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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. Aggressive intraabdominal fibromatosis

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    Stojković Mirjana

    2006-01-01

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

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

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    Ruiz Castellanos, Erika Johana; Martínez Torres, Javier

    2016-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

  9. 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...

  10. 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

  11. Disseminated Intra-Abdominal Hydatidosis

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    Concha, Fátima; Maguiña, Ciro; Seas, Carlos

    2013-01-01

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

  12. 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.

  13. [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.

  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. [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...

  18. Intra-abdominal pressure during swimming.

    Science.gov (United States)

    Moriyama, S; Ogita, F; Huang, Z; Kurobe, K; Nagira, A; Tanaka, T; Takahashi, H; Hirano, Y

    2014-02-01

    The present study aimed to determine the intra-abdominal pressure during front crawl swimming at different velocities in competitive swimmers and to clarify the relationships between stroke indices and changes in intra-abdominal pressure. The subjects were 7 highly trained competitive collegiate male swimmers. Intra-abdominal pressure was measured during front crawl swimming at 1.0, 1.2 and 1.4 m · s(-1) and during the Valsalva maneuver. Intra-abdominal pressure was taken as the difference between minimum and maximum values, and the mean of 6 stable front crawl stroke cycles was used. Stroke rate and stroke length were also measured as stroke indices. There were significant differences in stroke rate among all velocities (P swimming velocity. These findings do not appear to support the effectiveness of trunk training performed by competitive swimmers aimed at increasing intra-abdominal pressure. © Georg Thieme Verlag KG Stuttgart · New York.

  19. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-08-01

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

  1. 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.

  2. 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

  3. 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.

  4. 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

  5. Gallium-67 scintigraphy and intraabdominal sepsis. Clinical experience in 140 patients with suspected intraabdominal abscess

    Energy Technology Data Exchange (ETDEWEB)

    Hopkins, G.B.; Kan, M.; Mende, C.W.

    1976-12-01

    In 140 patients with suspected intraabdominal abscess, studies were made using gallium-67 citrate and technetium-99m labeled radiopharmaceuticals. Gallium-67 scintigrams correctly localized 52 of 56 intraabdominal abscesses confirmed at surgical operation or necropsy. In an additional 20 patients in whom findings on scintigrams were abnormal, there were clinically established infections. Sixty-one patients in whom findings on scintigrams were normal were conservatively managed and discharged from the hospital; none proved to have an abscess. Four false-negative and three false-positive studies were recorded. Gallium-67 scintigraphy is a useful noninvasive diagnostic adjunct that should be employed early in the evaluation of patients with suspected intraabdominal sepsis.

  6. 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

  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. 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

  9. Intra-abdominal gout mimicking pelvic abscess

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  10. 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

  11. 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.

  12. 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.

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

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    Enio Ricardo V. Ronque

    2010-09-01

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

  14. 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

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    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

  15. 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.

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

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    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.

  17. Evaluation and treatment of intraabdominal bilomas

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-05-01

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

  18. [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.

  19. Intra-abdominal hypertension--an experimental study of early effects on intra-abdominal metabolism.

    Science.gov (United States)

    Skoog, Per; Hörer, Tal; Nilsson, Kristofer F; Agren, Göran; Norgren, Lars; Jansson, Kjell

    2015-01-01

    The main aim of this experimental study was to investigate the early effects of intra-abdominal hypertension (IAH) on intra-abdominal metabolism and intestinal mucosal blood flow to evaluate whether metabolites can serve as markers for organ dysfunction during IAH. A swine model was used, and the animals were anesthetized and ventilated. Fifteen animals were subjected to IAH of 30 mm Hg for 4 hr by carbon dioxide insufflation. Seven animals served as controls. Hemodynamic data, arterial blood samples, and urine output were analyzed. Intraluminal laser Doppler flowmetry measured intestinal mucosal blood flow. Glucose, glycerol, lactate, and pyruvate concentrations and lactate-to-pyruvate (l/p) ratio were measured intraperitoneally and intramurally in the small intestine and rectum using microdialysis. IAH lowered the abdominal perfusion pressure by 12-18 mm Hg, reduced the intestinal mucosal blood flow by 45-63%, and decreased urine output by 50-80%. In the intervention group, glycerol concentrations increased at all locations, pyruvate concentrations decreased, and the l/p ratio increased intraperitoneally and intramurally in the small intestine. Control animals remained metabolically stable. Glucose and lactate concentrations were only slightly affected or unchanged in both the groups. IAH reduces intestinal blood flow and urinary output and causes early metabolic changes, indicating a discrete shift toward anaerobic metabolism. Intraperitoneal microdialysis may be useful in the early detection of impaired organ dysfunction with metabolic consequences in IAH and abdominal compartment syndrome. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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 ...

  3. 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...

  4. 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

  5. [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).

  6. 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.

  7. 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.

  8. 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)

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

    Directory of Open Access Journals (Sweden)

    F. Taroni

    2012-12-01

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

  10. 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.

  11. Is intra-abdominal drainage necessary after pancreaticoduodenectomy?

    Science.gov (United States)

    Heslin, M J; Harrison, L E; Brooks, A D; Hochwald, S N; Coit, D G; Brennan, M F

    1998-01-01

    Closed suction drains after pancreaticoduodenectomy are theoretically used to drain potential collections and anastomotic leaks. It is unknown whether such drains are effective, harmful, or affect the outcome after this operation. Eighty-nine consecutive patients underwent pancreaticoduodenectomy for presumed periampullary malignancy and were retrospectively reviewed. Thirty-eight had no intra-abdominal drains and 51 had drains placed at the conclusion of the operation. We analyzed patient, nutritional, laboratory, and operating room factors with end points being complications and length of hospital stay. Intra-abdominal complications were defined as intra-abdominal abscess and pancreatic or biliary fistula. Postoperative interventions were defined as CT-guided drainage and reoperation. Analysis was by Student's t test and chi-square test. Two of eight surgeons contributed 92% of the patients without drains. The groups were equivalent with respect to demographic, nutritional, and operative factors. Time under anesthesia was significantly shorter in the group without drains (P = 0.0001). There was no statistical difference in the rate of fistula, abscess, CT drainage, or length of hospital stay. Intra-abdominal drainage did not significantly alter the risk of fistula, abscess, or reoperation or the necessity for CT-guided intervention after pancreaticoduodenectomy. Routine use of drains after pancreaticoduodenectomy may not be necessary and should be subjected to a randomized trial.

  12. Laparoscopic Fowler Stephens orchidopexy for intra-abdominal testis

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. A adiposidade corporal e a idade prejudicam a capacidade funcional para realizar as atividades da vida diária de mulheres acima de 47 anos Body adiposity and age impair the capacity to perform daily living activities of women older than 47 years

    Directory of Open Access Journals (Sweden)

    Vagner Raso

    2002-12-01

    Full Text Available Este estudo teve como objetivo verificar o efeito da idade, peso, altura, índice de massa corporal e adiposidade corporal na capacidade funcional de mulheres acima de 47 anos para realizar as atividades da vida diária. Para tanto, a amostra foi constituída por 129 mulheres na faixa etária de 47 a 77 anos de idade. A adiposidade total (Adp T foi considerada por meio do somatório das dobras cutâneas bíceps (BI, tríceps (TRI, subescapular (SB, axilar média (AM, supra-ilíaca (SI, abdominal (ABD, coxa anterior (CA e panturrilha medial (PM. A adiposidade central (Adp C representou o somatório de SB, AM, SI e ABD, e a adiposidade periférica (Adp P, o somatório de BI, TRI, CA e PM. A capacidade funcional para realizar as atividades da vida diária foi predita mediante os testes: velocidade para se levantar de uma posição sentada (VLPS e para se levantar de uma posição deitada (VLPD, velocidade para calçar e amarrar o tênis (VCAT e velocidade para subir escada (VSE. Foi calculado o quartil (Q para todas as variáveis independentes (idade, peso, altura, índice de massa corporal e adiposidade corporal [total, central e periférica]. A análise estatística utilizada foi a ANOVA one way e os coeficientes de correlação linear de Pearson e Spearman rank-order. As diferenças estatisticamente significativas ocorreram principalmente entre os quartis das extremidades (Q1 x Q4 para VLPS e VLPD (exceção para peso e IMC, enquanto para VSE foi entre Q2 x Q4 (idade. As variáveis independentes exerceram efeito nulo sobre VCAT. A magnitude de variação percentual ocorreu entre a amplitude de 14,1% (idade [VLPD: Q3 x Q4] e 36,1% (Adp T [VLPS: Q2 x Q4]. Em ordem, as variáveis independentes que exerceram maior repercussão negativa sobre a performance nos testes de capacidade funcional (VLPS, VLPD, VSE para realizar as atividades da vida diária foram Adp C, idade, Adp T, Adp P, IMC e peso.The purpose of this study was to verify the effect of

  1. 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.

  2. 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...

  3. 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.

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

    Science.gov (United States)

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

    2017-06-01

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

  5. Laparoscopic resection of intra-abdominal extralobar pulmonary sequestration.

    Science.gov (United States)

    van der Zee, David C; NMa Bax, Klaas

    2005-10-01

    The intra-abdominal localization of extralobar pulmonary sequestration (EPS) is an uncommon entity, although there are an increasing number of publications in literature on EPS over recent years. There seems to be a predominance of left-sided suprarenal positioning of the sequester and so far resection has been undertaken by way of laparotomy. This paper describes the laparoscopic resection of EPS in two patients. In both instances the procedure was successful and the postoperative course was uneventful. It is concluded that EPS should be included in the differential diagnosis of suprarenal masses, particularly on the left side. Laparoscopic resection is the method of choice for EPS.

  6. Toxicity from Intra-Abdominal Injection of Chlorfenapyr

    OpenAIRE

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

    2013-01-01

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

  7. 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

  8. 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...

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

    DEFF Research Database (Denmark)

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

    2000-01-01

    Intra-abdominal obesity is associated with cardiovascular disease and non-insulin-dependent diabetes mellitus, and physical training has been suggested to alleviate these conditions. We compared epinephrine-stimulated lipolysis in vivo in three intra-abdominal adipose tissues (ATs: retroperitoneal...

  10. 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.

  11. 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.

  12. 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.

  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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Fabiana Braga Benatti

    2007-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Javier Otero

    2016-01-01

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

  17. Toxicity from intra-abdominal injection of chlorfenapyr.

    Science.gov (United States)

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

    2013-01-01

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

  18. Toxicity from Intra-Abdominal Injection of Chlorfenapyr

    Directory of Open Access Journals (Sweden)

    Jina Lee

    2013-01-01

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

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

    LENUS (Irish Health Repository)

    Sugrue, Michael

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Homero Soares Fogaça

    2003-07-01

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

  1. 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.

  2. 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

  3. 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.

  4. 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...

  5. 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.

  6. 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.

  7. 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.

  8. 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)....

  9. 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.

  10. 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.

  11. 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%.

  12. 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.

  13. 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.

  14. [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.

  15. [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.

  16. 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.

  17. 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.

  18. 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.

  19. Jávea consensus guidelines for the treatment of Candida peritonitis and other intra-abdominal fungal infections in non-neutropenic critically ill adult patients.

    Science.gov (United States)

    Pemán, Javier; Aguilar, Gerardo; Valía, Juan Carlos; Salavert, Miguel; Navarro, David; Zaragoza, Rafael

    Although the management of the invasive candidiasis has improved in the last decade, controversial issues yet remain, especially in the diagnostic and therapeutic approaches to Candida peritonitis and other forms of intra-abdominal fungal infections. We sought to identify core clinical knowledge about intra-abdominal fungal infections and to achieve high-agreement recommendations required to care for critically ill adult patients with Candida peritonitis and other forms of intra-abdominal fungal infection. A biregional Spanish survey, to elucidate the consensus about the already mentioned fungal infections by means of the Delphi technique, was conducted anonymously by e-mail with 29 multidisciplinary experts in invasive fungal infections from 14 hospitals in the Valencia and Murcia communities during 2014. Respondents included intensivists, anesthesiologists, microbiologists, pharmacologists, and infectious disease specialists, who answered 31 questions prepared by a coordination group after a strict review of the literature from the 5 previous years. The educational objectives spanned 6 categories: epidemiology, microbiological diagnosis, clinical diagnosis, antifungal treatment, de-escalation therapy, and special situations. The agreement required among the panelists for each item to be selected had to be higher than 70%. After extracting the recommendations from the selected items, a meeting at which the experts were asked to validate the previously selected recommendations in a second round of scoring took place. After the second round, 36 recommendations were validated according to the following distribution: epidemiology (5), microbiological diagnosis (4), clinical diagnosis (4), antifungal treatment (3), de-escalation therapy (4), and special situations (16). Treatment of Candida peritonitis and other forms of intra-abdominal fungal infections in ICU patients requires a broad range of knowledge application and skills that our recommendations address. Based

  20. 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.

  1. Comparação entre a adiposidade subcutânea dos hemicorpos direito e esquerdo Comparison between the subcutaneous adiposity of the right and left sides

    Directory of Open Access Journals (Sweden)

    Edilson Serpeloni Cyrino

    2009-12-01

    Full Text Available O objetivo deste estudo foi comparar os níveis de adiposidade subcutânea dos hemicorpos direito e esquerdo e, posteriormente, analisar o impacto dessas informações para o estudo da composição corporal. Setenta e seis indivíduos fisicamente ativos, 47 homens (21,6 ± 4,3 anos e 29 mulheres (21,0 ± 2,6 anos, fizeram parte da amostra. As espessuras das dobras cutâneas abdominal, suprailíaca, subescapular, tricipital, bicipital, axilar média e perna medial foram mensuradas com um compasso Lange. Em valores médios absolutos, as maiores diferenças verificadas foram de 0,9mm (6,9% e 0,8mm (6,8%, na dobra cutânea suprailíaca de homens e mulheres, respectivamente. Entretanto, nenhuma diferença estatisticamente significante foi encontrada na comparação entre os lados, em ambos os sexos, nas sete dobras cutâneas analisadas (P > 0,05. Similarmente, quando os valores medidos foram aplicados em equações preditivas para a determinação da gordura corporal relativa, de acordo com o sexo, nenhuma diferença significante foi encontrada (P > 0,05. Os resultados sugerem que fatores como o erro técnico de medida do avaliador, o tipo de compasso e a escolha da equação preditiva a ser utilizada, provavelmente tenham maior impacto para a estimativa da composição corporal pelo método de espessura de dobras cutâneas do que o lado a ser adotado como referência para a obtenção das medidas.The aim of this study was to compare subcutaneous adiposity levels of right and left sides and posteriorly to analyze the impact of this information to the body composition study. Seventy-six physically active individuals, 47 men (21.6 ± 4.3 years and 29 women (21.0 ± 2.6 years, comprised the sample. Abdominal, suprailiac, subscapular, triceps, biceps, midaxillary and mid calf skinfolds were measured using the Lange caliper. In terms of mean absolute values, the largest differences found were 0.9 mm (6.9% and 0.8 mm (6.8% for the suprailiac skinfold in

  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. 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...

  4. 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

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

    NARCIS (Netherlands)

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

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

  6. 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

  7. 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

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

    DEFF Research Database (Denmark)

    Bak, Martin

    1996-01-01

    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...

  9. Fibrin sealant prevents gastrointestinal anastomosis dehiscence in intra-abdominal sepsis.

    Science.gov (United States)

    Wang, Xinbo; Ren, Jianan; Zhu, Weiming; Li, Ning; Li, Jieshou

    2007-01-01

    We observed the potential use of fibrin sealant as a therapeutic modality for successful resolution of gastrointestinal anastomosis dehiscence in intra-abdominal sepsis. Forty-eight patients (33 men and 15 women) suffering from intra-abdominal sepsis were subjected to prophylactic appliance of fibrin sealant during immediate primary anastomosis during the laparotomy. The perioperative management invariably involved fluid resuscitation, active suction drainage of the abdominal liquor puris, nutritional supplementation, and growth hormone. The total surgical-related success ratio was 91.7% (44/48) for primary anastomosis with fibrin sealant in intra-abdominal sepsis. Anastomotic leakage occurred in the other four patients, two of which died because of leakage complications in our hospital. The hospital stay after the operation was 30.2 +/- 12.0 days. There has been no sign of recurrence over a follow-up period of 1-15 months. It is concluded that fibrin sealant may be useful in preventing gastrointestinal anastomosis dehiscence in intra-abdominal sepsis.

  10. 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...

  11. The Onset of Intra-Abdominal Adhesions During Closed-Abdomen Hyperthermic Intraperitoneal Chemotherapy.

    Science.gov (United States)

    Lotti, Marco; Giulii Capponi, Michela; Campanati, Luca; Poiasina, Elia; Ansaloni, Luca; Poletti, Eugenio; Frigerio, Luigi

    2016-12-01

    Hyperthermic intraperitoneal chemotherapy (HIPEC) is delivered after cytoreductive surgery (CRS) in selected patients with peritoneal carcinomatosis. The closed-abdomen technique, preferred by many centers, prevents heat loss and drug spillage, but does not warrant homogeneous distribution of the perfusion fluid (PF). The hypothesized formation of intra-abdominal adhesions during the closed-abdomen perfusion period has never been described. From March 2014 to April 2016, 10 consecutive patients with peritoneal carcinomatosis, selected for CRS, underwent the Laparoscopy-Enhanced HIPEC technique to explore the abdominal cavity during the perfusion. The aim of the study was to investigate the incidence and the extent of intra-abdominal adhesions that are formed after CRS during the perfusion period of closed-abdomen HIPEC. During the perfusion, adhesions developed in 70% of the patients. Adhesions developed mainly in the period between the closure of the abdomen and the subsequent filling of the abdomen with the PF. After their first division, during the following perfusion period, adhesions between the bowel and the abdominal wall reformed in 3 patients (30%). Intra-abdominal adhesions are frequently formed during closed-abdomen HIPEC and can hamper the adequate circulation of the PF. The Laparoscopy-Enhanced technique enables the early detection and the division of any intra-abdominal adhesions.

  12. 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

  13. 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...

  14. 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

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

    Science.gov (United States)

    2014-01-01

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

  16. 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.

  17. 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.)

  18. 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

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

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    Guangbing Wei

    2016-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Diego G. D Christofaro

    2011-06-01

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

  1. Evaluation of gastric pressures as an indirect method for measurement of intraabdominal pressures in the horse.

    Science.gov (United States)

    Munsterman, Amelia S; Hanson, Russell Reid

    2011-02-01

    To develop an indirect method for measurement of intraabdominal pressures in the standing horse using measurement of gastric pressures as a less invasive technique, and to compare this method with direct intraabdominal pressures obtained from the peritoneal cavity. Prospective, experimental study. University-based equine research facility. Ten healthy adult horses, 7 geldings and 3 mares. Gastric pressures were measured using a nasogastric tube with a U-tube manometry technique, while intraperitoneal pressures were measured with a peritoneal cannula. Measurements of intraabdominal pressure were obtained by both methods, simultaneously, and were evaluated using 5 increasing volumes of fluid infused into the stomach (0, 400, 1,000, 2,000, and 3,000 mL). Bias and agreement between the 2 methods were determined using Bland-Altman analysis and Lin's concordance correlation coefficients. Mean gastric pressure was 14.44 ± 4.69 cm H(2)O and ranged from 0 to 25.8 cm H(2)O. Intraperitoneal pressure measurements were generally subatmospheric, and ranged from -6.6 to 3.1 cm H(2) O (mean ± SD, -1.59 ± 2.09 cm H(2)O). Measurements of intraperitoneal pressures were repeatable; however, intra- and interindividual variance was significantly larger for measurements of gastric pressures. The mean and relative bias for comparison between the 2 techniques was 15.9 ± 5.3 cm H(2)O and 244.3 ± 199.2%, respectively. The Lin's concordance correlation coefficient between gastric and intraperitoneal pressures was -0.003 but this was not statistically significant (P=0.75). There was no statistical concordance between measurements of intraabdominal pressure using gastric and intraperitoneal pressure measurement, indicating that gastric pressures cannot be substituted for intraperitoneal pressure measurement. Direct measurement of intraperitoneal pressures may be a more consistent method for comparison of intraabdominal pressures between horses, due to less variability within and between

  2. 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.

  3. 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.

  4. 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.

  5. Clinical Analysis for the Correlation of Intra-abdominal Organ Injury in the Patients with Rib Fracture

    Science.gov (United States)

    2012-01-01

    Background Although it is rare for the fracture itself to become a life threatening injury in patients suffering from rib fracture, the lives of these patients are occasionally threatened by other associated injuries. Especially, early discovery of patients with rib fracture and intra-abdominal organ injury is extremely important to the prognosis. This study analyzed the link between rib fracture and intra-abdominal injury to achieve improved treatment. Materials and Methods Among trauma patients that had visited the hospital emergency room from January 2007 to December 2009, a retrospective study was conducted on 453 patients suffering from rib fracture due to blunt trauma. Rib fracture was classified according to location (left, right, and bilateral), and according to level (upper rib fracture [1-2nd rib], middle rib fracture [3-8th rib], and lower rib fracture [9-12th rib]). The researched data was statistically compared and analyzed to investigate the correlation between the location, level, and number of rib fracture and intra-abdominal organ injury. Results Motor vehicle injury was found to be the most common mechanism of injury with 208 cases (46%). Associated injuries accompanied with rib fracture were generated in 276 cases (61%). Intra-abdominal organ injury was discovered in 97 cases (21%). Liver injury was the most common intra-abdominal injury associated with rib fracture with 39 cases (40%), followed by spleen injury, with 23 cases (23%). Intra-abdominal injury according to level of rib fracture was presented as upper rib fracture in 11 cases (11%), middle rib fracture in 31 cases (32%), and lower rib fracture in 55 cases (57%), thus verifying that intra-abdominal injuries were commonly accompanied in lower rib fractures (p=0.03). In particular, significant increase of intra-abdominal injury was presented in fractures below the 8th rib (p=0.03). The number of intra-abdominal injuries requiring emergency operations was significantly higher in patients

  6. MRI findings of bilateral juvenile granulosa cell tumor of the testis in a newborn presenting as intraabdominal masses

    Energy Technology Data Exchange (ETDEWEB)

    Yikilmaz, Ali [Erciyes Medical School, Department of Radiology, Gevher Nesibe Hospital, Kayseri (Turkey); Lee, Edward Y. [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2007-10-15

    Juvenile granulosa cell tumor (JGCT) of the testis is a rare benign tumor that typically presents as a relatively small (<2 cm) unilateral scrotal mass in neonates or infants. Bilateral JGCT of the testes presenting as large intraabdominal masses in the neonate is very rare. Utilizing preoperative MRI findings, we report a rare case of bilateral JGCT of the testes presenting as large multiseptated abdominal masses originating from undescended intraabdominal testes in a neonate. (orig.)

  7. Laparoscopic resection of prenatally detected intra-abdominal testicular teratoma: Report of a neonatal case

    Directory of Open Access Journals (Sweden)

    Keigo Yada

    2017-08-01

    Full Text Available Prenatal detection of intra-abdominal testicular tumor is rare. In this paper, we discuss the early laparoscopic resection of prenatally detected testicular tumor of a neonate. At 33 weeks gestation, follow-up ultrasound showed the mass measuring 3 × 2 cm, on the fetal right lower quadrant. After full-term birth, we performed laparoscopic resection of the tumor, on day 14 of life. Histology of 4-cm right testicular tumor revealed immature teratoma. Postoperative course was favorable and no recurrence has occurred 3 years after operation. Prenatal diagnosis of the intra-abdominal testicular teratoma enabled the early tumor resection, and laparoscopic resection of the tumor is safe and feasible, even in a neonate.

  8. 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.

  9. INTRAABDOMINAL DESMOPLASTIC SMALL ROUND CELL TUMOR: CASE REPORT WITH LITERATURE REVIEW

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    Joseph Kreiker

    2015-04-01

    Full Text Available Intra-abdominal desmoplastic small round cell tumors are rare aggressive neoplasms, with a very poor prognosis, observed in young adults with a male predominance. Their etiology is unknown and the diagnosis is based on histopathology, immunohistochemistry and cytogenetics. Histological analysis shows typically clusters of round cells separated by abundant desmoplastic stroma. These tumors exhibit a multi-marker immunohistochemistry profile expressing the three embryonic lineages: epithelial, neural and mesenchymal. They are positive for desmin and cytokeratin and are characterized by a specific recurring translocation t (11: 22 (q12 - p13, which involves EWSR1 WT1 gene. They are usually fatal despite an aggressive multidisciplinary therapeutic approach. Hereby we report the case of a 39 year old man who presented with an intra-abdominal desmoplastic small round cell tumor. The diagnosis was made by radiological, histological and immunohistochemistry profile analyses of a CT scanguided biopsy. This article also includes a mini review of the literature.

  10. 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.

  11. 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.

  12. 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.

  13. Intra-abdominal infantile inflammatory myofibroblastic tumors: A report of three cases

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    Mala Banerjee

    2014-01-01

    Full Text Available Inflammatory myofibroblastic tumor occurring at intra-abdominal sites in children can be confused with malignancy because of its large size and location. It is a tumor classified as ′intermediate′ between benign and malignant, but usually benign, with a strong tendency for recurrence. Treatment is surgical excision. Here, we present a brief outline of three such cases presenting as abdominal mass in infants.

  14. Intra-abdominal desmoplastic small round-cell tumour: multiphase CT findings in two children

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hyoung; Goo, Hyun Woo; Yoon, Chong Hyun [Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-2 dong, Songpa-gu, Seoul, 138-736 (Korea)

    2003-06-01

    We report the multiphase CT findings of intra-abdominal desmoplastic small round-cell tumour (DSRCT) in two children. CT showed a huge heterogeneous intraperitoneal mass with or without direct invasion into solid organs such as liver or kidney, extensive intraperitoneal seeding, intratumoural calcification, ascites, and lymphadenopathy. DSRCT should be included in the differential diagnosis of malignant intraperitoneal neoplasm in children. Multiphase CT may be helpful in delineating tumour extent, vascularity and direct invasion into adjacent organs. (orig.)

  15. Altered polymorphonuclear leukocyte Fc gamma R expression contributes to decreased candicidal activity during intraabdominal sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Simms, H.H.; D' Amico, R.; Monfils, P.; Burchard, K.W. (Rhode Island Hospital, Providence (USA))

    1991-03-01

    We investigated the effects of untreated intraabdominal sepsis on polymorphonuclear leukocyte (PMN) candicidal activity. Two groups of swine were studied. Group I (n=6) underwent sham laparotomy, group II (n=7) underwent cecal ligation and incision. Untreated intraabdominal sepsis resulted in a progressive decrease in PMN candicidal activity. Concomitant rosetting and phagocytosis assays demonstrated a decrease in both the attachment and phagocytosis of Candida albicans opsonized with both normal and septic swine serum by PMNs in group II. Iodine 125-labeled swine immunoglobulin G (IgG) and fluorescein isothioalanate (FITC)-labeled swine IgG were used to investigate Fc gamma receptor ligand interactions. Scatchard analyses demonstrated a progressive decline in both the binding affinity constant and number of IgG molecules bound per PMN. Stimulation of the oxidative burst markedly reduced 125I-labeled IgG binding in both group I and group II, with a greater decrement being seen in animals with intraabdominal sepsis. Further, in group II, PMN recycling of the Fc gamma receptor to the cell surface after generation of the oxidative burst was reduced by postoperative day 4. Binding of monoclonal antibodies to Fc gamma receptor II, but not Fc gamma receptor I/III markedly reduced intracellular candicidal activity. Immunofluorescence studies revealed a homogeneous pattern of FITC-IgG uptake by nearly all group I PMNs, whereas by postoperative day 8 a substantial number of PMNs from group II failed to internalize the FITC-IgG. These studies suggest that untreated intraabdominal sepsis reduces PMN candicidal activity and that this is due, in part, to altered PMN Fc gamma receptor ligand interactions.

  16. 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.

  17. 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

    Directory of Open Access Journals (Sweden)

    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

  18. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  20. A Torted Ruptured Intra-abdominal Testicular Seminoma Presenting As An Acute Abdomen.

    Science.gov (United States)

    Nickalls, Oliver James; Tan, Char Loo; Thian, Yee Liang

    2015-12-01

    The susceptibility of the undescended testis to malignant transformation is well documented. The most common location of the undescended testis is within the inguinal canal, with only a minority located within the abdominal cavity. When a testicular mass develops, the risk of torsion increases. We describe a large intra-abdominal testicular seminoma that had undergone torsion, rupture and haemorrhage, presenting as an acute abdomen. A 30 year old man presented to the emergency department with right iliac fossa pain. Computed tomography in the emergency department showed haemoperitoneum and a torted large left testicular mass, likely malignant. The patient underwent laparotomy and excision of the mass. Histologic examination revealed a grossly enlarged seminomatous testis which had torted and ruptured. While pre-operative imaging diagnosis of an intra-abdominal testicular seminoma has been published, reports are few. To the best of the author's knowledge pre-operative imaging diagnosis of a malignant testicular mass with torsion and intra-abdominal haemorrhage presenting as an acute abdomen has not been described before.

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

    Science.gov (United States)

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

    2015-01-01

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

  2. A Torted Ruptured Intra-abdominal Testicular Seminoma Presenting As An Acute Abdomen

    Science.gov (United States)

    Nickalls, Oliver James; Tan, Char Loo; Thian, Yee Liang

    2015-01-01

    The susceptibility of the undescended testis to malignant transformation is well documented. The most common location of the undescended testis is within the inguinal canal, with only a minority located within the abdominal cavity. When a testicular mass develops, the risk of torsion increases. We describe a large intra-abdominal testicular seminoma that had undergone torsion, rupture and haemorrhage, presenting as an acute abdomen. A 30 year old man presented to the emergency department with right iliac fossa pain. Computed tomography in the emergency department showed haemoperitoneum and a torted large left testicular mass, likely malignant. The patient underwent laparotomy and excision of the mass. Histologic examination revealed a grossly enlarged seminomatous testis which had torted and ruptured. While pre-operative imaging diagnosis of an intra-abdominal testicular seminoma has been published, reports are few. To the best of the author’s knowledge pre-operative imaging diagnosis of a malignant testicular mass with torsion and intra-abdominal haemorrhage presenting as an acute abdomen has not been described before. PMID:27200173

  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. Continuous ambulatory peritoneal dialysis after intra-abdominally placed synthetic mesh for ventral hernia repair.

    Science.gov (United States)

    Schoenmaeckers, Ernst J P; Woittiez, Arend-Jan; Raymakers, Johan F T J; Rakic, S

    2011-10-01

    We present a unique experience with a patient who had undergone continuous ambulatory peritoneal dialysis (CAPD) after laparoscopic repair of ventral incisional hernia (LRVIH) with an expanded polytetrafluoroethylene (e-PTFE) mesh (DualMesh(®); WL Gore) and who later suffered from multiple episodes of CAPD-related peritonitis without any signs of mesh infection. A 48-year-old man with an open abdominal aortic reconstruction in 1994 for occlusive arterial disease presented with an incisional ventral hernia. He underwent LRVIH using an e-PTFE mesh of 30×20 cm. Postoperatively, he developed renal failure. For various reasons, the only therapeutic option was CAPD. A CAPD-catheter was implanted via laparoscopy, taking care not to compromise the mesh that was completely covered with neoperitoneum. After 3 months of uneventful CAPD, he developed a bacterial peritonitis. Antibiotic treatment failed and the CAPD-catheter was removed. The mesh was left in place and the patient recovered. Later on another CAPD-catheter was implanted via laparoscopy and used for 10 months. Again he developed peritonitis from which he recovered after catheter removal. Mesh was left in place and remained uninfected, probably protected from intra-abdominal bacteria by the neoperitoneum. The risk of secondary infection of an intra-abdominal mesh seems to diminish largely after neoperitonealization of the mesh. CAPD seems possible in a patient with an intra-abdominal mesh when it is covered with neoperitoneum.

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

    Directory of Open Access Journals (Sweden)

    Herzog T

    2010-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Sartelli Massimo

    2012-11-01

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

  7. 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

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

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    José Gustavo Parreira

    Full Text Available Objective: to assess predictors of intra-abdominal injuries in blunt trauma patients admitted without abdominal pain or abnormalities on the abdomen physical examination. Methods: We conducted a retrospective analysis of trauma registry data, including adult blunt trauma patients admitted from 2008 to 2010 who sustained no abdominal pain or abnormalities on physical examination of the abdomen at admission and were submitted to computed tomography of the abdomen and/or exploratory laparotomy. Patients were assigned into: Group 1 (with intra-abdominal injuries or Group 2 (without intra-abdominal injuries. Variables were compared between groups to identify those significantly associated with the presence of intra-abdominal injuries, adopting p<0.05 as significant. Subsequently, the variables with p<0.20 on bivariate analysis were selected to create a logistic regression model using the forward stepwise method. Results: A total of 268 cases met the inclusion criteria. Patients in Group I were characterized as having significantly (p<0.05 lower mean AIS score for the head segment (1.0±1.4 vs. 1.8±1.9, as well as higher mean AIS thorax score (1.6±1.7 vs. 0.9±1.5 and ISS (25.7±14.5 vs. 17,1±13,1. The rate of abdominal injuries was significantly higher in run-over pedestrians (37.3% and in motorcyclists (36.0% (p<0.001. The resultant logistic regression model provided 73.5% accuracy for identifying abdominal injuries. The variables included were: motorcyclist accident as trauma mechanism (p<0.001 - OR 5.51; 95%CI 2.40-12.64, presence of rib fractures (p<0.003 - OR 3.00; 95%CI 1.47-6.14, run-over pedestrian as trauma mechanism (p=0.008 - OR 2.85; 95%CI 1.13-6.22 and abnormal neurological physical exam at admission (p=0.015 - OR 0.44; 95%CI 0.22-0.85. Conclusion Intra-abdominal injuries were predominantly associated with trauma mechanism and presence of chest injuries.

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

    Science.gov (United States)

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

    2016-01-01

    Up to 93% of patients undergoing abdominal surgery will develop intra-abdominal adhesions with the subsequent morbidity that they represent. Various substances have been tested for the prevention of adhesions with controversial results; the aim of our study is to compare the capability of pirfenidone in adhesion prevention against sodium hyaluronate/carboxymethylcellulose. A randomized, prospective, longitudinal experimental study with Winstar rats. They were divided into 3 groups. The subjects underwent an exploratory laparotomy and they had a 4cm(2) cecal abrasion. The first group received saline on the cecal abrasion, and groups 2 and 3 received pirfenidone and sodium hyaluronate/carboxymethylcellulose respectively. All rats were sacrificed on the 21st day after surgery and the presence of adhesions was evaluated with the modified Granat scale. Simple frequency, central tendency and dispersion measures were recorded. For the statistical analysis we used Fisher's test. To evaluate adhesions we used the Granat's modified scale. The control group had a median adhesion formation of 3 (range 0-4). The pirfenidone group had 1.5 (range 0-3), and the sodium hyaluronate/carboxymethylcellulose group had 0 (range 0-1). There was a statistically significant difference to favor sodium hyaluronate/carboxymethylcellulose against saline and pirfenidone (P<0.009 and P<.022 respectively). The use of sodium hyaluronate/carboxymethylcellulose is effective for the prevention of intra-abdominal adhesions. More experimental studies are needed in search for the optimal adhesion prevention drug. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Concepción Blasco Cabañas

    2012-06-01

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

  11. 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.

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

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    Wei G

    2015-06-01

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

  13. 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

  14. 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

  15. 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

  16. 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.

  17. [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.

  18. 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.

  19. [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.

  20. Low Transmission of Airway Pressures to the Abdomen in Mechanically Ventilated Patients With or Without Acute Respiratory Failure and Intra-Abdominal Hypertension.

    Science.gov (United States)

    Heijnen, Bram G A D H; Spoelstra-de Man, Angelique M E; Groeneveld, A B Johan

    2017-03-01

    Intra-abdominal pressure, measured at end expiration, may depend on ventilator settings and transmission of intrathoracic pressure. We determined the transmission of positive intrathoracic pressure during mechanical ventilation at inspiration and expiration into the abdominal compartment. We included 9 patients after uncomplicated cardiac surgery and 9 with acute respiratory failure. Intravesical pressures were measured thrice (reproducibility of 1.8%) and averaged, at the end of each inspiratory and expiratory hold maneuvers of 5 seconds. Transmission, the change in intra-abdominal over intrathoracic pressures from end inspiration to end expiration, was about 8%. End-expiratory intra-abdominal pressure was lower than "total" intra-abdominal pressure over the entire respiratory cycle by 0.34 cm H2O. It was 0.73 cm H2O higher than "true" intra-abdominal pressure over the entire respiratory cycle, taking transmission into account. The percentage error was 3% for total and 10% for true pressure. Results did not differ among patients with or without acute respiratory failure and decreased respiratory compliance or between those with (≥12 mm Hg, n = 5) or without intra-abdominal hypertension. Transmitted airway pressure only slightly affects intra-abdominal pressure in mechanically ventilated patients, irrespective of respiratory compliance and baseline intra-abdominal pressure values. End-expiratory measurements referenced against atmospheric pressure may suffice for clinical practice.

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

    Directory of Open Access Journals (Sweden)

    Gabriela Dalsasso Ricardo

    2009-09-01

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

  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...... viability of the intra-abdominal testis. However, it is uncertain whether the more sensitive germ cells survive this procedure in addition to the Sertoli and interstitial cells of the human testis. Survival of germ cells is a prerequisite of later fertility potential....

  3. 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.

  4. Biochemical analysis of cystic fluid in the diagnosis of fetal intra-abdominal masses.

    Science.gov (United States)

    Lecarpentier, Edouard; Dreux, Sophie; Blanc, Thomas; Schaub, Bruno; Ville, Yves; Mandelbrot, Laurent; El Ghoneimi, Alaa; Oury, Jean-François; Muller, Françoise

    2012-07-01

    The aim of the study was to evaluate a biochemical analysis of fluid sampled in utero from fetal abdominal cystic masses. A retrospective study of 42 intra-abdominal cystic masses [ovarian cysts (n = 22), cloaca (n = 8), urodigestive fistulae (n = 4), and urogenital sinuses (n = 8)] was carried out. The control group (n = 30) consisted of fetal urine. Seven biochemical markers were assayed: sodium, estradiol, β(2) -microglobulin, total proteins and digestive enzymes, gamma-glutamyl transpeptidase, aminopeptidase M, and intestinal alkaline phosphatase isoenzyme. Outcome of pregnancies and final diagnosis of intra-abdominal mass were known in all cases. Biochemical patterns allowed to demonstrate (1) an ovarian origin based on elevated level of estradiol and of total proteins (100% specificity, 100% sensitivity); (2) urodigestive fistula based on the presence of high levels of digestive enzymes (cloaca in female fetuses or recto-urethral fistula in male fetuses); and (3) a renal origin (urinary pattern with low total proteins and absence of digestive enzymes); however, a biochemical pattern could not differentiate between fetal urogenital sinus and megacystis. Etiological diagnosis of a fetal cystic abdominal mass could impact both prenatal and postnatal management providing adapted prenatal counseling by a pediatric surgeon in surgically correctable congenital anomalies. © 2012 John Wiley & Sons, Ltd.

  5. A rare cause of intraabdominal tumors: An analysis of 21 patients with mesenteric cyst

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    Akın Önder

    2011-12-01

    Full Text Available Objectives: Mesenteric cysts are rare intraabdominal tumors. In this study, we aimed to investigate the clinical findings, pathological features and surgical approaches of mesenteric cysts.Materials and methods: Between January 1985 - December 2010 at Dicle University Medical Faculty General Surgery and Pediatric Surgery Department, 21 patients with mesenteric cyst were retrospectively analyzed.Results: Sixteen patients (76.2% were women and 5 (23.8% were men, with a mean age of 32.62 ± 22:19 (4-79 years. The most common symptoms were abdominal mass and pain. Mesenteric cysts were often located on the small bowel mesentery (61.9%. Cyst sizes ranged from 4-25 cm in diameters. The most common performed surgical procedures in patients were enucleation (90.5%. The histopathological diagnosis was confirmed as cystic lymphangioma in 17 (80.9% patients. The mean length of hospitals stay was 5.29 ± 2.28 (2-11 days. Postoperative morbidity rate was 33.3% and the most common complication was wound infection. There was no postoperative mortality.Conclusion: When physical examination revealed a palpable mass with regular margins and intraabdominal cystic mass is detected with imaging techniques, mesenteric cyst should be considered in differential diagnosis in patients presenting with abdominal pain. J Clin Exp Invest 2011; 2 (4: 380-383Key words: Mesenteric cyst, abdominal pain, palpabl mass, surgery

  6. 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.

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

    Science.gov (United States)

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

    2016-03-01

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

  8. Effect of Emodin on Preventing Postoperative Intra-Abdominal Adhesion Formation

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    Guangbing Wei

    2017-01-01

    Full Text Available Background. Postoperative intra-abdominal adhesions are a major complication after abdominal surgery. Although various methods have been used to prevent and treat adhesions, the effects have not been satisfactory. Emodin, a naturally occurring anthraquinone derivative and an active ingredient in traditional Chinese herbs, exhibits a variety of pharmacological effects. In our study, we demonstrated the effect of emodin treatment on preventing postoperative adhesion formation. Materials and Methods. A total of 48 rats were divided into six groups. Abdominal adhesions were created by abrasion of the cecum and its opposite abdominal wall. In the experimental groups, the rats were administered daily oral doses of emodin. On the seventh day after operation, the rats were euthanized, and blood and pathological specimens were collected. Abdominal adhesion formation was evaluated by necropsy, pathology, immunohistochemistry, Western blot, and enzyme-linked immunosorbent assay analyses. Results. Abdominal adhesions were markedly reduced by emodin treatment. Compared with the control group, collagen deposition was reduced and the peritoneal mesothelial completeness rate was higher in the emodin-treated groups. Emodin had anti-inflammatory effects, reduced oxidative stress, and promoted the movement of the intestinal tract (P<0.05. Conclusion. Emodin significantly reduced intra-abdominal adhesion formation in a rat model.

  9. 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.

  10. 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.

  11. Unexpected multiple intra-abdominal injuries after projectile fragmentation: report of three cases.

    Science.gov (United States)

    Unlü, Aytekin; Petrone, Patrizio; Karşıdağ, Tamer; Asensio, Juan A

    2012-11-01

    Explosives create and energize particles that act as projectiles prone to further fragmentation or create other secondary missiles in the body. These fragments may result in secondary injuries. This has been repeatedly described in the orthopedic and neurosurgical literature. We report the same process for abdominal injuries after fascial penetration in the military setting. This is an observational case series study. Local wound exploration as a standard approach was performed in conscious patients who sustained abdominal wall injuries. Patients with negative physical examination were excluded from the study. An intraperitoneal injury was assumed in those with a full-thickness fascial defect, and laparotomy was performed. Twenty patients met the study eligibility criteria. Of those 20 patients, 12 had negative wound exploration and were excluded from the study, while abdominal organ injuries were found in eight (40%) patients. During laparotomy, projectile-induced injuries in a sprayed distribution were found in three (38%) of these patients. These injuries were far from the predictable trajectory and in the absence of bone fragmentation. The overall mean number of peritoneal defects was 1.7, and a mean 6.8 intra-abdominal injuries for each peritoneal defect were found when through-and-through injuries were excluded.Despite a single peritoneal defect, there may be multiple intraperitoneal injuries due to further fragmentation of the projectile. Under mass casualties, wound exploration with a full-thickness fascial defect could serve as an indicator of possible intra-abdominal injuries, and consequently indicate exploratory laparotomy.

  12. Effect of intra-abdominal hypertension on left ventricular relaxation: a preliminary animal study.

    Science.gov (United States)

    Mahjoub, Y; Lorne, E; Maizel, J; Plantefève, G; Massy, Z A; Dupont, H; Slama, M

    2012-02-01

    In the intensive care unit, intra-abdominal hypertension (IAH) is a frequently encountered, life-threatening condition. The aim of this animal study was to evaluate the effect of IAH on left ventricular (LV) relaxation (i.e. the active phase of diastole). Seven male rabbits were anaesthetized before mechanical ventilation. A 20 mm Hg increase in intra-abdominal pressure (IAP) was then induced by intraperitoneal infusion of 1.5% glycine solution. Haemodynamic parameters were recorded and the relaxation time constant tau (considered to be the best index of left ventricle relaxation) was calculated. All haemodynamic measurements were recorded at baseline and then after induction of IAH. A 20 mm Hg increase in IAP was not followed by a significant change in arterial pressure, but was associated with increases in central venous pressure (from 2 [-2 to 6] to 7 [-2 to 12] mm Hg, P= 0.03), LV end-diastolic pressure (from 7 [6-8] to 15 [11-19] mm Hg, P= 0.04) and the relaxation time constant tau (from 16 [14-18] to 43 [34-52] ms, P= 0.048). In this animal study, a 20 mm Hg increase in IAP impaired LV relaxation. Further studies are necessary to identify the causes of this impairment.

  13. Prevention of Intraabdominal Adhesions: An Experimental Study Using Mitomycin-C and 4% Icodextrin.

    Science.gov (United States)

    Urkan, Murat; Özerhan, İsmail Hakkı; Ünlü, Aytekin; Can, Mehmet Fatih; Öztürk, Erkan; Günal, Armağan; Yağcı, Gökhan

    2017-01-01

    Intraabdominal adhesions remain a significant cause of morbidity and mortality. Moreover, intraabdominal adhesions can develop in more than 50% of abdominal operations. We compared the anti-adhesive effects of two different agents on postoperative adhesion formation in a cecal abrasion model. Experimental animal study. Forty Wistar albino type female rats were anesthetized and underwent laparotomy. Study groups comprised Sham, Control, Mitomycin-C, 4% Icodextrin, and Mitomycin-C +4% Icodextrin groups. Macroscopic and histopathological evaluations of adhesions were performed. The frequencies of moderate and severe adhesions were significantly higher in the control group than the other groups. The mitomycin-C and Mitomycin-C +4% Icodextrin groups were associated with significantly lower adhesion scores compared to the control group and 4% Icodextrin group scores (p=0.002 and p=0.008, respectively). The adhesion scores of the Mitomycin-C group were also significantly lower than those of the 4% Icodextrin group (p=0.008). Despite its potential for bone marrow toxicity, Mitomycin-C seems to effectively prevent adhesions. Further studies that prove an acceptable safety profile relating to this promising anti-adhesive agent are required before moving into clinical trials.

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

    Directory of Open Access Journals (Sweden)

    Khan Shehtaj

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Asok Kurup

    2014-09-01

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

  16. 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

  17. 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

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

    DEFF Research Database (Denmark)

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

    1999-01-01

    studied 17 nonpalpable testes in 10 patients 1 year and 7 months to 13(1/2) years old. Results of testicular biopsies of 13 intra-abdominal testes taken at stages 1 and 2 of surgery were available for histological comparison. RESULTS: Median number of spermatogonia per tubular cross section...

  19. 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

  20. 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

  1. 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

  2. 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

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

    NARCIS (Netherlands)

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

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

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

    NARCIS (Netherlands)

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

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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

  6. Postoperative antibiotic use and the incidence of intra-abdominal abscess in the setting of suppurative appendicitis: a retrospective analysis.

    Science.gov (United States)

    Bae, Esther; Dehal, Ahmed; Franz, Vanessa; Joannides, Michael; Sakis, Nicholas; Scurlock, Joshua; Nguyen, Patrick; Hussain, Farabi

    2016-12-01

    Although guidelines exist for postoperative antibiotic use in acute appendicitis that is perforated, gangrenous, or simple/uncomplicated, there are less data about its use in suppurative appendicitis. Here, we targeted this subgroup of patients to determine whether postoperative antibiotic administration affects incidence of intra-abdominal abscess formation. We retrospectively examined 1,192 patients who underwent laparoscopic appendectomy for acute appendicitis at Kaiser Permanente Fontana Hospital between August 2010 and August 2013. Suppurative appendicitis was described for 143 (12%) patients. Fifty-two patients received postoperative antibiotics for at least 1 week on discharge home, 91 did not. Of 143 patients with suppurative appendicitis, 1 (1.9%) who received postoperative antibiotics came back with an intra-abdominal abscess within 1 month. Of the 91 patients in the no antibiotic group, 1 (1.1%) came back with an intra-abdominal abscess. The administration of postoperative antibiotic in the setting of suppurative appendicitis has no effect on the rate of intra-abdominal abscess formation. Routine postoperative antibiotics may not be necessary in this patient population, and more evidence is needed to justify its use. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. 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

  8. Intra-abdominal spilled gallstones simulating peritoneal metastasis: CT and MR imaging features (2008: 1b)

    Energy Technology Data Exchange (ETDEWEB)

    Karabulut, Nevzat; Tavasli, Birnur; Kiroglu, Yilmaz [Pamukkale University Medical Center, Department of Radiology, Kinikli, Denizli (Turkey)

    2008-04-15

    Laparoscopic cholecystectomy has rapidly become the preferred treatment for symptomatic cholecystolithiasis. However, the procedure is associated with a number of complications, one of which is the spillage of gallstones into the peritoneal cavity. Unretrieved gallstones may cause a wide variety of complications such as abscess, adhesion and small-bowel obstruction, or they may remain asymptomatic and harmless. In the latter case, spilled gallstones in the peritoneal spaces may cause diagnostic difficulty or mimic peritoneal metastasis. We present the computed tomography (CT) and magnetic resonance (MR) imaging features of intra-abdominal gallstone spillage in a case with head and neck neoplasm. Awareness of radiologic features of dropped intraperitoneal gallstones is necessary as they may be mistaken for peritoneal metastases. (orig.)

  9. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    K. Mealy

    1997-01-01

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

  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. 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.

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

    Science.gov (United States)

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

    2011-01-01

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

  15. The Challenge of Antimicrobial Resistance in Managing Intra-Abdominal Infections.

    Science.gov (United States)

    Sartelli, Massimo; Catena, Fausto; di Saverio, Salomone; Ansaloni, Luca; Coccolini, Federico; Tranà, Cristian; Kirkby-Bott, James

    2015-06-01

    In recent years, there has been a worldwide increase in infections caused by microorganisms resistant to multiple antimicrobial agents. In the past few decades, an increased prevalence of infections caused by antibiotic-resistant pathogens, including Enterococcus spp., carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii, extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella spp., carbapenemase-producing Klebsiella pneumoniae, and resistant Candida spp., also has been observed among intra-abdominal infections (IAIs). The increasing prevalence of multi-drug resistance is responsible for a substantial increase in morbidity and mortality rates associated with IAIs. It is necessary for every surgeon treating IAIs to understand the underlying epidemiology and clinical consequences of antimicrobial resistance. Emergence of drug resistance, combined with the lack of new agents in the drug development pipeline, indicates that judicious antimicrobial management will be necessary to preserve the utility of the drugs available currently.

  16. 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.

  17. Hemorrhage exacerbates bacterial translocation at low levels of intra-abdominal pressure.

    Science.gov (United States)

    Gargiulo, N J; Simon, R J; Leon, W; Machiedo, G W

    1998-12-01

    It has been shown previously that the adverse cardiopulmonary sequelae of increased intra-abdominal pressure (IAP) are worsened by hemorrhage and resuscitation. Bacterial translocation (BT) to the mesenteric lymph nodes (MLNs), liver, and spleen has also been shown to occur with increased IAP. To investigate the hypothesis that BT associated with elevated IAP would be significantly increased after hemorrhage and resuscitation. Anesthetized adult male rats had femoral artery and vein catheters placed, and an intra-abdominal catheter placed to measure IAP. Group 1 underwent surgery only and served as controls. Group 2 had IAP raised to 10 mm Hg by infused lactated Ringer's solution for 40 minutes. Group 3 had a 25% hemorrhage, followed by resuscitation by infused lactated Ringer's solution and shed blood. Group 4 first had a 25% hemorrhage, resuscitated using infused lactated Ringer's solution and shed blood, and then had IAP raised to 10 mm Hg by infused lactated Ringer's solution for 40 minutes. All groups were killed after 2 hours, and had MLNs, liver, and spleen harvested for quantitative cultures. Hemorrhage and resuscitation alone did not increase BT to the MLNs, liver, or spleen. An increase in IAP to 10 mm Hg resulted in a significant level of BT to the MLNs and liver on MacConkey II agar (PBT only to the liver on trypticase soy agar with 5% sheep's blood (PBT to the liver and spleen when IAP was increased to 10 mm Hg (PBT to the MLNs, liver, or spleen. However, hemorrhage and resuscitation increased BT to the liver and spleen when IAP was increased to 10 mm Hg. This supports the concept that prior hemorrhage and resuscitation exacerbates the effects of increased IAP.

  18. Medical and surgical management of an intra-abdominal abscess of hepatic origin in a horse.

    Science.gov (United States)

    Cypher, Elizabeth E; Kendall, Anna T; Panizzi, Luca; Stewart, Allison J; Taylor, Sarah L; Bodaan, Christa J; Riley, Chris B; Gordon, Stuart J G; Whitfield, Lisa K

    2015-07-01

    A 4-year-old Arabian-cross mare was examined because of a 48-hour history of pyrexia, lethargy, and signs of abdominal discomfort. On initial evaluation, the horse was in good body condition, but febrile, tachycardic, tachypneic, and icteric and had signs of colic. Findings on CBC and serum biochemical analysis indicated marked systemic inflammation and hepatocellular damage. Serial abdominal ultrasonographic examinations revealed progressive, localized hepatic parenchymal abnormalities in the left ventral aspect of the abdomen in proximity to the left liver lobes, and eventual identification of an irregularly marginated, hyperechoic walled region of heterogenous echogenicity consistent with an encapsulated hepatic abscess. Medical treatment was initiated with administration of doxycycline and flunixin meglumine. After 7 days, the horse's clinical signs and hematologic values improved. After 14 days, the horse was discharged from the hospital and prescribed continuation of doxycycline treatment for 14 days. One week following hospital discharge, the horse was reevaluated for recurrent signs of colic and pyrexia. The horse was sedated, and the region overlying the caudal aspect of the seventh rib was desensitized with an inverted L nerve block by local infiltration with 2% lidocaine. While the horse was standing and sedated, drainage of an encapsulated intra-abdominal abscess was followed by rib resection and removal of a portion of necrotic left lateral liver lobe. The development of a pneumothorax following rib resection represented the only major surgical complication. Twelve months later, the horse was clinically normal and had returned to its previous level of performance. Rib resection in standing sedated horses, together with appropriate medical management, should be considered an option for removal of well-encapsulated cranially located intra-abdominal abscesses that are adherent to the ventrolateral aspect of the body wall in horses.

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

    Directory of Open Access Journals (Sweden)

    Edivaldo Massazo Utiyama

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

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

    Directory of Open Access Journals (Sweden)

    Nizahel Estévez Álvarez

    2010-09-01

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

  1. 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

  2. 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.

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

    DEFF Research Database (Denmark)

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

    2000-01-01

    Intra-abdominal obesity may be crucial in the pathogenesis of the insulin-resistance syndrome, and training may alleviate this condition. We compared insulin-mediated glucose uptake in vivo in three intra-abdominal adipose tissues (ATs; retroperitoneal, parametrial, and mesenteric......]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...... hyperinsulinemia, in part, reflecting an effect in muscle. During hyperinsulinemia, interstitial glucose concentrations were lower, glucose uptake per 100 g of tissue was higher in AT in trained compared with sedentary rats, and training influenced glucose uptake identically in all ATs. In conclusion, differences...

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    Benigno Filgueiras Ramos

    2001-03-01

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

  6. Infecciones genitales por VPH tratadas por microinmunoterapia

    National Research Council Canada - National Science Library

    Jacques Grauwet, Diego

    2011-01-01

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

  7. 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.

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

    Science.gov (United States)

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

    2011-06-01

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

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

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    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.)

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

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    Mari Mizuno

    2017-04-01

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

  11. Intra-abdominal pressure during Pilates: unlikely to cause pelvic floor harm.

    Science.gov (United States)

    Coleman, Tanner J; Nygaard, Ingrid E; Holder, Dannielle N; Egger, Marlene J; Hitchcock, Robert

    2015-08-01

    The objective was to describe the intra-abdominal pressures (IAP) generated during Pilates Mat and Reformer activities, and determine whether these activities generate IAP above a sit-to-stand threshold. Twenty healthy women with no symptomatic vaginal bulge, median age 43 (range 22-59 years), completed Pilates Mat and Reformer exercise routines each consisting of 11 exercises. IAP was collected by an intra-vaginal pressure transducer, transmitted wirelessly to a base station, and analyzed for maximal and area under the curve (AUC) IAP. There were no statistically significant differences in the mean maximal IAP between sit-to-stand and any of the Mat or Reformer exercises in the study population. Six to twenty-five percent of participants exceeded their individual mean maximal IAP sit-to-stand thresholds for 10 of the 22 exercises. When measuring AUC from 0 cm H2O, half the exercises exceeded the mean AUC of sit-to-stand, but only Pilates Reformer and Mat roll-ups exceeded the mean AUC of sit-to-stand when calculated from a threshold of 40 cm H2O (consistent with, for example, walking). Our results support recommending this series of introductory Pilates exercises, including five Mat exercises and six Reformer exercises to women desiring a low IAP exercise routine. More research is needed to determine the long-term effects of Pilates exercise on post-surgical exercise rehabilitation and pelvic floor health.

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

    Science.gov (United States)

    Hasan, Roumina; Monappa, Vidya; Kumar, Sandeep; Kumar, Vijay

    2016-05-01

    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.

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

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    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.

  14. 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.

  15. Cecal ameboma in nasopharyngeal carcinoma patient mimicking intra-abdominal malignancy

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    Chih-Wei Hsu

    2016-03-01

    Full Text Available Amebiasis is quite uncommon in developed countries. Its clinical presentation can vary from an asymptomatic carrier state to fulminant colitis and colonic perforation. We presented a 39-year-old female who received combined chemotherapy and radiotherapy for nasopharyngeal carcinoma 1 year prior to admission. Thereafter, she felt acute abdominal pain and diarrhea after traveling to Hainan 3 months ago. A physical examination of the patient revealed diffused peritoneal sign. Abdominal computed tomography showed a cecal tumor and intra-abdominal abscess. A subsequent exploratory laparotomy revealed an infiltrating yellowish tumor about 7 cm over the cecum and massive serous ascites. Pathology reported ambeic colitis with undermined ulcer and abscess formation of the cecum. Ameboma can be found in developed countries, particularly in patients with risk factors and a history of traveling to areas with the developing disease. Colonoscopy with biopsy is recommended for patients with suspected ameboma, and surgical intervention is likely indicated in complicated cases although the surgical mortality rate is high.

  16. 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.

  17. 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.

  18. Effect of intra-abdominal pressure on respiratory function in patients undergoing ventral hernia repair.

    Science.gov (United States)

    Gaidukov, Konstantin M; Raibuzhis, Elena N; Hussain, Ayyaz; Teterin, Alexey Y; Smetkin, Alexey A; Kuzkov, Vsevolod V; Malbrain, Manu Lng; Kirov, Mikhail Y

    2013-05-04

    To determine the influence of intra-abdominal pressure (IAP) on respiratory function after surgical repair of ventral hernia and to compare two different methods of IAP measurement during the perioperative period. Thirty adult patients after elective repair of ventral hernia were enrolled into this prospective study. IAP monitoring was performed via both a balloon-tipped nasogastric probe [intragastric pressure (IGP), CiMON, Pulsion Medical Systems, Munich, Germany] and a urinary catheter [intrabladder pressure (IBP), UnoMeterAbdo-Pressure Kit, UnoMedical, Denmark] on five consecutive stages: (1) after tracheal intubation (AI); (2) after ventral hernia repair; (3) at the end of surgery; (4) during spontaneous breathing trial through the endotracheal tube; and (5) at 1 h after tracheal extubation. The patients were in the complete supine position during all study stages. The IAP (measured via both techniques) increased on average by 12% during surgery compared to AI (P IGP and IBP (r = 0.65-0.81, P IGP was 8.0 (5.5-11.0) mmHg and the median IBP was 8.8 (5.8-13.1) mmHg. The overall r (2) value (n = 30) was 0.76 (P IGP or IBP demonstrated excellent concordance.

  19. 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

  20. [Monitoring of intra-abdominal pressure and abdominal perfusion pressure in urgent abdominal surgery].

    Science.gov (United States)

    Raĭbuzhis, E N; Fot, E V; Gaĭdukov, K M; Kirov, M Iu

    2014-01-01

    To evaluate the changes in intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) during perioperative period in urgent abdominal surgery and to assess the relationship of these parameters with gas exchange and tissue perfusion. Twenty-four patients undergoing emergency abdominal surgery were enrolled into a prospective observational study. We recorded IAP APP, mean arterial pressure, arterial and venous blood gases after induction of anesthesia, at the end of surgery, and 6, 12, 48 and 72 h postoperatively. LAP was measured by nasogastric tube using CiMON monitor (Pulsion Medical Systems, Germany). In addition, we studied the relationship of IAP and APP with blood gases parameters. We observed perioperative increase of IAP (> 12 mm Hg) in 75% of enrolled patients, tendency to postoperative rise of IAP and transient increase of arterial lactate at 6 h after surgery. APP remained within normal values. We found positive correlation of APP with PaO2/FiO2 and ScvO2 at 72 hours after surgery. Transient perioperative increase of IAP was observed in 75% patients undergoing urgent abdominal surgery; however in parallel with intensive care the abdominal perfusion pressure remained within normal values. Abdominal perfusion is related with arterial oxygenation and central venous saturation.

  1. 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.

  2. 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.

  3. 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...

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

    Science.gov (United States)

    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.

  5. 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.

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

    Science.gov (United States)

    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.

  7. 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.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

  12. 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.

  13. 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. 

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

    Science.gov (United States)

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

    2004-07-01

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

  15. 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...

  16. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  1. Comparison of technetium-99m-HM-PAO leukocytes with indium-111-oxine leukocytes for localizing intraabdominal sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Mountford, P.J.; Kettle, A.G.; O' Doherty, M.J.; Coakley, A.J. (Kent and Canterbury Hospital (England))

    1990-03-01

    Technetium-99m-HM-PAO (({sup 99m}Tc)HM-PAO) leukocyte and indium-111-oxine (111In-oxine) leukocyte scanning were carried out simultaneously in 41 patients at 4 hr and 24 hr after reinjection to determine whether the 4-hr {sup 99m}Tc scan could replace the 24-hr {sup 111}In scan for detecting intraabdominal sepsis. Abdominal infection was confirmed in 12 cases. The 4-hr {sup 99}Tc-leukocyte scan, the 4-hr {sup 111}In-leukocyte scan, and the 24-hr {sup 111}In-leukocyte scan yielded a sensitivity of 100%, 67%, and 100%, respectively, and a specificity of 62%, 90%, and 86%, respectively. The 24-hr {sup 99m}Tc-leukocyte scan also produced a sensitivity of 100%, but it was falsely positive in all 29 cases without infection due to physiologic bowel uptake. False-positive 4-hr {sup 99m}Tc-leukocyte scans were also produced by physiologic bowel uptake in seven cases all of whom had true-negative 4-hr and 24-hr {sup 111}In-leukocyte scans. Because of the high incidence of false-positive 4-hr ({sup 99m}Tc)HM-PAO leukocyte scans, it was concluded that they could not replace 24-hr {sup 111}In-leukocyte scans for detecting intraabdominal sepsis, and that serial {sup 99m}Tc leukocyte scans starting earlier than 4 hr after reinjection must be evaluated.

  2. Celulitis por citomegalovirus

    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.

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

    Directory of Open Access Journals (Sweden)

    E. A. ESTEVES

    2011-04-01

    Full Text Available

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

  4. 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...

  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. 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.

  7. 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

  8. Intra-Abdominal Hypertension and Abdominal Compartment Syndrome in Association with Ruptured Abdominal Aortic Aneurysm in the Endovascular Era: Vigilance Remains Critical

    Directory of Open Access Journals (Sweden)

    Matthew C. Bozeman

    2012-01-01

    In this review, we describe published experience with IAH and ACS complicating abdominal vascular catastrophes, experience with ACS complicating endovascular repair of rAAAs, and techniques for management of the abdominal wound. Vigilance and appropriate management of IAH and ACS remains critically important in decreasing morbidity and optimizing survival following catastrophic intra-abdominal vascular events.

  9. Dias.por.aqui

    OpenAIRE

    Dias, Inês de Almeida e Costa

    2006-01-01

    Tese de mestrado em Estudos Curatoriais, apresentada à Universidade de Lisboa, através da Faculdade de Belas Artes, 2006 DIAS .POR. AQUI is the title of a contemporary art exhibition project presenting the artists Francisco Vidal, Kiluanje Liberdade, Marco Kabenda and Carlos Bunga. These are artists of African origin (specifically, from portuguese speaking countries) who live, or have lived diasporic situations/experiences. DIAS.POR.AQUI is based on reflections on postcolonial theories, th...

  10. Risk Stratification for Major Postoperative Complications in Patients Undergoing Intra-abdominal General Surgery Using Latent Class Analysis.

    Science.gov (United States)

    Kim, Minjae; Wall, Melanie M; Li, Guohua

    2017-08-10

    Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients that are similar with respect to characteristics entered into the model. Moreover, the latent risk classes were predictive of 30-day mortality. We evaluated the use of latent risk classes to predict the risk of major postoperative complications. An observational, retrospective cohort of patients undergoing intra-abdominal general surgery in the 2005 to 2010 American College of Surgeons National Surgical Quality Improvement Program was obtained. Known preoperative comorbidity and risk factor data were entered into LCA models to identify the latent risk classes. Complications were defined as: acute kidney injury, acute respiratory failure, cardiac arrest, deep vein thrombosis, myocardial infarction, organ space infection, pneumonia, postoperative bleeding, pulmonary embolism, sepsis/septic shock, stroke, unplanned reintubation, and/or wound dehiscence. Relative risk regression determined the associations between the latent classes and the 30-day complication risks, with adjustments for the surgical procedure. The area under the curve (AUC) of the receiver operator characteristic curve assessed model performance. LCA fit a 9-class model on 466,177 observations. The composite complication risk was 18.4% but varied from 7.7% in the lowest risk class to 56.7% in the highest risk class. After adjusting for procedure, the latent risk classes were significantly associated with complications, with risk ratios (95% confidence intervals) (compared to the class with the average risk) varying from 0.56 (0.54-0.58) in the lowest risk class to 2.15 (2.11-2.20) in the highest risk class, a 4-fold difference. In models incorporating surgical

  11. 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

  12. Incidence of ESBL producers amongst Gram-negative bacilli isolated from intra-abdominal infections across India (based on SMART study, 2007 data).

    Science.gov (United States)

    Chaudhuri, B N; Rodrigues, C; Balaji, V; Iyer, R; Sekar, U; Wattal, Chand; Chitnis, D S; Dhole, T N; Joshi, Sangeeta

    2011-05-01

    This study was conducted in 9 centers spread over India from January 1 to December 31, 2007 to monitor in vitro susceptibility of Gram-negative bacilli to Group I carbapenem, ertapenem and other antimicrobials in intra-abdominal infections and to identify early changes in susceptibility pattern of community or hospital acquired organisms, with a focus on ESBL producers. Gram-negative bacilli isolated from intra-abdominal samples of patients with documented intra-abdominal infections were processed for identification by conventional/ automated methods and antimicrobial susceptibility by Micro-Scan (Siemens) MIC panel against 12 antimicrobials (3rd and 4th generation cephalosporins, Groups I and II carbapenems, amikacin, levofloxacin, amoxicillin-clavulanic acid and piperacillin-tazobactam). A total of 588 isolates were identified, of which 351 (60%) were E. coli and 114 (19%) were Klebsiella spp. 79% of E. coli and 70% of Klebsiella spp. were ESBL producers in general. 110 of E. coli and 35 of Klebsiella isolates were from community-acquired intra-abdominal infections. 80% of E. coli and 63% of Klebsiella isolates from community-acquired infections were ESBL producers, against 79% of E. coli and 73% of Klebsiella isolates from hospital-acquired infections. Amongst the ESBL-positive isolates of E. coli, 94% were susceptible in vitro to ertapenem, 96% to imipenem and 76% to piperacillin-tazobactam. For ESBL-positive isolates of Klebsiella spp., the corresponding figures were 80%, 94% and 59% respectively. The study showed a high incidence of ESBL-producers amongst Enterobacteriaceae isolates from intra-abdominal infections in both community-acquired and hospital-acquired settings across India. Ertapenem was comparable with imipenem against ESBL-positive E. coli isolates, while imipenem was more effective than ertapenem against ESBL-positive Klebsiella isolates.

  13. [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.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  15. Multicystic, peritoneal mesothelioma: a report with electron microscopy of a case mimicking intra-abdominal cystic hygroma (lymphangioma).

    Science.gov (United States)

    Mennemeyer, R; Smith, M

    1979-08-01

    A 27-year-old Caucasian female complained of persistent, poorly localized abdominal pain of several months' duration, found to be due to a multicystic diffuse lesion involving omentum, peritoneum and pelvic viscera. Three resections were required within a ten-month period for symptomatic control. The tumor showed many of the clinical, operative, gross and light microscopic features of intra-abdominal lymphagioma. Tissues removed at the third operation, however, were examined by electron microscopy, and found to consist of a myriad of small cysts and channels lined by mesothelial cells. In view of these findings, the lesion was regarded as a cystic peritoneal mesothelioma. Similarities between lymphangioma and peritoneal mesothelioma are discussed. It is suggested that electron microscopic examination of lining cells of cystic lesions which are considered grossly consistent with lymphagiomas may yield additional similar cases.

  16. 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).

  17. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  19. 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

    Directory of Open Access Journals (Sweden)

    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.

  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

    Directory of Open Access Journals (Sweden)

    Lucimara Zambon

    2009-10-01

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

  1. Effect of body mass index and intra-abdominal fat measured by computed tomography on the risk of bowel symptoms.

    Directory of Open Access Journals (Sweden)

    Naoyoshi Nagata

    Full Text Available This study aims to investigate the association between body mass index (BMI or intra-abdominal fat measured by computed tomography (CT and bowel symptoms.A cohort of 958 Japanese adults who underwent colonoscopy and CT and completed questionnaires after excluding colorectal diseases was analyzed. Six symptoms (constipation, diarrhea, loose stools, hard stools, fecal urgency, and incomplete evacuation using a 7-point Likert scale were evaluated between baseline and second questionnaire for test-retest reliability. Associations between BMI, visceral adipose tissue (VAT, subcutaneous adipose tissue (SAT, and symptom score were analyzed by a rank-ordered logistic model, adjusting for age, sex, smoking, and alcohol consumption, hypertension, diabetes mellitus, and dyslipidemia.Some bowel symptom scores were significantly (p<0.05 different between the age groups, sexes, smoking, and alcohol consumption. In multivariate analysis, constipation was associated with low BMI (p<0.01, low VAT area (p = 0.01, and low SAT area (p<0.01. Moreover, hard stools was associated with low BMI (p<0.01 and low SAT area (p<0.01. The remaining symptoms were not significantly associated with BMI or intra-abdominal fat. Test-retest reliability of bowel symptom scores with a mean duration of 7.5 months was good (mean kappa, 0.672.Both low BMI and low abdominal fat accumulation appears to be useful indicators of increased risk for constipation and hard stools. The long-term test-retest reliability of symptom score suggests that bowel symptoms relevant to BMI or visceral fat remain consistent over several months.

  2. 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

  3. Evaluation of adhesion formation and host tissue response to intra-abdominal polytetrafluoroethylene mesh and composite prosthetic mesh.

    Science.gov (United States)

    Matthews, Brent D; Mostafa, Gamal; Carbonell, Alfredo M; Joels, Charles S; Kercher, Kent W; Austin, Catherine; Norton, H James; Heniford, B Todd

    2005-02-01

    The purpose of this study was to measure the extent of adhesion formation to ePTFE mesh (DualMesh, W.L. Gore & Associates, Inc, Flagstaff, AZ) and two composite prosthetic materials, ePTFE and polypropylene (Bard Composix, C.R. Bard, Inc, Murray Hill, NJ) and hyaluronic acid/carboxymethylcellulose and polypropylene (Sepramesh, Genzyme Corp, Cambridge, MA) after their intra-abdominal placement on an intact peritoneum, simulating laparoscopic ventral hernia repair, and to evaluate host tissue response to the prosthetic biomaterials. Through a midline laparotomy, a 2 x 2 cm piece of mesh (n = 60) was sewn to an intact peritoneum on each side of a midline incision in 30 New Zealand white rabbits. Mesh adhesions were scored using a modified Diamond scale (0 = 0%, 1 = 1-25%, 2 = 26-50%, 3 >50%) at 1, 3, 9, and 16 weeks by serial microlaparoscopy (2 mm). All laparoscopic evaluations were videotaped for blinded scoring by three surgeons. Host tissue response was graded (1-4) for inflammation, tissue ingrowth, and mesothelialization. The predominant cell type (polymorphonuclear leukocytes versus foreign body giant cell) was recorded. Statistical differences (P value DualMesh) intra-abdominal against an intact peritoneum results in significantly fewer adhesions than the composite prosthetic meshes during a 4-month follow-up. The host tissue response is equivalent for the three prosthetic biomaterials. The long-term consequences of increased adhesion formation to the composite meshes and the ultimate biocompatibility of the nonabsorbable and absorbable barriers on the polypropylene mesh are to be determined.

  4. 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.

  5. Asma inducido por ejercicio

    OpenAIRE

    Ramos Zabala, Mª Gracia

    1997-01-01

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

  6. 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...

  7. 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...

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

    Directory of Open Access Journals (Sweden)

    Nilson Chaves Jr

    2007-10-01

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

  9. [Clinicopathologic and immunohistochemical study of intra-abdominal non-Hodgkin B-cell lymphoma occurring in children].

    Science.gov (United States)

    Yang, Wen-ping; Zhu, Cai-di; Gong, Li-ping; Lü, Bei-bei; Zou, Yin; Zhong, Hua-sheng; Xiao, Qiang; Wu, Yan; Xu, Hong-yan; Zeng, Song-tao; Huang, Hui

    2009-11-01

    To study the clinicopathologic features, immunohistochemical findings, EBV and c-myc gene status of intra-abdominal non-Hodgkin B-cell lymphoma occurring in children. Seventy-four cases of pediatric intra-abdominal non-Hodgkin B-cell lymphoma were retrieved from the archival file. The cases were classified according to the 2008 WHO classification. Tissue microarray including tumor tissues from all the 74 cases was produced. Immunohistochemical study (SP method) for CD20, CD3, CD79a, CD10, bcl-6, MUM1, bcl-2, CD43, CD38 and Ki-67 was performed. In-situ hybridization for Epstein-Barr virus-encoded RNA (EBER) and fluorescence in-situ hybridization for c-myc gene were also carried out. Amongst the 74 cases studied, 65 of them (87.8%) were Burkitt lymphoma (BL), 4 cases (5.4%) were diffuse large B-cell lymphoma (DLBCL) and the remaining 5 cases (6.8%) showed features in-between DLBCL and BL (DLBCL/BL). The patients often presented with abdominal pain, abdominal masses, ileus and intussusception. The ileocecal bowel wall and mesenteric lymph nodes were commonly involved. The lymphoma cells were of high histologic grade and suggested an aggressive clinical behavior. The staining for CD20 and CD79a were positive in all of the cases, while CD3 was negative. The positive rates of CD10, bcl-6, bcl-2, MUM1, CD43, CD38 and EBER in BL were 96.9% (63 cases), 95.4% (62 cases), 0 (0 case), 23.1% (15 cases), 70.8% (46 cases), 96.9% (63 cases) and 41.5% (27 cases), respectively. Fifty-four cases carried translocation of c-myc gene. As for DLBCL, the positive cases of CD10, bcl-6, bcl-2, MUM1, CD43, CD38 and EBER were 3 cases, 2 cases, 3 cases, 2 cases, 2 cases, 2 cases and 0 case, respectively. One of these cases showed c-myc gene translocation. Amongst the 4 cases of DLBCL, 2 of them belonged to germinal center B-cell-like subtype, while the remaining 2 cases were of non-germinal center B-cell-like subtype. The expression rates of CD10, bcl-6, bcl-2, MUM1, CD43, CD38 and EBER in

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    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...... with a specific radioimmunoassay. Insulin sensitivity was measured by the Minimal Model and glucose tolerance by an oral glucose tolerance test (OGTT). Serum lipid concentrations were measured by standard methods. RESULTS: The gallbladder volume in the fasting state increased with increasing intra-abdominal fat...

  11. 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.

  12. Apendicitis por Paracoccidioides brasiliensis

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    Ana Beatriz MUÑOZ URRIBARRI

    2006-01-01

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

  13. Osteomielitis por salmonella

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    Alicia Velázquez Pérez

    2014-08-01

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

  14. 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

  15. 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

  16. causada por Fusarium moniliforme

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    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

  17. La lucha por Guayaquil

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    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.

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

    Science.gov (United States)

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

    2015-11-01

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

  19. 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....

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

    OpenAIRE

    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

    2015-01-01

    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%) ...

  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. Validation of a novel method for measuring intra-abdominal pressure and gastric residual volume in critically ill patients.

    Science.gov (United States)

    Van Stappen, Johan; Pigozzi, Chiara; Tepaske, Robert; Van Regenmortel, Niels; De Laet, Inneke; Schoonheydt, Karen; Dits, Hilde; Severgnini, Paolo; Roberts, Derek J; Malbrain, Manu L N G

    2014-01-01

    Gastric residual volume (GRV) can be measured in a variety of ways in critically ill patients, most often, the nasogastric tube is disconnected and the GRV is aspirated via a 60 mL syringe. Bladder pressure (IBP) measurement is the gold standard for intra-abdominal pressure (IAP) estimation. This study will look at the validation of a novel method combining measurement of GRV and estimation of IAP via intra-gastric pressure (IGP). In total 135 paired IAP and 146 paired GRV measurements were performed in 37 mechanically ventilated ICU patients. The IAP was estimated via the bladder (i.e. IBP) using the FoleyManometer and via the stomach (i.e. IGP) with the new device. The GRV was measured with the new device (GRVprototype) and via the classic method (GRVclassic). The devices were provided by Holtech Medical (Charlottenlund, Denmark) and data were retrospectively analysed. The number of paired measurements in each patient was 4 ± 1. The mean IBP was 10.7 ± 4.1 and mean IGP was 11.6 ± 4.1 mm Hg. Correlation between the IBP and IGP was significant, however moderate (R2 = 0.51). Analysis according to Bland and Altman showed a bias and precision of 0.8 and 2.7 mm Hg respectively, however the limits of agreement (LA) were large and ranged from -4.5 to 6.1 mm Hg. Changes in IGP correlated well with changes in IBP. The median GRVprototype was 80 mL (0-1050) and equal to the median GRVclassic of 80 mL (0-1250). Correlation between the 2 methods was excellent (R2 = 0.89). Analysis according to Bland and Altman showed a bias and precision of -0.8 and 52.3 mL respectively and the LA ranged from -103 to 102 mL. Changes in GRVclassic correlated well with changes in GRVprototype. The results of this multicentre pilot study show that GRV can be measured with the new device. Furthermore this allows simultaneous screening for intra-abdominal hypertension with IAP estimation via IGP.

  3. 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

  4. 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

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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.

  9. Relationship between the clinical efficacy and AUC/MIC of intravenous ciprofloxacin in Japanese patients with intraabdominal infections.

    Science.gov (United States)

    Ohki, Emiko; Yamagishi, Yuka; Mikamo, Hiroshige

    2013-10-01

    The efficacy of fluoroquinolones (FQs) correlates with the pharmacokinetic/pharmacodynamic (PK-PD) parameter, AUC/MIC. To our knowledge, however, no prospective studies have reported the relationship between FQ efficacy and PK-PD parameters in intraabdominal infection; therefore, we prospectively investigated the relationship between the efficacy of intravenous ciprofloxacin (CPFX IV) and PK-PD parameters. The study included 16 patients diagnosed with peritonitis between 2006 and 2008: 14 patients infected with a single organism and 2 patients infected with more than one organism. Each patient was treated with CPFX IV (300 mg twice daily). The response rate was 56% (9 responders and 7 non-responders). Non-responders were infected with Escherichia coli, Pseudomonas aeruginosa, and Bacteroides fragilis (6 patients were infected with a single organism and 1 with more than one organism). Plasma drug concentrations were measured 1 h and 2 or 4 h after administration of CPFX IV. AUC for 24 h (AUC(0-24))/MIC values was calculated. The range of AUC(0-24)/MIC values in responders [95.3-3628.4 (geometric mean, 521.6)] was significantly different from that in non-responders [7.0-45.2 (geometric mean, 16.5)] (p = 0.001). The target AUC/MIC value of CPFX IV would be considered to be 45-95 in patients with peritonitis.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. Worsening central sarcopenia and increasing intra-abdominal fat correlate with decreased survival in patients with adrenocortical carcinoma.

    Science.gov (United States)

    Miller, Barbra S; Ignatoski, Kathleen M; Daignault, Stephanie; Lindland, Ceit; Doherty, Megan; Gauger, Paul G; Hammer, Gary D; Wang, Stewart C; Doherty, Gerard M

    2012-07-01

    Accurate prediction of survival from adrenocortical carcinoma (ACC) is difficult and current staging models are unreliable. Central sarcopenia as part of the cachexia syndrome is a marker of frailty and predicts mortality. This study seeks to confirm that psoas muscle density (PMD), lean psoas muscle area (LPMA), lumbar skeletal muscle index (LSMI), and intra-abdominal (IA) or subcutaneous fat (SC) can be used in combination to more accurately predict survival in ACC patients. PMD, LPMA, IA, and SC fat were measured on serial CT scans of patients with ACC. Clinical outcome was correlated with quantitative data from patients with ACC and analyzed. A linear regression model was used to describe the relationship between PMD, LPMA, LSMI, IA, and SC fat, time to recurrence, and length of survival according to tumor stage. One hundred twenty-five ACC patients (94 females) were treated from 2005 to 2011. Significant morphometric predictors of survival include PMD, LPMA, and IA fat (p ≤ 0.0001, ≤ 0.0024, increase in LPMA confers an 8 % lower hazard of death. LSMI does not change significantly between stages (p = 0.3196). Decreased PMD, LPMA, and increased IA fat suggest decreased survival in ACC patients and correlate with traditional staging systems. A more precise prediction of survival may be achieved when staging systems and morphometric measures are used in combination. Serial measurements of morphometric data are possible. The rate of change of these variables over time may be more important than the absolute value.

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

    Directory of Open Access Journals (Sweden)

    N. E. Wester

    2013-01-01

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

  14. 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.

  15. Por mil devaluados pesos

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    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.

  16. 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...

  17. 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...

  18. 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

  19. 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

  20. 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 ...

  1. Iluminados por el fuego

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    Manuel Gárate

    2006-05-01

    Full Text Available No es coincidencia que en menos de un año dos películas latinoamericanas den cuenta de la temática de la guerra durante el período de los llamados « años de plomo » de las dictaduras latinoamericanas. Primero fue « Mi mejor enemigo » del chileno Alex Bowen, estrenada durante el 2005 y que relata la cuasi guerra entre Chile y Argentina durante los tensos meses finales de 1978. En este caso se trata de « Iluminados por el fuego » de Tristán Bauer, quien nos da cuenta del trauma de la Guerra de...

  2. 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.

  3. 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.

  4. Motivado por cirujanos

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    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….

  5. 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

  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

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    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. 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

  8. Comparing intra-abdominal pressures in different body positions via a urinary catheter and nasogastric tube: a pilot study.

    Science.gov (United States)

    Rooban, Nirooshan; Regli, Adrian; Davis, Wendy A; De Keulenaer, Bart L

    2012-07-05

    Intra-abdominal pressure (IAP) is most commonly measured via the bladder with the patient in the supine position. In the ICU, patients are nursed with the head of the bed elevated at 30° (HOB30) to reduce the risk of ventilator-associated pneumonia. This study investigated whether gastric pressure at HOB30 can be used as a surrogate measure of IAP via the bladder in the supine position. A prospective observational study was conducted in a single-centre intensive care unit. A total of 20 patients were included. IAP was recorded simultaneously via the bladder catheter (bladder pressure, IBP) and via nasogastric tube (gastric pressures, IGP) in the supine and HOB30 position. Each patient had three sets of IAP measurements performed at least 4 h apart. In the supine position, mean IBP was 12.3 ± 4.5 mmHg compared to IGP of 11.8 ± 4.7 mmHg. The bias between the two groups was 0.5 and precision of 3.7 (LA, -6.8 to 7.5 mmHg). At 30 degrees, mean IBP was 15.8 ± 4.9 mmHg compared to IGP of 13.1 ± 6.1 mmHg. The bias between both groups was 2.7 with a precision of 5.5 (LA, -8.0 to 13.5). Comparing IBP in the supine position with IGP at 30° showed a bias of -0.8 and precision of 5.6 (LA, -10.1 to 11.6 mmHg). IAP measured via a nasogastric tube was less influenced by changing the body position from supine to HOB30 than was bladder pressure.

  9. Clinical characteristics and predictors of mortality in cirrhotic patients with candidemia and intra-abdominal candidiasis: a multicenter study.

    Science.gov (United States)

    Bassetti, Matteo; Peghin, Maddalena; Carnelutti, Alessia; Righi, Elda; Merelli, Maria; Ansaldi, Filippo; Trucchi, Cecilia; Alicino, Cristiano; Sartor, Assunta; Toniutto, Pierluigi; Wauters, Joost; Laleman, Wim; Tascini, Carlo; Menichetti, Francesco; Luzzati, Roberto; Brugnaro, Pierluigi; Mesini, Alessio; Raviolo, Stefania; De Rosa, Francesco G; Lagunes, Leonel; Rello, Jordi; Dimopoulos, George; Colombo, Arnaldo L; Nucci, Marcio; Vena, Antonio; Bouza, Emilio; Muñoz, Patricia; Tumbarello, Mario; Losito, Raffaella; Martin-Loeches, Ignacio; Viscoli, Claudio

    2017-04-01

    The aim of the study was to describe the characteristics of cirrhotic patients with candidemia and intra-abdominal candidiasis (IAC) and to evaluate the risk factors associated with 30-day mortality. A multicenter multinational retrospective study including all consecutive episodes of candidemia and IAC in adult patients with liver cirrhosis in 14 European hospitals during the period 2011-2013 was performed. A total of 241 episodes (169 candidemia, 72 IAC) were included. Most Candida infections were acquired in hospital (208, 86.3%), mainly in the intensive care unit (ICU) (121, 50.2%). At clinical presentation, fever was seen in 60.6% of episodes (146/241) and septic shock in 34.9% (84/241). C. albicans was the most common species (found in 131 episodes, 54.4%), followed by C. glabrata (35, 14.5%) and C. parapsilosis (34, 14.1%). Overall, the 30-day mortality was 35.3%. Multivariable analysis identified candidemia (OR 2.2, 95% CI 1.2-4.5) and septic shock (OR 3.2, 95% CI 1.7-6) as independent factors associated with 30-day mortality. Adequate antifungal treatment (OR 0.4, 95% CI 0.3-0.9) was associated with survival benefit. A shift towards increasing prevalence of C. glabrata and C. parapsilosis species in patients with liver disease was documented. Candidemia and IAC were associated with significant mortality in cirrhotic patients. Thirty-day mortality was associated with candidemia and severe clinical presentation, whereas adequate antifungal treatment improved the prognosis.

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

    Science.gov (United States)

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

    2014-01-01

    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. 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. 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. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  16. Prospective evaluation of new 22 gauge endoscopic ultrasound core needle using capillary sampling with stylet slow-pull technique for intra-abdominal solid masses.

    Science.gov (United States)

    Paik, Woo Hyun; Park, Yangsoon; Park, Do Hyun; Hong, Seung-Mo; Lee, Byung Uk; Choi, Jun-Ho; Lee, Sang Soo; Seo, Dong-Wan; Lee, Sung Koo; Kim, Myung-Hwan

    2015-03-01

    The aim of this study was to evaluate the adequacy and diagnostic yield of the histologic core obtained with a 22 G endoscopic ultrasound histology needle using capillary sampling with stylet slow-pull technique without on-site cytopathologist. No standard technique for new EUS histology needle has been established. A total of 125 consecutive patients with intra-abdominal solid masses were enrolled prospectively between October 2011 and March 2013. EUS-guided fine needle biopsy (EUS-FNB) with a 22 G histology needle using capillary sampling with stylet slow-pull technique was performed. A total of 133 EUS-FNB procedures targeting the pancreas, lymph node, retroperitoneal mass, ampulla of Vater, gallbladder, common bile duct, duodenum, and liver were performed in 125 patients. EUS-FNB was technically feasible in all cases, and a visible core was obtained in 128 cases (96%). Histologic core specimens suitable for pathologic assessment were reported in 111 cases (83%). There were no procedure-related adverse events. According to the determinants of malignancy with EUS-FNB, the sensitivity, specificity, positive and negative predictive values, and accuracy were 85%, 98%, 99%, 77%, and 89%, respectively. In addition, histologic architecture with or without immunohistochemical staining of the core biopsy specimens was useful for pathologic confirmation in 101 cases (76%). A 22 G EUS-FNB using capillary sampling with stylet slow-pull technique showed a high diagnostic yield and histologic core acquisition for the histologic diagnosis of various intra-abdominal masses without an on-site cytopathologist. Furthermore, a histologic core with or without immunohistochemical staining was helpful for clinical decision making in 76% of the intra-abdominal solid masses.

  17. 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

  18. 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

  19. 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

  20. 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.

  1. El recuerdo viaja por Italia

    Directory of Open Access Journals (Sweden)

    Néstor Madrid Malo

    1965-09-01

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

  2. 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.

  3. 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

  4. 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.

  5. 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

  6. 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)....

  7. 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 ...

  8. 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.

  9. 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

  10. 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.

  11. Clinical effect of early bowel-relaxing treatment and drainage in treatment of severe acute pancreatitis with intra-abdominal hypertension

    Directory of Open Access Journals (Sweden)

    WANG Qiang

    2017-01-01

    Full Text Available ObjectiveTo investigate the clinical effect of early bowel-relaxing treatment and drainage in the treatment of severe acute pancreatitis (SAP. MethodsA retrospective analysis was performed for the clinical data of 52 patients with SAP who were admitted to Department of Hepatopancreatobiliary Surgery, Zhuzhou Central Hospital, from January 2009 to January 2015, and these patients were divided into conventional treatment group with 22 patients and early bowel-relaxing/drainage group with 30 patients. The incidence of multiple organ dysfunction syndrome and abdominal compartment syndrome within 2 weeks, time to intra-abdominal pressure reduced to below 15 cm H2O, time to gastrointestinal function recovery, pancreatic infection rate, and mortality rate were compared between the two groups. The independent samples t-test was used for comparison of continuous data between the two groups, and the chi-square test was used for comparison of categorical data. ResultsCompared with the conventional treatment group, the early bowel-relaxing/drainage group had significant reductions in the incidence rates of multiple organ dysfunction syndrome (31.8% vs 10.0%, χ2=3.89, P=0.049 and abdominal compartment syndrome (22.7% vs 3.3%, χ2=4.68, P=0.031 within 2 weeks, pancreatic infection rate (40.9% vs 13.3%, χ2=515, P=0.023, and mortality rate (22.7% vs 3.3%, χ2=4.68, P=0.031. Compared with the conventional treatment group, the early bowel-relaxing/drainage group had significantly shortened time to intra-abdominal pressure reduced to below 15 cm H2O, time to bowel sound recovery, and time to the recovery of passing of flatus and defecation (t=1.02, 6.67, and 2.13, all P<0.01. ConclusionIn the early stage of SAP, bowel-relaxing treatment and drainage can effectively reduce intra-abdominal hypertension, protect vital organ function, alleviate the condition of SAP, reduce the incidence of complications, and thus significantly improve the prognosis of SAP.

  12. 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...

  13. Congenital intra-abdominal bilateral juvenile granulosa cell tumors of the testis associated with constitutional loss of material from chromosome 4.

    Science.gov (United States)

    Yu, David C; Pathak, Bhavana; Vargas, Sara O; Javid, Patrick J; Hisama, Fuki M; Wilson, Jay M; Linden, Bradley C

    2011-01-01

    Juvenile granulosa cell tumor (JGCT) is an uncommon gonadal stromal tumor that occurs rarely in the testis. We report a newborn boy with bilateral intra-abdominal JGCT presenting with abdominal distention and respiratory distress at birth. He was taken to the operating room emergently, and 2 large masses connected by gubernacula to the inguinal canals were resected. Associated abnormalities included a constitutional chromosome 4 abnormality, polymicrogyria, and renal cysts. This report describes a rare presentation of JGCT with abdominal compression and expands the literature to include bilateral testicular involvement. Additionally, it is the 1st report of JGCT associated with a chromosome 4 abnormality, highlighting a genetic region that may be important in JGCT development.

  14. 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.

  15. 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.

  16. 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.

  17. A cost-effectiveness analysis comparing a clinical decision rule versus usual care to risk stratify children for intraabdominal injury after blunt torso trauma.

    Science.gov (United States)

    Nishijima, Daniel K; Yang, Zhuo; Clark, John A; Kuppermann, Nathan; Holmes, James F; Melnikow, Joy

    2013-11-01

    Recently a clinical decision rule (CDR) to identify children at very low risk for intraabdominal injury needing acute intervention (IAI) following blunt torso trauma was developed. Potential benefits of a CDR include more appropriate abdominal computed tomography (CT) use and decreased hospital costs. The objective of this study was to compare the cost-effectiveness of implementing the CDR compared to usual care for the evaluation of children with blunt torso trauma. The hypothesis was that compared to usual care, implementation of the CDR would result in lower CT use and hospital costs. A cost-effectiveness decision analytic model was constructed comparing the costs and outcomes of implementation of the CDR to usual care in the evaluation of children with blunt torso trauma. Probabilities from a multicenter cohort study of children with blunt torso trauma were derived; estimated costs were based on those at the study coordinating site. Outcome measures included missed IAI, number of abdominal CT scans, total costs, and incremental cost-effectiveness ratios. Sensitivity analyses varying imputed probabilities, costs, and scenarios were conducted. Using a hypothetical cohort of 1,000 children with blunt torso trauma, the base case model projected that the implementation of the CDR would result in 0.50 additional missed IAIs, a total cost savings of $54,527, and 104 fewer abdominal CT scans compared to usual care. The usual care strategy would cost $108,110 to prevent missing one additional IAI. Findings were robust under multiple sensitivity analyses. Compared to usual care, implementation of the CDR in the evaluation of children with blunt torso trauma would reduce hospital costs and abdominal CT imaging, with a slight increase in the risk of missed intraabdominal IAI. © 2013 by the Society for Academic Emergency Medicine.

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

    Science.gov (United States)

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

    2016-06-01

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

  19. Ptose palpebral causada por Paquidermoperiostose

    Directory of Open Access Journals (Sweden)

    Patricia Regina de Pinho Tavares

    2014-08-01

    Full Text Available A paquidermoperiostose é uma síndrome caracterizada por acometimento cutâneo e ósseo, e em alguns casos ocorre comprometimento palpebral leve. É uma síndrome rara, idiopática ou hereditária, com provável herança autossômica dominante de penetrância variável. Descreve-se o caso de um paciente com ptose grave por paquidermoperiostose elucidando sua fisiopatologia e conduta cirúrgica aplicada.

  20. 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 ...

  1. 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.

  2. 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...

  3. 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.

  4. Por que leer a Maquiavelo?

    National Research Council Canada - National Science Library

    Castillo Cisneros, Mery; Molano Rojas, Andres

    2013-01-01

    ... a Maquiavelo. Para empezar, hay que leer a Maquiavelo porque Maquiavelo, y en particular El Principe, es un clasico. Y un clasico, dice Calvino, es un libro del cual "se suele oir decir: 'Estoy releyendo ...' y nunca 'Estoy leyendo ...'" (1). En efecto, ningun lector lee en realidad a Maquiavelo por primera vez (siempre se lo lee con ...

  5. Celulitis por citomegalovirus Cytomegalovirus cellulitis

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    A. Ruiz Lascano

    2002-12-01

    Full Text Available Las lesiones cutáneas por citomegalovirus (CMV son infrecuentes y a menudo una manifestación tardía de una enfermedad sistémica, que generalmente anuncia un curso fatal. Comunicamos un caso de celulitis por CMV: una mujer de 70 años con trasplante renal efectuado 1 mes antes de la consulta, terapia inmunosupresora con ciclosporina A y metilprednisona. La paciente ingresó por fiebre, dolor e impotencia funcional en pierna derecha. Comprobamos la existencia de una placa de 8 por 4 cm eritematoedematosa. La tratamos con antibióticos sin mejoría, por lo que realizamos un estudio histopatológico de piel que mostró cambios citopáticos compatibles con infección por CMV. Los cultivos bacteriológicos y micológicos fueron negativos. La inmunohistoquímica específica para CMV y el estudio de reacción en cadena de la polimerasa (PCR de la biopsia de piel fueron positivas, al igual que la antigenemia. El tratamiento con ganciclovir produjo la mejoría del cuadro clínico. En la literatura revisada no hemos encontrado la celulitis como manifestación de enfermedad cutánea por CMV.Cutaneous lesions in CMV infection are rare, often a late manifestation of systemic infection, and usually herald a fatal course. A 70 year-old woman received a kidney transplantation one month before consulting and immunosuppressive therapy that included cyclosporine A and methylprednisone. She complained of fever, local pain in her right leg, and an erythematous and swelling plaque. She was treated with intravenous antibiotics without improvement. A skin biopsy was performed and the tissue obtained was sent for bacterial and fungal cultures as well as for histological examination. Cultures were negative. The biopsy showed CMV cytopathic changes. Immunoperoxidase staining was positive for CMV and polymerase chain reaction (PCR testing revealed CMV DNA. She was treated with ganciclovir with resolution of the lesion. CMV cellulitis is a rare cutaneous manifestation

  6. (phoenicopterus roseus por intoxicación aguda por plomo

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    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.

  7. 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.

  8. Esporotricosis diagnosticada por el laboratorio

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    Nelly Ordóñez

    1989-06-01

    Full Text Available De 1976 a 1989 se han diagnosticado 40 casos de esporotricosis en el laboratorio de Micología del Instituto Nacional de Salud. La enfermedad se presentó en pacientes entre 4 y 52 años y tuvo predilección por el sexo masculino: 35 de 40 (87,5%; las formas clínicas más frecuentes fueron la cutánea fija, 18 de 40 (45%, y la linfocutánea, 17 de 40 (42,5%, con localización mayor en miembros superiores, 18 de 40 (45%. El diagnóstico se estableció por el aislamiento del Sporothrix schenckii en 35 de 38 pacientes (92%; los otros dos pacientes se diagnosticaron empleando otras técnicas: inmunofluorescencia directa, intradermorreacción y aglutinación en tubo.

  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. 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.

  11. 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.

  12. 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

  13. Abdome agudo por obstrução por ileobiliar

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    Márcia Cristina de Alencastro

    Full Text Available OBJETIVO: descrever a experiência na abordagem dos doentes com abdome agudo por obstrução por IB, desde o diagnóstico até o tratamento definitivo. MÉTODOS: estudo retrospectivo incluindo todos os casos de IB tratados em um período de 23 anos. De acordo com a abordagem cirúrgica realizada, os pacientes foram divididos em dois grupos (1 enterolitotomia com colecistectomia no segundo momento; e (2 enterolitotomia, colecistectomia e abordagem da fístula. RESULTADOS: Doze pacientes foram incluídos, sendo 11 mulheres (91,6%, com média de idade de 72,2 anos. Todos os pacientes apresentavam doenças associadas, principalmente hipertensão arterial sistêmica (75%. Dois pacientes não apresentavam sintomas significativos de obstrução intestinal. O diagnóstico de IB foi realizado em seis pacientes (50% antes da laparotomia. O grupo 1 foi constituído de oito pacientes e o grupo 2 de quatro, e a morbidade foi, respectivamente, 33,3% e 8,3%. A mortalidade foi 16,6% (um paciente de cada grupo. CONCLUSÃO: O manejo do IB deve ser individualizado. O tratamento da obstrução mediante remoção do cálculo biliar por enterotomia proximal é a escolha inicial para o tratamento do IB. A colecistectomia e a correção da fístula bilioentérica podem ser realizadas juntamente com a remoção do cálculo, no entanto, em pacientes com comorbidades significativas, esses procedimentos devem ser realizados posteriormente.

  14. 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

  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. 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...

  17. 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 ...

  18. 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...

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

    Directory of Open Access Journals (Sweden)

    Castillo Caicedo Maribel

    2007-08-01

    Full Text Available Este trabajo aporta una perspectiva del fenómeno de la sobreeducación,
    entendida como un desajuste por exceso, entre el nivel educativo alcanzado
    por el individuo y el exigido por el puesto de trabajo en el cual se
    desempeña; esto se debe a que existe una demanda laboral estrecha de
    puestos de trabajo para personas calificadas en Colombia. Se analizan las
    contribuciones empíricas existentes y el debate sobre las mismas; se
    examinan las teorías que permiten explicar la existencia de un desajuste
    educativo y se realiza una revisión de la literatura internacional y
    nacional sobre el tema. Adicionalmente, se plantean una serie de hipótesis
    para desarrollar un esquema que permita determinar el comportamiento
    del individuo en el fenómeno de la sobreeducación.

  20. 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.

  1. Muerte materna por malaria grave por Plasmodium vivax

    Directory of Open Access Journals (Sweden)

    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.

  2. Miasis ocular por Oestrus ovis

    Directory of Open Access Journals (Sweden)

    María Beltrán F

    2006-01-01

    Full Text Available Se presentan tres casos de miasis ocular (dos adultos y un niñoprocedentes de zonas ganaderas de la provincia de Huaura,departamento de Lima,que acudieron al Hospital Regional de Huacho por presentar el ojo rojo,fotofobia, edema palpebral y sensación de cuerpo extraño;se extrajeron larvas adheridas al canto interno del ojo,las cuales se recibieron en el Instituto Nacional de Salud y fueron identificadas como Oestrus ovis .

  3. Clonagem de canistel por estaquia

    Directory of Open Access Journals (Sweden)

    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.

  4. Medidor de distancias por ultrasonidos

    OpenAIRE

    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...

  5. 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...

  6. A Vida por Outros Lados

    Directory of Open Access Journals (Sweden)

    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.

  7. Por um hospital mais urbano

    OpenAIRE

    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...

  8. [Antimicrobial susceptibility of Gram-negative bacilli of community acquired intra-abdominal infections in a hospital at Buenos Aires, Argentina].

    Science.gov (United States)

    Morganti, L; Córdova, E; Cassini, E; Gómez, N; López Moral, L; Badía, M; Rodríguez, C

    2016-08-01

    Community acquired complicated intra-abdominal infections (cIAI) are a common condition. Few data are available about the level of antimicrobial resistance of Gram-negative bacteria isolated from community acquired cIAIs in Argentina. Retrospective-prospective observational study (March 2010 to February 2012). Gram-negative bacteria antimicrobial susceptibility of isolates from community acquired cIAIs were evaluated. During this period, a total of 85 patients were included and 138 pathogens were collected. Male sex: 58%. Median age: 33. Monomicrobial cultures were obtained in 49% of the cases. Ninety (65%) corresponded to Gram-negative organisms, and 48 (38%) to Gram-positive cocci. Gram-negative organisms most frequently observed were: Escherichia coli 76%, Klebsiella pneumoniae 8%, Pseudomonas aeruginosa 7% and Enterobacter spp. 6%. E. coli and K. pneumoniae showed a high percentage of strains resistance to ciprofloxacin of 37% and 29%, respectively. Similarly, resistance to ampicillin/sulbactam was observed in a 16% of the E. coli isolates. The prevalence of multiresistant Gram-negative organisms was 38%. A high level of resistance to antimicrobials was observed in community acquired cIAIs, mainly to ciprofloxacin and ampicillin/sulbactam two of the most used antimicrobial for empirically treatment of cIAIs in our country. In addition a significant proportion of multiresistant Gram-negative organisms were identified.

  9. Susceptibility trends and molecular characterization of Gram-negative bacilli associated with urinary tract and intra-abdominal infections in Jordan and Lebanon: SMART 2011-2013.

    Science.gov (United States)

    Hayajneh, Wail A; Hajj, Aline; Hulliel, Fawzi; Sarkis, Dolla Karam; Irani-Hakimeh, Noha; Kazan, Lama; Badal, Robert E

    2015-06-01

    To investigate phenotypic and genotypic patterns of antimicrobial resistance among Gram-negative bacilli associated with urinary tract infection (UTI) and intra-abdominal infection (IAI) in medical centres of Jordan and Lebanon. Gram-negative bacilli from the SMART study, collected between the years 2011 and 2013, were first identified at local laboratories. These isolates were shipped to a central laboratory where re-identification, susceptibility testing, and molecular characterization were performed using standard methods. Among the 523 UTI-associated isolates, Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis were the most frequent (70%, 14%, and 5%, respectively). E. coli, K. pneumoniae, and Pseudomonas aeruginosa were the most frequent species among the 527 IAI-associated isolates (46%, 14%, and 12%, respectively). Incidence rates of extended-spectrum beta-lactamase (ESBL) producers among UTI-associated E. coli, K. pneumoniae, and P. mirabilis were 43%, 54%, and 4%, respectively. Corresponding rates among IAI-associated isolates were 49%, 56%, and 12%, respectively. Acinetobacter baumannii and P. aeruginosa isolates showed very disturbing low susceptibility patterns. CTX-M-15 was the most prevalent ESBL produced. Seventeen isolates were non-susceptible to carbapenems (estimated prevalence of 1.6%). The alarmingly high rates of ESBL production and emergence of carbapenemases emphasize the urgent need to develop antimicrobial stewardship initiatives and to maintain antimicrobial resistance surveillance systems. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. 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.

  11. 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.

  12. [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.

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

    Science.gov (United States)

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

    2017-09-21

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

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

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    James A. Karlowsky

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

  15. 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.

  16. 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 (

  17. 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

  18. Polioencefalomalacia experimental em bovinos induzida por toxicose por enxofre

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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...

  6. 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

  7. Mortalidad intrahospitalaria por accidente cerebrovascular

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    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.

  8. 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...

  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

    to a huge number of different cytochromes P450s (from 50 to several hundred within one plant). Within the eudicotyledons, PORs can be divided into two major clades, POR 1 and POR 2. Based on our own sequencing analysis and publicly available data, we have identified 45 PORs from the angiosperm order Apiales...

  10. Miotoxicidade por organofosforados Organophosphate myotoxicity

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    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

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

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    Yong Pil Chong

    Full Text Available Complicated intra-abdominal infection (cIAI is infection that extends beyond the hollow viscus of origin into the peritoneal space, and is associated with either abscess formation or peritonitis. There are few studies that have assessed the actual costs and outcomes associated with failure of initial antibiotic therapy for cIAI. The aims of this study were to evaluate risk factors and impact on costs and outcomes of failure of initial antibiotic therapy for community-onset cIAI.A retrospective study was performed at eleven tertiary-care hospitals. Hospitalized adults with community-onset cIAI who underwent an appropriate source control procedure between August 2008 and September 2011 were included. Failure of initial antibiotic therapy was defined as a change of antibiotics due to a lack of improvement of the clinical symptoms and signs associated with cIAI in the first week.A total of 514 patients hospitalized for community-onset cIAI were included in the analysis. The mean age of the patients was 53.3 ± 17.6 years, 72 patients (14% had health care-associated infection, and 48 (9% experienced failure of initial antibiotic therapy. Failure of initial antibiotic therapy was associated with increased costs and morbidity. After adjustment for covariates, patients with unsuccessful initial therapy received an additional 2.9 days of parenteral antibiotic therapy, were hospitalized for an additional 5.3 days, and incurred $3,287 in additional inpatient charges. Independent risk factors for failure of initial antibiotic therapy were health care-associated infection, solid cancer, and APACHE II ≥13.To improve outcomes and costs in patients with community-onset cIAI, rapid assessment of health care-associated risk factors and severity of disease, selection of an appropriate antibiotic regimen accordingly, and early infection source control should be performed.

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

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    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.

  13. Comparative pharmacoeconomics and efficacy analysis of a new antibiotic adjuvant entity and piperacillin-tazobactam for the management of intra-abdominal infections: A retrospective study

    Directory of Open Access Journals (Sweden)

    Sandip Jadhav

    2016-01-01

    Full Text Available Objective: To analyze the comparative efficacy of piperacillin-tazobactam (PIP-TAZ and ceftriaxone-sulbactam with adjuvant (CSA in the treatment of intra-abdominal infections (IAIs and to assess the costs associated with respective therapies. Methods: The present study analyzed the data collected from 94 IAI patients treated at a tertiary-care hospital. Patient characteristics, infection types, surgical procedures, antibiotic therapies, treatment durations were recorded and overall cost involved in the infections management was estimated in Indian rupee. Results: In total, 46 patients received PIP-TAZ and 48 patients received CSA. The clinical cure was seen in 39.13% patients of PIP-TAZ group and 62.50% patients of CSA group. The patients diagnosed with mixed culture (Gram-positive and negative infections, needed additional cover of clindamycin to achieve clinical success. The failure patients from PIP-TAZ group were shifted to meropenem therapy. For the patients where meropenem and CSA therapy failed, colistin was given as an additional cover. Comparative cost expenditure analysis of the two drug treatment groups revealed that, the overall treatment cost for patients cured with empirical PIP-TAZ group was 51.79% more than that of CSA therapy. The strongest predictor of the increase in treatment costs was clinical failure. Similar trends were maintained for the patients cured with clindamycin additional therapy and change of therapy, with PIP-TAZ group accounting 36.11% and 39.99% more expenditure than CSA group. Conclusions: This study demonstrates that CSA has comparatively higher efficacy as compared to PIP-TAZ when used along with metronidazole in patients with different types of IAIs. Pharmacoeconomic analysis clearly shows that starting appropriate empirical antibiotic therapy has a large impact on the cost of treatment in management of IAIs and selection of CSA, can significantly reduce the cost involved in the treatment.

  14. 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.

  15. [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.

  16. [The value of postoperative C-reactive protein in predictive diagnosis of postoperative intra-abdominal septic complications for patients with Crohn disease].

    Science.gov (United States)

    Li, Y; Zhu, W M; Gong, J F; Guo, Z; Cao, L

    2016-08-01

    To analyze the value of postoperative C-reactive protein (CRP) in predictive diagnosis of postoperative intra-abdominal septic complications (IASC) for patients with Crohn disease (CD). Clinical data of patients with CD received intestinal resection and anastomosis surgery at Research Institute of General Surgery, Jinling Hospital from January 2011 to January 2015 were analyzed. Patients were divided into two groups by whether suffer from IASC 1 month after surgery, including IASC group and no-IASC group. Propensity score matching method was used to match the general clinical data. A total of 54 patients were analyzed, including IASC 17 cases, no-IASC 37 cases. Postoperative CRP at 1-day and 3-day were compared between the two groups using t test. Receiver operator characteristic (ROC) cure was used to analyze the value of postoperative CRP in predictive diagnosis of IASC. IASC group had higher levels of CRP at 1-day ((78±13) mg/L vs. (54±19) mg/L, t=4.633, P=0.000) and 3-day ((103±19) mg/L vs. (69±21) mg/L, t=5.859, P=0.000) after surgery than no-IASC group. ROC analysis showed that the CRP 3-day after surgery cut-off point value of 81.45 mg/L, as used for the predictive diagnosis of IASC, provided a sensitivity of 94.1%, a specificity of 82.9%, an area under the curve of 0.90, better than CRP 1-day after surgery. Postoperative CRP can be used as a predictive diagnosis of IASC for CD patients received intestinal resection and anastomosis surgery.

  17. 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.

  18. por láser

    Directory of Open Access Journals (Sweden)

    Mayra Garcimuño

    2013-01-01

    Full Text Available En el presente trabajo, la técnica Espectroscopia de plasmas producidos por láser (Laser-induced breakdown spectroscopy –LIBS– se aplicó a la determinación cuan- titativa de Na en agua natural dulce, de interés en agricultura para el estudio de la alcalinidad de aguas de regadío. Para efectuar el análisis, se prepararon soluciones con concentraciones conocidas del analito, se mezclaron con óxido de calcio y se compactaron en pastillas sólidas. Los plasmas se produjeron en aire a presión atmos- férica utilizando un láser pulsado Nd:YAG. Se construyó una curva de calibración y se calculó el límite de detección. Se analizaron muestras de agua natural y los resultados se compararon con los obtenidos mediante espectroscopia de absorción atómica. Se demostró la factibilidad del método para la determinación de Na en agua natural dulce.

  19. 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.

  20. 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...

  1. ¿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...

  2. ¿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...

  3. 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。

  4. 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...

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

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    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.

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

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    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.

  7. La inconstitucionalidad por omisión

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    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.

  8. Verdad por definición

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    Garrido Garrido, Julián

    1997-07-01

    Full Text Available Not available.La verdad por definición es un tipo peculiar de verdad científica, distinguible de las verdades lógicas, matemáticas y empíricas. La definición, por su parte, designa diversos procedimientos de asignación de significado, cuyas diferencias exigen una adjetivación cuidadosa: definiciones ostensivas y operacionales, definiciones de diccionario y definiciones teóricas. Pero sólo las del último tipo son verdaderas por definición. En el presente artículo se precisa el concepto formal de definición teórica, se delimita la estructura de esos enunciados, se analiza la verdad por definición, y se comparan, por último, las definiciones teóricas con los otros tipos de definición.

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

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    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

  10. Comparative evaluation of adhesion formation, strength of ingrowth, and textile properties of prosthetic meshes after long-term intra-abdominal implantation in a rabbit.

    Science.gov (United States)

    Novitsky, Yuri W; Harrell, Andrew G; Cristiano, Joseph A; Paton, B Lauren; Norton, H James; Peindl, Richard D; Kercher, Kent W; Heniford, B Todd

    2007-06-01

    Effective laparoscopic ventral herniorrhaphy usually mandates the use of an intraperitoneal prosthetic. Visceral adhesions and changes in textile characteristics of prosthetics may complicate repairs, especially long-term. The aim of this study was to compare the adhesion formation, tissue ingrowth, and textile characteristics one year after intra-abdominal placement of the commonly used prosthetic meshes. Forty (4 x 4 cm) meshes were sutured using absorbable suture to an intact peritoneum in 20 New Zealand white rabbits. The study groups included: polypropylene (PP) [Marlex; C.R. Bard Inc, Cranston, NJ], expanded polytetrafluoroethylene (ePTFE) [DualMesh; WL Gore, Flagstaff, AZ], ePTFE and PP (ePTFE/PP) [Composix, C.R. Bard Inc], reduced weight PP and oxidized regenerated cellulose (rPP/C) [Proceed; Ethicon, Inc, Somerville, NJ]. The meshes were explanted after one year. Adhesions were scored as a percentage of explanted biomaterials' affected surface area. Prosthetic shrinkage was calculated. The strength of incorporation and mesh compliance were evaluated using differential variable reluctance transducers. Mesh ingrowth was measured as the load necessary to distract the mesh/tissue complex. Mesh compliance was calculated as the change in linear displacement of the sensors due to applied load. The groups were compared using Student's t-test and Fisher's exact test. ePTFE had significantly less adhesions (0%) than both ePTFE/PP (40%) and PP (80%) groups (P < 0.001). The mean area of adhesions for the rPP/C (10%) and the ePTFE/PP (14%) groups was less than that for the PP group (40%) (P = 0.02). Prosthetic shrinkage was greatest in the ePTFE (32%) group than in any other group (P = 0.001). There were no differences in mesh incorporation between the groups. At explantation, mesh compliance in the ePTFE group was superior to other meshes (P < 0.0001). The rPP/C mesh induced the smallest change in the compliance of the tissue adjacent to the mesh (P = 0

  11. 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.

  12. Molecular characteristics of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae causing intra-abdominal infections from 9 tertiary hospitals in China.

    Science.gov (United States)

    Liao, Kang; Chen, Yili; Wang, Menghe; Guo, Penghao; Yang, Qiwen; 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; Xu, Yingchun

    2017-01-01

    Recently, the emergence of multidrug-resistant organisms such as extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has raised considerable concern regarding the appropriate treatment of intra-abdominal infections (IAIs). In this study, we investigated the molecular characteristics of ESBL among clinical isolates of Escherichia coli and Klebsiella pneumoniae causing IAIs and their pattern of antimicrobial resistance, which can provide useful information about the epidemiology and risk factors associated with these infections. One hundred sixty-seven E.coli and 47 K. pneumoniae ESBL-producing strains causing IAIs were collected from 9 hospitals in China, during 2012 and 2013. The antimicrobial susceptibility profile of these strains was determined. Polymerase chain reaction and sequencing were performed to identify genes for β-lactamase (blaTEM, blaSHV, blaOXA-1-like, and blaCTX-M). The isolates were also analyzed by pulsed-field gel electrophoresis (PFGE). In 167 ESBL-producing E. coli strains, 104 strains (62.3%) were positive for CTX-M, and 9 strains (5.39%) were positive for SHV. Among the 47 K. pneumoniae strains, 35 strains (74.5%) were positive for SHV-2a, 12 strains (25.5%) were positive for CTX-M. No TEM-type and OXA-1-like strain was detected among all the ESBL-producing strains. Regarding the CTX-M-positive E. coli and K. pneumoniae strains, CTX-M-15 was the most common genotype in E. coli and K. pneumoniae strains, accounting for 28.7% and 17.0%, respectively, followed by CTX-M-55 accounting for 16.2% and 2.13%, respectively; the remaining genotypes included CTX-M-123 and CTX-M-82. PFGE showed that E.coli and K. pneumoniae ESBL-producing strains causing IAIs were diverse and that emerging resistance may not be due to the dissemination of national clones. The present study revealed that in ESBL-producing strains causing IAIs in China, the most common genotype for E.coli was CTX-M-15 and for K. pneumoniae was SHV-2a. However, there was a

  13. 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

  14. The effect of intermittent intraabdominal pressure elevations and low cardiac output on the femoral to carotid arterial blood pressure difference in piglets.

    Science.gov (United States)

    Aksakal, Devrim; Hückstädt, Thomas; Richter, Steffen; Klitscher, Daniela; Wowra, Tobias; Schier, Felix; Wessel, Lucas M; Kubiak, Rainer

    2016-11-01

    Our previous work in a laparoscopic setting in piglets revealed that the systolic femoral artery pressure was approximately 5 % higher than its carotid counterpart, whereas the mean and diastolic values showed no significant difference. This remained idem when the intraabdominal pressure (IAP) was gradually increased. In this study, we aimed to investigate the effect of (1) intermittent IAP elevations and (2) a low cardiac output (CO) on the blood pressure (BP) difference cranially (carotid artery) and caudally (femoral artery) of a capnoperitoneum (ΔP = P a fem-P a carot). A total of twenty-two piglets (mean body weight 11.0 kg; range 8.9-13.3 kg) were studied. Of these, 14 underwent intermittent IAP elevations at 8 and 16 mmHg, and ΔP was measured. In another 8 piglets, a model of reduced CO was created by introducing an air embolism (2 ml/kg over 30 s) in the inferior caval vein (VCI) at 12 mmHg IAP to further assess the influence of this variable on ΔP. Systolic ΔP remained at a mean of 5.6 mmHg and was not significantly affected by insufflation or exsufflation up to an IAP of 16 mmHg. Diastolic and mean values showed no differences between P a carot and P a fem. P a fem, systol remained higher than its carotid counterpart as long as the cardiac index (CI) was above 1.5 l/min/m(2), but fell significantly below P a carot, systol at a low CI. There was no CO-dependent effect on diastolic and mean ΔP. Repeated IAP elevations do not significantly influence ΔP. Intermittent IAP elevations do not significantly influence ΔP. Despite of a CO-dependent inversion of systolic ΔP, mean BP measurements at the leg during laparoscopy remain representative even at low CO values.

  15. 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.

  16. 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

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    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

  17. 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。

  18. 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

  19. 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...

  20. CONFIANZA PARA EFECTUAR COMPRAS POR INTERNET

    Directory of Open Access Journals (Sweden)

    MIGUEL DAVID ROJAS LÓPEZ

    2009-01-01

    Full Text Available En este artículo se presenta una revisión sobre el estado del arte de la confianza, características principales y diferentes disciplinas desde donde se ha definido. Por otro lado, se aborda la confianza para realizar compras por Internet y se identifican sus diferentes características, a través del modelo basado en la jerarquía de aprendizaje estándar. Además, se agregan varios aspectos que han sido representativos para Colombia al momento de definir la confianza en Internet por parte de los consumidores. Finalmente, se expresan las principales conclusionessobre el tema.

  1. 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...

  2. 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...

  3. 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.

  4. Cirugía antirreflejo por laparoscopia

    OpenAIRE

    Vélez Londoño, José Pablo; Fundación Valle de Lili

    2002-01-01

    ¿Qué es el reflujo gastroesofágico?/¿Qué contribuye al RGE?/¿Cómo se diagnostica el RGE?/¿Qué es el esófago de Barrett?/¿Cómo se trata el RGE?/¿Cómo se realiza la cirugía antirreflujo por laparoscopía?/¿Cuáles son los resultados esperados después de la cirugía antirreflujo por laparoscopia?/¿Cuales son los riesgos de la cirugía antirreflujo por laparoscopia?/¿Qué sucede si la cirugía no puede realizarse completamente por vía laparoscopía?/¿Hay efectos molestos después de esta operación?/¿Qué ...

  5. 14 Nobel, preocupados por el CERN

    CERN Document Server

    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).

  6. Micetoma por Nocardia brasiliensis: reporte de caso

    Directory of Open Access Journals (Sweden)

    Miriam Guevara R

    2003-07-01

    Full Text Available Se presenta el caso de un paciente peruano, agricultor, con una infección cutánea de origen traumático causada por Nocardia brasiliensis, que evolucionó hacia la amputación del miembro inferior afectado. El diagnóstico se realizó por examen directo y cultivo del espécimen.

  7. 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.

  8. 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.

  9. Intoxicación por metales

    Directory of Open Access Journals (Sweden)

    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.

  10. Angiografia por tomografia computadorizada dos aneurismas intracranianos

    Directory of Open Access Journals (Sweden)

    Laureano Vinícius Santos

    2002-01-01

    Full Text Available Este trabalho foi realizado para avaliar os achados da angiografia por tomografia computadorizada, comparativamente à angiografia por subtração digital, em relação aos aneurismas intracranianos, e a possibilidade da maior utilização da angiografia por tomografia computadorizada no Brasil. Foram analisados oito pacientes que apresentavam um total de sete aneurismas não tratados e um aneurisma tratado. Houve subseqüente correlação com outros trabalhos publicados na literatura médica. Os exames foram realizados em uma clínica e em dois hospitais privados, na cidade do Rio de Janeiro, RJ. Foi demonstrada boa correlação entre os métodos estudados, em relação ao diagnóstico dos aneurismas, no acompanhamento e avaliação pré-terapêutica dessas lesões. A angiografia por tomografia computadorizada foi um exame menos invasivo, de menor custo e maior acessibilidade. Concluiu-se que a angiografia por tomografia computadorizada é um exame que deve ser utilizado com maior freqüência para avaliação nesta enfermidade.

  11. 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.).

  12. 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

  13. 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

  14. 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

  15. Neumopericardio debido a herida por arma blanca

    Directory of Open Access Journals (Sweden)

    Samuel I. Merino Barrera

    2015-10-01

    Full Text Available Hombre de 24 años de edad que ingresó en el hospital debido a una herida por arma blanca penetrante en el hemitórax derecho. La herida, de 3 cm a nivel de la piel, se localizaba a nivel del segundo espacio intercostal derecho y la radiografía de tórax demostró un neumotórax del mismo lado y una colección radiotransparente, por debajo del pericardio parietal, desde el origen de los grandes vasos hasta la porción apical del ventrículo izquierdo.

  16. 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...

  17. 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...

  18. Endoftalmite por Candida albicans Candida albicans endophthalmitis

    Directory of Open Access Journals (Sweden)

    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.

  19. 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...

  20. 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.

  1. Pedro Teixeira y su viaje por Mesopotamia

    Directory of Open Access Journals (Sweden)

    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.…

  2. Conflictos por el espacio y orden urbano

    Directory of Open Access Journals (Sweden)

    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.

  3. 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.

  4. 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.

  5. Osteomielitis esternal y escrofuloderma por vacuna BCG.

    Directory of Open Access Journals (Sweden)

    Ivohne Fernanda Corrales

    2003-06-01

    Full Text Available La vacuna BCG se ha usado en todo el mundo desde principios del siglo XX para la prevención de la tuberculosis. Se describe el caso de una niña de 13 meses de edad, previamente sana, que consultó por una masa esternal. El estudio radiológico mostró erosión perióstica. La lesión fue resecada y en la histopatología se encontró una reacción inflamatoria crónica con granulomas caseificantes con compromiso óseo y cutáneo. Se realizó una amplificación por PCR con iniciadores específicos de Mycobacterium tuberculosis del ADN obtenido a partir del tejido incluido en parafina, cuyo resultado fue negativo. Los antecedentes de vacunación con BCG, la aparición de este tipo de granulomas y la ausencia de ADN de M. tuberculosis en el tejido resecado apoyan el diagnóstico de osteomielitis esternal y escrofuloderma por BCG. La osteomielitis es una complicación infrecuente de la vacunación por BCG, que puede presentarse especialmente en pacientes inmunosuprimidos. La evolución clínica de la paciente no ha demostrado ninguna forma de inmunodeficiencia.

  6. 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.

  7. Linfoma de Burkitt: informe de un caso diagnosticado por laparotomía Burkitt's lymphoma: report of a case diagnosed by laparotomy

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    Rafael Pinilla González

    2008-12-01

    Full Text Available El linfoma de Burkitt no endémico es un tumor de frecuente localización abdominal, por lo que se debe tener presente ante cualquier masa intraabdominal. Aunque el tratamiento de elección es la quimioterapia, existe controversia respecto del papel que debe desempeñar la cirugía, especialmente en casos donde el diagnóstico se establece durante una laparotomía exploradora. Este fue el caso de una adolescente de 14 años que presentó una masa hipogástrica y otra menor en la fosa ilíaca derecha. Algunos autores no aceptan la cirugía y añaden que puede retrasar y complicar el tratamiento quimioterápeutico, mientras que otros autores defienden la cirugía reductora de masa tumoral asociada a la quimioterapia. Esta controversia es especialmente importante cuando el diagnóstico se establece en el curso de una laparotomía exploradora, durante la cual hay que decidir si extirpar la masa tumoral o no hacerlo. En nuestro caso decidimos extirpar todo el tumor macroscópico. La buena evolución de nuestra paciente y los resultados comunicados apoyan esta postura.Non-endemic Burkitt's lymphoma is a tumor of frequent abdominal localization that should be taken into consideration before any intraabdominal mass. Although chemotherapy is the election treatment, there is controversy as regards the role surgery should play, specially in those cases where the diagnosis is established by explorative laparotomy. This was the case of a 14-year-old adolescent that presented a hypogastric mass and another lower mass in the right iliac fossa. Some authors do not accept surgery and state that it may delay and complicate chemotherapy, whereas other authors defend the tumoral mass-reducing surgery associated with chemotherapy. This controversy is particularly important when the diagnosis is made in the course of an explorative laparotomy and it should be decided wether to remove the tumoral mass or not. In our case, it was decided to remove the whole macroscopic

  8. Eficacia del tratamiento guiado por cultivo en la infección por Helicobacter pylori

    OpenAIRE

    Puig del Castillo, Ignasi

    2016-01-01

    Los estudios que conforman esta Tesis Doctoral van dirigidos a ofrecer un análisis cualitativo y cuantitativo de la eficacia del tratamiento guiado por cultivo en la infección por Helicobacter pylori. Los resultados de estos estudios han sido recogidos en 2 artículos originales publicados en revistas de amplia difusión internacional. Tras la investigación de la eficacia del tratamiento guiado por cultivo, continuamos investigando la eficacia del tratamiento triple empírico con amoxicilina, me...

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

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    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.

  10. 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.

  11. 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.

  12. Obesidad y síndrome metabólico en niños y adolescentes

    Directory of Open Access Journals (Sweden)

    Dr. Castillo-Durán Garlos

    2012-03-01

    Full Text Available La obesidad general y en niños es un problema de salud pública con claro aumento a nivel mundial y en Chile. En las edades pediátricas, aparte de sus consecuencias traumatológicas, metabólicas y psicológicas, ya tiene un impacto en el riesgo de enfermedades en las edades adultas. El concepto de síndrome metabólico está en uso hace algunos años en la edad adulta, para aunar factores de riesgo de llegar a desarrollar diabetes tipo II y enfermedad cardiovascular. En pediatría hay suficiente evidencia que son factores predictores de riesgo desde la edad escolar la mayoría de los componentes estudiados en adultos: aumento de circunferencia abdominal, de presión arterial sistólica y diastólica, de triglicéridos y disminución de colesterol HDL sérico. Están en estudio otros componentes del síndrome: resistencia insulínica, adiposidad intraabdominal, hiperuricemia, hiperleptinemia, grosor aumentado de íntimamedia arterial, signos sugerentes de hígado graso. Se justifica el estudio de estos factores en niños y adolescentes obesos y su manejo intensivo por un equipo profesional entrenado.

  13. 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...

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

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    Nicolás Polanía Tello

    2012-12-01

    Full Text Available La sociedad por acciones simplificada –SAS–, como los demás esquemas societarios, se funda en y está informada por el principio de la buena fe. Pero a diferencia de los otros modelos, la SAS tiene concreciones particulares de la buena fe que permiten un amparo más efectivo y eficiente de los derechos de los socios y de los terceros, en la medida en que instituciones como el fraude a la ley, el perjuicio injusto a terceros, el abuso del derecho y el administrador de hecho, todos estructurados a partir de violaciones a la buena fe, permiten tramitar los eventos de responsabilidad por ilícitos atípicos y llegar incluso a desestimar por ello el atributo de la limitación de responsabilidad.

  15. 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.

  16. Tratamiento para manchas por fluorosis dental por medio de micro abrasion sin instrumentos rotatorios

    National Research Council Canada - National Science Library

    Molina-Frechero, Nelly; Villegas-Ham, Julio; Nevarez-Rascon, Alfredo; Bologna-Molina, Ronell; Castaneda-Castaneira, Enrique; Nevarez-Rascon, Martina M

    2010-01-01

    ... llenar las expectativas esteticas del paciente. La microabrasion es uno de los tratamientos mas conservadores para tratar las pigmentaciones y defectos causados en el esmalte dental por la ingesta de fluor...

  17. 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...

  18. Eumicetoma por Madurella grisea: relato de caso

    Directory of Open Access Journals (Sweden)

    Maria do Rosário Rodrigues Silva

    1991-03-01

    Full Text Available E relatado um caso de micetoma por Madurella grisea de localização podai em uma mulher do lar. A identificação da amostra foi feita através das características macro e microscópicas do agente em ágar Sabouraud e através da assimilação de açúcares. Este é o quinto caso de micetoma por Madurella grisea relatado no Brasil.One case of mycetoma produced by Madurella grisea localised on the foot of a house wife is reported. The identification of the strain was made through the following features: aspect of the grains, micro e macromorphology in Sabouraud agar and capacity of assimilation of the sugars. This is the fifth case of mycetoma by Madurella grisea reported from Brasil.

  19. Intoxicación por Superwarfarinas

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    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.

  20. Celulitis por cuerpo extraño

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    Miguel B. Carrasco Guzmán

    2016-01-01

    Full Text Available Las infecciones de la piel y el tejido celular subcutáneo surgen como un grupo importante de afecciones con una alta morbilidad en edades pediátricas, generalmente relacionada con traumatismo y cuerpos extraños. Se presenta el caso de una escolar femenina de 6 años de edad, con síntomas y signos clínicos que sugieren celulitis en el muslo derecho,  por su evolución tórpida se le realizó el estudio ultrasonográfico que confirmó el diagnóstico etiológico de una celulitis secundaria a un traumatismo, provocada por la introducción de un gran cuerpo extraño, que pasó inadvertido para a familia de la menor.

  1. 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.

  2. 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 ...

  3. 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.

  4. 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

  5. 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 ...

  6. 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.

  7. 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.

  8. Por un humor ético

    Directory of Open Access Journals (Sweden)

    Victor Paramo Valero

    2016-04-01

    Full Text Available Ética del humor es una obra original, abundantemente documentada, de contenido científico y filosófico, que aborda un problema de gran importancia en los actuales estudios de éticas aplicadas. La ética del humor es una nueva ética aplicada que pretende comprender el fenómeno del humor a la luz de sus implicaciones éticas. Como señala el autor, Juan Carlos Siurana, reputado experto en el ámbito de la filosofía práctica, el interés por el humor es un interés por la ética. En la obra no presenta una nueva teoría filosófica del humor –las cuales se han venido sucediendo, al menos, desde los Diálogos de Platón–, sino una nueva teoría ética, que toma al humor como objeto principal de análisis. Por tanto, la finalidad es realizar una aportación dentro del ámbito de la ética. Para ello se nutre de distintos estudios psicológicos, biológicos, fisiológicos y neurológicos sobre el humor, así como de clásicas obras de filosofía que han abordado esta cuestión.

  9. 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.

  10. Eritema multiforme mayor desencadenado por antimicrobianos

    Directory of Open Access Journals (Sweden)

    Ronaldo de Carvalho Raimundo

    2010-03-01

    Full Text Available El eritema multiforme, aparece como una enfermedad sistémica con la participación de la piel y las membranas mucosas en relación con varios factores como las infecciones bacterianas o virales, y en particular la administración de drogas, analgésicos y antibióticos en general. Se presenta un paciente masculino de 29 años de edad con eritema multiforme mayor desencadenado por antimicrobianos con la aparición de lesiones vesiculares-bulloso-ulcerosas en las regiones de los labios, encías, la lengua y la mucosa genital en tratamiento de una infección del tracto urinario con norfloxacino 400 mg por una semana. Fue realizado un tratamiento de soporte con el uso de colutorios para la higienización bucal y pomada a base de corticoide para protección de las úlceras, antihistamínicos y orientación nutricional de dieta líquida hipercalórica e hiperproteica. Este síndrome está caracterizado como un proceso eruptivo buloso agudo que compromete la calidad de vida del paciente y no hay pruebas de laboratorio específicas por lo que su diagnóstico debe estar basado en la revisión minuciosa de la anamnesis y en los hallazgos clínicos.

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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

  16. 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.

  17. Antimicrobial susceptibility of gram-negative pathogens isolated from patients with complicated intra-abdominal infections in South African hospitals (SMART Study 2004-2009): impact of the new carbapenem breakpoints.

    Science.gov (United States)

    Brink, Adrian J; Botha, Roelof F; Poswa, Xoliswa; Senekal, Marthinus; Badal, Robert E; Grolman, David C; Richards, Guy A; Feldman, Charles; Boffard, Kenneth D; Veller, Martin; Joubert, Ivan; Pretorius, Jan

    2012-02-01

    The Study for Monitoring Antimicrobial Resistance Trends (SMART) follows trends in resistance among aerobic and facultative anaerobic gram-negative bacilli (GNB) isolated from complicated intra-abdominal infections (cIAIs) in patients around the world. During 2004-2009, three centralized clinical microbiology laboratories serving 59 private hospitals in three large South African cities collected 1,218 GNB from complicated intra-abdominal infections (cIAIs) and tested them for susceptibility to 12 antibiotics according to the 2011 Clinical Laboratory Standards Institute (CLSI) guidelines. Enterobacteriaceae comprised 83.7% of the isolates. Escherichia coli was the species isolated most commonly (46.4%), and 7.6% of these were extended-spectrum β-lactamase (ESBL)-positive. The highest ESBL rate was documented for Klebsiella pneumoniae (41.2%). Overall, ertapenem was the antibiotic most active against susceptible species for which it has breakpoints (94.6%) followed by amikacin (91.9%), piperacillin-tazobactam (89.3%), and imipenem-cilastatin (87.1%), whereas rates of resistance to ceftriaxone, cefotaxime, ciprofloxacin, and levofloxacin were documented to be 29.7%, 28.7%, 22.5%, and 21.1%, respectively. Multi-drug resistance (MDR), defined as resistance to three or more antibiotic classes, was significantly more common in K. pneumoniae (27.9%) than in E. coli (4.9%; p<0.0001) or Proteus mirabilis (4.1%; p<0.05). Applying the new CLSI breakpoints for carbapenems, susceptibility to ertapenem was reduced significantly in ESBL-positive E. coli compared with ESBL-negative isolates (91% vs. 98%; p<0.05), but this did not apply to imipenem-cilastatin (95% vs. 99%; p=0.0928). A large disparity between imipenem-cilastatin and ertapenem susceptibility in P. mirabilis and Morganella morganii was documented (24% vs. 96% and 15% vs. 92%, respectively), as most isolates of these two species had imipenem-cilastatin minimum inhibitory concentrations in the 2-4 mcg/mL range, which

  18. 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.

  19. 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.

  20. 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.

  1. Vasculitis inducida por metimazol: Reporte de caso

    Directory of Open Access Journals (Sweden)

    Miguel Pinto

    2011-07-01

    Full Text Available Se reporta el caso de una paciente con enfermedad de Graves, que presentó vasculitis asociada al uso de metimazol. Mujer de 14 años, que acudió a consulta por presentar intolerancia al calor, tremor distal y palpitaciones. El examen físico mostró bocio difuso, y el perfil tiroideo, TSH suprimida y hormonas tiroideas elevadas. Los anticuerpos antiperoxidasa tiroidea fueron positivos. Se inició tratamiento con metimazol y beta bloqueadores. Después de 20 días, la paciente regresó por presentar malestar general, fiebre, poliartralgia, lesiones cutáneas maculopapulares y edema de miembros inferiores. Los anticuerpos antinucleares fueron negativos y los anticuerpos anticitoplasma de los neutrófilos (ANCA, positivos. Se suspendió el metimazol y se inició prednisona. Después de 10 días de tratamiento, las molestias desaparecieron y la paciente recibió I 131.Las vasculitis asociadas al uso de tionamidas son poco frecuentes, no dependen de la dosis y están asociadas a la presencia de anticuerpos tipo ANCA. Clásicamente, afectan a los vasos pequeños de la piel; sin embargo, también pueden afectar los riñones y pulmones. El cuadro clínico se caracteriza por artralgias y mialgias. En algunos casos puede ocurrir insuficiencia renal de grado variable. En la mayoría de casos, el cuadro remite con la suspensión de la droga; pero, en algunos se requiere el uso de glucocorticoides o inmunosupresores.(Rev Med Hered 2011;22:147-150.

  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. Aprendizaje por indagación: Electromagnetismo

    OpenAIRE

    Fernández Sánchez, David

    2014-01-01

    El aprendizaje por indagación se presenta como una estrategia que proporciona una educación de calidad haciendo partícipe al alumnado en la construcción de su conocimiento. El trabajo cooperativo, la investigación y una nueva forma de aprender son algunos de los beneficios que aporta para mejorar el proceso de enseñanza-aprendizaje de las ciencias. Se presentan en este trabajo una revisión teórica y una propuesta didáctica destinada a alumnos del tercer ciclo de Educación Primaria. El o...

  4. Neumonía por Stenotrophomonas maltophilia

    Directory of Open Access Journals (Sweden)

    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.

  5. 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...

  6. 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 ...

  7. 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

  8. 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 ...

  9. Osteonecrosis de los maxilares por bifosfonatos

    OpenAIRE

    Vidal Real, Carmen

    2017-01-01

    La osteonecrosis por bifosfonatos es una de las mayores complicaciones exclusivas de los huesos maxilares derivadas del tratamiento con bifofonatos orales e intravenosos en pacientes con osteoporosis, Enfermedad de Paget o metástasis óseas. EL origen de dicha complicación es desconocido pero se sabe que estos farmacos interfieren en los procesos de remodelación ósea, y además la flora bacteriana es un factor que puede promover su aparición y también retrasar su curación. El tratamiento conser...

  10. 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...

  11. 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%...

  12. 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 ...

  13. 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.

  14. Por uma arte no mundo da vida

    Directory of Open Access Journals (Sweden)

    Rachel Costa

    2016-12-01

    Full Text Available O artigo visa debater a análise colocada por Jacinto Lageira no texto “As razões do agir, contribuição a uma poética da ação”. O debate se estabelece no que concerne ao problema da autonomia da arte e suas consequências, tendo em vista a necessidade de pensar possibilidades contemporâneas para a experiência estética que pressuponham o mundo material. Isso é realizado a partir da teoria dos gestos do filósofo Vilém Flusser.

  15. 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...

  16. 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.

  17. Eritema multiforme mayor desencadenado por antimicrobianos

    OpenAIRE

    Ronaldo de Carvalho Raimundo; Thiago de Santana Santos; José Paulo da Silva Filho; Daniela Guimarães de Melo Albert; Emanuel Dias de Oliveira e Silva; Ana Cláudia Amorim Gomes

    2010-01-01

    El eritema multiforme, aparece como una enfermedad sistémica con la participación de la piel y las membranas mucosas en relación con varios factores como las infecciones bacterianas o virales, y en particular la administración de drogas, analgésicos y antibióticos en general. Se presenta un paciente masculino de 29 años de edad con eritema multiforme mayor desencadenado por antimicrobianos con la aparición de lesiones vesiculares-bulloso-ulcerosas en las regiones de los labios, encías, la len...

  18. 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 ...

  19. 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...

  20. Celulitis por Microascus trigonosporus(anamorfo Scopulariopsis trigonospora)

    National Research Council Canada - National Science Library

    DELIA CANLE CORTIÑAS; RICARDO FERNÁNDEZ RODRÍGUEZ; ANA CID LAMA; MARIA DOLORES DÍAZ LÓPEZ

    2013-01-01

    ... régimen de tratamiento para las infecciones por Scopulariopsis spp. Presentamos un caso excepcional de celulitis por Microascus trigonosporus en un paciente con tratamiento prolongado con corticoides. Abstract...