple organ dysfunction syndrome (MODS) between the IAH and control groups (P < 0.05).Multivariable logistic regression analysis demonstrated that decreased PCIS,MODS,shock,gastrointestinal dysfunction and ascites were major risk factors for the occurrence of IAH.Conclusions Children with sepsis who have decreased PCIS,MODS,shock,gastrointestinal dysfunction and ascites are at risk for the occurrence of IAH.%目的 探讨小儿脓毒症并腹内高压(IAH)的危险因素,为早期诊断、及时干预治疗提供理论依据.方法 采用膀胱测压法对119例脓毒症患儿进行腹内压检测,根据腹内压检测结果将患儿分为腹内压正常组(对照组,n =80)与IAH组(n=39).采用单因素和非条件logistic回归分析对两组患儿的临床资料进行分析,以调查脓毒症患儿并发IAH的危险因素.结果 单因素分析发现小儿危重病评分(PCIS)、降钙素原(PCT)、PaCO2、血清乳酸值及肠道/腹腔感染、腹水、胃肠功能障碍、机械通气、休克和多脏器功能不全(MODS)的发生比例在IAH和对照组间比较差异均具有统计学意义(P<0.05).Logistic回归分析显示PCIS降低、MODS、休克、胃肠功能障碍和腹水是脓毒症合并IAH

  8. Effects of dexmedetomidine versus propofol on intraabdominal pressure in the patients with sepsis%右美托咪定与丙泊酚对脓毒症患者腹内压的影响

    Institute of Scientific and Technical Information of China (English)

    焦燕娜; 孟建标

    2012-01-01

    Objective To compare the effects propofol with dexmedetomidine on intraabdominal pressure in the patients with sepsis after abdominal surgery. Methods Forty patients undergoing surgical treatment for intestinal obstruction and were expected to require postoperative sedation and mechanical ventilation were enrolled in this study. The patients received either a loading dose of propofol (1 mg/kg, n = 20) in 15 mins followed by a maintenance dose of 3 mg·kg-1·h-1or a loading dose of dexmedetomidine (1 μg/kg, n = 20) in 10 mins followed by a maintenance dose of 0.2 -2.5 μg·kg-1·h-1 for over 24 h. Intraabdominal pressure was recorded before injection and at 24 h and 48 h after injection. Results Intraabdominal pressure in dexmedetomidine group was significantly lower than that in propofol group at 24 h ([12. 25 ± 5. 73] mmHg vs. [18. 1 ± 2. 73] mmHg [1 mmHg = 0.133 kPa]) and 48 h ([13.8±6.05] mmHg vs. [18.6 ± 3.35] mmHg) after injection (both P< 0.05). Conclusion Dexmedetomidine can significantly decrease intraabdomina, pressure compared with propofol for the patients with severe sepsis.%目的 比较右美托咪定与丙泊酚对脓毒症患者腹内压(IAP)的不同影响.方法 将腹部手术术后需行机械通气的合并脓毒症的肠梗阻患者随机分入右美托咪定组和丙泊酚组,每组20例.丙泊酚组于15 min内静脉注射丙泊酚1 mg/kg,随后以3 mg· kg-1·h-1的剂量持续静脉滴注维持.右美托咪定组于10 min静脉注射右美托咪定1μg/kg,随后以0.2~0.25 μg·kg-1·h-1的剂量予持续静脉滴注维持.两组患者镇静持续时间均>24 h.分别记录患者镇静治疗前、镇静后24及48 h的IAP水平.结果 右美托咪定组于镇静后24及48h的IAP水平分别为(12.25±5.73)和(13.8±6.05) mmHg(1 mmHg=0.133 kPa),显著低于丙泊酚组同时间点的(18.1±2.73)和(18.6±3.35) mmHg(P值均<0.05).结论 与丙泊酚相比,右美托咪定可以更有效地降低严重脓毒症患者的IAP.

  9. Prognostic value of procalcitonin and endotoxin concentrations for intra-abdominal sepsis%降钙素原及内毒素对腹腔感染脓毒症患者预后的评估

    Institute of Scientific and Technical Information of China (English)

    黄凤楼; 刁孟元; 钱海飞; 秦保东; 仲人前

    2014-01-01

    目的:探讨降钙素原(procalcitonin,PCT)及内毒素对于腹腔感染脓毒症患者预后的评估价值。方法回顾性分析腹腔感染脓毒症86例的临床资料,根据预后(存活和死亡)和病情严重程度(局部感染、脓毒症、严重脓毒症及脓毒症休克)分组,比较不同组别之间的PCT及内毒素水平,比较PCT和内毒素同急性生理和慢性健康状况评分Ⅱ( acute physiology and chronic health evaluation Ⅱ,APACHE Ⅱ)和脓毒症相关器官功能障碍评分( sepsis-related organ failure assessment score ,SO-FA)的相关性,并比较PCT、内毒素和两个临床评分系统对于患者预后的评估价值。结果根据不同评分及预后分组,各组之间PCT水平差异具有统计学意义,而内毒素水平差异无统计学意义。 PCT与两个评分系统具有很好的相关性,而内毒素与评分系统无显著相关。 PCT、内毒素、APACHE Ⅱ和SOFA评分对于预后的受试者工作特征曲线( ROC 曲线)下面积分别为85.7%、56.3%、86.7%和86.0%。结论 PCT较内毒素能更好地评价腹腔感染脓毒症患者的预后。%Objective To evaluate the value of serum procalcitonin and endotoxin concentrations in prognosis of intra -abdom-inal sepsis.Methods A total of 86 patients with intra-abdominal sepsis were included into the study .We compared PCT and endotoxin concentrations according to classification of different outcomes ( survivors and nonsurvivors ) and intra-abdominal sepsis ( local infec-tions,sepsis,severe sepsis and septic shock ).The correlation of PCT or endotoxin concentrations to APACHE Ⅱ or SOFA score were also analyzed ,then see their function in judging the prognosis of sepsis .Results Nonsurvivors had a higher level of PCT than survi-vors.PCT concentrations was higher in patients with severe sepsis and septic shock than that with sepsis or local infections .PCT concen-trations was associated with

  10. 危重患者腹腔内高压的发生率及其影响因素%Incidence and risk factors of high intraabdominal pressure in critically ill patients

    Institute of Scientific and Technical Information of China (English)

    杨飞

    2013-01-01

    目的:观察危重患者腹腔内高压(IAH)的发生率及其影响因素.方法:采用前瞻性队列研究方法,选择我院重症监护病房(ICU)的患者341例,采用经膀胱尿管间接测定方法,每日监测患者IAP,连续监测7d,按IAH的有无分组并进行临床资料比较,计量资料用t检验,计数资料用x2检验,危险因素以单因素及多因素Logistic回归模型进行分析.结果:341例患者中88例(25.8%)患者发生腹腔内高压(IAH),15例(4.5%)患者发生腹腔间室综合征(ACS).腹腔感染,大量液体复苏,肠梗阻,感染性休克,肝功能不全与IAH的发生密切相关(P=0.000,0.000,0.007,0.000,0.000).结论:IAH的发生在危重患者中较常见,腹腔感染,大量液体复苏,感染性休克,肝功能不全可能是IAH发生的独立危险因素.%Objective:To investigate the incidence and risk factors of high intra abdominal pressure(IAP) in critically ill patients in intensive care unit(ICU). Method:This was a prospective cohort study. This study was conducted at the intensive care unit in Changshu No. 2 people's hospital. The enrolled patients included all those consecutively admitted during 9 months. Intraabdominal pressure was continuously monitored twice daily for 7 days. Result:Of 341 patients,88 patients (25. 8%)had intra-abdominal hypertension and 15 patients(4. 5%) had ACS. Independent risk factors for IAH were abdominal infection, fluid resuscitation, sepsis shock and liver dysfunction. Conclusion: IAH was frequent in Intensive Care Unit. Abdominal infection, fluid resuscitation,sepsis shock and liver dysfunction were independent risk factors for IAH.

  11. Study on preventive effect of volatile oil extracted from Foeniculum vulgare Mill. Seeds on postoperative intra-abdominal adhesions%小茴香挥发油对术后腹腔黏连的预防作用探讨

    Institute of Scientific and Technical Information of China (English)

    滕光寿; 王成果; 毛峰峰; 张琰; 刘兴友; 杨鹏; 石磊; 刘曼玲

    2011-01-01

    Objective To study the preventive effect of volatile oil extracted from Foeniculum vulgare Mill. Seeds on the formation of postoperative intra-abdominal adhesion. Methods Thirty-eihgt SD rats were randomly divided into sham operation group (10), operation group (14) and volatile oil treated group (14):sham operation group was only operated by abdominal incision, the rest two groups were established animal model of abdominal adhesion by rubbing the procussus vermiformis of cecum with dry sterile gauze, clamping and scuffing abdominal wall. Half of rats were separately killed on day 7 and day 14 after surgery, respectively.The degree of adhesion was evaluated according to Phillips 5-scale grade and the feature of this model. Results The scores of intra-abdominal adhesion were significantly lower in the carbachol group than those in operation group both on 7 d and 14 d(P<0.01 ). Conclusion Volatile oil extracted from Foeniculum vulgare Mill. Seeds may take a significant role in the prevention of postoperative abdominal adhesion in rats.%目的 探讨小茴香挥发油对术后腹腔黏连的预防作用.方法 将38只雄性SD大鼠按随机数字表法分为假手术组(10只)、手术对照组(14只)及小茴香挥发油组(14只).假手术组只开腹,后两组开腹后无菌干纱布摩擦大鼠盲肠蚓突部,以钳夹和刮伤腹壁法制作大鼠腹腔黏连动物模型.各组于术后第7 d、14 d各处死一半动物,参考Phillips 5级分类法并结合本模型特点进行大体黏连程度分级评分.结果 小茴香挥发油组第7 d、14 d大体黏连程度评分均明显低于手术对照组,差异有统计学意义(P<0.01).结论 小茴香挥发油可预防大鼠腹腔黏连形成.

  12. La responsabilidad civil medioambiental por productos defectuosos

    OpenAIRE

    2014-01-01

    La tesis cuestiona por una parte la exhaustividad del marco regulador de la responsabilidad Civil por productos defectuosos y, por la otra, la singularidad de los daños medioambientales. Así, pretende, entre otros objetivos, contribuir en la construcción del Derecho Civil medioambiental, buscando, dentro del ámbito de protección de la legislación sobre productos defectuosos, el posible anclaje de los daños medioambientales. Gira en torno a la cuestión del régimen aplicable a supuesto...

  13. Búsquedas por similitud en PostgreSQL

    OpenAIRE

    2012-01-01

    Las búsquedas en espacios métricos y los operadores para búsquedas por similitud han sido estudiados y son actualmente material de estudio recurrente debido al auge de datos no convencionales como por ejemplo audio o video disponibles en grandes repositorios de datos. Por lo tanto, surge la necesidad de almacenar y posteriormente consultar dichos datos. A pesar de ello no se encuentran gestores de bases de datos que implementen todos los operadores relevantes sobre datos de estas característi...

  14. TERAPIA ASSISTIDA POR ANIMAIS (TAA – ZOOTERAPIA)

    OpenAIRE

    Tadeu Junior, Flavio Gomes; Residente do Hospital Veterinário da Faculdade Dr. Francisco Maeda - FAFRAM; Costa, Paula Ferreira; Professora Dra. da fundação Educacional de Ituverava.; Palazzo, Elzylene Lega; Professora Dra. da Fundação Educacional de Ituverava

    2014-01-01

    A Terapia Assistida por Animais (TAA) envolve a interação entre pacientes e um animal treinado, sob a supervisão de profissionais da saúde devidamente capacitados e habilitados. Utiliza-se da forte ligação homem animal em intervenções direcionadas como parte integrante do tratamento do paciente. O presente estudo tem como objetivo apresentar a efetividade e alguns dos benefícios que a Terapia Assistida por Animais traz à saúde dos pacientes, por estímulo de ativida...

  15. Hemoperitoneo agudo espontáneo por ruptura de várices intraabdominales en un paciente con cirrosis hepática

    Directory of Open Access Journals (Sweden)

    Maikel Vargas- Sanabria

    2006-09-01

    Full Text Available Se presenta el caso de un paciente con antecedente de etilismo crónico e historia de muerte súbita. Al realizarse la autopsia medicolegal se encontró un hemoperitoneo, várices gastroesplénicas rotas y cirrosis hepática. El hemoperitoneo agudo espontáneo secundario a ruptura de várices intraabdominales en pacientes portadores de cirrosis hepática, cuya primera manifestación clínica es la muerte, constituye un caso extremadamente raro y por tanto de difícil indagación médica.We present the case of an alcoholic patient who died suddenly. The medicolegal autopsy found a massive hemoperitoneum and hepatic cirrhosis. Acute spontaneous hemoperitoneum secondary to intraabdominal variceal rupture in patients with hepatic cirrhosis whose first clinical manifestation is sudden death, is an extremely rare condition and therefore difficult from the medical point of view.

  16. Intoxicación por Paraquat

    Directory of Open Access Journals (Sweden)

    Glenda Viales López

    2014-12-01

    Full Text Available El paraquat es un herbicida bipiridílico que actúa por contacto, se presenta en forma líquida en concentraciones del 20% para uso agrícola. Su nombre químico es eI 1-1´-dimetil-4-4- bipiridilo, con el nombre comercial de Gramoxone. La intoxicación por paraquat tiene una tasa de mortalidad elevada. La intoxicación grave se caracteriza por la afectación de múltiples órganos, principalmente los pulmones, los riñones y el hígado. El pulmón es el órgano diana en la intoxicación por paraquat y la insuficiencia respiratoria con fibrosis pulmonar aguda es la causa más común de muerte.

  17. 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).

  18. 晚期糖基化终末产物受体在腹腔感染脓毒症中的研究进展%Recent progress of RAGE in sepsis induced by intra-abdominal infection

    Institute of Scientific and Technical Information of China (English)

    廖延年(综述); 黄骞; 黎介寿(审校)

    2015-01-01

    Sepsis caused by complicated intra-abdominal infection has a poor prognosis since the mechanism of sepsis has not been fully clarified .Research about the effect of Receptor of Advanced Glycation Endproducts on sepsis was paid extensive attention . In this paper , the construction and function of RAGE , the relationship between RAGE and inflammation and action of RAGE during sepsis are summarized .%严重腹腔感染导致的脓毒症预后不佳,与其机制的未充分阐明有关。近年来关于晚期糖基化终末产物受体( re-ceptor of advanced glycation endproducts , RAGE)在脓毒症中的作用的研究受到广泛关注。文中就RAGE的结构与功能,RAGE与炎症的关系以及RAGE在腹腔感染脓毒症中的作用等问题作一综述。

  19. Open abdomen in the treatment of intra-abdominal hypertension in patients with severe acute pancreatitis%重症急性胰腺炎的腹腔高压与腹腔开放治疗

    Institute of Scientific and Technical Information of China (English)

    李宁

    2010-01-01

    @@ 早在20世纪初期,就有学者注意到腹腔高压对患者心血管、肾脏等的功能产生不利影响.重症急性胰腺炎(severe acute pancreatitis,SAP)常导致腹腔高压,不仅限制腹式呼吸,减少机体氧供,而且对泌尿、循环、消化和中枢神经系统等产生一系列严重影响,如不及时治疗,将导致腹腔间室综合征(abdominal compartment syndrome,ACS).%Severe acute pancreatitis (SAP) can induce intra-abdominal hypertension, which has an adverse effect on the function of urinary, circulatory, digestive and neurological system, and finally leads to abdominal compartment syndrome (ACS) if patients were not timely treated. This article focuses on the close relationship between SAP and ACS, which included the definition, classification, pathogenesis of ACS and its pathophysiologic effects on other important organs. The different types and indications of surgical interventions of ACS were discussed in detail. For SAP patients complicated with ACS, urgent open abdomen is important to decrease the abdominal pressure and to prevent the incidence of multi-organ dysfunction syndrome. Complications after open abdomen, such as intestine fistula,abdominal sepsis, intestinal dysfunction and abdominal deficit,should be managed prudently.

  20. MSCT and multiplanar reconstruction in diagnosis and classification of intraabdominal hernia%MSCT 多平面重建技术在腹内疝诊断及分型中的临床价值

    Institute of Scientific and Technical Information of China (English)

    王礼同; 蔡玉建; 李澄

    2015-01-01

    Objective To explore the clinical value of multi-slice spiral CT ( MSCT) and multiplanar reconstruction (MPR) in diagnosis and classification of intraabdominal hernia. Methods A total of 27 cases of intraabdominal hernia confirmed surgically or by follow-up between August 2010 and December 2014, were retrospectively analyzed with axial CT and MPR. The intestinal heterotopic distribution and its space occupying effect, signs of intestinal obstruction and intestinal wall/ mesentery ischemia, and the relationship between intestinal loop and adjacent bowel/ mesentery were observed. Results There were 13 cases of adhesive band hernia, 3 cases of right paraduodenal hernia, 3 cases of pelvic hernia, 3 cases of pericecal hernia, 2 cases of sigmoid colon around hernia, 1 case of intestinal mesenteric hernia, 1 case of left mesocolon hiatal hernia and 1 case of anastomotic posterior hernia. The contents of hernia were small bowels and its mesentery. Intestinal loop herniated presented as mass, bag shaped or cluster. There were 18 cases of closed loop obstruction. The walls of small bowels thickened with edema in 9 cases, including 5 cases of intestinal necrosis and 1 case of intestinal perforation. There were 15 cases of proximal small bowel obstruction. The mesenteric vein thickened in 17 cases, concentrated to the hernia orifice parts and showed “ cable” sign. There were 15 cases with CT follow-up examination: closed loop obstruction or proximal small bowel obstruction became heavier in 7 cases, relieved in 4 cases and no obvious change in 4 cases. Conclusion MSCT and multiplanar reconstruction can accurately diagnose intraabdominal hernia and provide a reliable basis for surgery, which can be used as the first choice of examination methods in diagnosis and classification of intraabdominal hernia.%目的:探讨 MSCT 多平面重建(MPR)技术在腹内疝诊断及分型中的临床应用价值。方法回顾性分析2010年8月至2014年12月,扬州市第一人民医

  1. Correlation study of recovery degrees and intra-abdominal pressure changes for patients after ilealcolon neobladder surgery%原位回结肠新膀胱术后患者恢复程度与腹压变化的相关性研究

    Institute of Scientific and Technical Information of China (English)

    段利英

    2014-01-01

    目的:探讨原位回结肠新膀胱术后患者恢复程度与腹内压变化的相关性研究,以指导护理工作,防止并发症。方法:对60例患者根据 UBP 不同分为实验组和对照组,行膀胱全切、原位回结肠代膀胱术后患者进行 UBP 与生命体征、术后恢复程度观察指标的监测。结果:实验组患者胃肠功能恢复明显优于对照组,两组患者 MP 比较差异无统计学意义(t=1.64,P>0.05),心率、呼吸频率、疼痛三个指标,两组比较差异有统计学意义(P0. 05). There were differences in heart rate, breathing rate, and pains between the two groups (P<0. 05). The correlation analysis for the intra-abdominal pressure and postoperative recovery indices of the two groups showed that the intra-abdomi-nal pressure was positively correlated with bowel sounds recovery time, anus exhaust time, heart rate, breathing rate, and pains, but was negatively correlated with daily food intake; and the intra-abdominal pressure was also negatively correlated with the mean arterial pressure (P<0. 05). The incidence rates of abdominal distention and complications of control group were higher than those of experi-mental group, and there were statistical difference between the two groups. Conclusions: After the ilealcolon neobladder surgery, the recovery is closely related with the intra-abdominal pressure changes. Therefore, UBP for monitoring the intra-abdominal pressure is a good method for observing the patients' conditions and recovery degrees after the surgery.

  2. Micetoma por Nocardia brasiliensis: reporte de caso

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    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.

  3. Intoxicación por metales

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    A. Ferrer

    Full Text Available Los metales están entre los tóxicos más antiguos conocidos por el hombre. En el industrializado mundo actual las fuentes de exposición a metales son ubicuas tanto en el campo laboral como a partir de agua, los alimentos o el ambiente contaminados. Su toxicidad está caracterizada por el elemento metálico en cuestión pero se ve modificada por el tipo de compuesto, orgánico o inorgánico y sus características de hidro o liposolubilidad, que determina su toxicocinética y por tanto sus posibilidad de alcanzar sus dianas. Las biomoléculas más afectadas por los metales son las proteínas con actividad enzimática por lo que su patología es multisistema. Los principales sistemas afectados son el gastrointestinal, neurológico central y periférico, hemático y renal. Algunos de los compuestos metálicos son carcinógenos. Los metales se benefician de un tratamiento condicionado por su reactividad química. Pueden ser inactivados y eliminados mediante la administración de substancias quelantes que producen con ellos moléculas complejas, atóxicas y excretables. Los principales agentes quelantes son: BAL (British Anti-Lewisite o dimercaprol, DMPS (ácido 2,3-dimercapto-1-propanosulfonico y DMSA (ácido meso-2,3-dimercatosuccínico o Succimer, EDTA, Penicilamina (ß,ß-dimetilcisteína y Desferoxamina. Se exponen a continuación las características toxicocinéticas, mecanismo de acción, clínica y tratamiento de alguno de los metales y metaloides más relevantes: plomo, mercurio y arsénico.

  4. MACRONUTRIENT INTAKE IS CORRELATED WITH DYSLIPIDEMIA AND LOW-GRADE INFLAMMATION IN CHILDHOOD OBESITY BUT MOSTLY IN MALE OBESE.

    Science.gov (United States)

    Antunes, Barbara de Moura Mello; Monteiro, Paula Alves; Silveira, Loreana Sanches; Brunholi, Claudia de Carvalho; Lira, Fábio Santos; Freitas Júnior, Ismael Forte

    2015-09-01

    Introducción y objetivo: la hipoxia causada por la hipertrofia de las células adiposas en la obesidad desencadena macrófagos de reclutamiento y la producción de citoquinas. Además, el alto consumo de ácidos grasos saturados (AGS) y las comidas con alto índice glucémico pueden contribuir al estrés oxidativo y la inflamación crónica de bajo grado por los aumentos de activación de NF-kB. Por lo tanto, el objetivo del estudio fue analizar la contribución de la ingesta de macronutrientes en el perfil metabólico e inflamatorio, por niveles de lipoproteínas, resistencia a la insulina, citoquinas anti y pro inflamatorias, en adolescentes obesos según el género. Métodos: la muestra estaba compuesta por 37 adolescentes, de ambos géneros, identificados como obesos según el índice de masa corporal (IMC). La composición corporal se evaluó mediante absorciometría de energía dual de rayos X (DEXA) y medidas de adiposidad intraabdominal (IAAT) y del tejido adiposo subcutáneo (SAT) se realizaron mediante ecografía. Los análisis bioquímicos se realizaron mediante la medición de citoquinas; los ácidos grasos y la insulina se realizaron por la técnica de ELISA. La estimación del consumo de macronutrientes fue llevado a cabo durante tres días mediante el registro de alimentos con respecto a la ingesta total. La significación estadística se estableció en el valor p.

  5. Por que morrem os cortadores de cana?

    OpenAIRE

    Alves, Francisco

    2006-01-01

    O objetivo deste trabalho é demonstrar que a morte dos trabalhadores assalariados rurais, cortadores de cana, advém do pagamento por produção. Os processos de produção e de trabalho vigentes no Complexo Agroindustrial Canavieiro foram concebidos objetivando a produtividade crescente do trabalho e, combinados ao pagamento por produção, provocam a necessidade de os trabalhadores aumentarem o esforço despendido no trabalho. O crescimento do dispêndio de energia e do esforço para cortar mais cana...

  6. Algunos problemas de rutas por arcos

    OpenAIRE

    Ávila Valverde, Thais

    2014-01-01

    En esta tesis se estudian tres problemas de rutas por arcos muy importantes tanto a nivel práctico como teórico. Se tratan del General de Rutas por Arcos en un grafo dirigido (Directed General Routing Problem, DGRP), su caso particular, el problema de la Grúa (Stacker Crane Problem, SCP) y el problema del Cartero Rural Generalizado en un grafo dirigido (Generalized Directed Rural Postman Problem, GDRPP). El primer problema estudiado es problema de la Grúa el cual se define en un grafo mi...

  7. Endoftalmite por Candida albicans Candida albicans endophthalmitis

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    Pedro Duraes Serracarbassa

    2003-10-01

    Full Text Available O autor descreve os aspectos epidemiológicos, histopatológicos e clínicos da endoftalmite endógena por Candida albicans. Apresenta ainda novos métodos diagnósticos e opções terapêuticas utilizadas no tratamento das infecções fúngicas intra-oculares, por meio de revisão bibliográfica.The author describes epidemiological, histopathological and clinical aspects of endogenous Candida albicans endophthalmitis. He also presents new diagnostic methods and therapeutical options to treat intraocular fungal infections, based on literature review.

  8. Neumopericardio debido a herida por arma blanca

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    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.

  9. ACATISIA INDUCIDA POR TIETILPERAZINA EN PACIENTE EMBARAZADA

    OpenAIRE

    Vera,Gabriela; Varas,Aldo

    2002-01-01

    La acatisia es un efecto lateral neurológico agudo común a diversos fármacos que actúan a nivel dopaminérgico, su manifestación fundamental es la inquietud psicomotora, es importante diagnosticar y tratar precozmente este síndrome. Tietilperazina es una fenotiazina cuyo efecto antiemético es usado en diversas circunstancias clínicas, presentamos el caso de una paciente hospitalizada por hiperemesis gravídica que es derivada a psiquiatría por la presencia de síntomas aparentemente ansiosos. El...

  10. Surveillance of antimicrobial susceptibility of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections in China: the 2002-2009 Study for Monitoring Antimicrobial Resistance Trends (SMART).

    Science.gov (United States)

    Yang, Qiwen; Wang, Hui; Chen, Minjun; Ni, Yuxing; Yu, Yunsong; Hu, Bijie; Sun, Ziyong; Huang, Wenxiang; Hu, Yunjian; Ye, Huifen; Badal, Robert E; Xu, Yingchun

    2010-12-01

    The objective of this study was to investigate the distribution and susceptibility of aerobic and facultative Gram-negative bacilli (GNB) isolated from patients with intra-abdominal infections (IAIs) in China. From 2002 to 2009, minimum inhibitory concentrations of 14 antibiotics for 3420 aerobic and facultative GNB from up to eight hospitals in six cities were determined by the broth microdilution method. Enterobacteriaceae comprised 82.9% (2834/3420) of the total isolates, with Escherichia coli (49.2%) being the most commonly isolated species followed by Klebsiella pneumoniae (17.0%), Enterobacter cloacae (5.8%) and Citrobacter freundii (2.3%). Amongst the antimicrobial agents tested, the three carbapenems (ertapenem, imipenem and meropenem) were the most active agents against Enterobacteriaceae, with susceptibility rates of 96.1-99.6% (2002-2009), 98.2-100% (2002-2009) and 99.6-100% (2002-2004), respectively, followed by amikacin (86.8-95.1%) and piperacillin/tazobactam (84.5-94.3%). Susceptibility rates of all tested third- and fourth-generation cephalosporins against Enterobacteriaceae declined by nearly 30%, with susceptibility rates of 40.2%, 39.1%, 56.3% and 51.8% in 2009 for ceftriaxone, cefotaxime, ceftazidime and cefepime, respectively. The occurrence of extended-spectrum β-lactamases increased rapidly, especially for E. coli (from 20.8% in 2002 to 64.9% in 2009). Susceptibility of E. coli to ciprofloxacin decreased from 57.6% in 2002 to 24.2% in 2009. The least active agent against Enterobacteriaceae was ampicillin/sulbactam (SAM) (25.3-44.3%). In conclusion, Enterobacteriaceae were the major pathogens causing IAIs, and carbapenems retained the highest susceptibility rates over the 8-year study period. Third- and fourth-generation cephalosporins, fluoroquinolones and SAM may not be ideal choices for empirical therapy of IAIs in China.

  11. Antimicrobial susceptibility and extended-spectrum beta-lactamase rates in aerobic gram-negative bacteria causing intra-abdominal infections in Vietnam: report from the Study for Monitoring Antimicrobial Resistance Trends (SMART 2009-2011).

    Science.gov (United States)

    Biedenbach, Douglas J; Bouchillon, Samuel K; Hoban, Daryl J; Hackel, Meredith; Phuong, Doan Mai; Nga, Tran Thi Thanh; Phuong, Nguyen Tran My; Phuong, Tran Thi Lan; Badal, Robert E

    2014-08-01

    Treatment options for multidrug-resistant pathogens remain problematic in many regions and individual countries, warranting ongoing surveillance and analysis. Limited antimicrobial susceptibility information is available for pathogens from Vietnam. This study determined the bacterial susceptibility of aerobic gram-negative pathogens of intra-abdominal infections among patients in Vietnam during 2009-2011. A total of 905 isolates were collected from 4 medical centers in this investigation as part of the Study for Monitoring Antimicrobial Resistance Trends. Antimicrobial susceptibility and extended-spectrum beta-lactamase (ESBL) rates among the appropriate species were determined by a central laboratory using Clinical and Laboratory Standards Institute methods. Among the species collected, Escherichia coli (48.1% ESBL-positive) and Klebsiella pneumoniae (39.5% ESBL-positive) represented the majority (46.4%) of the isolates submitted for this study. Ertapenem MIC90 values were lowest for these 2 species at 0.12 and 0.25μg/mL and remained unchanged for ESBL-positive isolates. Imipenem MIC90 values were also the same for all isolates and ESBL-positive strains at 0.25 and 0.5μg/mL, respectively. Ertapenem MIC90 values for additional species with sufficient numbers for analysis, including Enterobacter cloacae, Proteus mirabilis, Acinetobacter baumannii, and Pseudomonas aeruginosa, were 1, 0.06, >4, and >4μg/mL, respectively. Analysis of beta-lactamases in a subset of 132 phenotypically ESBL-positive Enterobacteriaceae demonstrated that CTX-M variants, particularly CTX-M-27 and CTX-M-15, were the predominant enzymes. High resistance rates in Vietnam hospitals dictate continuous monitoring as antimicrobial inactivating enzymes continue to spread throughout Asia and globally.

  12. Clinical analysis of antimicrobial resistance of Gram-negative bacilli isolated from patients with intra-abdominal infections%腹腔感染革兰阴性细菌耐药性临床分析

    Institute of Scientific and Technical Information of China (English)

    田文广; 黄文祥; 贾蓓; 辛小娟; 李崇智; 郑行萍; 史方静

    2011-01-01

    Objective To investigate epidemiological characteristics of Gram-negative bacilli (GNB) isolated from patients with non-recurrent intra-abdominal infections in our hospitals from 2008 to 2010, and to analyze antimicrobial resistance of GNB to common antibiotics and ESBLs-producing ratio of GNB. Methods A total of 290 cases of GNB were isolated from patients with intra-abdominal infections from 2008 to 2010. In antimicrobial susceptibility test, agar dilution method was applied for MIC determination according to NCCLS guidelines. All the data were analyzed using WHONET 5. 4 and SPSS 13. 0. Results In the total of 290 GNB, enterobacteriaceae accounted for 82. 7% and non-fermentative bacteria accounted for 17. 93%. There were six types of common bacteria in which E. Coli accounted for 55. 3% , and the ratio of Acinetobacter baumannii complex increased apparently (7. 96%). The positive rates of ESBLs production in E. Coli and Klebsiella spp were 74. 38% and 55. 56% , respectively. E. Coli was highly sensitive to carbapenems, piperacillin/tazobaetam and amikacin, but not to the third-generation cephalosporins and cefepime. The non-ESBLs-producing Klebsiella spp was sensitive to the twelve common anti-GNB antibiotics, while ESBLs-producing Klebsiella spp was sensitive to amikacin, piperacillin/tazobaetam and carbapenems. The susceptibility rates of Pseudomonas aerltgillosa to imipenem, piperacillin/tazobaetam and amikacin were all above 90% and to cefepime and two quinolones were 80% to 90% , but the susceptibility rate to ceftazidime decreased below 80%. The drug resistance rate of Acinetobacter baumannii to carbapenems was above 80%. Multidrug resistant (MDR) strains accounted for 32% , mainly including Acinetobacter baumannii complex and Pseudomonas aerltgillosa.Eighty percent MDR strains were resistant to almost all commonly used antibiotics. Conclusion The antimicrobial resistance of GNB isolated from patients with intra-abdominal infections increases apparently

  13. Tavares Bastos por Evaristo de Moraes Filho

    OpenAIRE

    Ferreira, Gabriela Nunes [UNESP

    2002-01-01

    A reedição de volume dedicado pelo jurista e pensador político Evaristo de Moraes Filho à obra de Tavares Bastos é comentada por autora de obra recente sobre essa importante figura política do Império brasileiro.

  14. Endocardite infecciosa causada por Eikenella corrodens

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    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.

  15. Conflictos por el espacio y orden urbano

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    Emilio Duhau

    2004-01-01

    Full Text Available En este artículo se explora una interpretación de los conflictos en torno al espacio en la Zona Metropolitana de la Ciudad de México (ZMCM con base en los conceptos de orden y de contextos urbanos. Para ello se presenta en primer término un conjunto de formas históricas de producción del espacio urbano que, de acuerdo con los autores, conforman en la actualidad cuatro “ciudades”, es decir, otros tantos contextos urbanos que se diferencian entre sí, entre otras cuestiones, por el tipo de conflictos por el espacio que en cada uno de ellos aparece como dominante. En segundo término se examina el concepto de orden urbano y se propone una línea de interpretación de los conflictos relacionados con el espacio que marcan en la actualidad dicho orden en la metrópoli. Por último se describen e ilustran las dinámicas que caracterizan a cada uno de los cuatro contextos urbanos o “ciudades” a partir de las formas en que se combinan diferentes modalidades de organización del espacio, usos del espacio público y privado y conflictos dominantes por el espacio.

  16. 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.…

  17. Sugar intake is correlated with adiposity and obesity indicators and sedentary lifestyle in Brazilian individuals with morbid obesity La ingesta de azúcar se correlaciona con indicadores de adiposidad y el sedentarismo en los individuos brasileños con obesidad mórbida

    Directory of Open Access Journals (Sweden)

    M.I.B. Penatti

    2012-10-01

    Full Text Available Obesity is a chronic disease characterized by increased accumulation of body fat. We evaluated the socioeconomic aspects, body composition, risk of metabolic complications associated with obesity, eating habits and lifestyle in both women and men adults and elderly with body mass index (BMI > 40 kg/m². Among the subjects studied, 79% (n = 32 are female, 5% (n = 2 smokers, 39% (n = 16 use alcohol and only 24% (n = 10 are practitioners of physical exercise. The higher food intake was breads, followed by rice. The daily intake of fruits and vegetables is low. Positive correlation between consumption of sugar and BMI and abdominal circumference (AC was observed. In summary, was found that morbidly obese patients that looking for nutritional counseling presents increased body fat, poor eating habits and sedentary lifestyle.La obesidad es una enfermedad crónica caracterizada por una acumulación aumentada de grasa corporal. Evaluamos los aspectos socioeconómicos, la composición corporal, el riesgo de complicaciones metabólicas asociadas con la obesidad, los hábitos dietéticos y el estilo de vida en mujeres y hombres adultos y ancianos con un índice de masa corporal (IMC > 40 kg/m². De entre los sujetos estudiados, el 79% (n = 32 eran mujeres, el 5% (n = 2 fumadores, el 39% (n = 16 consumía alcohol y sólo el 24% (n = 10 practicaba algún ejercicio físico. El mayor consumo de alimentos fue de pan seguido de arroz. El consumo diario de frutas y verduras fue bajo. Se observó una correlación positiva entre el consumo de azúcar y el IMC y la circunferencia abdominal (CA. En resumen, se halló que los pacientes con obesidad mórbida que buscan consejo nutricional presentan un aumento de la grasa corporal, hábitos alimenticios deficientes y un estilo de vida sedentario.

  18. Study and classification of the abdominal adiposity throughout the application of the two-dimensional predictive equation Garaulet et al., in the clinical practice Estudio y clasificación de la adiposidad abdominal mediante la aplicación de la ecuación predictiva bidimensional de Garaulet et al., en la práctica clínica

    Directory of Open Access Journals (Sweden)

    C. M.ª Piernas Sánchez

    2010-04-01

    Full Text Available Introduction: The excess of visceral abdominal adipose tissue is one of the major concerns in obesity and its clinical treatment. Objective: To apply the two-dimensional predictive equation proposed by Garaulet et al. to determine the abdominal fat distribution and to compare the results with the body composition obtained by multi-frequency bioelectrical impedance analysis (M-BIA. Subjects/methods: We studied 230 women, who underwent anthropometry and M-BIA. The predictive equation was applied. Multivariate lineal and partial correlation analyses were performed with control for BMI and % body fat, using SPSS 15.0 with statistical significance P Introducción: El exceso de tejido adiposo abdominal visceral es una de las mayores preocupaciones en la obesidad y su tratamiento clínico. Objetivo: Aplicar la ecuación predictiva bidimensional propuesta por Garaulet et al., para determinar la distribución de la grasa abdominal y comparar los resultados con la composición corporal obtenida mediante el análisis de impedancia bioeléctrica multi-frecuencia (M-BIA. Sujetos/métodos: Estudiamos a 230 mujeres a las que se sometió a antropometría y M-BIA. Se aplicó la ecuación predicitiva. Se realizaron correlaciones lineales multivariadas y parciales controlando el IMC y el % de grasa corporal, utilizando SPSS 15.0 con significación estadística P < 0,05. Resultados: En global, se consideró que las mujeres tenían una distribución subcutánea de la grasa abdominal. La grasa troncal, regional y la masa muscular se asociaron negativamente con VA/SApredicted, mientras que le índice visceral obtenido mediante M-BIA se correlacionó positivamente con VA/SApredicted. Discusión/conclusión: La ecuación predictiva puede ser útil en la práctica clínica para obtener una clasificación segura, barata y precisa de la obesidad abdominal.

  19. 产后出血患者的液体管理及其继发腹高压的危险因素%Fluid management and risk factors of intra-abdominal hypertension secondary to postpartum hemorrhage

    Institute of Scientific and Technical Information of China (English)

    王胤佳; 李超; 李志伟; 李立

    2016-01-01

    mol/L,t=5.33]均较治疗前降低,白蛋白[(24.45±4.80)与(21.35±5.69)g/L,t=-4.47]升高,差异均有统计学意义(P值均<0.05). 结论 产后出血患者合并子痫前期、大量输液及液体出量过少,均是发生腹高压的危险因素.腹高压对肝肾功能不利,并延长住院时间.采用液体负平衡治疗能降低腹内压,改善肝肾功能.%Objective To investigate fluid management and risk factors of intra-abdominal hypertension (IAH) after postpartum hemorrhage.Methods Clinical data of 64 patients of postpartum hemorrhage who were admitted to Intensive Care Unit (ICU) of the First People's Hospital of Kunming from January 2013 to January 2015 were collected.The patients were divided into IAH group and non-IAH group based on intra-abdominal pressure on admission to ICU.Diuresis or dialysis were offered to patients whose output exceeded 1 000 ml of their input after hospitalization.The background information,including maternal age,existence of pre-eclampsia and whether hysterectomy and transcatheter arterial embolization were performed,intra-abdominal pressure,liver and renal function and length of stay in hospital between the two groups were compared.The intra-abdominal pressure and liver and renal function before and 24 h after negative fluid administration of all subjects were compared as well.Independent-samples t test,paired-samples t test,Chisquare test and logistic regression analysis were applied for statistics.Results Among all of the 64 patients,15(23,4%) presented with IAH on admission,25 (39.1%) were complicated with preeclampsia,one (1.6%) had the uterus removed,and 16 (25.0%) had transcatheter arterial embolization performed.Within 12 h before admission,the average blood loss of the 64 women was (4 022± 1 275) ml,crystal solution input was (8 894±2 597) ml,colloidal fluid input was (343 ± 87) ml,blood products input was (1 370± 346) ml,total fluid input was (10 607± 2 825) ml,total fluid output was (5 176±2 334) ml

  20. Dermatoses provocadas por plantas (fitodermatoses Dermatosis due to plants (phytodermatosis

    Directory of Open Access Journals (Sweden)

    Vitor Manoel Silva dos Reis

    2010-08-01

    Full Text Available As dermatoses causadas por plantas são relativamente comuns no nosso meio e podem ocorrer por diversos mecanismos patogênicos. São descritas dermatoses por trauma físico, por ação farmacológica, mediadas por IgE, por irritação, por ação conjunta da luz e por sensibilização. Também são descritas na introdução desta revisão as pseudofitodermatoses causadas por elementos veiculados pelas plantas e, por isso, aparentemente causadas pelas plantas.Dermatosis caused by plants is relatively common and may occur by various pathogenic mechanisms. Dermatitis due to physical trauma, pharmacological action, irritation, sensitization, mediated by IgE and induced by light are described. Pseudophytodermatosis caused by plant-delivered elements is also described in the introduction to this work.

  1. 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.

  2. Responsabilidad por violación de la buena fe en la sociedad por acciones simplificada

    Directory of Open Access Journals (Sweden)

    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.

  3. DIATERMIA POR ONDAS CURTAS: ANÁLISE DA TEMPERATURA CORPORAL SUPERFICIAL POR TERMOGRAFIA

    OpenAIRE

    Sergio Fernando Zavarize; Anderson Martelli; Samara Aparecida Machado; Estela Maria Correia Sant’Ana

    2014-01-01

    Introdução: Poucos estudos relacionam os efeitos da diatermia por ondas curtas (DOC) e a área de aquecimento promovido por sua aplicação. Objetivo: O objetivo do trabalho foi avaliar o comportamento da temperatura superficial corporal antes e após a aplicação de DOC por meio da termografia cutânea. Materiais e métodos: A análise da temperatura corporal no local da aplicação foi realizada através da captura da imagem por meio de câmera termográfica após quinze minutos de repouso do...

  4. Mastite por Paracoccidioidomicose: Relato de Caso

    Directory of Open Access Journals (Sweden)

    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.

  5. Intoxicación por Superwarfarinas

    Directory of Open Access Journals (Sweden)

    Patricia Crecente Otero

    2012-09-01

    Full Text Available Las denominadas superwarfarinas se desarrollaron a partir de la década de 1970 como solución a las resistencias que habían desarrollado los roedores a los raticidas hasta entonces existentes1. Sus principales ventajas son su mayor potencia (hasta 100 veces más potentes que la warfarina2 y el disponer de una semivida más larga (hasta 6-8 semanas. Presentamos el caso de un paciente varón que ingresa en nuestro servicio de Medicina Interna por otorragia y hematuria para estudio. Como único antecedente es consumidor ocasional de cocaína inhalada. Se confirma la intoxicación por un potente raticida, la bromadiolona.

  6. Celulitis por cuerpo extraño

    Directory of Open Access Journals (Sweden)

    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.

  7. Conservación por calor

    OpenAIRE

    Cobos García, Angel; Díaz Rubio, Olga

    2011-01-01

    Esta unidade didáctica denominada Conservación por calor forma parte da materia «Tecnoloxía do procesado de alimentos» que se impartirá no primeiro semestre do 2º curso do Grao en Nutrición Humana e Dietética. A materia estrutúrase en diferentes unidades didácticas, tratando cada unha delas as diferentes tecnoloxías de procesado dos alimentos, tanto de conservación coma de transformación. A presente unidade didáctica aborda a conservación dos alimentos por calor. Este método permite destruír ...

  8. Muestreo por conglomerados en encuestas poblacionales

    OpenAIRE

    Zapata-Ossa, Helmer de Jesús; Cubides-Munévar, Angela M.; López, María C.; Pinzón-Gómez, Elisa M.; Filigrana-Villegas, Paola A.; Cassiani-Miranda, Carlos A.

    2012-01-01

    Objetivo Describir la técnica estadística del muestreo por conglomerados en encuestas de salud poblacionales. Métodos Se describen los aspectos más importantes de cada uno de los pasos metodológicos   haciendo énfasis en los fundamentos del Muestreo por Conglomerados. Éste se aplicó sobre una población  de aproximadamente 100 000 habitantes de la comuna 18 de Cali. La muestra abarcó 30 manzanas y se encuestaron 3 026 personas. La información se recolectó usando el Sistema de Información de ba...

  9. 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

    . These were subjected to a phylogenetic analysis along with 237 other publicly available (NCBI and oneKP) POR sequences found within the clade Asterids. Here, we show that the order Apiales only harbor members of the POR 2 clade, which are further divided into two distinct subclades. This is in contrast...... (available from the SRA at NCBI). All three genes were shown to be functional upon reconstitution into nanodiscs, confirming that none of the isoforms are pseudogenes....

  10. Muerte por Ahorcadura Death by Hanging

    OpenAIRE

    A. Sibón Olano; P. Martínez-García; RJ. Palacios Granero; JL. Romero Palanco

    2005-01-01

    La muerte por ahorcadura, suspensión o colgamiento, es generalmente suicida y con menos frecuencia accidental. El ahorcamiento homicida es inusual, estando descrito como mecanismo para disimular la verdadera causa de la muerte. La presencia de signos vitales van a permitir distinguir entre una suspension vital y otra postmortal. En este número, vamos a mostrar imágenes de algunos signos de ahorcadura discutiendo su origen vital. La autopsia reglada del cuello, en ocasiones, no muestra signos ...

  11. Claude Lefort: Democracia e Luta por Direitos

    Directory of Open Access Journals (Sweden)

    Silvana de Souza Ramos

    2016-06-01

    Full Text Available RESUMO: Tendo como eixo organizador o debate acerca da noção de direitos do homem e do cidadão e a eficácia destes no que se refere à luta política por novos direitos, o artigo investiga o caráter inovador da democracia moderna. Em sua abordagem do tema, C. Lefort combate três teses: a de que a defesa de direitos humanos universais representaria um perigo à política vigorosa, instituída em Estados benevolentes; a de que esses direitos seriam a expressão mais acabada da ideologia do individualismo burguês e corresponderiam a formalidades vazias, cujo sentido seria apenas o de escamotear a violência social e sacralizar privilégios; e, por fim, a tese segundo a qual as instituições democráticas visariam somente a reproduzir as relações de propriedade e força vigentes no capitalismo e não permitiriam que as contradições sociais fossem expressas ou mesmo resolvidas no campo da política. Trata-se de retomar a filosofia política proposta por C. Lefort, a qual enfatiza o caráter inédito da democracia moderna, para então explicitar, contrariando tais críticas, a perspectiva histórica de luta por direitos aberta pela invenção democrática.

  12. sobrevida de ratas intoxicadas por paraquat

    Directory of Open Access Journals (Sweden)

    Y. Aular

    2005-01-01

    Full Text Available La vitamina C (VC y la trimetazidina (TMZ como antioxidantes y la posible acción intiinflamatoria de esta última podrían ser de utilidad en la intoxicación por paraquat. Por tal razón se decidió evaluar el efecto de esta asociación en los niveles de VC, peso y sobrevida de ratas intoxicadas por paraquat, para ello se diseñó un estudio con 56 ratas divididas en 8 grupos: A (control negativo; B (control positivo, recibieron 11 mg/Kg. de paraquat IP; C (pre tratadas con 28.5mg/Kg. VC oral; D (tratadas con 28.5mg/Kg. VC post intoxicación; E (pre tratadas con 5mg/Kg. TMZ oral; F (tratadas con 5mg/Kg. TMZ post intoxicación; G (pre tratadas con VC- TMZ; H (tratadas con VC- TMZ post intoxicación. Se determinaron niveles de VC, cambios de peso y sobrevida en los grupos experimentales durante 31 días. Los resultados mostraron el día 24 de experimentación: disminución de los niveles de VC en el grupo E (p<0.05 y aumento en el grupo G (p< 0.001, sobrevida de 62.5% (grupo G, 50% (grupos E y H y 25% (grupos C y D. Se concluye que la asociación VC- TMZ aumentó la sobrevida de ratas intoxicadas por paraquat

  13. 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.

  14. Leibniz damnificado por el terremoto de Lisboa

    Directory of Open Access Journals (Sweden)

    Evaristo ÁLVAREZ MUÑOZ

    2009-11-01

    Full Text Available RESUMEN: En las páginas que siguen se argumenta que al filósofo alemán Gottfried Wilhelm Leibniz —fallecido en Hannover en 1716— o, al menos, a su obra Teodicea, cabría contarlos, echadas las cuentas de la manera que se verá, entre las víctimas del terremoto de Lisboa de 1755. Asimismo se subraya la persistencia del pensamiento de Leibniz en las respuestas dadas por los filósofos del siglo XVIII al trágico suceso. Se estudian las reacciones de Voltaire, de Rousseau y de Kant ante los estragos provocados por el seísmo y se concluye que las manifestaciones de los dos primeros ya habían sido previstas en Teodicea e, incluso, la vía científica pretendida por Kant había sido abierta en Protogaea.ABSTRACT: It is argued here that German philosopher Gottfried Wilhelm Leibniz, passed away in 1716, and, specially, that his work Teodicea, could be considered amongst the victims of the Lisbon earthquake of 1755. The persistence of the Leibniz’s thought in the answers given by the philosophers of the 18th Century to the tragic event is also emphasized. Voltaire and Rousseau’s reactions to the damage caused by the earthquake had been anticipated in Teodicea and the scientific way followed by Kant had been initiated in Protogaea.

  15. Intoxicación por drogas

    Directory of Open Access Journals (Sweden)

    I. Gainza

    Full Text Available El consumo de drogas ilegales en nuestro país ha experimentado un notable cambio en los últimos años, relegando a la heroína e incorporando la cocaína, los derivados anfetamínicos como el "éxtasis" (MDMA, el "éxtasis líquido" (GHB y, en menor medida, la ketamina. Se lleva a cabo una revisión de la intoxicación aguda por opiáceos y de su tratamiento en los servicios de urgencias, teniendo en cuenta el descenso progresivo de los casos que se presentan con el advenimiento de nuevas formas de administración, así como la presencia de nuevas drogas adictivas que han dado lugar a un desplazamiento en los hábitos de consumo. Se expone la intoxicación por cocaína haciendo referencia a la clínica, el diagnóstico y el tratamiento. Se realiza una revisión sobre el cannabis y sus derivados, la historia de su consumo y preparaciones utilizadas, los efectos que producen en los distintos sistemas del organismo y sus principales mecanismos de acción. Por último se comentan los efectos del LSD y de las setas alucinógenas.

  16. 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.

  17. Study of Intraabdominal Adiposity Detected by Ultrasonography in Infertility Patients with Polycystic Ovary Syndrome%超声检测PCOS不孕症患者腹腔内脂肪的研究

    Institute of Scientific and Technical Information of China (English)

    何冰; 谭卫红; 万里凯; 覃捷; 陆建柳; 滕敏; 覃利华

    2012-01-01

    目的 探讨经超声检测内脏脂肪厚度在多囊卵巢综合征(PCOS)诊疗中的价值,为更好地治疗PCOS不孕症提供依据.方法 采用超声检测199例育龄期PCOS及87例非PCOS患者的肝前脂肪、肝前皮下脂肪、内脏脂肪、腹部皮下脂肪,并测量身高、体重、腰围、臀围等,对两组间上述指标进行对比分析.结果 PCOS组肝前脂肪厚度、内脏脂肪厚度均大于非PCOS组(P<0.05);PCOS组的体重、体质量指数(BMI)、腰围、腹围、臀围、腰臀比(WHR)均明显高于非PCOS组(P<0.05);身高则差异无统计学意义(P>0.05).结论 PCOS不孕症患者腹腔内脂肪及腹部皮下脂肪厚度值均明显高于非PCOS不孕症患者,减重尤其是减少内脏脂肪堆积对治疗PCOS具有重要意义.%Objective To explore the value of prehepatic fat thickness measured by ultrasonography in the diagnosis and treatment of polycystic ovary syndrome( PCOS ),and to provide more references for the treatment of infertility patients with PCOS. Methods One hundred and ninty-nine PCOS cases of childbearing age( PCOS group ) and 87 non-PCOS cases( non-POCS group ) were enrolled in the study. Their prehepatic fat thickness,prehepatic subcutaneous fat thickness,visceral fat thickness and abdominal subcutaneous fat thickness were detected by ultrasound,and their height,weight,waist circumference and hip circumference were also measured. A comparison of the indices above was done between the two groups. Results Prehepatic fat thickness and visceral fat thickness of PCOS group were significantly larger than those of non-PCOS group( P 0. 05 ). Conclusion Intraabdominal adiposity and abdominal subcutaneous fat thickness of PCOS patients are significantly higher than those of non-PCOS patients. Weight-reducing,especially reducing visceral fat is of great importance to the treatment of PCOS.

  18. Antimicrobial susceptibility of Gram-negative ESKAPE pathogens isolated from hospitalized patients with intra-abdominal and urinary tract infections in Asia-Pacific countries: SMART 2013-2015.

    Science.gov (United States)

    Karlowsky, James A; Hoban, Daryl J; Hackel, Meredith A; Lob, Sibylle H; Sahm, Daniel F

    2017-01-01

    Gram-negative ESKAPE pathogens (Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.) are responsible for increases in antimicrobial-resistant infections worldwide. We determined in vitro susceptibilities to eight parenteral antimicrobial agents using Clinical and Laboratory Standards Institute broth microdilution methodology for Gram-negative ESKAPE pathogens isolated from hospitalized patients with intra-abdominal infections (IAIs) (n=3052) and urinary tract infections (UTIs) (n=1088) in 11 Asia-Pacific countries/regions from 2013 to 2015. Amikacin (98.3, 96.4 %), imipenem (97.1, 95.5 %) and ertapenem (95.3, 93.2 %) demonstrated the highest rates of susceptibility for isolates of K. pneumoniae from IAI and UTI, respectively, whereas susceptibility to advanced-generation cephalosporins was <84 and <71 %, respectively. K. pneumoniae with an extended-spectrum β-lactamase-positive phenotype were more common in UTI (27.1 %) than IAI (16.2 %). Imipenem and amikacin were the most active agents against extended-spectrum β-lactamase-positive K. pneumoniae from IAI (95.1, 91.8 %) and UTI (94.9, 92.3 %), respectively, whereas <54 % were susceptible to piperacillin-tazobactam. Against Enterobacter spp. and P. aeruginosa, amikacin demonstrated the highest rates of susceptibility for isolates from IAI (99.7, 95.5 %) and UTI (90.9, 91.5 %), respectively. K. pneumoniae, Enterobacter spp. and P. aeruginosa from urine demonstrated lower susceptibility to levofloxacin (74.1, 81.8 and 73.8 %) than from IAI (87.6, 91.8 and 85.4 %). For A. baumannii, rates of susceptibility to all agents tested were <43 %. We conclude that the studied Gram-negative ESKAPE pathogens demonstrated reduced susceptibility to commonly prescribed advanced-generation cephalosporins, piperacillin-tazobactam and levofloxacin, while amikacin and carbapenems were the most active. Ongoing surveillance to monitor evolving resistance trends and

  19. 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.

  20. Diarrea recurrente por Cystoisopora belli en pacientes con infección por VIH con TARGA

    Directory of Open Access Journals (Sweden)

    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.

  1. 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.

  2. 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...

  3. RUPTURA UTERINA ESPONTANEA POR PLACENTA PERCRETA

    OpenAIRE

    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

  4. Principo de micromanipulacion inmersa por hielo.

    OpenAIRE

    C. Lopez Walle, Beatriz; Gauthier, Michaël; Chaillet, Nicolas

    2007-01-01

    International audience; Uno de los mayores problemas en la manipulación y ensamble de micro-objetos cuyo tamaño está comprendido entre un micrómetro y un milímetro es el desarrollo de estrategias de prensión altamente fiables y precisas, particularmente durante la fase de liberación del micro-objeto [1], [2]. Además, cuando las dimensiones del objeto son inferiores a 100 µm, la fase de liberación está fuertemente perturbada por el ambiente [3], [4]. Un análisis comparativo en [5] muestra que ...

  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. Uso de suplementos alimentares por adolescentes

    OpenAIRE

    Alves,Crésio; Lima,Renata Villas Boas

    2009-01-01

    OBJETIVO: Revisar crititcamente o uso, benefícios e efeitos adversos dos principais suplementos alimentares utilizados por adolescentes. FONTES DOS DADOS: A pesquisa bibliográfica, realizada nos últimos 10 anos, utilizou os bancos de dados MEDLINE e LILACS. Foram examinados 377 artigos, sendo selecionados 52. SÍNTESE DOS DADOS: O consumo de suplementos dietéticos é amplamente difundido entre adolescentes. Tal fato é constatado, com frequência, nos consultórios de pediatria e hebeatria. Na mai...

  7. Toxicidad por óxido de etileno

    OpenAIRE

    Téllez M. Jairo A.

    2010-01-01

    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 ...

  8. 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.

  9. Pênfigo vegetante induzido por uso de enalapril

    OpenAIRE

    Adriano,André Ricardo; Gomes Neto, Antonio; Gustavo R Hamester; 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...

  10. Regulación por precios tope

    Directory of Open Access Journals (Sweden)

    Gerardo Soto Carrillo

    2009-06-01

    Full Text Available El presente trabajo describe las principales características del mecanismo de regulación por precios tope, incluyendo su ubicación dentro de las posibilidades de acción regulatoria, las críticas que se han planteado al mismo, así como los mecanismos complementarios utilizados y los riesgos involucrados en su desarrollo.---This article describes the main characteristics of the price cap regime of price regulation, including its location among other regulatory possibilities, critics received, complementary mechanisms and risks involved in its development.

  11. Herida antebraquial infectada por Aeromonas hydrophila

    OpenAIRE

    1995-01-01

    Se presenta un caso de celulitis por Aeromonas hydrophila, en un paciente de 23 años, tras una herida antebraquial producida en el medio acuático. La celulitis se resolvió mediante desbridamiento agresivo y quimioterapia. En los controles posteriores no se han apreciado déficits funcionales tras la infección. A case of Aeromonas hidrophila cellulitis developped in a 23-year-old patient, after aquatic environment forearm wound is presented. His cellulitis was effectively resolve...

  12. Neumonía por Stenotrophomonas maltophilia

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    Verny Huertas-Franco

    2014-03-01

    Full Text Available La Stenotrophomonas maltophilia es un bacilo gram negativo ambiental emergente que ha venido posicionándose entre el grupo de microorganismos multirresistentes como causa de infección en diversos órganos en ambiente hospitalario y en la comunidad. Se reporta este caso de insuficiencia respiratoria con neumonía severa por S. maltophilia adquirida en la comunidad en una paciente inmunocompetente que tuvo una rápida respuesta a tratamiento con trimetoprim sulfametoxazol cuando se logró identificar la bacteria.

  13. Estrategias de crecimiento empresarial aplicadas por hipermercados

    OpenAIRE

    Miraidy Leal Morantes; Yilian Cefalá Chirinos

    2003-01-01

    El presente estudio tiene como objetivo caracterizar las estrategias de crecimiento empresarial, representadas por alianzas y adquisiciones, que han sido aplicadas en el sector de distribución de bienes de consumo masivo, específicamente en los hipermercados ubicados en Maracaibo, Estado Zulia, como manera de responder al entorno competitivo y cambiante en el cual se desenvuelven. La investigación se desarrolló a través de un estudio de carácter descriptivo; para la recolección ...

  14. Hiperplasia gengival induzida por ciclosporina A

    OpenAIRE

    Ramalho Vera Lúcia Costa; Ramalho Horácio José; Cipullo José Paulo; Burdmann Emmanuel A.

    2003-01-01

    O crescente uso da ciclosporina A (CSA) em transplantes de órgãos e no tratamento de doenças auto-imunes aumentou a incidência de seus efeitos adversos, entre eles a hiperplasia gengival (HG). Esta acarreta problemas estéticos, de fala, mastigação e de erupção dentária nos pacientes afetados. A prevalência de hiperplasia gengival induzida por ciclosporina varia nos diversos estudos, podendo chegar a 85%, dependendo do critério utilizado para seu diagnóstico. Esta revisão aborda aspectos etiol...

  15. Risk Factors for Postoperative Intra-abdominal Septic Complications in Crohn ’s Disease%克罗恩病术后腹腔感染性并发症的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    左芦根; 朱维铭; 李毅; 龚剑峰; 曹磊; 顾立立; 李宁; 黎介寿

    2014-01-01

    Background:As postoperative intra-abdominal septic complications( IASCs)in Crohn’s disease( CD)are difficult to manage,it is of great importance to prevent this condition in CD patients after surgery. Till now,there are no large sample studies on risk factors for postoperative IASCs in CD in China. Aims:To determine the risk factors for postoperative IASCs in CD for guiding the formulation of preventive strategies. Methods:This retrospective study was based on a computerized database of CD patients who had undergone surgery for CD complications between 1999 and 2014 at Nanjing General Hospital of Nanjing Military Command,PLA. Patients were divided into IASCs group and non-IASCs group. Thirty potential variables were selected,and both univariate and multivariate( Logistic regression)analyses were performed to identify the risk factors for IASCs after surgery. Results:Seven hundred and sixteen operations were reviewed,and IASCs occurred in 41 cases(5. 7%). By univariate and multivariate analyses,IASCs were significantly associated with one stage anastomosis(OR=1. 656,95% CI:1261-3. 279),preoperative low albumin level( 10 mg/L)(OR=8. 641,95% CI:3. 376-16. 364),preoperative steroids use ≥3 months(OR=3. 785,95% CI:1. 237-4. 671)and presence of intra-abdominal abscess or infection at the time of surgery(OR=1. 784,95% CI:1. 155-3. 826). However,enterostomy(OR =0. 125,95% CI:0. 062-0. 561)and preoperative enteral nutrition ≥ 1 month( OR =0. 147,95% CI:0. 078-0. 781 ) were found to be the independent protective factors. Conclusions:Malnutrition,active CD and preoperative long-term steroids use increase the risk of postoperative IASCs in CD. Patients with these risk factors should not receive immediate surgery. If surgery is inevitable, enterostomy instead of resection and anastomosis should be the first choice. Preoperative enteral nutrition is helpful for reducing the occurrence of IASCs after surgery.%背景:克罗恩病( CD)术

  16. 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.

  17. Inibição da formação de abscesso abdominal em rato: mortalidade por sepse Inhibition of abdominal abscess formation in rat: Mortality by sepsis

    Directory of Open Access Journals (Sweden)

    Fernando Henrique Oliveira Carmo Rodrigues

    2005-03-01

    Full Text Available RACIONAL: Atribui-se aos abscessos intra-abdominais e às aderências peritoniais a função de isolar os processos sépticos e proteger o organismo da bacteremia. Por outro lado, esses fenômenos também dificultam o afluxo de fatores imunitários e antibióticos para a região infectada. OBJETIVO: Avaliar o efeito da prevenção de abscessos na sobrevida após peritonite bacteriana. MÉTODOS: Foram estudados 30 ratos Wistar machos que receberam solução de fezes a 50% intra-abdominal e que foram distribuídos em três grupos (n = 10. Grupo 1: controle (solução de fezes; grupo 2: solução de fezes mais solução salina a 0,9%; grupo 3: solução de fezes mais carboximetilcelulose a 1%, para inibir a formação de aderências. Os três grupos foram divididos em dois subgrupos (n = 5: subgrupo A: nova laparotomia, após 4 dias, para inspeção da cavidade abdominal; e subgrupo B: acompanhamento durante 30 dias para avaliação da mortalidade e da causa de morte. A análise estatística utilizou o teste exato de Fisher. RESULTADOS: O acréscimo de solução salina a 0,9% não aumentou a mortalidade do grupo. Entretanto, no grupo em que se acrescentou a solução de carboximetilcelulose, houve menor formação de abscessos, que também foram mais tênues e a mortalidade aumentou em relação ao grupo controle. CONCLUSÃO: A inibição na formação de aderências peritoniais e de abscessos acompanha-se de maior mortalidade decorrente do processo séptico intra-abdominal generalizado.

  18. 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.

  19. Choque séptico por ehrliquiosis

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    Viviana Hernández-de Mezerville

    2007-04-01

    Full Text Available La ehrliquiosis humana es una infección zoonótica transmitida por "garrapatas duras" causada por Anaplasma sp y Ehrlichia sp. Puede presentarse como un cuadro pseudogripal con fiebre, malestar general, mialgias y cefalea o hasta un choque séptico con falla multiorgánica y muerte. La mitad de los pacientes requieren atención hospitalaria en algún momento y se reporta una mortalidad de hasta el 5% secundaria a enfermedades oportunistas o a hemorragias. El diagnóstico se puede sospechar visualizando las mórulas intracitoplasmáticas en las células afectadas en frotis de sangre periférica, y se confirma con serología, con cultivos o con detección molecular. El tratamiento de elección es la doxiciclina con buena respuesta clínica. Se reporta un caso probable de ehrliquiosis humana asociado a choque séptico y falla multiorgánica tratado exitosamente en el Hospital Dr. Rafael Angel Calderón Guardia.

  20. Hemomediastino por rotura de aneurisma bronquial

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    E. Martínez

    2013-04-01

    Full Text Available El hemomediastino por rotura de aneurisma bronquial es una patología muy poco frecuente. La presentación clínica puede ser variable, pudiendo simular patología aórtica y ser diagnosticado en situaciones de emergencia. La tomografía computarizada (TC de tórax es la prueba de imagen inicial para el diagnóstico. Se presenta el caso clínico de un varón de 70 años con clínica inicial de dolor torácico transfixivo que simulaba patología aórtica aguda. Se realiza TC con diagnóstico de sospecha de neoplasia mediastínica (Unidades Hounsfield/UH 38 - tejidos blandos realizándose toma de biopsia por gastroscopia y broncoscopia con citología hemorrágica, presentando leve anemización al ingreso y permaneciendo hemodinámicamente estable y asintomático. Ante alta sospecha clínica de patología arterial se repite TC donde se describe hemomediastino en resolución confirmándose posteriormente la existencia de rotura de aneurisma bronquial mediante angiografía y procediendo a su embolización terapéutica.

  1. (Mol. Stuntz por arrastre de vapor

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    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.

  2. Luchas por el control territorial en Colombia

    Directory of Open Access Journals (Sweden)

    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.

  3. Postpartum intra-abdominal haemorrhage: Case report

    Directory of Open Access Journals (Sweden)

    Tubić-Pavlović Aleksandra

    2010-01-01

    Full Text Available Introduction. The most frequent cause of gynaecological haemoperitoneum is ruptured ectopic pregnancy. Haemoperitoneum after a normal vaginal delivery is rare and it is associated with high maternal mortality. Case report. A 22-year-old primipara had a normal vaginal delivery. She experinced acute abdominal pain and hypovolemic shock ten hours after the delivery and was referred to our hospital twenty one hours after the delivery. An urgent ultrasound profile was done, which revealed free fluid in pelvis and in the whole abdomen. An immediate laparotomy was done and 2 litres of blood were found within the peritoneal cavity. The uterine wall was intact. We found a haematoma on the anterior wall of rectum and livid colours of broad ligament. The peritoneal cavity was cleaned and revised. Any injury of the spleen or liver was excluded. Discussion and conclusion. Haematoperitoneum after a normal vaginal delivery is rare but life threatening to mothers. It is important to recognize this condition to avoid delay in diagnosis and treatment because of high maternal mortality. Our patient was bleeding from superficial rectal vessels. Only a few cases with undefined aetiologies have been reported in literature.

  4. Intraabdominal knoglenydannelse – heterotop mesenteriel ossifikation

    DEFF Research Database (Denmark)

    Nerup, Nikolaj; Hansen, Philip; Gocht-Jensen, Peter

    2014-01-01

    Calcified bowel mesentery – heterotopic mesenteric ossification A 64-year-old man suffered blunt abdominal trauma. He developed ischaemic colon and had a colectomy with primary anastomosis, complicated with anastomotic leakage. A temporary stoma was created. Six months later when the stoma...

  5. Hepatitis autoinmune precedida por infección aguda por citomegalovirus en una mujer inmunocompetente

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    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.

  6. Comparison between micafungin and caspofungin for the empirical treatment of severe intraabdominal infections in surgical intensive care patients%外科重症腹腔感染患者使用米卡芬净与卡泊芬净的疗效比较

    Institute of Scientific and Technical Information of China (English)

    闫婷; 李双玲; 王东信

    2016-01-01

    Objective To compare the efficacy and safety of micafungin with caspofungin for the empirical treatment of severe intra-abdominal infections in surgical intensive care patients.Method This was a retrospective cohort study.From May 1 st 2012 to April 30 2015,47 patients with severe intraabdominal infection complicated with specific risk of Intra-abdominal invasive candidiasis (IAC) receiving empirical treatment of echinocandins were enrolled in Department of Critical Care Medicine,Peking University First Hospital.Micafungin and caspofungin substituted each other every six months.The baseline information,risk factors of IAC,characteristics of intra-abdominal infections,antifungal treatment and other intra-abdominal infections (IAI) related treatment information,clinical outcome were collected and compared between the micafungin and caspofungin groups.Result Forty-seven patients met inclusion/exclusion criteria.The average score of APACHE Ⅱ was 19.0 ± 7.7),the incidence of IAC was 23.4%.The patients were divided into the micafungin group (n =26) and the caspofungin group (n =21).The average therapeutic course was 10 (5,13) days.There were no significant differences in the baseline information,risk factors of IAC,characteristics of intra-abdominal infections and other IAI related treatment informations between the two groups.SOFA score,body temperature,persistence of extra-gastrointestinal fungal colonization significantly improved from the baseline in both groups.The leukocyte count decrease was different between the micafungin group and the caspofungin group respectively [(12.5 ± 5.4) 109/L vs (9.8±4.3) 109/L,P=0.013;(12.9±5.4) 109/L vs (10.4±4.7) 109/L,P=0.134].There were no significantly differences in the recovery of GI function,the incidence of breakthrough IC,the incidence of newly developed organ failure,the 30-day mortality,the length of ICU stay and hospitalization period or the incidence of alternative antifungal therapy between the micafungin group

  7. Conservación por calor

    OpenAIRE

    Cobos García, Angel; Díaz Rubio, Olga

    2011-01-01

    Grao en Nutrición Humana e Dietética Esta unidade didáctica denominada Conservación por calor forma parte da materia «Tecnoloxía do procesado de alimentos» que se impartirá no primeiro semestre do 2º curso do Grao en Nutrición Humana e Dietética. A materia estrutúrase en diferentes unidades didácticas, tratando cada unha delas as diferentes tecnoloxías de procesado dos alimentos, tanto de conservación coma de transformación. A presente unidade didáctica aborda a conservación dos alimentos ...

  8. 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.

  9. 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...

  10. 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.

  11. proposta de terapia assistida por animais

    OpenAIRE

    Ribeiro, Ana Rita Barata do Amaral Peixoto

    2010-01-01

    Dissertação apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Psicologia, especialização em Psicologia Clínica e da Saúde. Foi objectivo analisar os níveis de auto-estima e de resiliência numa amostra de jovens em risco, estudar a relação entre estas variáveis e perceber a opinião desta amostra em relação à aplicação da Terapia Assistida por Animais (TAA). Para a concretização destes objectivos, procedeu-se à administração do p...

  12. 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.

  13. NEFROPATÍAS POR TÓXICOS

    OpenAIRE

    Avellán Boza, Marta

    2011-01-01

    La lesión renal aguda relacionada con tóxicos,   tiene una frecuencia relativamente alta en   pacientes,   tanto ambulatorios   como hospitalizados. Basado en el caso de una paciente femenina de 49 años, que desarrolló insuficiencia renal agudano oligúrica por tóxicos, se hace una revisión bibliográfica de las nefropatías tóxicas, tanto su mecanismo de lesión como factores de riesgo más frecuentes y medidas de prevención. Se determina que el mecanismo más frecuente de daño es la necrosis tubu...

  14. Celulitis por cuerpo extraño

    OpenAIRE

    2016-01-01

    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 traumat...

  15. Pneumonia por "Pneumocystis carinii": forma tumoral

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    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.

  16. Osteoporosis inducida por glucocorticoides Glucocorticoid induced osteoporosis

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    R. Gutiérrez-Polo

    2003-01-01

    Full Text Available 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 fragilidad, sobre todo vertebrales, y la discapacidad funcional resultante. Se produce de forma temprana, siendo más rápida la pérdida ósea en los meses siguientes a la instauración de dicha terapia, en relación fundamentalmente con la dosis diaria. La patogenia de este tipo de osteoporosis es multifactorial, pero destaca el efecto inhibidor que presentan los glucocorticoides sobre la formación ósea. El manejo adecuado de este serio problema de salud requiere una actitud activa, que sin embargo no es lo suficientemente óptima en la actualidad. Incluye inicialmente las mismas medidas diagnósticas, preventivas y terapéuticas disponibles para otros casos de osteoporosis, pero con ciertas matizaciones y particularidades, especialmente las concernientes al propio manejo de los corticosteroides. Es conveniente un plan multidisciplinar, que se ha mostrado efectivo, principalmente si se realiza de forma temprana desde el inicio de la terapia. No obstante, quedan aún muchas cuestiones por esclarecer tanto en aspectos referentes a la corticoterapia, en general, como a la osteoporosis ocasionada, en particular. Es necesario el estudio y la búsqueda de nuevas terapias que mejoren la efectividad conseguida con las actuales para minimizar las repercusiones adversas que tiene para la salud de estos enfermos la administración de glucocorticoides.Glucocorticoids are a group of drugs widely used in medical practice due to their unquestionable utility

  17. Vayamos por partes... dijo Jack el Destripador

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    Miguel Baños González

    2012-04-01

    Full Text Available En la cada día más compleja actividad de comunicación comercial, la publicidad es solamente una herramienta más con diferentes grados de importancia en función del tipo de anunciante. La tendencia a dividir el proceso creativo hasta definir una estructura de fases sucesivas, y en muchos casos de obligado seguimiento, es una visión que se aleja notablemente de la práctica profesional y de la realidad de un mercado holista y global. Por eso, proponemos un cambio de enfoque, analizando la creatividad publicitaria desde una perspectiva que nos permita un conocimiento más profundo, tanto desde punto de vista académico como desde el profesional. 

  18. Síndrome cerebeloso por amiodarona

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    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.

  19. Hiperparatiroidismo primario por adenoma paratiroideo mediastinal

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    Jeffry Solís-Torres

    2015-06-01

    Full Text Available El hiperparatiroidismo primario cursa con un aumento de la secreción de hormona paratiroidea, generalmente debido a un adenoma, e hipercalcemia. Su presentación clásica se diagnostica con la determinación de calcio sérico y de hormona paratiroidea, asociada con estudios de imágenes. Su tratamiento es quirúrgico y tiene altas tasas de éxito. Se analiza el caso de una paciente hipertensa, de 63 años, con historia de pérdida de apetito y debilidad de un año y medio de evolución, por lo que se le realizaron exámenes de laboratorio que revelaron hipercalcemia y elevación de la hormona paratiroidea. Se le indicó entonces una gamagrafía con Tecnecio 99, que evidenció un nódulo de 18mm de diámetro, ubicado 2 centímetros caudal al lóbulo tiroideo derecho. Se le efectuó una exploración cervical sin encontrarse la lesión, por lo que requirió una esternotomía media superior, que permitió encontrar un adenoma en el mediastino superior, detrás de la vena braquiocefálica derecha, de manera que se procedió a su extracción. Los controles de calcio y de hormona paratiroidea a las 24 horas estaban entre los límites normales, y se egresó.

  20. Intoxicación por alcoholes

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    J. Roldán

    Full Text Available La intoxicación etílica es la primera toxicomanía en muchos países del mundo. Afecta a todos los tramos de edad, en los dos sexos y en casi todos los grupos sociales. La mortalidad asociada sólo a la intoxicación etílica aguda es excepcional, pero puede ser un importante factor si coexiste con ingesta de otras drogas de abuso. Es responsable directo de más de la mitad de los accidentes de tráfico. El diagnóstico es fácil por la anamnesis y la clínica y se puede confirmar determinando el nivel de etanol en sangre. El tratamiento es de sostén, intentando proteger al paciente de complicaciones secundarias. El metanol o alcohol de quemar se utiliza como disolvente, encontrándose también como adulterante de bebidas alcohólicas. La intoxicación vía oral es la más frecuente. Oxidado en el hígado a través de la enzima alcohol deshidrogenasa, la toxicidad se debe a sus metabolitos, formaldehído y ácido fórmico. La clínica consiste fundamentalmente en cefalea, náuseas, vómitos, hipotensión y depresión del SNC. El nervio óptico es especialmente sensible pudiendo producirse una ceguera total e irreversible. El etilenglicol se utiliza como disolvente y anticongelante; la toxicidad se debe a la acumulación de sus metabolitos. La clínica incluye síntomas comunes con la intoxicación metílica. Puede ocurrir fallo renal por necrosis tubular y depósito de cristales de oxalato.

  1. Un paseo por la Alhambra restaurada

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    Gallego Roca, Francisco Javier

    1993-10-01

    Full Text Available In this article, the author analyzes the impact which the restoration work undertaken in the Alhambra had on its present look. The idea of recomposing, without falsifying, the architectural elements and, that was most important, the capacity which restoration has to maintain the evocation power of the monument, guided the work done on this monument by various restoration architects. The replacement of the materials, permanent action through small repair works, as well as the consolidation of structures, both justified and necessary given the extreme fragility of the Alhambra architecture, have been, above all other considerations, the constant references in its preservation.

    El autor analiza en este artículo la incidencia que han tenido las restauraciones acometidas en la Alhambra en su imagen actual. La idea de recomponer, sin falsificaciones, los elementos arquitectónicos y, lo que es más significativo, la capacidad que tiene la restauración para mantener el poder de evocación del monumento, han presidido la labor desarrollada en el mismo por distintos arquitectos conservadores. La sustitución de ¡os materiales, la permanente actuación mediante pequeñas obras de reparación, así como las de consolidación de sus estructuras, justificadas y necesarias dado el carácter extremadamente frágil de su arquitectura, han sido, por encima de otras consideraciones, las referencias constantes en la conservación del monumento.

  2. Choque séptico por ehrliquiosis

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    Viviana Hernández-de Mezerville

    2007-04-01

    Full Text Available La ehrliquiosis humana es una infección zoonótica transmitida por "garrapatas duras" causada por Anaplasma sp y Ehrlichia sp. Puede presentarse como un cuadro pseudogripal con fiebre, malestar general, mialgias y cefalea o hasta un choque séptico con falla multiorgánica y muerte. La mitad de los pacientes requieren atención hospitalaria en algún momento y se reporta una mortalidad de hasta el 5% secundaria a enfermedades oportunistas o a hemorragias. El diagnóstico se puede sospechar visualizando las mórulas intracitoplasmáticas en las células afectadas en frotis de sangre periférica, y se confirma con serología, con cultivos o con detección molecular. El tratamiento de elección es la doxiciclina con buena respuesta clínica. Se reporta un caso probable de ehrliquiosis humana asociado a choque séptico y falla multiorgánica tratado exitosamente en el Hospital Dr. Rafael Angel Calderón Guardia.Human ehrlichiosis is a tick-borne infectious disease caused by Anaplasma sp and Ehrlichia sp. The presentation can range from a flu-like syndrome with fever, malaise, myalgia and headache to a septic shock state with multiorganic dysfunction. Half the patients require in- hospital care and the mortality rate is 5% as a result of opportunistic infections or hemorrhage. The diagnosis can be made by the visualization of intracytoplasmatic morulae in the blood smear, serology, cultives or polymerase chain reaction. The treatment of choice is doxycicline and generally carries a good response. We report a case of human ehrlichiosis associated with septic shock and multiorganic dysfunction successfully treated at the Calderon Guardia Hospital.

  3. 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.

  4. 家兔长时间腹腔内高压致腹腔筋膜室综合征模型的建立及生长抑素的干预作用%Effects of somatostatin in a rabbit model of abdominal compartment syndrome induced by prolonged intra-abdominal hypertension

    Institute of Scientific and Technical Information of China (English)

    陈煜; 薛翔; 王丽; 金春华; 邹衍泰

    2012-01-01

    Objective To establish a rabbit model of abdominal compartment syndrome (ACS) induced by prolonged intra-abdominal hypertension (IAH) and evaluate the therapeutic effect of somatostatin on ACS. Methods Twelve New Zealand rabbits were randomized equally into normal saline (NS) group and somatostatin group. ACS model was established by intra-abdominal bleeding (IAB) and intra-abdominal infusion with nitrogen gas to achieve an intra-abdominal pressure of 15 mmHg. The hemodynamics (SP, HR, CVP), hepatic function (ALT), renal function (BUN), antioxidation level (SOD, MDA) and blood electrolyte level (pH, [Na+], [Cl], [Ca2+], [K+]) of the rabbits were recorded 1-6 h after establishment of IAH. Results Prolonged IAH caused decreased hemodynamic functions and antioxidation level as well as hyperkalemia and hypocalcemia (P<0.05), but these changes showed no significant differences between NS group and somatostatin group. Conclusion Prolonged IAH causes cardiovascular function damages in rabbits possibly related to acidosis, electrolyte disturbances, and oxidative damage due to tissue ischemia and hypoxia. Somatostatin produces no obvious protective effects against the occurrence and progression of ACS.%目的 制作家兔长时间腹腔内高压所致的腹腔筋膜室综合征(ACS)模型,研究较长时间的腹腔内高压征(IAH)对家兔循环功能、肝肾功能、抗氧化能力及血液电解质水平的影响,并观察生长抑素是否对ACS有防治作用.方法 将12只新西兰兔平均分为2组,分别为生理盐水对照组、生长抑素干预组.通过模拟兔腹部失血和注入氮气建立动物IAH/ACS模型.并在IAH15 mmHg后1~6h观察兔各项指标变化,包括动脉收缩压、心率、中心静脉压(CVP)、血液酸碱及电解质指标,同时测定代表肝肾功能的谷丙转氨酶和尿素氮(BUN),以及反映组织过氧化反应的超氧化物歧化酶(SOD)和丙二醛(MDA)的变化情况.结果 长时间的IAH可使机体血压下降

  5. Estrategias de crecimiento empresarial aplicadas por hipermercados

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    Miraidy Leal Morantes

    2003-01-01

    Full Text Available El presente estudio tiene como objetivo caracterizar las estrategias de crecimiento empresarial, representadas por alianzas y adquisiciones, que han sido aplicadas en el sector de distribución de bienes de consumo masivo, específicamente en los hipermercados ubicados en Maracaibo, Estado Zulia, como manera de responder al entorno competitivo y cambiante en el cual se desenvuelven. La investigación se desarrolló a través de un estudio de carácter descriptivo; para la recolección de datos se aplicó un cuestionario estructurado, bajo la modalidad de entrevista, a gerentes generales y financieros. Los resultados evidencian que las estrategias de crecimiento empresarial utilizadas son la apertura de nuevos establecimientos comerciales, adquisición de empresas y participación accionaria en grandes cadenas, las cuales propician la concentración del mercado de distribución comercial, afectando a algunas empresas venezolanas del sector cuya oferta no puede competir; asimismo, los proveedores se enfrentan a cadenas con gran poder de negociación.

  6. Identidad e interculturalidad: un horizonte por visitar

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    Marian Pérez Bernal

    2016-01-01

    Full Text Available En el presente trabajo mantenemos que el concepto de identidad defendido por Amin Maalouf puede ser una interesante vía para conseguir una aproximación entre las distintas culturas capaz de conducirnos a un diálogo fructífero que nos permitan gestionar la multiculturalidad actual. Defendemos que las culturas sean vistas como escenas de debate y contestación en constante proceso de construcción y reconstrucción y en las que siempre primen unos valores que nos conciernen a todos y que han de ser irrenunciables.In this paper, it is stated that the concept of identity defended by Amin Maalouf could be an interesting way to achieve a rapprochement amongst different cultures. This could lead to a fruitful dialog allowing to manage today’s multiculturalism. It is also defended that cultures should be considered as instruments of debate and reply on a continuous process of construction and reconstruction. However, cultures should not prevail over a series of values that concern to all of us and that should be inalienable.

  7. Estudio electrofisiologico en la neuropatia por Vincristina

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    Olga P. Sanz

    1975-12-01

    Full Text Available Diez pacientes afectados por diversas patologías que requerían tratamiento crónico con Vincristina, fueron sometidos a estudios electrofisiológicos en los que se valoró: el número de unidades motoras (UM funcionantes en los músculos de la eminencia tenar, los valores de los incrementos medios de UM, velocidad de conducción motora y su latencia residual en el nervio mediano, la velocidad de conducción sensitiva del mismo nervio y el estado de la transmisión neuromuscular. Los valores obtenidos fueron comparados con grupos controles. Los resultados mostraron disminución del número de UM; las UM remanentes presentaron amplitud reducida junto a otras cuyo tamaño no superaba el del grupo control, hecho que sugiere la incapacidad de lograr una reinervación adecuada. Las velocidades de conducción motora y sensitiva mostraron valores diminuídos, con mayor compromiso en los segmentos distales. Junto a estos datos se halló respuesta miasteniforme al estímulo repetitivo. Todos estos resultados permiten postular la existencia de un compromiso de la unidad motora, abarcando todos sus segmentos, en pacientes intoxicados con Vincristina.

  8. Libertad, igualdad, sostenibilidad. Por un ecofeminismo ilustrado

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    Puleo, Alicia H.

    2008-06-01

    Full Text Available This article presents the proposal of an enlightened Ecofeminism and defines it as an ethic-political thinking about human relations to Nature. It aims at ecojustice and sustainability, which are characterized through the criticism of prejudice, through the principles of equality and autonomy, and through the nominalist conceptualization of gender, intercultural dialogue and the sensible acceptance of science and technique. The enlightened Ecofeminism universalizes virtues such as caring for the human and non-human Nature, and defends a compassionate moral towards the radical finitude of the world.

    En este artículo se presenta la propuesta de un ecofeminismo ilustrado entendido como reflexión ético-política sobre las relaciones de los humanos con la Naturaleza. Orientado a la ecojusticia y la sostenibilidad, el ecofeminismo ilustrado se caracterizaría por la crítica al prejuicio, la defensa de los principios de igualdad y autonomía, la conceptualización nominalista del género, el diálogo intercultural, la aceptación prudente de la ciencia y la técnica, la universalización de las virtudes del cuidado aplicadas a los humanos y al resto de la Naturaleza, y una moral de la compasión frente a la radical finitud del mundo.

  9. A prospective, multi centre, randomized clinical study to compare the efficacy and safety of Ertapenem 3 days versus Ampicillin - Sulbactam 3 days in the treatment of localized community acquired intra-abdominal infection. (T.E.A. Study: Three days Ertapenem vs three days Ampicillin-sulbactam

    Directory of Open Access Journals (Sweden)

    Gazzotti Filippo

    2011-04-01

    Full Text Available Abstract Background The recommendations outlined in the latest guidelines published by the Surgical Infection Society (SIS and the Infectious Disease Society of America (IDSA regarding the proper duration of antibiotic therapy in patients with intra-abdominal infections are limited and non-specific. This ambiguity is due mainly to the lack of clinical trials on the topic of optimal duration of therapy. It is well known that the overuse of antibiotics has several important consequences such as increased treatment costs, reduced clinical efficacy, and above all, the increased emergence of antibiotic-resistant pathogens. Ampicillin-Sulbactam is a commonly used "first line" antibiotic for intra-abdominal infections. Ertapenem and Ampicillin-sulbactam are recommended as primary treatment agents for localized peritonitis by both the SIS and IDSA guidelines. Methods/Design This study is a prospective multi-center randomized investigation. The study will be performed in the Departments of General, Emergency, and Transplant Surgery of Sant'Orsola-Malpighi University Hospital in Bologna, Italy, in the General Surgery Department of the Ospedali Riuniti of Bergamo, Italy, and in the Trauma and Emergency Surgery Department of Maggiore Hospital in Bologna, Italy, and will be conducted by all surgeons willing to participate in the study. The inclusion period of the study will take approximately two years before the planned number of 142 enrolled patients is reached. Discussion Ertapenem and Ampicillin-sulbactam are recommended both as primary treatment agents for localized peritonitis by both the SIS and IDSA guidelines. As one of the discussed topic is the optimal duration of the antibiotic therapy and this ambiguity is due mainly to the lack of clinical trials on the topic, the present study aims for obtain precise data. Trial Registration ClinicalTrials.gov: NCT00630513

  10. [Not Available].

    Science.gov (United States)

    Zubiaga, Lorea; Ruiz-Tovar, Jaime; Giner, Lorena; González, Juan; Aguilar, María Del Mar; García, Alejandro; Calpena, Rafael; Durán, Manuel

    2016-07-19

    Introducción y objetivo: el IMC puede resultar engañoso para ciertas complexiones corporales, por lo que se han propuesto otros parámetros como la adiposidad (calculada a través de fórmula CUN-BAE,) el índice de Framingham de riesgo cardiovascular (IF) y el índice aterogénico (IA) (rCT/HDL-c) como predictores de riesgo cardiovascular. Se propone comparar estos factores como marcadores de éxito terapéutico tras cirugía en pacientes obesos sometidos a gastrectomía vertical laparoscópica (GVL) como procedimiento de cirugía bariátrica.Material y métodos: realizamos un estudio observacional prospectivo de pacientes sometidos a GVL y con un periodo de seguimiento mínimo de 1 año. Analizamos la evolución de IMC, adiposidad, IF e IA.Resultados: analizamos 140 pacientes. El IMC preoperatorio fue de 49,1 kg/m2, con una adiposidad del 54,8%, un IF 7,54% y un IA de 4,2. A los 12 meses el IMC era de 28,4 kg/m2, con una adiposidad del 39,4%, un IF del 3,7% y un IA de 1,64. En función de estos resultados, a los 12 meses el IMC medio está en rango de sobrepeso, la adiposidad en niveles de obesidad (obesidad: > 25% en hombres y > 35% en mujeres), el IF en rango de riesgo cardiovascular bajo (IMC se correlaciona con la adiposidad tanto en valores preoperatorios (Pearson 0,486; p = 0,004), posoperatorios (Pearson 0,957; p IMC se incluye en la fórmula CUN-BAE para el cálculo de la adiposidad. En los valores posoperatorios se objetiva una correlación de la adiposidad con el IF (Pearson 0,814, p = 0,036) y con el IA (Pearson 0,517; p = 0,049). En los valores preoperatorios no se objetivan dichas correlaciones. El IMC no se correlacionó con la adiposidad.Conclusión: la adiposidad se correlaciona con índices de riesgo cardiovascular, como el índice de Framingham o el índice aterogénico, pero solo en las determinaciones posoperatorias. Estos elementos suponen herramientas útiles para valorar la disminución del riesgo de enfermedad cardiovascular después de

  11. ¿Inconstitucionalidad por omisión?

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    Alfredo Quispe Correa

    2006-01-01

    Full Text Available El autor realiza un análisis del sistema peruano de control de constitucionalidad desarrollado en control abstracto por el Tribunal Constitucional y en control concreto por los tribunales de justicia, para luego centrar su análisis sobre la inconstitucionalidad por omisión, considerando la doctrina desarrollada en la materia, planteando sus reservas en la materia, especialmente cuando el tribunal constitucional se convierte en legislador positivo.

  12. El impacto familiar de la dependencia por ictus cerebral

    OpenAIRE

    Laparte Pérez, Nerea

    2014-01-01

    El objetivo de este proyecto es analizar el impacto familiar que produce la dependencia por ictus cerebral. Para ello se ha realizado un estudio de caso basado en la experiencia de mi propia familia, uno de cuyos miembros es una persona dependiente por las secuelas de esta enfermedad, a la que mi familia presta cuidados. El estudio se ha basado en entrevistas semiestructuradas realizadas a cada miembro de la unidad familiar, y en una narrativa plasmada por escrito en primera persona por mí. L...

  13. MORTALIDAD POR ABORTO EN CHILE: ANALISIS EPIDEMIOLOGICO 1985-2000

    OpenAIRE

    Szot M,Jorge; Moreno W,Cristina

    2003-01-01

    El aborto, por su contribución a la mortalidad materna, ha sido tradicionalmente un problema de salud pública en América Latina y en Chile. En la actualidad, si bien es cierto la mortalidad por esta causa ha disminuido, la cantidad de abortos realizados permanece alta. Por este motivo, se ha querido efectuar una caracterización desde la perspectiva epidemiológica de la mortalidad por aborto ocurrido en Chile entre 1985 y 2000. Los resultados confirman la baja en la mortalidad durante el perío...

  14. Intoxicación por gases Gas poisoning

    OpenAIRE

    2003-01-01

    La intoxicación por gases en nuestro medio es un problema importante debido a su alta incidencia. En el caso concreto de la intoxicación por monóxido de carbono, es la principal causa de muerte por intoxicación involuntaria en nuestro medio, muchas veces coexistiendo con una intoxicación por cianuro. Ambas intoxicaciones pueden ser de carácter grave, basándose su diagnóstico en la mera sospecha del médico. Además, su importancia radica en que ambas intoxicaciones tienen un tratamiento concret...

  15. Intoxicación por metales Metal poisoning

    OpenAIRE

    Ferrer, A.

    2003-01-01

    Los metales están entre los tóxicos más antiguos conocidos por el hombre. En el industrializado mundo actual las fuentes de exposición a metales son ubicuas tanto en el campo laboral como a partir de agua, los alimentos o el ambiente contaminados. Su toxicidad está caracterizada por el elemento metálico en cuestión pero se ve modificada por el tipo de compuesto, orgánico o inorgánico y sus características de hidro o liposolubilidad, que determina su toxicocinética y por tanto sus posibilidad ...

  16. Motivado por cirujanos Motivated by Surgeons

    Directory of Open Access Journals (Sweden)

    Carlos Salazar-Vargas

    2010-12-01

    Full Text Available Comenzaba la década de los 60 y nuestro grupo nerviosamente iniciaba lecciones en los hospitales de San José. En aquellos años, el estudiante de medicina empezaba su contacto con pacientes, por lo menos 1 ó 2 años después de iniciada la carrera. El estudio del ser humano normal que ya habíamos concluido, continuaba con el del enfermo, y más adelante aprenderíamos el tratamiento. La enfermedad descrita en el libro, de pronto se convertía en un enfermo, y es a este quien hoy veíamos, cohibido pero inquisidor, en la cama de un hospital. Los profesores nos enseñaban a interrogar y a examinar a los pacientes, y cada gesto suyo, cada pregunta, cada maniobra, eran celosamente guardados en la memoria de los educandos. Con claridad percibíamos, aun a temprana edad, las diferencias entre los especialistas, y casi de manera involuntaria, cada quien iba tomando partido y escogía su futuro camino. Fue durante esos tempranos años, cuando mi vida se cruzó con la de 7 maravillosas personas y excelentes cirujanos, que marcaron para siempre mi destino y, sin quererlo ellos, me hicieron inclinarme por la cirugía. Dos eran serios y profundamente académicos: el Dr. Manuel Aguilar Bonilla y el Dr. Vesalio Guzmán Calleja; 3, decididos, incansables y muy hábiles: el Dr. Longino Soto Pacheco, el Dr. Claudio Orlich Carranza y el Dr. Carlos Prada Díaz, y 2, abordables, prácticos, joviales y amistosos: el Dr. Fernando Valverde Soley y el Dr. Randall Ferris Iglesias….During the early 60´s our class just started clinical lessons in different hospitals of San Jose. In those years the medical student became in contact with patients 1 or 2 years after initiating his or her career. The study of the normal human being continued with that of the diseased and later on we would learn how to treat our patients. The disease described in our textbooks, suddenly was a reality, a person lying in a hospital bed, shy but inquisitive. Our teachers taught us how to

  17. Effects of Intravenous Fluid Restriction on Hepato-Nephro Function in Elderly Patients Undergoing Intra-Abdominal Surgery%限制性输液对老年开腹手术患者肝肾功能的影响

    Institute of Scientific and Technical Information of China (English)

    江朝秀; 倪玉霞; 刘春东; 刘敬臣

    2013-01-01

    目的探讨围术期限制性输液对老年开腹手术患者肝、肾功能的影响。方法将60岁以上择期行腹部手术患者60例按随机数字表法分为两组:S组30例为常规输液组,围术期按常规补液方案进行补液;R组30例为限制性补液组,麻醉诱导前至进腹1 h内补累积缺失量的1/2,之后每15 min测1次中心静脉压( CVP),维持CVP的数值在5~7 cm H2 O,输液速度约为4 ml· kg -1· h-1。两组晶、胶体输入比均为2∶1。比较两组术前、术后24 h肝、肾功能指标以及术后并发症、胃肠道恢复时间和术后住院时间。结果 R组液体输入总量显著少于S组(P<0.05)。 R组术后血谷草转氨酶(AST)水平高于术前(P<0.05),但尚处于正常范围;两组术后血谷丙转氨酶(ALT)、尿素氮、肌酐水平与术前比较,差异均无统计学意义(P>0.05);与S组比较,R组术后并发症发生率低,胃肠道功能恢复时间快,术后住院时间短( P均<0.05)。结论老年人腹部手术中采用限制性输液方案是安全可行的。%Objective To explore the effects of intravenous fluid restriction on hepato-nephro function in eld-erly patients undergoing intra-abdominal operation .Methods Sixty patients older than 60 years who were undergoing elective operation on abdominal region were randomly divided into two groups ,30 cases in the standard group ( Group S) while 30 cases in the restriction group ( Group R) .In the standard group ,fluid management according to the stand-ard fluid administration was performed .In the restriction group ,patients were administered a half of accumulative fluid loss within one hour before anaesthesia induction , and their central venous pressure ( CVP ) , which ranged from 5 cmH2 O to 7 cmH2 O,was measured once every 15 minutes,the initial infusion rate was 4 ml· kg -1 · h -1 .The ratio of crystals input to colloid input was 2:1 in both groups .A

  18. 腹腔高压对重症急性胰腺炎病人预后的影响与机制初探%Effects on prognosis and mechanism of intra-abdominal hypertension in severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    李磊; 闵东; 武钧; 张泓; 张如愿; 瞿洪平; 汤耀卿

    2013-01-01

    目的:分析腹腔高压对重症急性胰腺炎(severe acute pancreatitis,SAP)病人脓毒血症发生率和生存率等预后指标的影响,并从胆道压力梯度分析其发病机制.方法:回顾性分析2007年1月至2008年12月间我院外科重症监护病房收治的63例SAP病人资料.根据腹腔压力水平和持续时间,分为腹腔高压(intra-abdominal hypertension,IAH)组31例和非腹腔高压(NIAH)组32例,比较两组病人的APACHEⅡ评分、发病4周内脓毒血症发生率、转手术率和生存率.进一步将IAH组病人分为胆道高压(biliary hypertation,BH)组27例和非胆道高压(NBH)组4例,比较两组病人的上述指标.结果:IAH组病人APACHEⅡ平均评分显著高于NIAH组(P=0.007).IAH组病人发病4周内脓毒血症发生率高于NIAH组(22.6%比15.6%,P=0.28),而生存率较NIAH组降低(67.7%比100%,P<0.01).入院当天NBH组与BH组病人APECHEⅡ评分差异无统计学意义.BH组病人发病4周内脓毒血症发生率、中转手术率和生存率分别为25.9%、11.1%和62.9%,NBH组病人4周内均无需手术治疗,未并发脓毒血症,且最终全部生存(P<0.01).结论:IAH是SAP病人并发脓毒血症的原因之一,胆道压力梯度被破坏可能导致感染机会增加、预后差.%Objective To compare the incidence of sepsis and the prognosis of severe acute pancreatitis(SAP) in patients with the intra-abdominal hypertension (IAH),and to explore whether the loss of biliary pressure gradient is the mechanisms of sepsis resulting from the SAP.Methods We retrospectively enrolled sixty-three patients with SAP who were admitted to the surgical intensive care unit during Jan 2007 to Dec 2008.According to IAH and the duration,the subjects were divided into IAH group and non-IAH (NIAH) group (31 vs.32).The clinical and prognosis data were collected.The APACHE Ⅱ score on admission,the first 4 weeks sepsis and operation rates,and survival rates were compared between the two groups

  19. EL TRABAJO POR AMOR A DIOS Y POR UN LUGAR EN EL CIELO

    OpenAIRE

    Virginia Ávila-García

    2014-01-01

    Este artículo trata de cómo las numerarias auxiliares, cientos de mujeres que trabajan para el Opus Dei en México, dedican sus vidas y esfuerzos a esta organización religiosa bajo la promesa de conseguir un lugar en el cielo, ...y un ingreso básico e insufici ente . Las numerarias son un grupo vulnerable, integrado por mujeres que proviene del campo y de los barrios marginales de las ciudades, o de las comunidades indígenas . En la Obra 2 son instruidas para amar a Dios a través del carisma, ...

  20. MODULACION FUNCIONAL DE HEMICANALES FORMADOS POR CONEXINAS POR ESTIMULOS DE DISTINTA NATURALEZA

    OpenAIRE

    SCHALPER CASANOVA, KURT ALEX

    2008-01-01

    Las conexinas (Cxs) son una familia de al menos 21 proteínas integrales de transmembrana que forman los canales intercelulares de las uniones en hendidura o "gap junctions" en vertebrados. Los canales de las uniones en hendidura (CUH) se forman a partir de la unión en serie de dos hemicanales (HCs) provenientes de células adyacentes, cuyas paredes se encuentran a su vez formadas por dominios de 6 subunidades proteicas, que oligomerizan alrededor de un poro central. Los HCs p...

  1. OPINIÓN: PARA TRABAJAR POR CARTAGENA POR DÓNDE COMENZAR?

    Directory of Open Access Journals (Sweden)

    Carmen Cabrales Vargas

    2004-08-01

    Full Text Available Ciertamente son muchos los flancos desde los cuales acercarnos a esta ciudad que se encuentra en permanente y profunda movilidad con respecto a lo que era hace dos décadas. Cartagena ha estallado y seguirá estallando en muchos pedazos, convirtiéndose en una ciudad que por su compleja dinámica no alcanza a recomponerse en su organización social ni en sus espacios físicos; por ello se nos muestra como un lugar donde la confrontación con el orden instituido para su funcionamiento es permanente. En ese sentido, puede anotarse que son pocos los que acogen con rigor las normas de tránsito o respetan el espacio público, o practican el cuidado ambiental o respetan el derecho del otro al uso de los recursos institucionales que se ofrecen. Dicho de otra forma, en los imaginarios de estos habitantes parece no encontrarse el de la ciudad en cuanto organización espacial con reglas y normas que le dan sentido.

  2. Mujeres por la utilidad de la virtud

    Directory of Open Access Journals (Sweden)

    Nancy Rodríguez Pupo

    2014-08-01

    Full Text Available La mujer cubana ostenta una vasta tradición combativa y es ejemplo de entereza, abnegación, sacrificio y compromiso social. Quien se acerque a la historia de nuestro proceso nacional-liberador a todo lo largo de su devenir, constatará su presencia como forjadoras de la nación. Integrante fundamental de la sociedad, la mujer hizo suyas las ansias libertadoras y desempeñó un rol importante en aras de crear una patria común. Se trata de entender que en lo más mínimo su papel fue de “retaguardia”, sino todo lo contrario, su trabajo fue necesario y en no pocas ocasiones empuñó las armas y con valentía gritó ¡viva Cuba libre!, incluso a cambio de su vida, como lo protagonizó la tunera Mercedes Varona. El ejemplo de la mujer cubana y particularmente tunera, es imperecedero en su doble función de ser social y generadora de nuevas vidas, con amplias posibilidades de realización personal y profesional luego de 1959. Su actuación se manifiesta en cada actividad del sector de la salud pública como médica, enfermera, técnica, profesora y estomatóloga, así como también en otros puestos de trabajo no menos necesarios. Ellas con altruismo, solidaridad, responsabilidad y humanismo, son continuadoras de las mejores tradiciones científicas, patrióticas y revolucionarias de nuestro pueblo. Esta edición se dedica al 8 de marzo, día internacional de la mujer, las homenajeamos y recordamos la obra de Laura Martínez Carvajal, primera médica cubana, quien desafió los prejuicios de su época o Isabel Rubio que puso sus conocimientos de medicina farmacéutica al servicio del Ejército Libertador, en el que alcanzó los grados de capitana de sanidad; por citar dos entre las grandes. Otras féminas de la localidad ejercieron en la manigua sus dotes de parteras o enfermeras, tal el caso de Anita Cruz, magnífica artillera, quien estuvo al frente de un hospital de campaña durante la guerra. Allí curó heridas, infecciones, disenter

  3. Epidemia de hepatite veiculada por gamaglobulina contaminada

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    Anastácio Ferreira Morgado

    1982-12-01

    gamaglobulina foram testadas, em laboratórios de referência da Organização Mundial de Saúde, encontrando-se o Ag HB em seis (54,5%J. Os autores concluem que houve alguma falha grave no processo de preparo da gamaglobulina em apreço. E por isto deve-se ter reservas quanto á noção difundida de que esse medicamento está isento do risco de transmitir o vírus hepatite.

  4. Impacto do manejo da água na toxidez por ferro no arroz irrigado por alagamento

    Directory of Open Access Journals (Sweden)

    Fabiana Schmidt

    2013-10-01

    Full Text Available A toxidez por ferro é o distúrbio nutricional de maior ocorrência em arroz (Oryza sativa L. cultivado em sistemas alagados, derivada da quantidade excessiva de íons ferrosos (Fe2+ gerados pela redução de óxidos de ferro em solos alagados. Em experimento conduzido em casa de vegetação, foram avaliados os efeitos de manejos da água de irrigação na dinâmica de redução de um Planossolo e na manifestação da toxidez por ferro em arroz. Os tratamentos dispostos em blocos completos ao acaso com quatro repetições constaram de cinco manejos da água: T1- início do alagamento no estádio V2-V3 do arroz; T2- início do alagamento no estádio V6-V7; T3- T1 e drenagem no estádio V10-V11; T4- T2 e drenagem no estádio V10-V11; e T5- T1 e drenagens nos estádios V7-V8 e V10-V11. O atraso do início do alagamento para o estádio V6-V7 do arroz manteve os valores do Eh da solução do solo mais elevados, promovendo menor disponibilidade de Fe2+ na solução do solo e deslocando a máxima liberação de Fe2+ na solução do solo para estádios fenológicos mais avançados do arroz. A realização de drenagens ao longo do ciclo vegetativo do arroz promoveu a reoxidação do solo, que ocasionou o aumento dos valores de Eh e redução da concentração de Fe2+ na solução do solo. O uso de drenagens durante o período vegetativo do arroz foi eficiente no controle da toxidez por excesso de ferro, em arroz cultivado em solo alagado.

  5. Por una Cabeza and Film Music%Por una Cabeza与电影音乐

    Institute of Scientific and Technical Information of China (English)

    张翠

    2013-01-01

    在电影产业高速发展又高度发达的今天,电影从单一的视觉艺术的过去进入到了一个视听均衡的新阶段.电影中的音乐对于推动剧情发展、烘托影片主题,渲染画面情绪,调节气氛等都有着重要作用.音乐Por una Cabeza在影片《闻香识女人》,《辛德勒名单》以及《真实的谎言》中均有出现,与不同影片结合的同一原声,在电影作品中又有着不同的表现.

  6. Ansiedad percibida por los pacientes hospitalizados por quemaduras, en una Unidad de Quemados

    Directory of Open Access Journals (Sweden)

    M. Alcázar-Gabás

    2014-06-01

    Full Text Available El presente trabajo, pretende describir el estado de ansiedad que experimentan los pacientes ingresados en una Unidad de Quemados. Uno de los factores clave en los cuidados del paciente quemado es una buena atención psicológica. La realidad demuestra que es el profesional de enfermería quien observa los síntomas emocionales durante los primeros días de ingreso y trata de responder a esa demanda de cuidado. Pretendemos, a través de la medición del nivel de ansiedad que perciben los pacientes ingresados en la Unidad de Quemados elegida para nuestro estudio durante el primer semestre del año 2009, identificar a aquellos que estén en riesgo de padecer mayores niveles de ansiedad durante su hospitalización, para así poder establecer un plan de cuidados adaptado a las necesidades emocionales de cada uno. Los resultados obtenidos nos permiten concluir que los pacientes quemados ingresados en la Unidad de Quemados presentaron niveles elevados de ansiedad que son superiores entre la población femenina, así como en aquellos pacientes con lesiones de mayor extensión. Determinamos también que los pacientes ingresados por quemaduras en la Unidad de Quemados a estudio fueron mayoritariamente varones, de nacionalidad española, residentes en medio urbano con una media de edad de 50 años, siendo las quemaduras producidas por llama en accidentes domésticos la causa más frecuente.

  7. El tiempo libre y ocio reivindicado por los trabajadores

    Directory of Open Access Journals (Sweden)

    Guillermo Miranda Román

    2006-01-01

    Full Text Available Estas líneas están referidas a la realización de actividades del ocio en el tiempo libre que como derecho ha sido logrado por las luchas de aquellas sociedades cuyo desarrollo industrial y comercial es caracterizado por la designación de tiempos para la producción o distribución de las mercancías. Los trabajadores históricamente han luchado por el derecho a un tiempo libre necesario para el desarrollo de las aptitudes del hombre, asunto que tratamos de discurrir, o en el mejor de los casos, reflexionar.

  8. Topoplastia de Cvintal assistida por laser de femtossegundo

    Directory of Open Access Journals (Sweden)

    Alexandre Takayoshi Ishizaki

    2013-06-01

    Full Text Available Apresentamos um relato de astigmatismo tardio progressivo pós-transplante de córnea para ceratocone, associado à afinamento periférico na junção doador-receptor, o que presumidamente pode ser considerado como recorrência da ectasia. O caso foi tratado por meio de Topoplastia de Cvintal assistida por laser de femtossegundo para a confecção da incisão com geometria "top hat", seguido de sutura com ajuste per-operatório guiado por ceratoscopia.

  9. El aprendizaje por indagación I.

    OpenAIRE

    Gómez Martín, Francisco

    2013-01-01

    Este artículo explora cómo se puede usar el aprendizaje por indagación en la enseñanza de las matemáticas. En las matemáticas hace años que se emplea bajo múltiples formas: aprendizaje por resolución de problemas, el método Moore, aprendizaje por proyectos, aprendizaje orientado al proceso, entre otros. En la música, a la luz de nuestro más leal conocimiento, parece que apenas está implantado.

  10. Fragilización por envejecimiento de aceros inoxidables moldeados

    OpenAIRE

    Mazorra Incera, Luis; Gutiérrez-Solana Salcedo, Federico; González Martínez, Javier Jesús; Varona Ruiz, José María

    1989-01-01

    RESUMEN. En este artículo se presenta, por una parte, la exposición resumida de los modelos teóricos existentes sobre la fragilización de aceros inoxidables moldeados austenoferríticos causada por envejecimiento térmico a 280ºC y, por otra, el análisis-aplicación a un acero real fragilizado, procedente del circuito de recirculación de una central nuclear. Los resultados obtenidos advierten de una importante fragilización al prever una reducción del 50% de la tenacidad a temperatura ambiente e...

  11. Miasis gastrointestinal por Eristalis tenax en Costa Rica

    OpenAIRE

    Rivera Barquero, Ángelo; Sánchez Rodríguez, Claudio

    2015-01-01

    Las miasis gastrointestinales son infestaciones poco frecuentes y de difícil identificación por su sintomatología inespecífica y por requerir la expulsión de las larvas para hacer un diagnóstico certero. Se presenta el primer caso reportado de miasis gastrointestinal por Eristalis tenax en Costa Rica. La paciente es una mujer de 45 años, que reside en una zona rural con problemas de abastecimiento de agua potable. Presenta un cuadro de diarrea crónica, dolor abdominal, y sensación de cuerpo e...

  12. Lesiones por humedad. Revisión de conocimientos

    OpenAIRE

    Zapata Sampedro, M. A.; Castro Varela, L.; Tejada Caro, Rocío

    2015-01-01

    La dermatitis asociada a la incontinencia, una manifestación clínica de lesiones de la piel asociadas a la humedad, es un estado caracterizado por irritación e inflamación, y es una consideración común en pacientes con incontinencia urinaria y/o fecal. Debido a la localización y apariencia de estas “lesiones por humedad”, a menudo se confunden con las úlceras por presión. Objetivo: Llevar a cabo una revisión bibliográfica acerca del término “lesiones por humedad”. Método: Se realizó una...

  13. CARACTERÍSTICAS DA VIOLÊNCIA SEXUAL SOFRIDA POR CRIANÇAS ASSISTIDAS POR UM PROGRAMA DE APOIO

    OpenAIRE

    KELLY LINHARES VASCONCELOS; ADRIANA GOMES NOGUEIRA FERREIRA; ELIANY NAZARÉ OLIVEIRA; DANIELLE D\\u2019ÁVILA SIQUEIRA; PATRÍCIA NEYVA DA COSTA PINHEIRO

    2010-01-01

    En Brasil, las estadísticas de la violencia sexual contra niños están lejos de reflejar la verdadera realidad actual debido a la baja notificación de los casos. La finalidad de este estudio fue caracterizar el abuso sexual sufrido por niños asistidos por el Programa Sentinela y el perfil del agresor, en Sobral-Ceará, en el periodo que va del 2002 al 2006. La muestra no probabilística intencional fue compuesta por 50 víctimas de abuso sexual y de las mismas, el 66% es del sexo femenino, con pr...

  14. Limitado por lo políticamente correcto.

    Directory of Open Access Journals (Sweden)

    Juan Carlos Ceballos Salgado

    2005-01-01

    Full Text Available He comenzado a sentirme limitado por tanta correctividad política que se nos ha impuesto tanto por el ala derecha como la izquierda. Ambas partes constantemente intentan infringir nuestra libertad diciéndonos que podemos o no podemos, decir o hacer. Me estoy hartando de esto. A continuación algunos ejemplos acerca de lo que están tratando de imponernos.

  15. Secagem por spray: uma revisão

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    Arlan Caldas Pereira Silveira

    2013-04-01

    Full Text Available O objetivo deste artigo foi apresentar os princípios da secagem por spray e os mais recentes resultados de pesquisas na área de leite e derivados. Visando abranger este assunto, o artigo foi dividido em seis partes: introdução, princípios da secagem por spray, atomização, secagem em estágios, resultados de pesquisas e conclusão.

  16. Pronóstico de la diarrea por rotavirus

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    Mota-Hernández Felipe

    2001-01-01

    Full Text Available Objetivo. Comparar la gravedad de la diarrea por rotavirus (RV y por no rotavirus. Material y métodos. Estudio transversal en 520 lactantes con diarrea aguda, efectuado entre octubre de 1994 y marzo de 1995 en siete centros del primer nivel de atención en cinco estados de México. El diagnóstico de RV se realizó con ensayo inmunoenzimático o por electroforesis. El análisis se hizo a través de medidas de tendencia central. Los resultados se presentan como promedio y desviación estándar o mediana o variación. Resultados. Se aisló RV en 264 lactantes (50.7% con predominio en varones de 6 meses a un año. Las manifestaciones clínicas fueron significativamente diferentes entre el grupo rotavirus positivo y el grupo rotavirus negativo en mediana de evacuaciones por 24 horas, frecuencia de vómitos, temperatura > 38° C, deshidratación y calificación de gravedad, respectivamente. Conclusiones. Estos resultados mostraron peor pronóstico por mayor gravedad de la diarrea por RV en lactantes, con relación a otra etiología. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html

  17. The PorX response regulator of the Porphyromonas gingivalis PorXY two-component system does not directly regulate the Type IX secretion genes but binds the PorL subunit.

    Directory of Open Access Journals (Sweden)

    Maxence S Vincent

    2016-08-01

    Full Text Available The Type IX secretion system (T9SS is a versatile multi-protein complex restricted to bacteria of the Bacteriodetes phylum and responsible for the secretion of surface attachment of diverse proteins that participate to S-layer formation, gliding motility or pathogenesis. The T9SS is poorly characterized but a number of proteins involved in the assembly of the secretion apparatus in the oral pathogen Porphyromonas gingivalis have been identified based on genome substractive analyses. Among these proteins, PorY and PorX encode typical two-component system (TCS sensor and CheY-like response regulator respectively. Although the porX and porY genes do not localize at the same genetic locus, it has been proposed that PorXY form a bona fide TCS. Deletion of the porX in P. gingivalis causes a slight decrease of the expression of a number of other T9SS genes, including sov, porT, porP, porK, porL, porM, porN and porY. Here, we show that PorX and the soluble cytoplasmic domain of PorY interact. Using electrophoretic mobility shift, DNA-protein co-purification and heterologous host expression assays, we showed that PorX does not bind and does not directly regulate expression of the T9SS genes. Finally, we show that PorX interacts with the cytoplasmic domain of PorL, a component of the T9SS membrane core complex and propose that the CheY-like PorX protein might be involved in the dynamics of the T9SS.

  18. The PorX Response Regulator of the Porphyromonas gingivalis PorXY Two-Component System Does Not Directly Regulate the Type IX Secretion Genes but Binds the PorL Subunit

    Science.gov (United States)

    Vincent, Maxence S.; Durand, Eric; Cascales, Eric

    2016-01-01

    The Type IX secretion system (T9SS) is a versatile multi-protein complex restricted to bacteria of the Bacteriodetes phylum and responsible for the secretion or cell surface exposition of diverse proteins that participate to S-layer formation, gliding motility or pathogenesis. The T9SS is poorly characterized but a number of proteins involved in the assembly of the secretion apparatus in the oral pathogen Porphyromonas gingivalis have been identified based on genome substractive analyses. Among these proteins, PorY, and PorX encode typical two-component system (TCS) sensor and CheY-like response regulator respectively. Although the porX and porY genes do not localize at the same genetic locus, it has been proposed that PorXY form a bona fide TCS. Deletion of porX in P. gingivalis causes a slight decrease of the expression of a number of other T9SS genes, including sov, porT, porP, porK, porL, porM, porN, and porY. Here, we show that PorX and the soluble cytoplasmic domain of PorY interact. Using electrophoretic mobility shift, DNA-protein co-purification and heterologous host expression assays, we demonstrate that PorX does not bind T9SS gene promoters and does not directly regulate expression of the T9SS genes. Finally, we show that PorX interacts with the cytoplasmic domain of PorL, a component of the T9SS membrane core complex and propose that the CheY-like PorX protein might be involved in the dynamics of the T9SS. PMID:27630829

  19. The PorX Response Regulator of the Porphyromonas gingivalis PorXY Two-Component System Does Not Directly Regulate the Type IX Secretion Genes but Binds the PorL Subunit.

    Science.gov (United States)

    Vincent, Maxence S; Durand, Eric; Cascales, Eric

    2016-01-01

    The Type IX secretion system (T9SS) is a versatile multi-protein complex restricted to bacteria of the Bacteriodetes phylum and responsible for the secretion or cell surface exposition of diverse proteins that participate to S-layer formation, gliding motility or pathogenesis. The T9SS is poorly characterized but a number of proteins involved in the assembly of the secretion apparatus in the oral pathogen Porphyromonas gingivalis have been identified based on genome substractive analyses. Among these proteins, PorY, and PorX encode typical two-component system (TCS) sensor and CheY-like response regulator respectively. Although the porX and porY genes do not localize at the same genetic locus, it has been proposed that PorXY form a bona fide TCS. Deletion of porX in P. gingivalis causes a slight decrease of the expression of a number of other T9SS genes, including sov, porT, porP, porK, porL, porM, porN, and porY. Here, we show that PorX and the soluble cytoplasmic domain of PorY interact. Using electrophoretic mobility shift, DNA-protein co-purification and heterologous host expression assays, we demonstrate that PorX does not bind T9SS gene promoters and does not directly regulate expression of the T9SS genes. Finally, we show that PorX interacts with the cytoplasmic domain of PorL, a component of the T9SS membrane core complex and propose that the CheY-like PorX protein might be involved in the dynamics of the T9SS.

  20. La mujer por fuerza, El condenado por desconfiado and El burlador de Sevilla, Three Comedies Attributed to Tirso de Molina

    Directory of Open Access Journals (Sweden)

    Alfredo Rodríguez López-Vázquez

    2010-03-01

    Full Text Available We expose three attribution problems in several cases of doubtful authorship in the theater of the Siglo de Oro: El condenado por desconfiado and La mujer por fuerza, both edited as Tirso’s works in the problematic Segunda parte and El burlador de Sevilla, edited under the name of Tirso in the volume Doze comedias de Lope de Vega y otros autores (about 1630. We have applied a methodology concerning the analysis of metaphors and inusual lexical items, and we have comparated it with several works by the two dramaturgians concerned by its attributions, Tirso and Claramonte, and also with several others, as reference group. We conclude that La mujer por fuerza is a work by Tirso, El burlador de Sevilla is a Claramonte’s work, and El condenado por desconfiado is also a work by Claramonte, perhaps with a collaboration from Mira de Amescua.

  1. Neuropatia experimental por DDT: análise de nervo por microdissecção de fibras

    Directory of Open Access Journals (Sweden)

    Edison Matos Nóvak

    1984-09-01

    Full Text Available Estudou-se o nervo gênito-femural do rato albino submetido a intoxicação crônica por DDT, administrado por 180 dias na dose de 5 mg/kg de peso via oral. Os resultados mostraram proporção anormal de fibras tipo C, sendo sugerido ocorrer degeneração tipo axonal determinada pelo DDT.

  2. Análise da redistribuição de calor com agentes inalatórios, em ratos submetidos a laparotomia e pneumoperitônio, através da termografia infravermelha Análisis de la redistribución de calor con agentes inhalatorios, en ratones sometidos a laparotomia y pneumoperitonio, a través de termografia infraroja Analysis of heat loss using inhalation agents in rats subjected to laparotomy and increased intra-abdominal pressure, using digital infrared thermal image

    Directory of Open Access Journals (Sweden)

    Daniel Colman

    2002-06-01

    , distribuidos en tres grupos, en que fueron utilizados: halotano, isoflurano y sevoflurano. En cada grupo hubo división en otros tres sub-grupos: I - control, II - laparotomia mediana con exposición de alzas intestinales; III - pneumoperitonio de 15 mmHg. La análisis termodinámica se realizó de dos formas: a través de la temperatura central esofágica y de la imagen digital térmica infrarroja. RESULTADOS: No hubo diferencia significativa en relación a los anestésicos inhalatorios entre los grupos I y II en relación a la pérdida de calor. En relación al grupo III, hubo diferencia entre el isoflurano y el sevoflurano, siendo el isoflurano el anestésico responsable por la mayor pérdida de temperatura en el animal. CONCLUSIONES: El sevoflurano fue el agente anestésico inhalatorio que determinó menor pérdida de calor frente al pneumoperitonio, en relación al isoflurano y halotano.BACKGROUND AND OBJECTIVES: Anesthesiology involves the handling of situations inherent to anesthetic and surgical procedures which lead to patients thermal homeostasis unbalance, with noxious physiological effects. This study aimed at qualifying and quantifying thermal redistribution in rats subjected to inhalation anesthesia, during induction and in surgical situations of laparotomy and increased intra-abdominal pressure. METHODS: The study involved 90 rats, submitted to inhalation anesthesia, which were distributed in three groups: halothane; isoflurane; sevoflurane. Each group was divided in subgroups: I - control; II - median laparotomy with bowel exposure; III - 15 mmHg Increase in intra-abdominal pressure. Heat loss was measured by an esophageal probe and infrared thermal image. RESULTS: There were no significant differences among inhalation anesthetics regarding heat loss between groups I and II. In group III, there was a difference between isoflurane and sevoflurane and isoflurane was responsible for the highest heat loss.

  3. Por y para en los manuales de ELE

    Directory of Open Access Journals (Sweden)

    Sidoti, Rossana

    2008-12-01

    Full Text Available La oposición por / para es una de las cuestiones gramaticales que comportan mayor dificultad a la hora de acercarse al estudio del español como L2 sobre todo cuando remiten a conceptos lingüísticos difíciles de entender por no tener ésta referente alguno en el mundo extralingüístico. Si, por un lado, nos resulta fácil entender lo que tiene un referente en el mundo concreto; por otro, no podemos advertir el referente extralingüístico de preposiciones como por / para, si este no existe. Si las preposiciones son elementos abstractos, difíciles de aferrar de por sí, podemos sólo examinar los elementos que éstas ponen en relación y en qué contextos esta relación se determina. Para poder utilizar con precisión las dos preposiciones, es importante no reducirlas a una sola preposición como ocurre en otros idiomas, y sobre todo no relacionarlas sólo a los conceptos de causa y finalidad. Este trabajo se propone individualizar los manuales de español como lengua extranjera más utilizados en las universidades italianas para luego comparar las distintas fuentes de información sobre por / para y exponer comentarios, reflexiones y sugerencias sobre el tema con el fin de precisar en qué medida se puede mejorar lo que los manuales reducen o generalizan, puesto que para los estudiantes de ELE estos representan una herramienta valiosa a la que acudir.

  4. La responsabilidad del Estado por la actividad del legislador

    Directory of Open Access Journals (Sweden)

    María Consuelo Alonso García

    2012-12-01

    Full Text Available Analizar el fenómeno de la responsabilidad del Estado causada por los hechos del legislador ha sido un trabajo desarrollado tanto por la doctrina y la jurisprudencia internacional a mediados del siglo xx. En Francia, por ejemplo, se presentó el primer antecedente jurisprudencial en el año de 1934. En España, su estudio empezó a gestionarse con la promulgación de la Constitución de 1978, presentándose el primer fallo judicial en el año de 1993. Para el caso colombiano, la Constitución de 1991 introdujo en su artículo 90 el fundamento constitucional de la responsabilidad patrimonial del Estado, sin que esto significase que la jurisprudencia del Consejo de Estado encontrase las bases de esta responsabilidad en diferentes disposiciones de la Constitución. Sin embargo, los primeros fallos relacionados con este título de imputación en Colombia fueron emitidos por el máximo tribunal de lo contencioso administrativo en 1998, y por la Corte Constitucional a través de la sentencia C-038 de 2006, providencia judicial que estableció algunas de las características que posee esta figura jurídica.

  5. Riesgos antrópicos generados por la actividad minera

    Directory of Open Access Journals (Sweden)

    Ana Violeta Argüello Mejía

    2013-10-01

    Full Text Available Las actividades productivas generan riesgos antrópicos [1] a mediano y largo plazo. La zona de estudio se ubica en las Parroquias de Pomasqui, San Antonio y Calacalí, donde se han producido riesgos debido a las actividades humanas, en este caso, por la explotación de las canteras para abastecer el mercado de la construcción del Distrito Metropolitano de Quito. La investigación propone determinar los riesgos antrópicos generados por la actividad minera. Los pobladores de la zona identifican que la minería artesanal en sus inicios constituyó una fuente de trabajo, donde sus familias también se involucraban. Actualmente, se observa que en la mayoría de las canteras se utiliza maquinaria especializada y no participan los trabajadores de la zona. Los taludes de las canteras son de 80o y 90o grados, generando amenazas para los trabajadores y moradores de las viviendas aledañas. Uno de los mayores impactos es la contaminación del aire, sin embargo, el suelo y los cursos de agua están siendo afectados por los desperdicios que produce la actividad minera. La población, que está expuesta permanentemente al polvo ocasionado por las canteras y al transporte de material, acusa enfermedades de tipo respiratorio. Así mismo, el ruido ocasionado por el transporte constituye una molestia constante para los pobladores.

  6. Micetoma pulmonar por Scedosporium sp, reporte de dos casos

    Directory of Open Access Journals (Sweden)

    José G. Somocurcio

    2009-07-01

    Full Text Available Se reporta los dos primeros casos de micetoma pulmonar por Scedosporium sp, en el Perú, tratados quirúrgicamente en el Hospital Nacional Hipólito Unanue. Se practicó resección pulmonar debido a micetoma pulmonar de donde se tomó muestras que fueron enviadas a microbiología y anatomía patológica para cultivo y estudio histopatológico. Se identificó el moho Scedosporium sp en dos pacientes con secuelas cavitarias por tuberculosis, quienes presentaron tos y hemoptisis de dos meses y tres años de evolución, respectivamente. Radiológicamente las cavidades estaban ocupadas por una "bola fúngica". La histopatología indicó presencia de abundantes hifas, indistinguibles de las de Aspergillus sp, mientras que la inmunodifusión para Aspergillus fue negativa.

  7. Neumonitis por hipersensibilidad asociado al cuidado de aves

    Directory of Open Access Journals (Sweden)

    Ana María González-Zúñiga

    2015-01-01

    Full Text Available La neumonitis por hipersensibilidad asociada al cuidado de las aves es uno de los tipos más frecuentes de esta que se presentan. Aunque no se tienen datos epidemiológicos claros sobre su prevalencia, en los hospitales llegan casos de este tipo. No es una patología muy común; sin embargo, una muestra representativa de la población se encuentra expuesta a las aves y, consecuentemente, a los antígenos que causan la enfermedad. Su diagnóstico temprano puede significar para el paciente evitar daños, al dejar de exponerse al antígeno; por el contrario, si no se realiza un diagnóstico temprano, puede generarse un daño pulmonar irreversible. En este artículo, se presenta un caso clínico de neumonitis por hipersensibilidad al cuidado de aves.

  8. Infección aguda por el VHC

    Directory of Open Access Journals (Sweden)

    A. Martínez Echeverría

    Full Text Available La infección aguda por el virus C de la hepatitis produce un cuadro clínico y bioquímico no específico e indistinguible de los causados por otros virus hepatotropos. El diagnóstico específico de la hepatitis aguda por virus C se basa en la detección en sangre del RNA-VHC mediante una técnica de reacción en cadena de la polimerasa cuyo resultado será positivo a partir de 1-2 semanas tras el contacto inicial con el virus. Los anticuerpos frente al VHC se detectan más tardíamente (a las 7-8 semanas por término medio no siendo útiles, como determinación aislada, para distinguir infección aguda de infección crónica o aclaramiento del virus (espontáneo o tras tratamiento. El 55-85% de los pacientes con infección aguda por el VHC no aclaran el virus y desarrollan una infección crónica con riesgo de evolución a cirrosis y de desarrollo de hepatocarcinoma. Por ello, la tendencia actual es tratar con interferón a todos aquellos pacientes en los que el RNA-VHC se mantenga positivo más allá de 3-4 meses tras el diagnóstico de la infección aguda.

  9. Responsabilidad del empleador por accidentes de trabajo y enfermedades profesionales

    Directory of Open Access Journals (Sweden)

    Cristina Mangarelli

    2014-01-01

    Full Text Available Introducción. 1. Responsabilidad del “empleador” por accidentes de trabajo y enfermedades profesionales. Noción. 2. La indemnización “tarifada”. Fundamento de su procedencia 3. Responsabilidad del empleador por accidentes de trabajo o enfermedades profesionales en la ley uruguaya (ley Nº 16.074. 4. La “ampliación” de la responsabilidad del empleador por el derecho común en el derecho uruguayo (artículo 7 ley Nº 16.074. 5. Requisitos para la ampliación de la responsabilidad patronal: culpa grave en el incumplimientode normas de seguridad y prevención. 6. La culpa grave. Concepto. 7. El modelo del hombre a tener en cuenta en la “culpa grave” no es el del buen padre de familia. 8. El grado de la culpa no puede ser medido por el resultado del accidente. 9. Se aplican las eximentes de la responsabilidad civil. 10. Distintos ámbitos de la responsabilidad patronal por accidentes de trabajo o enfermedades profesionales: A ante la víctima o los derecho-habientes; B ante el Banco de Seguros del Estado; C ante el Ministerio de Trabajo ySeguridad Social. 11. Recupero del BSE en caso de culpa grave en el incumplimiento de normas de seguridad y prevención. Requisitos 12. Responsabilidad del empleador en caso de accidente de trabajo o enfermedad profesional sufrido por un adolescente. Conclusiones.

  10. Intoxicación por gases Gas poisoning

    Directory of Open Access Journals (Sweden)

    I Santiago

    2003-01-01

    Full Text Available La intoxicación por gases en nuestro medio es un problema importante debido a su alta incidencia. En el caso concreto de la intoxicación por monóxido de carbono, es la principal causa de muerte por intoxicación involuntaria en nuestro medio, muchas veces coexistiendo con una intoxicación por cianuro. Ambas intoxicaciones pueden ser de carácter grave, basándose su diagnóstico en la mera sospecha del médico. Además, su importancia radica en que ambas intoxicaciones tienen un tratamiento concreto. La oxigenoterapia normo o hiperbárica es el tratamiento de elección de la intoxicación por monóxido de carbono. En el caso de la intoxicación por cianuro, la hidroxocobalamina es hoy día el tratamiento de elección, ya que ha demostrado ser un eficaz antídoto.Poisoning by gases in our area is an important problem due to its high incidence. In the specific case of carbon monoxide poisoning, this is the main cause of death by poisoning in our environment, on many occasions coexisting with cyanide poisoning. Both poisonings can be severe, their diagnosis being based on the mere suspicions of the doctor. Besides, their importance lies in the fact that both poisonings have a very specific treatment. Normo or hyperbaric oxygenotherapy is the treatment for carbon monoxide poisoning. In the case of cyanide poisoning, hydroxocobalamin is nowadays the treatment of choice, since it has proved itself to be an efficient antidote.

  11. Varmetransport i evakuerede porøse materialer

    DEFF Research Database (Denmark)

    Schultz, Jørgen Munthe

    Indlægget omhandlede varmetransport i porøse materialer (ledning, konvektion og stråling) under atmosfæretryk og under vacuum. Specielt omhandlede præsentationen også silica aerogel som et eksempel på et højporøst isoleringsmateriale.......Indlægget omhandlede varmetransport i porøse materialer (ledning, konvektion og stråling) under atmosfæretryk og under vacuum. Specielt omhandlede præsentationen også silica aerogel som et eksempel på et højporøst isoleringsmateriale....

  12. Hemorragia incoercible por trauma maxilofacial: experiencia del Hospital del Trabajador

    OpenAIRE

    Andrades C,Patricio; Román F,José Luis; Bartel A,Ricardo; Borel B,Claudio; Hernández N,Rodrigo; Rojas S,René; Lankin B,Jorge; Villalobos A,Rodrigo

    2012-01-01

    Introducción: El objetivo del presente trabajo es mostrar nuestra experiencia en el manejo de la hemorragia incoercible por trauma facial durante los últimos 10 años, para determinar su incidencia y delinear los principios básicos del tratamiento. Material y Método: Estudio retrospectivo de todos los pacientes con hemorragia incoercible por trauma maxilofacial entre 1999 y 2009. Criterios de inclusión fueron hemorragia oro-nasal secundaria a traumatismo maxilofacial, sin otras lesiones asocia...

  13. Guía por las lindes transilvanas

    Directory of Open Access Journals (Sweden)

    Rafael Guillermo Serrano

    1998-04-01

    Full Text Available Paul EluardRecorrer ahora el territorio dejado por Bram Stoker y su novela Drácula -a cien años de su primera edición- resulta sin duda caminar por las alucinantes fronteras del mundo delirante del vampiro como el hijo con- sentido de la nocturnidad y de las sombras. Aunque el terreno abonado es significativo, convocamos aquí un breve merodeo en relación con el tema en la literatura y su cuota de realidad; agregamos como postre un grupo de poemas y la conseja para prevenir la visita del vampiro.

  14. Guía por las lindes transilvanas

    OpenAIRE

    Rafael Guillermo Serrano

    1998-01-01

    Paul EluardRecorrer ahora el territorio dejado por Bram Stoker y su novela Drácula -a cien años de su primera edición- resulta sin duda caminar por las alucinantes fronteras del mundo delirante del vampiro como el hijo con- sentido de la nocturnidad y de las sombras. Aunque el terreno abonado es significativo, convocamos aquí un breve merodeo en relación con el tema en la literatura y su cuota de realidad; agregamos como postre un grupo de poemas y la conseja para prevenir la visita del vampi...

  15. Sepse por Serratia marcescens KPC Serratia marcescens KPC sepsis

    OpenAIRE

    Pedro Fernandez Del Peloso; Matheus Felipe Leal de Barros; Fernanda Abreu dos Santos

    2010-01-01

    A resistência aos carbapenems entre as bactérias não fermentadoras de glicose é comumente descrita. Porém, os relatos de resistência aos carbapenems em enterobactérias ainda são fatos isolados. Neste relato de caso, descrevemos um caso de infecção generalizada por Serratia marcescens carreadora de gene blaKPC. No Brasil, já foram relatados casos de isolados de Klebsiella pneumoniae e Escherichia coli carreando gene blaKPC, ficando evidente a emergência desse tipo de carbapenemase e sua dissem...

  16. Envenenamento por paraquat em cães e gatos

    OpenAIRE

    2009-01-01

    Dissertação de Mestrado Integrado em Medicina Veterinária O Paraquat é um herbicida da família dos bipiridilio, sendo um dos três mais usados a nível mundial. É aplicado na agricultura tendo a vantagem de evitar a erosão dos solos por não atacar as raízes. Desde que aplicado correctamente o paraquat é considerado moderadamente tóxico pela Environmental Protection Agency e Joint Meeting Pesticide Residues, no entanto, vários casos fatais de envenenamento por ingestão foram re...

  17. Resiliencia: Diferencias por edad en hombres y mujeres mexicanos

    OpenAIRE

    González-Arratia López Fuentes,Norma Ivonne; Valdez Medina, José Luis

    2013-01-01

    En este estudio se examinan los niveles de resiliencia considerando diferencias de edad y sexo, por lo que se presentan datos provenientes de una muestra compuesta por 607 participantes divididos en cuatro grupos de edad: niños, adolescentes, adultos jóvenes y adultez media, hombres y mujeres todos de la ciudad de Toluca México, aplicándose el cuestionario de resiliencia de González Arratia (2011). Los resultados de los análisis factoriales exploratorios para cada tramo de edad, indican una e...

  18. Morbidade referida por moradores ribeirinhos de Porto Rico, PR, Brasil

    OpenAIRE

    Silva,Doris Marli Petry Paulo da; Tomanik,Eduardo Augusto

    2010-01-01

    Objetivo: Investigar a morbidade referida por ribeirinhos de Porto Rico, PR, Brasil. Métodos: Estudo de caso comparou a morbidade referida entre dois grupos de moradores. A amostra constituiu-se por um representante das 63 moradias dos três conjuntos habitacionais do município. Informações obtidas através de inquérito domiciliar, nos meses de julho/2005 e janeiro/2006. Resultados: A maioria dos entrevistados percebeu sua saúde de forma positiva. Principais problemas citados foram relacionados...

  19. Estimaciones de la demanda de carnes utilizando regresiones por cuantiles

    OpenAIRE

    Fernández, Santiago Javier

    2007-01-01

    Existe evidencia a favor de que una baja ingesta de carne vacuna es perjudicial para la salud, como así también lo es una ingesta excesivamente alta de este tipo de alimentos. Un comestible que es recomendado por los especialistas como un posible sustituto de la carne vacuna es el pollo. Por este motivo, resulta de interés investigar el comportamiento en los hogares frente a este tipo de bienes. Tradicionalmente los análisis de consumo recurren a regresiones estándar en donde la variable expl...

  20. Contractura axilar por quemadura tratada con Integra®

    OpenAIRE

    ROA G,RICARDO; LAS HERAS F,ROCÍO; Piñeros B,José L; Correa S,Gerardo; Norambuena B,Hernán; Marré N,Diego

    2011-01-01

    Las quemaduras axilares severas son un accidente infrecuente que evolucionan a la retracción generando deficiencias cosméticas y funcionales. Estas cicatrices son difíciles de tratar por las características anatómicas del área, donde la corrección de un vector de movimiento puede alterar otro. Objetivo: Mostrar nuestros resultados utilizando el sustituto cutáneo Integra® en el tratamiento de cicatrices retráctiles axilares por quemadura. Pacientes y Métodos: Se recolectaron antecedentes médic...

  1. Heidegger y la pregunta por el sentido del ser

    OpenAIRE

    2010-01-01

    La contribución más duradera de Heidegger a la filosofía de nuestra época consiste en la defensa del cometido «ontológico» de la filosofía. En su amplio itinerario planteó la pregunta por el ser de tres maneras: como pregunta por el sentido del ser, la verdad del ser y el lugar del ser. En este artículo examinaremos críticamente su primera formulación: la que desembocó en una de las obras más influyentes del siglo XX, "Ser y tiempo".

  2. Mortalidad por envenenamiento en niños

    OpenAIRE

    Híjar Martha; Blanco Julia; Carrillo Carlos; Rascón Alberto

    1998-01-01

    Objetivo. Conocer el panorama de las muertes por envenenamiento en niños de 0-14 años ocurridas en la República mexicana, entre 1979 y 1994. Material y métodos. Se utilizaron fuentes secundarias. Las variables analizadas fueron: edad, sexo, año, causa externa de traumatismos y envenenamientos, de la IX Clasificación Internacional de Enfermedades: E850-E858, E860-E869 y E905. Mediante un modelo de regresión Poisson se analizaron tendencias por causa específica y se obtuvieron riesgos relativos...

  3. Intoxicación por estricnina en Costa Rica

    OpenAIRE

    Grettchen Flores Sandí

    1995-01-01

    La estricnina es un alcaloide de origen vegetal, de efecto convulsivante el cual ha sido usado en Costa Rica como plaguicida y rodenticida y también como adulterante de drogas de abuso. Su utilización terapéutica ha sido rechazada. La intoxicación por este tóxico es rara debido al uso actualmente restringido en Costa Rica para la eliminación de perros callejeros por personal de salud. La sintomatología, primordialmente neurológica y cardiorrespiratoria, es de diagnostico clínico y de laborato...

  4. Síndrome oculoglandular de Parinaud causada por esporotricose

    OpenAIRE

    Ribeiro,Alexandre Sampaio de Abreu; Bisol,Tiago; Menezes,Marcela Sant'Ana

    2010-01-01

    A síndrome oculoglandular de Parinaud é uma doença ocular rara causada por diferentes agentes etiológicos, entre eles bactérias, vírus e fungos. É caracterizada por uma conjuntivite granulomatosa, acompanhada de linfadenopatia pré-auricular adjacente e pode trazer sequelas caso não seja prontamente tratada. Neste artigo é relatado o caso de uma jovem técnica de enfermagem e estudante de medicina veterinária apresentando a síndrome oculoglandular de Parinaud causada pelo fungo Sporothrix schen...

  5. Neumonitis por hipersensibilidad en la ciudad de México

    Directory of Open Access Journals (Sweden)

    Carrillo-Rodríguez José G.

    2000-01-01

    Full Text Available OBJETIVO: Determinar la asociación entre la zona urbana de origen del paciente en la ciudad de México y la prevalencia de neumonitis por hipersensibilidad inducida por antígeno aviario. MATERIAL Y MÉTODOS: Se trata de un estudio de casos y controles realizado en el Instituto Nacional de Enfermedades Respiratorias, en la ciudad de México, en el año de 1999. Se estudiaron 109 casos con neumonitis por hipersensibilidad y 184 controles: de éstos, 39, con fibrosis pulmonar idiopática; 63, con tuberculosis pulmonar, y 82, con asma. La ciudad de México y las zonas conurbadas se dividieron en cinco zonas geográficas: centro, noreste, sureste, noroeste y el suroeste. Se calcularon las prevalencias de las diferentes enfermedades por zona urbana de los pacientes que participaron en el estudio; como medida de asociación, se estimó la razón de momios, con un intervalo de confianza al 95%. Asimismo, se realizó regresión logística múltiple ajustando por edad, sexo y estrato socioeconómico. RESULTADOS: Ochenta casos de neumonitis por hipersensibilidad se concentraron en el sur del noreste de las zonas conurbadas y la parte norte del sureste de la ciudad de México, 48 y 32, respectivamente (RM= 3.86, IC 95% 2.17-6.96. Treinta y seis controles de asma se localizaron en el suroeste de la ciudad de México, zona donde se ubica el Intituto Nacional de Enfermedades Respiratorias (p<0.05 y cuatro en la zona conurbada. Los controles de tuberculosis pulmonar y fibrosis pulmonar idiopática estuvieron dispersos en la ciudad de México y en las zonas conurbadas. CONCLUSIONES: La zona sur del noreste y el norte de la sureste están asociadas a la neumonitis por hipersensibilidad. Las causas de esta asociación no parece ser geográfica, pero existe el antecedente de que esa zona fue basurero de la ciudad, por lo que partículas orgánicas en el ambiente pudieran coadyuvar a la aparición de esta enfermedad.

  6. Mastitis bovina causada por Staphylococcus coagulasa negativos

    OpenAIRE

    Bonetto, César C.

    2014-01-01

    El presente Trabajo de Tesis se desprende como una línea de investigación del grupo de la UNRC dedicado al estudio de la problemática de la mastitis bovina tanto en aspectos básicos como aplicados con estudios genéticos, epidemiológicos y de virulencia de los principales microorganismos involucrados en la mastitis bovina. Staphylococccus coagulasa negativo (SCN) es un grupo bacteriano formado por varias especies que por lo general eran considerados flora oportunista de la piel y age...

  7. Hydrogen-atom transfer in reactions of organic radicals with [Co-II(por)](center dot) (por = porphyrinato) and in subsequent addition of [Co(H)(por)] to olefins

    NARCIS (Netherlands)

    de Bruin, B.; Dzik, W.I.; Li, S.; Wayland, B.B.

    2009-01-01

    The mechanisms for hydrogen-atom transfer from the cyanoisopropyl radical C-center dot(CH3)(2)CN to [Co-II(por)](center dot) (yielding [Co-III(H)(por)] and CH2=C(CH3)(CN); por = porphyrinato) and the insertion of vinyl acetate (CH2=CHOAc) into the Co-H bond of [Co(H)(por)] (giving [Co-III{CH-(OAc)CH

  8. ¿Son útiles las pérdidas por evaporación en el riego por aspersión?

    OpenAIRE

    2012-01-01

    Durante el riego por aspersión, una parte del agua emitida por el aspersor puede perderse por evaporación y arrastre por el viento (PEA). Estas pérdidas causan una reducción de la evapotranspiración (ET) durante el riego. Esta reducción de la ET puede ser beneficiosa para los cultivos sobre todo durante los riegos diurnos. En el presente trabajo se han estudiado las pérdidas por evaporación y arrastre brutas (PEA ) brutas durante el riego por aspersión en una cobertura fija de aspersión en do...

  9. Levantamiento del proceso de registros contables por causación de las cuentas por cobrar a clientes

    OpenAIRE

    Mayele-Rodríguez, Luz

    2013-01-01

    De igual forma el Proyecto de Mejora de Procesos a elaborar, desarrollar e implementar en el Área Administrativa y Financiera del Centro de Pinturas Automotriz “LMS”, es realizar el levantamiento del Proceso de Registros Contables por Causación de las cuentas por cobrar a clientes. Lo anterior se puede desarrollar a partir de un poder de negociación con proveedores que incluye entre otros los siguientes factores : El plazo alcanzado en la negociación de compras de insumos, materias primas, co...

  10. Signos Vitales de los CDC-Muertes por intoxicación por alcohol (Alcohol Poisoning Deaths)

    Centers for Disease Control (CDC) Podcasts

    2015-01-06

    Este podcast se basa en la edición de enero del 2015 del informe Signos Vitales de los CDC. En los Estados Unidos, mueren en promedio seis personas cada día debido a la intoxicación por alcohol. Infórmese sobre lo que puede hacer para prevenir los atracones de alcohol y las intoxicaciones por alcohol.  Created: 1/6/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/6/2015.

  11. Paraplegia aguda por compressão da medula espinhal torácica causada por tofo gotoso

    OpenAIRE

    2007-01-01

    O acometimento axial pela gota é um evento raro, e o envolvimento da coluna torácica foi descrito em apenas 17 casos na literatura. Apresentamos um caso de paciente do sexo masculino de 48 anos com história de gota, sob tratamento irregular com alopurinol e colchicina, que desenvolveu paraplegia aguda decorrente de compressão medular por tofo gotoso. Realizou-se o diagnóstico por meio de ressonância magnética e anatomia patológica. Foi tratado com antiinflamatórios e descompressão cirúrgica c...

  12. La mujer por fuerza, El condenado por desconfiado y El burlador de Sevilla, tres comedias atribuidas a Tirso de Molina

    OpenAIRE

    Rodríguez López-Vázquez,Alfredo

    2010-01-01

    Planteamos tres problemas de atribución de obras autoría dudosa en el teatro del Siglo de Oro: El condenado por desconfiado y La mujer por fuerza, editadas a nombre de Tirso en la problemática Segunda parte, y El burlador de Sevilla, editada a nombre de Tirso en el volumen de Doze comedias de Lope de Vega y otros autores (circa 1630). Aplicamos una metodología de análisis de metáforas y de léxico poco usual, y cotejamos con varias obras de los dos dramaturgos implicados en su atribución, Tirs...

  13. Experimental model of the formation of pelvic adhesions by videolaparoscopic in female rabbits Modelo experimental de formação de aderências pélvicas por videolaparoscopia em coelhas

    Directory of Open Access Journals (Sweden)

    Rosi Pereira Balbinotto

    2010-02-01

    Full Text Available PURPOSE: To verify the frequency of postsurgical pelvic adhesion formation in an experimental animal model using videolaparoscopy. METHODS: Experimental study in a sample of 11 non-pregnant female rabbits, aged 5 to 7 months. After general anesthesia, access to the abdominal cavity was performed by an open puncture technique, with 10mm optics, placing two other 5 mm trochars under direct visualization, in the iliac fossae. Then a fragment of peritoneum was resected, followed by electrocauterization. In 21 days, the videolaparoscopy was repeated, and adhesion formation and score was looked at, with biopsies at the surgical site. RESULTS: 54 % of adhesion formation was observed, and the median score of adhesions was 6 (minimum of 3 and maximum of 10, all of them found in the bladder and the anterior abdominal wall. CONCLUSION: The method used presents a high frequency of intra-abdominal adhesion formation.OBJETIVO: Verificar a freqüência da formação de aderências pélvicas pós-cirúrgicas, em um modelo experimental animal, por videolaparoscopia. MÉTODOS: Estudo experimental, em uma amostra de 11 coelhas, não prenhas, com idade entre cinco e sete meses. Após anestesia geral, o acesso da cavidade abdominal foi efetuado por técnica de punção aberta, com óptica de 10 mm, colocando-se outros dois trocateres de 5 mm, sob visão direta, nas fossas ilíacas. Realizou-se, então, ressecção de fragmento de peritônio, seguida de cauterização com eletrocautério. Em 21 dias, foi repetida a videolaparoscopia, verificando-se a formação e escore de aderências e realizando-se biópsias do local da cirurgia. RESULTADOS: Observou-se 54,5% de formação de aderências, sendo o escore total mediano de aderências seis (mínimo de três e máximo de 10, todas encontradas na bexiga e na parede abdominal anterior. CONCLUSÃO: O procedimento utilizado apresentou alta freqüência de formação de aderências intra-abdominais.

  14. Enoftalmos unilateral por várice orbitaria

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    Ricardo J. Smith

    2014-04-01

    Full Text Available El enoftalmos es un motivo de consulta poco frecuente en la práctica médica. La mayor parte de los casos se debe a un aumento de la cavidad ósea orbitaria de origen traumático. Presentamos el caso de una mujer de 63 años que consultó por enoftalmos progresivo de su ojo izquierdo, de doce años de evolución. El examen oftalmológico reveló la presencia de un marcado enoftalmos del lado izquierdo, que mejoraba notablemente con maniobras de Valsalva. Una tomografía computarizada y una resonancia magnética de la órbita permitieron diagnosticar una várice orbitaria no complicada. Las várices orbitarias son infrecuentes y por lo general se manifiestan por episodios de exoftalmos intermitente. Sin embargo, en raras ocasiones, la distensión y colapso repetidos pueden llevar a un enoftalmos progresivo por atrofia de la grasa orbitaria.

  15. Analisis cualitativo asistido por computadora Computer-assisted qualitative analysis

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    César A. Cisneros Puebla

    2003-01-01

    Full Text Available Los objetivos de este ensayo son: por un lado, presentar una aproximación a la experiencia hispanoamericana en el Análisis Cualitativo Asistido por Computadora (ACAC al agrupar mediante un ejercicio de sistematización los trabajos realizados por diversos colegas provenientes de disciplinas afines. Aunque hubiese querido ser exhaustivo y minucioso, como cualquier intento de sistematización de experiencias, en este ejercicio son notables las ausencias y las omisiones. Introducir algunas reflexiones teóricas en torno al papel del ACAC en el desarrollo de la investigación cualitativa a partir de esa sistematización y con particular énfasis en la producción del dato es, por otro lado, objetivo central de esta primera aproximación.The aims of this article are: on the one hand, to present an approximation to the Hispano-American experience on Computer-Assisted Qualitative Data Analysis (CAQDAS, grouping as a systematization exercise the works carried out by several colleagues from related disciplines. Although attempting to be exhaustive and thorough - as in any attempt at systematizing experiences - this exercise presents clear lacks and omissions. On the other hand, to introduce some theoretical reflections about the role played by CAQDAS in the development of qualitative investigation after that systematization, with a specific focus on data generation.

  16. La podredumbre del cuello del sorgo causada por Fusarium verticilloides

    OpenAIRE

    Galvez Patón, Laura; Paris de la Rosa, M.; Cordes, G.; Iglesias Gonzalez, Concepcion; Palmero Llamas, Daniel

    2012-01-01

    El sorgo anual ha sido clasificado por de Wet (1978) como Sorghum bicolor (L.) Moench (2n=20) subespecie bicolor, con 5 razas básicas: bicolor, guinea, caudatum, kafir y durra, las que incluyen los distintos tipos de sorgo existentes en el mercado como los graniferos, los forrajeros tipo sudán, dulces y escoberos (Giorda y Cordes, 2005).

  17. Disposicion a Pagar del Consumidor por Carnes de Especialidad

    OpenAIRE

    Curtis, Kynda; Feuz, Shane; Aybar, Nelissa

    2014-01-01

    A medida que la demanda de alimentos orgánicos y naturales aumenta en los EE.UU, es importante entender las preferencias del consumidor y su disposición a pagar, en términos de primas, por productos de especialidad o no tradicionales.

  18. Hemorragia cerebral causada por enfermedad de la membrana hialina

    OpenAIRE

    Iglesias Rozas, José Rafael, 1942-

    1982-01-01

    Seis imágenes de una hemorragia cerebral en un neonato causada por la enfermedad de la membrana hialina (también conocida como síndrome de dificultad respiratoria neonatal). Six pictures of a cerebral hemorrhage in a neonate caused by the hyaline membrane disease (also known as neonatal respiratory distress syndrome).

  19. Validade por processo de resposta no teste de Cloze

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    Neide de Brito Cunha

    2009-12-01

    Full Text Available Tendo por base considerações sobre as evidências de validade por processo de resposta, foram analisados neste estudo os erros cometidos num teste de Cloze. Participaram 266 crianças, de ambos os sexos, entre 8 e 13 anos, de terceiras e quartas séries do Ensino Fundamental de escolas públicas e particulares de São Paulo. Foram formados dois grupos de protocolos: das crianças que tiveram as melhores e as piores pontuações, para a construção de uma escala dos tipos de erros cometidos, a saber: branco, fonológico, lexical, sintático e semântico. Os resultados mostraram que as crianças com médias mais altas cometeram mais erros lexicais e as com médias mais baixas, erros semânticos. Embora tenha sido encontrada a evidência de validade por processo de resposta, por meio da avaliação da homogeneidade na distribuição dos tipos de erros, é preciso ampliar o conhecimento sobre as características psicométricas do teste de Cloze.

  20. Responsabilidad de las organizaciones internacionales por actos Ultra vires

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    Amaya Querejazu Escobari

    2013-01-01

    Full Text Available Este artículo de investigación tiene por objeto analizar la responsabilidad de las organizaciones internacionales (OI por actos ultra vires. La metodología utilizada consistió básicamente en la revisión documental de libros y artículos referidos al estudio de las organizaciones internacionales y al tema de responsabilidad internacional específicamente. Asimismo, se estudiaron las opiniones consultivas de la Corte Internacional de Justicia (CIJ3 en las que se hace referencia directa o indirecta al tema de la responsabilidad, la subjetividad y la autonomía de las organizaciones internacionales. Se analizan algunos elementos y conceptos del derecho de las OI, como el de sus facultades y poderes (entre ellos los de interpretación y capacidad para crear órganos4. Lo establecido se aplicará por regla general a la mayoría de las OI, a menos que sus respectivos tratados constitutivos establezcan lo contrario. Este trabajo hace énfasis en la ONU y el sistema onusiano por ser el ámbito más universal y en el que existe mayor legislación interna. Se concluye que, en general, no existen normas específicas para tratar la discusión sobre le legalidad de actos ultra vires, ni mecanismos de impugnación ni control de legalidad de los actos de las organizaciones internacionales.

  1. Trombocitopenia induzida por heparina Heparin-induced thrombocytopenia

    Directory of Open Access Journals (Sweden)

    Fernanda Longhi

    2001-08-01

    Full Text Available O objetivo deste relato é fazer uma revisão a fim de obter informações atualizadas sobre trombocitopenia induzida por heparina, suas manifestações clínicas, seu diagnóstico e seu manejo terapêutico. Após, concluímos que a trombocitopenia induzida por heparina é uma complicação comum em pacientes submetidos a tratamento com heparina, indiferentemente da doença de base. Complicações trombóticas potencialmente fatais têm sido descritas. Por essa razão, se houver suspeita de trombocitopenia induzida por heparina, uma abordagem adequada incluindo suspensão precoce da heparina é mandatória. Produtos que substituem a heparina incluem hirudina e danaparóide sódico. Heparina de baixo peso molecular é contra-indicada.The aim of this paper is to review current information about the clinical manifestations, diagnosis and management of heparin-induced thrombocytopenia. This was achieved by a bibliographic review using Public Medline and consulting Hematology textbooks. From this study we concluded that heparin-induced thrombocytopenia is a common complication of patients exposed to heparin therapy regardless of underlying conditions. Potentially fatal thrombotic complications have been reported. Therefore, if heparin-induced thrombocytopenia is suspected, an adequate approach including early heparin discontinuation is mandatory. Alternative products for heparin include hirudin and danaparoid sodium. Low-molecular-weight heparin is contraindicated.

  2. Celulitis por Microascus trigonosporus(anamorfo Scopulariopsis trigonospora

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    DELIA CANLE CORTIÑAS

    2013-06-01

    Full Text Available Resumen: Microascus trigonosporus ( anamorfo Scopulariopsis trigonospora es un hongo filamentoso ubicuo que se encuentra en el suelo , plumas de aves, material vegetal e insectos. Aunque Scopulariopsis spp se consideran comúnmente hongos contaminantes , pueden causar ocasionalmente infecciones en humanos, en especial onicomicosis . Excepcionalmente se han descrito infecciones de piel, abscesos cerebrales, endocarditis ,sinusitis e infecciones diseminadas por Scopulariopsis spp , casi siempre en pacientes inmunodeprimidos . En los últimos años se han publicado un mayor número de casos de infecciones oportunistas por Scopulariopsis spp y otros hialohifomicetos multiresistentes. Todavía no está establecido cuál es el mejor 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: Microascus trigonosporus ( Anamorph Scopulariopsis trigonospora is a cosmopolitan filamentous fungus that inhabits soil, feathers ,plant material and insects. While Scopulariopsis is commonly considered as a contaminat fungus it may cause occasionally infections in humans ,especially onychomycosis .Skin lesions, brain abscess , endocarditis, sinusitis and disseminated infections due to Scopulariopsis species have been rarely reported , usually in immunocompromised patients . Over the last few years opportunistic infections by Scopulariopsis species and others multi-resistant hyalohyphomycetes have been increasingly reported . No clear treatment regimen for Scopulariopsis species infections has been established yet. We present a exceptional case of cellulitis due to Microascus trigonosporus in a patient with prolonged steroid therapy.

  3. Relatos cortos escritos por mujeres en el siglo XIX

    Directory of Open Access Journals (Sweden)

    Marta Giné

    2014-04-01

    Full Text Available A propósito de la obra editada por Concepción Palacios y Pedro Méndez, Femmes nouvellistes françaises du XIXesiècle(Berna, Peter Lang, coll. « Espacios literarios en contacto », vol. 4, 2013, 366 p. ISBN: 978-3-0343-1409-1.

  4. Mortalidad por envenenamiento en niños

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    Híjar Martha

    1998-01-01

    Full Text Available Objetivo. Conocer el panorama de las muertes por envenenamiento en niños de 0-14 años ocurridas en la República mexicana, entre 1979 y 1994. Material y métodos. Se utilizaron fuentes secundarias. Las variables analizadas fueron: edad, sexo, año, causa externa de traumatismos y envenenamientos, de la IX Clasificación Internacional de Enfermedades: E850-E858, E860-E869 y E905. Mediante un modelo de regresión Poisson se analizaron tendencias por causa específica y se obtuvieron riesgos relativos según edad, sexo y entidad federativa. Resultados. Hubo un total de 11 272 defunciones en menores de 15 años; las principales causas fueron el envenenamiento y las reacciones tóxicas causadas por plantas y animales venenosos (E905, el envenenamiento accidental por gas de uso doméstico y por monóxido de carbono (E868 y el envenenamiento accidental por otras drogas (E858. El grupo de edad que presentó los mayores riesgos, para las causas mencionadas, fue el de menores de un año con un riesgo relativo (RR de 29.6, IC95% 29.2-33.4; RR 3.47, IC95% 2.86-4.22, y RR 31.86, IC95% 24.8-40.9. El riesgo fue similar en ambos sexos, salvo para la causa E905. El estado de Aguascalientes se situó sistemáticamente entre los de mayor riesgo para todas las causas analizadas, mientras que Nuevo León siempre se ubicó entre los de riesgo más bajo. Conclusiones. El envenenamiento constituye una importante causa de muerte en los niños; el riesgo se incrementa al disminuir la edad. Considerando que esas muertes son potencialmente evitables y que la mayor parte de los envenenamientos ocurren en el hogar, para prevenirlos, se recomienda a los familiares vigilar y mantener fuera de peligro al niño. Por otra parte, la multicausalidad del fenómeno requiere que su prevención se realice desde una perspectiva multidisciplinaria que genere una cultura y un ambiente de seguridad en la sociedad.

  5. Mortalidade por leucemias relacionada à industrialização

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    Leal Carmen Helena Seoane

    2002-01-01

    Full Text Available OBJETIVO: Analisar a distribuição espacial da mortalidade por leucemia na população, buscando identificar agregados e estabelecer sua relação com os níveis de industrialização. MÉTODOS: O estudo foi realizado nas 43 regiões de governo do Estado de São Paulo, no qüinqüênio 1991-1995. Foi construído um "índice de industrialização relativo à leucemia" (IIRL baseado no número de indústrias e empregos industriais por 100.000 habitantes, valor adicionado fiscal, variedade de ramos industriais e indústrias com potenciais exposições de risco para a leucemia. O IIRL foi distribuído em cinco categorias. Verificaram-se os coeficientes padronizados de mortalidade por leucemia em cada uma das regiões, também distribuídos em cinco categorias e comparados ao mapa IIRL. RESULTADOS: As regiões mais industrializadas em ordem decrescente foram Campinas, Piracicaba, Jundiaí, Sorocaba e São Paulo. Não foi encontrada associação entre mortalidade, por nenhum tipo de leucemia, e industrialização. A região de Jales foi a que apresentou o mais alto coeficiente padronizado de mortalidade por leucemia. CONCLUSÕES: A distribuição da mortalidade por leucemia ocorreu de forma homogênea no Estado de São Paulo, não apresentando correlação com o nível de industrialização. Entretanto, aspectos relacionados ao método epidemiológico adotado -- estudo ecológico -- e ao uso do parâmetro "mortalidade por leucemia", doença cujo prognóstico tem mudado muito nas últimas décadas, limitaram a interpretação dos resultados.

  6. Mortalidade por leucemias relacionada à industrialização

    Directory of Open Access Journals (Sweden)

    Carmen Helena Seoane Leal

    2002-08-01

    Full Text Available OBJETIVO: Analisar a distribuição espacial da mortalidade por leucemia na população, buscando identificar agregados e estabelecer sua relação com os níveis de industrialização. MÉTODOS: O estudo foi realizado nas 43 regiões de governo do Estado de São Paulo, no qüinqüênio 1991-1995. Foi construído um "índice de industrialização relativo à leucemia" (IIRL baseado no número de indústrias e empregos industriais por 100.000 habitantes, valor adicionado fiscal, variedade de ramos industriais e indústrias com potenciais exposições de risco para a leucemia. O IIRL foi distribuído em cinco categorias. Verificaram-se os coeficientes padronizados de mortalidade por leucemia em cada uma das regiões, também distribuídos em cinco categorias e comparados ao mapa IIRL. RESULTADOS: As regiões mais industrializadas em ordem decrescente foram Campinas, Piracicaba, Jundiaí, Sorocaba e São Paulo. Não foi encontrada associação entre mortalidade, por nenhum tipo de leucemia, e industrialização. A região de Jales foi a que apresentou o mais alto coeficiente padronizado de mortalidade por leucemia. CONCLUSÕES: A distribuição da mortalidade por leucemia ocorreu de forma homogênea no Estado de São Paulo, não apresentando correlação com o nível de industrialização. Entretanto, aspectos relacionados ao método epidemiológico adotado -- estudo ecológico -- e ao uso do parâmetro "mortalidade por leucemia", doença cujo prognóstico tem mudado muito nas últimas décadas, limitaram a interpretação dos resultados.

  7. Rupture of Ovarian Mature Cystic Teratoma: Computerized Tomography Findings; Rotura de teratoma quistico madure de ovario: hallazgos por tomografia computerizada

    Energy Technology Data Exchange (ETDEWEB)

    Sebastia, C.; Sarrias, M.; Sanchez-Aliaga, E.; Quiroga, S.; Boye, R.; Alvarez-Castells, A. [Hospital General Universitari Vall d' Hebron. Barcelona (Spain)

    2004-07-01

    We present computed tomography findings of three cases of intraperitoneal rupture of ovarian mature cystic teratoma. Acute-phase radiological findings include presence of intraabdominal liquid, infiltration of mesenteric fat and calcified pelvic mass which also showed interior fatty content. Chronic-phase findings include infiltration of peritoneal fat, as well as increase in the size of adjacent ganglion due to chronic inflammatory response to histologically verified foreign bodies. Differential diagnoses between chronic and acute intraperitoneal ruptures of mature teratoma have been reviewed. (Author)

  8. Por una Historia Política de las Poblaciones

    Directory of Open Access Journals (Sweden)

    PAUL-ANDRÉ ROSENTAL

    2006-01-01

    Full Text Available ¿Cómo hacer la historia de las poblaciones? En las décadas de posguerra, la respuesta es proporcionada por Louis Henry, en el INED, quien promueve una demografía histórica esencialmente estadística, no sin el legado de Fernand Braudel y de la escuela de los Anales. Pero durante los años 1980, la deconstrucción de categorías inspirada por Michel Foucault, la crítica del objetivismo, el descubrimiento por la historia de la estadística de raíces ideológicas ambiguas en la demografía (natalismo, eugenismo, voluntad de control biopolítico, desestabilizan la disciplina. Para impedir que la reflexividad sustituya a la producción de conocimientos, se introducen nuevos métodos (la micro-historia y nuevos objetos (las instituciones. A la antigua demografía histórica le sucederá una historia social y política de las poblaciones. Su objeto es la construcción simultánea de instituciones, políticas y conocimientos relativos a las poblaciones. Condorcet, combatido por Malthus, Achille Guillard, inventor de la palabra demografía, y por supuesto Maurice Halbwachs, han formalizado la naturaleza «social» de la población. En oposición a las tentaciones sociobiológicas contemporáneas, el vínculo orgánico entre población y protección social provoca toda la cuestión de la auto-creación de la sociedad.

  9. LUCHA POR LA TIERRA EN EL NORTE DE URUGUAY

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    Gabriel Oyhantçabal Benelli

    2011-12-01

    Full Text Available Este artículo analiza la trayectoria de la lucha por la tierra en Bella Unión, una región característica en Uruguay por la producción de caña de azúcar, a través de los movimientos de clase de sus principales protagonistas: los cortadores de caña sindicalizados en la Unión de Trabajadores Azucareros de Artigas (UTAA. El recorrido histórico hace énfasis en dos períodos históricos diferentes: 1961-1973 y 2005-presente. El primero va desde la fundación del sindicato hasta el golpe militar. Se da en un contexto de auge de la lucha de masas en Uruguay en el cual los trabajadores rurales se organizan en la UTAA levantando, entre otras, la bandera de la Reforma Agraria. El segundo período está marcado por la llegada al gobierno nacional del Frente Amplio, una coalición social-demócrata que reactiva la producción de caña de azúcar en Bella Unión. Este cambio supone una oportunidad para las luchas sociales que la UTAA aprovecha con ocupaciones de tierra favoreciendo un proceso de colonización para los trabajadores rurales. Sin embargo el acceso a la tierra genera nuevas contradicciones, y por tanto nuevos desafíos, por los cambios en la forma de subsunción del trabajo al capital.

  10. Morbilidad oculta por parasitismo intestinal en Lagunita, municipio Girardot, Venezuela

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    Yanelis Núñez Gómez

    2014-08-01

    Full Text Available Se realizó un estudio epidemiológico descriptivo de corte transversal, con el objetivo de determinar la morbilidad oculta por parasitismo intestinal en Lagunita, municipio Girardot, Venezuela; en el período de enero a octubre de 2009. El universo fue de 286 niños, lo que se corresponde con la población total del grupo de edad de menores de 15 años. De estos se seleccionaron por muestreo aleatorio simple 43 pacientes, a los que se les aplicó un cuestionario y se confeccionó una guía de observación, para describir los factores epidemiológicos que influyen en la infestación por parasitismo intestinal. Además, se les realizaron análisis de las heces fecales seriadas para el diagnóstico del parasitismo. El método estadístico fue el cálculo de las frecuencias absolutas y relativas. A través del estudio de las heces fecales seriadas se obtuvo que 27 pacientes tenían parasitosis intestinal, para una morbilidad de 62,79%, con una mayor incidencia en los niños de cinco a nueve años de edad. El sexo femenino fue el más afectado. Los factores epidemiológicos que más influyeron fueron: los malos hábitos higiénicos personales, el entorno desfavorable y el consumo de agua no potable; existió relación entre el nivel socioeconómico, los factores epidemiológicos y la morbilidad por parasitismo intestinal. Predominó la parasitosis por Entamoeba Histolytica, con 11 casos, para un 40,74%. La diarrea, las molestias abdominales y la pérdida de apetito constituyeron los principales síntomas

  11. CARACTERÍSTICAS DA VIOLÊNCIA SEXUAL SOFRIDA POR CRIANÇAS ASSISTIDAS POR UM PROGRAMA DE APOIO

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    KELLY LINHARES VASCONCELOS

    2010-01-01

    Full Text Available En Brasil, las estadísticas de la violencia sexual contra niños están lejos de reflejar la verdadera realidad actual debido a la baja notificación de los casos. La finalidad de este estudio fue caracterizar el abuso sexual sufrido por niños asistidos por el Programa Sentinela y el perfil del agresor, en Sobral-Ceará, en el periodo que va del 2002 al 2006. La muestra no probabilística intencional fue compuesta por 50 víctimas de abuso sexual y de las mismas, el 66% es del sexo femenino, con predominio de rango de edad entre 8-12 años incompletos, (58%; en el 36% de los casos los padres están separados, siendo la madre la principal responsable por la familia (62%. La mayoría de los agresores es del sexo masculino (78%. En el ambiente fuera de la familia los agresores son conocidos o amigos de la familia (14%; dentro del seno familiar el padrastro es identificado como siendo el agresor más frecuente (18%. Los datos destacan características similares a las de otros estudios, definiendo una cierta igualdad en este tipo de violencia.

  12. Pancreatic and biliary drainage for the treatment of bile leakage and severe intra-abdominal infection after pancreatiduodenectomy due to severe trauma%急诊胰十二指肠切除术后并发胆胰漏的处理

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    朱耀明

    2012-01-01

    目的 探讨因腹部外伤行急诊胰十二指肠切除术( pancreaticoduodenectomy,PD)后胆胰漏的发生及并发严重腹腔感染需再次手术时的处理策略.方法 回顾分析10年来因腹部外伤而急诊行PD手术病人共35例,术后发生胆胰漏12例,发生率为34.3%.经保守治疗、调整腹腔引流管或穿刺引流后治愈3例,另9例发生严重腹腔感染,再次手术行腹腔清洗和置管引流.结果 再手术者中8例未行胆胰管支撑引流,其中6例术后胆胰漏之积液区未有效局限,腹腔感染持续并加重,3例并发腹腔出血;均行第3次手术,于胰管和(或)胆管内置管外引流,感染区留置双套管术后冲洗腹腔并负压引流;6例均存活,6个月后行决定性手术.结论 胰十二指肠外伤行PD术后胆胰漏发生率高,再次手术时行胰管和(或)胆管内置支撑管外引流,可迅速有效地控制腹腔感染,降低死亡率.%Objective The objective of this study was to investigate the incidence and the operation strategy of biliary and pancreatic leakage and related severe intra-abdominal infection after pancre-aticoduodenectomy (PD) due to abdominal trauma. Methods A total of 35 patients who underwent e-mergent PD in our department due to severe abdominal trauma during past ten years were retrospectively analyzed. Results Postoperative biliary and pancreatic leakages developed in 12 cases with an incidence of 34.3 %, in which 3 patients were cured by non-operating treatment, including peritoneal drainage tube,and other 9 patients had severe abdominal infectious complications and needed re-operation. In these patients who required re-operations without biliary and pancreatic drainage, bile and pancreatic secreting fluid were not limited effectively, resulting in severe intraperitoneal infection in 6 cases, in which 3 patients needed to be re-operated for the third time due to a massive bleeding. Other 6 patients were treated with effectively drainage by

  13. Application of pelvis free liquid deepness measured by ultrasound in evaluating intra-abdominal hemorrhage volume in ectopic pregnancy patients%超声测盆腔积液深度在评估异位妊娠腹腔内出血量中的应用

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    刘岿然; 王昌霆; 杨雨; 张淑兰

    2012-01-01

    Objective To compare the pelvis free liquid quantity deepness measured by ultrasound and actual blood volume in abdominal cavity observed during operation in ectopic pregnancy patients, so as to predict the pre-operation intra-abdominal hemorrhage volume. Methods Five hundred patients with ectopic pregnancy receiving emergent operation were included in the present study. The patients took lithotomy position and were examined by vaginal probe before operation. The pelvis free liquid quantity measured by ultrasound (x) and the actual blood volume in abdominal cavity (y) observed during operation were subjected to statistical analysis using SPSS 16. 0 software. Results The pelvis free liquid measured by ultrasound and the actual quantity of blood in abdominal cavity accorded with the following equation: y=i3. 306 e0.74x, R2 = 0. 983, P<0.05. The actual volume of blood in pelvis could be calculated by the equation. When the quantities of free liquid in pelvis were 3 cm, 3. 5 cm, 4. 0 cm, and 4. 5 cm, the actual volumes of blood in pelvis were 357. 91 ml, 508. 92 ml, 732. 64 ml, and 1 028. 95 ml, respectively. Conclusion The quantity of intra-abdominal hemorrhage can be predicted by the pelvis free liquid deepness in ectopic pregnancy patients, which may pave a way for more effective treatment of the patients.%目的 通过比对异位妊娠患者术前盆腔积液深度的彩色超声测量结果与术中记录的实际腹腔内积血量,建立估测术前腹腔内出血量的方法.方法 选择2008年1月至2009年12月在本院诊断为异位妊娠并行急诊手术的患者500例.术前患者取半卧截石位,行阴式超声检查.按彩超提示盆腔积液深度(x)和术中记录与之对应的腹腔内实际出血量(y),利用SPSS 16.0统计软件行统计学分析并建立方程.结果 盆腔积液深度(x)与腹腔内实际出血量(y)符合方程:y=43.306 e0.704x,R2 =0.983,P<0.05.按此方程推算腹腔内实际出血量,当盆腔积液深度为3、3.5

  14. Modified sliding rectus abdominus myofascial flap for huge planned abdominal hernia after intra-abdominal volume increment%改良腹直肌推徙术治疗腹腔扩容术后巨大计划性腹疝

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    孙士锦; 杨越涛; 吴文元; 马柏强; 谭浩; 王韬; 李英才; 张连阳

    2014-01-01

    目的 探讨改良腹直肌推徙术治疗腹腔扩容术后巨大计划性腹疝的效果. 方法 回顾性分析7例巨大计划性腹疝患者的临床资料,其中男4例,女3例;平均年龄43.4岁.合并造口4例,胰瘘1例,肠瘘1例,胆囊炎1例.所有患者均接受改良腹直肌推徙术治疗,行确定性腹壁重建,计划性腹疝至确定性重建的平均时间为6.4个月. 结果 7例均救治成功.平均手术时间180 min,术中平均失血量150 ml.术后发生皮下血清肿1例,皮缘坏死1例,均经引流治愈,无严重感染并发症.无复发性腹腔间隙综合征发生,无脏器功能障碍等发生.腹直肌功能恢复良好,无其他不适症状.随访l ~21个月,平均12.3个月,轻度复发l例,暂时观察中. 结论 改良腹直肌推徙术治疗巨大计划性腹疝,效果良好,为腹腔扩容术后巨大计划性腹疝患者临床治疗提供了新的可供选择的手术方法.%Objective To examine the effect of modified sliding myofascial flap of the rectus abdominis to intervene the huge planned hernia following intra-abdominal volume increment.Methods A retrospective review was made on 7 cases (4 males and 3 females at mean age of 43.4 years).Colostomy or ileumstomy co-occurred in 4 cases,pancreatic fistula in 1,intestinal fistula in 1,cholecystitis in 1.Definite abdominal wall reconstruction was performed using the modified sliding rectus abdominus myofascial flap and mean delay time was 6.4 months.Results Surgical success rate was 100%.Mean operation time was 180 minutes and mean intraoperative blood loss was 150 ml.One case of subcutaneous hematoma and one skin marginal necrosis were noted after operation,but cured later by volume drainage.There were no postoperative complications such as infection,reproductive abdominal compartment syndrome (ACS),and organ function impairment.Rectus abdominis functioned well without any other symptoms.At the follow-up of 1-21 months (mean,12.3 months),1 case had mild relapse

  15. Vivencias psicosociales reveladas por niños que reciben tratamiento con quimioterapia por cáncer

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    BLANCA CECILIA VANEGAS DE AHOGADO

    2009-12-01

    Full Text Available Se realizó un estudio cualitativo con el propósito de descubrir las vivencias psicosociales de niños y niñas de 9 a 12 años que recibían tratamiento con quimioterapia por cáncer. La recolección de la información se hizo mediante encuentros lúdicos con el apoyo de algunas preguntas básicas que facilitaron las revelaciones narrativas. Tres aspectos se destacan en los hallazgos del estudio: vivencias desfavorables, vivencias relacionadas con la autoestima y vivencias favorables; las dos primeras, de diversa manera, afectan en estos niños su vida personal, familiar, escolar y, en general, todo su entorno. Es de resaltar que, como consecuencia de la caída del cabello, con frecuencia han sido objeto de burla y de rechazo por sus compañeros de estudio, lo que produce el más notorio efecto sobre su autoimagen; por otra parte, el ausentismo escolar conlleva dificultades académicas y sentimientos de tristeza en estos niños, situación que empeora cuando, por motivos de tratamiento, su lugar de residencia está alejado de la ciudad, viéndose sometidos a largos periodos de separación, no solo de su familia sino de sus pares. Se concluye que la mayor parte de las revelaciones son impactantes por su gran contenido de sufrimiento y dolor para estos niños, lo que demuestra la urgencia de retomar los hallazgos del estudio para orientar el cuidado de enfermería de manera más integral y apoyar para que se haga lo propio en el hogar y en las instituciones educativas.

  16. BROTE POR SALMONELLA ENTERITIDIS EN UNA RESIDENCIA DE ANCIANOS

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    José Luis Yáñez Ortega

    2001-01-01

    Full Text Available Fundamento: Se describe un brote de gastroenteritis por Salmonella Enteritidis, fagotipo 1, declarado en una residencia de ancianos de Burgos el 15 de noviembre de 1999. El objetivo de la investigación del brote ha sido determinar la fuente de infección, el mecanismo de transmisión y proponer las medidas adecuadas para evitar la recurrencia del problema. Métodos: Se ha realizado un estudio observacional de cohortes retrospectivo encuestando a 106 de un total de 119 residentes y a 9 trabajadores del centro. Se ha estimado el Riesgo Relativo de enfermar en función del consumo de diversos alimentos. Se ha utilizado la Regresión Logística para calcular las odds ratio ajustadas por edad, sexo y por el consumo de alimentos y vino. Se ha estudiado la concordancia del diagnóstico clínico frente al diagnóstico por coprocultivo mediante el índice de concordancia Kappa de Cohen. Resultados: Un total de 42 personas refirieron sintomatología (37 residentes y 5 empleados. La tasa de ataque clínico fue de 36,5 %. De 91 coprocultivos realizados (82 en residentes y 9 en empleados 45 resultaron positivos (41 en residentes y 4 en empleados. La Tasa de ataque de casos confirmados por coprocultivo fue de 49,5% en los investigados. La leche frita ha sido el alimento implicado epidemiológicamente con la aparición del brote: RR: 3,25 (IC95% 1,10-9,59. El efecto protector del vino (Odds Ratio: 0,68 no alcanzó significación estadística (p=0,36. El índice Kappa resultó 0,43 (p < 0,001, lo que demuestra la escasa concordancia del diagnóstico clínico frente al diagnóstico mediante coprocultivo. Conclusiones: Existe evidencia epidemiológica de que el consumo de leche frita ha sido el mecanismo de transmisión de la infección, y la conservación a temperatura inadecuada del alimento ha sido el factor contribuyente determinante en la eclosión del brote. Esto demuestra que lo más idóneo para prevenir este tipo de brotes son las prácticas y h

  17. Brote por Salmonella enteritidis en una residencia de ancianos

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    Yáñez Ortega Jose Luis

    2001-01-01

    Full Text Available Fundamento: Se describe un brote de gastroenteritis por Salmonella Enteritidis, fagotipo 1, declarado en una residencia de ancianos de Burgos el 15 de noviembre de 1999. El objetivo de la investigación del brote ha sido determinar la fuente de infección, el mecanismo de transmisión y proponer las medidas adecuadas para evitar la recurrencia del problema. Métodos: Se ha realizado un estudio observacional de cohortes retrospectivo encuestando a 106 de un total de 119 residentes y a 9 trabajadores del centro. Se ha estimado el Riesgo Relativo de enfermar en función del consumo de diversos alimentos. Se ha utilizado la Regresión Logística para calcular las odds ratio ajustadas por edad, sexo y por el consumo de alimentos y vino. Se ha estudiado la concordancia del diagnóstico clínico frente al diagnóstico por coprocultivo mediante el índice de concordancia Kappa de Cohen. Resultados: Un total de 42 personas refirieron sintomatología (37 residentes y 5 empleados. La tasa de ataque clínico fue de 36,5 %. De 91 coprocultivos realizados (82 en residentes y 9 en empleados 45 resultaron positivos (41 en residentes y 4 en empleados. La Tasa de ataque de casos confirmados por coprocultivo fue de 49,5% en los investigados. La leche frita ha sido el alimento implicado epidemiológicamente con la aparición del brote: RR: 3,25 (IC95% 1,10-9,59. El efecto protector del vino (Odds Ratio: 0,68 no alcanzó significación estadística (p=0,36. El índice Kappa resultó 0,43 (p<0,001, lo que demuestra la escasa concordancia del diagnóstico clínico frente al diagnóstico mediante coprocultivo. Conclusiones: Existe evidencia epidemiológica de que el consumo de leche frita ha sido el mecanismo de transmisión de la infección, y la conservación a temperatura inadecuada del alimento ha sido el factor contribuyente determinante en la eclosión del brote. Esto demuestra que lo más idóneo para prevenir este tipo de brotes son las prácticas y h

  18. Distribution and antibiotic resistance of pathogen isolated from intra-abdominal infection associated sepsis in surgical intensive care unit%外科重症监护病房腹腔感染相关脓毒症病原菌分布及耐药性分析

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    殷娜; 邓小明

    2014-01-01

    目的:了解上海交通大学医学院附属新华医院外科重症监护病房(S IC U )近5年腹腔感染相关脓毒症患者的病原菌分布以及耐药性,为临床经验用药提供参考依据。方法收集2008年1月至2012年12月入住该院S IC U的65例腹腔感染相关脓毒症患者的腹腔引流液标本,进行病原菌分析和药敏监测。结果共分离出151株病原菌,其中革兰阴性菌104株(68.9%),革兰阳性菌29株(19.2%),真菌18株(11.9%)。在所有病原菌中分离率名列前5位的分别是大肠埃希菌(23.2%)、鲍曼不动杆菌(15.2%)、屎肠球菌(13.2%)、铜绿假单胞菌(8.6%)、肺炎克雷伯菌(7.9%)。大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶菌株分离率分别为80.0%和33.3%,对碳青霉烯类抗菌药物耐药率低;鲍曼不动杆菌中56.5%为多重耐药菌株,30.4%为泛耐药菌株。结论腹腔感染相关脓毒症患者分离的病原菌耐药率高,及早、合理的经验性抗感染治疗有利于控制细菌耐药的产生和播散。%Objective To investigate the distribution and antibiotic resistance of clinical pathogen isolated from patients of intra-abdominal infection associated sepsis in surgical intensive care unit (SICU ) during recent 5 years ,then instruct clinical application of antibiotics reasonably .Methods Abdominal drainage of 65 patients of intra-abdominal infection associated sepsis were collected from January 2008 to December 2012 .All the specimens were analyzed for pathogen distribution and drug susceptibility .Results A total of 151 strains of pathogenic bacteria was isolated ,in which Gram-negative bacteria were the most popular pathogen (104 strains ,68 .9% ) ,whereas Gram-positive bacteria and fungi accounted for 19 .2% (29 strains) and 11 .9% (18 strains) ,respectively . The five most common pathogens were Escherichia coli(23 .2

  19. Clinical efficacy of high-dose induction therapy by maintenance with recombinant human erythropoietin (rhEPO) in intestinal fistula patients complicated with intra-abdominal infection with anemia%rhEPO大剂量冲击维持疗法治疗肠瘘合并腹腔感染病人贫血的临床研究

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    洪之武; 任建安; 刘颂; 顾国胜; 袁玉杰; 周波; 闫冬升; 黎介寿

    2012-01-01

    目的 探讨重组人红细胞生成素(recombinant human erythropoietin,rhEPO)大剂量冲击维持疗法治疗肠瘘合并腹腔感染病人贫血的临床价值.方法 选择2010年9月至2011年12月南京军区南京总医院肠瘘治疗病区114例肠瘘致腹腔感染伴贫血且资料完整的病例,按照机体含铁量情况分为机体铁含量正常组和机体铁缺乏组,同时铁含量正常组再次随机分为单纯营养支持治疗(enteral nutrition/parenteral nutrition,EN/PN)组和EN/PN联合大剂量rhEPO冲击维持治疗组(各30例);铁缺乏组分为EN/PN联合铁剂(iron)组和EN/PN联合iron、大剂量rhEPO冲击维持治疗组(各27例).入组病例全部给予足量EN/PN、rhEPO和(或)蔗糖铁注射剂治疗并进行疗效观察.结果 两组病人治疗前后血红蛋白(Hb)比较,治疗前Hb差异无统计学意义(P>0.05).体内含铁量正常病人,在rhEPO治疗组2周后Hb明显高于未实施rhEPO干预组(P<0.05);体内含铁缺乏病人,铁剂联合rhEPO治疗组2周后Hb明显高于未实施rhEPO治疗组(P<0.05).大多数病人耐受良好.结论 肠瘘致腹腔感染伴贫血病人给予皮下注射rhEPO大剂量冲击维持疗法可有效快速提高病人的红细胞(RBC)及Hb水平,改善病人的贫血状况.该疗法耐受性较好,值得进一步扩大临床研究.%Objective To study clinical efficacy of recombinant human erythropoietin (rhEPO) in intestinal fistula patients complicated with intra-abdominal infection with anemia. Methods One hundred and fourteen patients with intestinal fistula complicated with intra-abdominal infection with anemia admitted from September 2010 to December 2011 in General Hospital of Nanjing Military Command were enrolled. In accordance with the iron content of the body the patients were divided into the group with the normal iron content in the body and the group with the deficient iron content. The normal iron content group was randomly divided into nutrition support

  20. Calidad percibida por el espectador de fútbol

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    Isabel Mar\\u00EDa Rosa D\\u00EDaz

    2012-01-01

    Full Text Available Para lograr competitividad, las organizaciones se esfuerzan por comprender las necesidades de sus clientes, con el fin de satisfacerlas adecuadamente. En esta línea, en el ámbito de la gestión deportiva se ha iniciado un caminocuyo objetivo consiste en crear medidas específicas de la calidad del servicio y la satisfacción del cliente. Este es el contexto en el que se enmarca la presente investigación, cuyo objetivo fundamental consisteen determinar las dimensiones de la calidad del servicio deportivo ofrecido por los clubes de fútbol. Para ello se ha aplicado un cuestionario a través del método de la encuesta personal. Los datos obtenidos han sido tratados mediante un análisis factorial exploratorio. Los resultados permiten identificar diez dimensiones básicas de la calidad del servicio deportivo analizado.