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

[Intraabdominal hypertension and abdominal compartment syndrome

DEFF Research Database (Denmark)

Sonne, M.; Hilligsø, Jens Georg

2008-01-01

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

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.

Presión intraabdominal y síndrome compartimental en cirugía. Artículo de revisión Intraabdominal pressure and compartment syndrome in surgery. Review article

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Roberto Sosa Hernández

2007-03-01

Full Text Available La hipertensión intraabdominal se define como el incremento de la presión dentro de la cavidad abdominal por encima de 10 cm. H2O, y se clasifica en cuatro grados de acuerdo a la severidad: I- 10 -15 cm. H2O, II- 16 -25 cm. H2O, III- 26 -35 cm. H2O y IV- mayor de 35 cm. H2O. El interés por la PIA y sus mediciones comenzó en la última mitad del siglo XIX; en la revisión de la literatura se encontró que desde principios de siglo, en EE.UU. se midió por primera vez la PIA, hasta que se propuso un método estandarizado de medirla con la ayuda de la sonda de Foley por vía transvesical a mediado de siglo. Con la determinación de múltiples factores que incrementan la PIA se conocieron las causas que provocan cambios fisiopatológicos sistémicos, la aparición de las manifestaciones clínicas y del SCA en los grados III y IV, permitiendo tomar una conducta quirúrgica precoz y menos riesgosa que podría mejorar los resultados de la atención a estos pacientes y su mortalidad.Intraabdominal hypertension is defined as the pressure increase within the abdominal cavity above 10 cm. H2O, and is classified into 4 degrees according to the severity: I, 10 - 15 cm. H2O; II, 16 - 25 cm. H2O; III, 26 - 35 cm. H2O; and IV, greater than 35 cm. H2O. The interest in the IP (Intraabdominal Pressure and its measurements began in the last half of the 19th. century. In the review of the literature it was found that, since the beginning of the century, in U.S.A. IP was first measured, until a standardized method was proposed to measure it, with the help of a Foley's probe, transvesically, by the half of the century. As multiple factors were determined that increase IP, the causes that trigger system pathological changes were known, as well as the emergence of clinical manifestations and abdominal compartment syndrome of degree III and IV, which allowed to take a less risky and earlier surgical stand.

Ratos isogênicos F344 como modelo biológico de sepsis intra-abdominal

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Sueli Blanes Damy

2002-01-01

Full Text Available Com o objetivo de estudar um modelo biológico de sepsis intra-abdominal aguda para estudos experimentais, foram infectados ratos isogênicos F344, convencionais, com a bactéria Escherichia coli (E.coli, cepa ATCC 11775, sorotipo H7:O1:K1. Os animais inoculados, machos e fêmeas, apresentaram 6 horas após a inoculação por E.coli os seguintes sintomas: arqueamento do dorso, piloereção, hiperpnéia e diminuição das atividades motoras. A dose que produziu 50% de mortalidade (DL50 após 7 dias, determinada pelo método Reed & Muench, foi de 6 x 10(5 CFU/ml (analisado em 32 machos e 32 fêmeas. A maior concentração de mortalidade foi observada nas primeiras 24 horas. A disfunção hepática, comum em sepsis intra-abdominal, foi avaliada por provas enzimáticas, em 0, 24, 48 e 168 horas após a inoculação. O estudo da migração de células polimorfonucleares-neutrófilos (PMN e mononucleares-macrófagos (MN apontou um aumento significante de PMN entre o grupos de machos (z ³ 4,7; p < 0,003 e de fêmeas (z ³ 6,2; p < 0,0003 inoculados E.coli, quando comparados ao grupos controles. Quanto às células MN, não houve diferença entre os grupos inoculados e os controles, tanto para os machos (z=2,3; p = 0,0107, como para as fêmeas (z=1,8; p =0,0359. Em conclusão, estes resultados demonstram que os ratos isogênicos F344 são modelos biológicos adequados para estudos de sepsis intra-abdominal aguda.

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

African Journals Online (AJOL)

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

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

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Gabriela Dalsasso Ricardo

2012-10-01

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

New Technique of Direct Intra-abdominal Pressure Measurement

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Elena Risin

2006-10-01

Conclusion: Direct measurement of intra-abdominal pressure using 14-Fr PVC round drain is a newly described technique that is simple, fast and credible. Future investigation will be needed to confirm the reliability of this method during postoperative follow-up of intra-abdominal pressures in selected patients.

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

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

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

2015-01-01

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

Does intra-abdominal fluid increase the resting energy expenditure?

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Zarling, E J; Grande, A; Hano, J

1997-10-01

In patients with intra-abdominal fluid collection, caloric needs are based on an estimated dry weight. This is done because intra-abdominal fluid has been assumed to be metabolically inactive. One recent study of patients with slowly resolving ascites suggested otherwise. In our study, the effect of intra-abdominal fluid on the resting energy expenditure (REE) and apparent lean body mass was determined in 10 stable patients requiring peritoneal dialysis. For each subject, in both the empty and full state, we measured REE by indirect calorimetry, and body composition by the bioelectric impedance method. In the full state, the VCO2 was significantly increased (210 +/- 11 versus 197 +/- 9 mL/min, P empty state. This caused an increase in the calculated resting energy expenditure (1531 +/- 88 kcal/d empty versus 1593 +/- 94 kcal/d full, P calories derived from glucose absorbed out of the dialysate. Estimates of body fat, lean body mass, and total water also were not affected by the intra-abdominal fluid. We conclude that intra-abdominal fluid will not affect the measured REE and hence may be considered to be metabolically inactive.

Mechanical ventilation and intra-abdominal hypertension: 'Beyond Good and Evil'

OpenAIRE

Pelosi, Paolo; Vargas, Maria

2012-01-01

Intra-abdominal hypertension is frequent in surgical and medical critically ill patients. Intra-abdominal hypertension has a serious impact on the function of respiratory as well as peripheral organs. In the presence of alveolar capillary damage, which occurs in acute respiratory distress syndrome (ARDS), intra-abdominal hypertension promotes lung injury as well as edema, impedes the pulmonary lymphatic drainage, and increases intra-thoracic pressures, leading to atelectasis, airway closure, ...

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

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Jamili Anbar Torquato

2009-02-01

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

Intra-abdominal fat area measurement using chest CT data

International Nuclear Information System (INIS)

Moriya, Hiroshi; Midorikawa, Shigeo; Hashimoto, Kouji; Ishii, Akira; Saitou, Kumi; Andou, Tomonori; Kitamura, Naoko; Sakuma, Koutarou

2007-01-01

Intra-abdominal fat obesity, which is linked with the metabolic syndrome, is usually characterized by measuring intra-abdominal fat area at the umbilical level of abdominal CT scan. In recent year, the chances of chest CT scanning are increased, as lung cancer screening survey or individual medical examination. Thus, we presented a method of measuring the areas of intra-abdominal fat and subcutaneous fat at the lower slice of chest CT scan. Fat areas found with this method were significantly correlated with those obtained at the umbilical level. (author)

Perinatal and early adulthood factors associated with adiposity Fatores perinatais e da vida adulta jovem associados à adiposidade

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Vanda Maria Ferreira Simões

2012-07-01

Full Text Available We used body mass index (BMI and waist circumference (WC as fat indicators to assess whether perinatal and early adulthood factors are associated with adiposity in early adulthood. We hypothesized that risk factors differ between men and women and are also different when WC is used for measuring adiposity as opposed to BMI. We conducted a longitudinal study based on a sample of 2,063 adults from the 1978/1979 Ribeirão Preto birth cohort. Adjustment was performed using four sequential multiple linear regression models stratified by sex. Both perinatal and early adulthood variables influenced adulthood BMI and WC. The associations differed between men and women and depending on the measure of abdominal adiposity (BMI or WC. Living with a partner, for both men and women, and high fat and alcohol intake in men were factors that were consistently associated with higher adulthood BMI and WC levels. The differences observed between sexes may point to different lifestyles of men and women, suggesting that prevention policies should consider gender specific strategies.Utilizou-se o índice de massa corporal (IMC e a circunferência de cintura (CC para avaliar se alguns fatores perinatais e da vida adulta se associam com adiposidade na vida adulta jovem. Trabalhou-se com a hipótese de que os fatores de risco diferem entre homens e mulheres e também são diferentes quando a CC é utilizada como medida de adiposidade em vez do IMC. Realizou-se estudo longitudinal baseado em 2.063 pessoas da coorte de nascimentos de 1978/1979 de Ribeirão Preto, São Paulo, Brasil. Foi feito ajuste sequencial em quatro modelos de regressão linear múltipla, estratificados por sexo. Tanto variáveis do início da vida como atuais interferiram no IMC e na CC. As associações foram diferentes para homens e mulheres, e também quando se considerou o IMC ou a CC. Homens e mulheres que vivem com companheira(o e homens que têm consumo elevado de gordura e álcool apresentam

Intraabdominal abscess caused by Stenotrophomonas maltophilia: A case report

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Toyomitsu Sawai

Full Text Available Introduction: Stenotrophomonas maltophilia usually causes nosocomial infections, but intraabdominal abscesses or organ/space surgical site infection (SSI secondary to this organism has been rarely reported. Here, we reported a rare case of SSI that presented as intraabdominal abscess caused by S. maltophilia. Presentation of case: A 68-year-old woman presented to our hospital with transverse colon cancer. Further work up with abdominal computed tomography (CT revealed left renal cell carcinoma. Transverse colon resection and left kidney partial resection were performed. On post-operative day 10, she started to have fever at 38 °C and repeat abdominal CT showed intraabdominal abscess. Empiric treatment with piperacillin/tazobactam (TAZ/PIPC was initiated. However, fever persisted and the abscess size did not change despite 10 days of antibiotic. On post-operative day 20, drainage of intraabdominal abscess was performed. TAZ/PIPC was then shifted to meropenem (MEPM. After two days, S. maltophilia was identified in the culture of the abscess, and MEPM was shifted to minocycline (MINO. Fever disappeared after 7 days of treatment and abdominal CT after 14 days showed almost complete resolution of the abscess. Discussion: S. maltophilia is a multi-drug resistant, aerobic, non-glucose fermenting, non-sporulating, Gram-negative bacillus. S. maltophilia may cause a variety of infections, but intraabdominal abscesses as a manifestation of SSI due to this organism is relative rare. Conclusion: Although usually a non-pathogenic organism or colonizer, S. maltophilia can cause organ/space SSI in an immunocompromised host. Therefore, clinicians should be aware of the possibility that S. maltophilia may cause organ/space SSI. Keywords: Stenotrophomonas maltophilia, Intraabdominal abscess, Surgical site infections

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

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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.

Diagnosis of intra-abdominal infections and management of catastrophic outcomes

NARCIS (Netherlands)

Atema, J.J.

2015-01-01

Intra-abdominal infections are a diverse group of frequently encountered conditions of varying severity with various underlying pathologies. The first part of this thesis focused on the diagnostic work-up of suspected intra-abdominal infections. The diagnosticvalue of commonly used inflammatory

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.

Value and limitations of transpulmonary pressure calculations during intra-abdominal hypertension.

Science.gov (United States)

Cortes-Puentes, Gustavo A; Gard, Kenneth E; Adams, Alexander B; Faltesek, Katherine A; Anderson, Christopher P; Dries, David J; Marini, John J

2013-08-01

To clarify the effect of progressively increasing intra-abdominal pressure on esophageal pressure, transpulmonary pressure, and functional residual capacity. Controlled application of increased intra-abdominal pressure at two positive end-expiratory pressure levels (1 and 10 cm H2O) in an anesthetized porcine model of controlled ventilation. Large animal laboratory of a university-affiliated hospital. Eleven deeply anesthetized swine (weight 46.2 ± 6.2 kg). Air-regulated intra-abdominal hypertension (0-25 mm Hg). Esophageal pressure, tidal compliance, bladder pressure, and end-expiratory lung aeration by gas dilution. Functional residual capacity was significantly reduced by increasing intra-abdominal pressure at both positive end-expiratory pressure levels (p ≤ 0.0001) without corresponding changes of end-expiratory esophageal pressure. Above intra-abdominal pressure 5 mm Hg, plateau airway pressure increased linearly by ~ 50% of the applied intra-abdominal pressure value, associated with commensurate changes of esophageal pressure. With tidal volume held constant, negligible changes occurred in transpulmonary pressure due to intra-abdominal pressure. Driving pressures calculated from airway pressures alone (plateau airway pressure--positive end-expiratory pressure) did not equate to those computed from transpulmonary pressure (tidal changes in transpulmonary pressure). Increasing positive end-expiratory pressure shifted the predominantly negative end-expiratory transpulmonary pressure at positive end-expiratory pressure 1 cm H2O (mean -3.5 ± 0.4 cm H2O) into the positive range at positive end-expiratory pressure 10 cm H2O (mean 0.58 ± 1.2 cm H2O). Despite its insensitivity to changes in functional residual capacity, measuring transpulmonary pressure may be helpful in explaining how different levels of positive end-expiratory pressure influence recruitment and collapse during tidal ventilation in the presence of increased intra-abdominal pressure and in

The first experience with intraabdominal chemotherapy in patients with disseminated ovarian cancer

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A. S. Tyulyandina

2011-01-01

Full Text Available Ovarian cancer (OC is characterized by its late diagnosis, mainly local tumor dissemination within the abdomen and small pelvis, and a relatively high susceptibility to drug therapy . Intraabdominal chemotherapy (CT allows the higher intraabdominal drug concentrations to be produced as compared to systemic CT and, according to the data of some investigations, improves the results of treatment in a few patients with minimal tumor foci. In this connection, it is urgent to master the procedure of intraperitoneal CT, including to pl ace an intraabdominal port, to elaborate a regimen, and to determine the spectrum of its toxicity and safety.Subjects and methods. The paper gives the preliminary results of a pilot trial using intraabdominal CT in 8 patients with disseminated OC and fallopian tubes who have undergone optimal-volume surgical interventions in stage 1. All the patients received CT by the scheme: intravenous paclitaxel (135 mg/m 2 on day 1, intraabdominal cisplatin (75 mg/m 2 on day 2, and intraabdominal paclitaxel (60 mg/m 2 on day 8. A total of 6 courses were scheduled.Results. At the analysis of the results, 5 out the 8 patients received all the scheduled courses of CT, 3 patients continued treatment, including 1 patient in whom the intraabdominal port w as removed after the first course of CT because of significant fibrosis along the in traabdominal catheter, thereafter she continued to be treated by the standard intravenous scheme. Among local toxicity signs, there was a preponderance of grades 1–2 abdominal pains occurring after the intraabdominal administrations of chemotherapy preparations. Systemic toxicity, including hematological one, was moderate; in any cases it did not cause life-threatening complications or lead to the increase of course intervals or to the refusal of intraabdominal CT. At a median follow-up of 10.2 months (range 1.9–24.7 months or more, one patient w as found to have disease progression 12 months of

Complicated Intra-Abdominal Infections Observational European study (CIAO Study

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Sartelli Massimo

2011-12-01

Full Text Available Abstract Complicated intra-abdominal infections are frequently associated with poor prognoses and high morbidity and mortality rates. Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. In order to describe the clinical, microbiological, and management-related profiles of both community-acquired and healthcare-acquired complicated intra-abdominal infections (IAIs, the World Society of Emergency Surgery (WSES, in collaboration with the Surgical Infections Society of Europe (SIS-E and other prominent European surgical societies, has designed the CIAO study. The CIAO study is a multicenter, observational study and will be carried out in various surgical departments throughout Europe. The study will include patients undergoing surgery or interventional drainage for complicated IAI.

Orchiopexy for intra-abdominal testes: factors predicting success.

Science.gov (United States)

Stec, Andrew A; Tanaka, Stacy T; Adams, Mark C; Pope, John C; Thomas, John C; Brock, John W

2009-10-01

Intra-abdominal testes can be treated with several surgical procedures. We evaluated factors influencing the outcome of orchiopexy for intra-abdominal testis. We retrospectively reviewed 156 consecutive orchiopexies performed for intra-abdominal testis, defined as a nonpalpable testis on examination and located in the abdomen at surgery. All surgical approaches were included in the study. Primary outcome was the overall success rate and secondary outcomes were success based on surgical approach, age and a patent processus vaginalis. Success was considered a testis with normal texture and size compared to the contralateral testis at followup. Multivariate analysis was performed to determine factors predictive of success. The overall success rate of all orchiopexies was 79.5%. Median patient age at orchiopexy was 12 months and mean followup was 16 months. Of the patients 117 had a patent processus vaginalis at surgery. One-stage abdominal orchiopexy was performed in 92 testes with 89.1% success. Of these cases 32 were performed laparoscopically with 96.9% success. One-stage Fowler-Stephens orchiopexy was performed in 27 testes and 2-stage Fowler-Stephens orchiopexy was performed in 37 with success in 63.0% and 67.6%, respectively. Multivariate analysis revealed that 1-stage orchiopexy without vessel division had more successful outcomes than 1 and 2-stage Fowler-Stephens orchiopexy (OR 0.24, p = 0.007 and 0.29, p = 0.19, respectively). Neither age at surgery nor an open internal ring was significant (p = 0.49 and 0.12, respectively). The overall success of orchiopexy for intra-abdominal testis is 79.5%. While patient selection remains a critical factor, 1-stage orchiopexy without vessel division was significantly more successful and a laparoscopic approach was associated with the fewest failures for intra-abdominal testes.

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

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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.

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 ...

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

NARCIS (Netherlands)

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

1994-01-01

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

A case study in intra-abdominal sepsis.

Science.gov (United States)

Paul, Jasmeet S; Ridolfi, Timothy J

2012-12-01

Intra-abdominal infections are a common problem for the general surgeon and major sources of morbidity and mortality in the intensive care unit. Some of these patients present with peritonitis that can rapidly progress to septic shock. The basic principles of care include prompt resuscitation, antibiotics, and source control. This article will use a detailed case study to outline the management of a patient with severe intra-abdominal infection from diverticulitis from initial resuscitation to reconstruction. Components of the Surviving Sepsis Campaign as they pertain to surgical patients are discussed and updated, and the concept of damage control general surgery is applied. Copyright © 2012. Published by Elsevier Inc.

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

Directory of Open Access Journals (Sweden)

Luís Paulo Gomes Mascarenhas

2005-08-01

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

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: retroperitonea...... be beneficial in alleviating intra-abdominal obesity by enhancing lipolysis in intra-abdominal fat depots.......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......: 73 +/- 12 (trained) vs. 14 +/- 4 (sedentary) ml. 100 g(-1). min(-1), P abdominal than in subcutaneous AT in both trained...

Intra-abdominal fat: Comparison of computed tomography fat segmentation and bioimpedance spectroscopy.

Science.gov (United States)

Finch, Peter

2017-06-01

Intra-abdominal fat is an important factor in determining the metabolic syndrome/insulin resistance, and thus the risk of diabetes and ischaemic heart disease. Computed Tomography (CT) fat segmentation represents a defined method of quantifying intra-abdominal fat, with attendant radiation risks. Bioimpedance spectroscopy may offer a method of assessment without any risks to the patients. A comparison is made of these two methods. This was a preliminary study of the utility of multifrequency bioimpedance spectroscopy of the mid abdomen as a measure of intra-abdominal fat, by comparison with fat segmentation of an abdominal CT scan in the -30 to -190 HU range. There was a significant (P abdominal fat and mid-upper arm circumference, as well as the bioimpedance parameter, the R/S ratio. Multivariate analysis showed that these were the only independant variables and allowed the derivation of a formula to estimate intra-abdominal fat: IAF = 0.02 × MAC - 0.757 × R/S + 0.036. Circumabdominal bioimpedance spectroscopy may prove a useful method of assessing intra-abdominal fat, and may be suitable for use in studies to enhance other measures of body composition, such as mid-upper arm circumference.

The Increase of Intra-Abdominal Pressure Can Affect Intraocular Pressure

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Ilhan Ece

2015-01-01

Full Text Available Objective. This study aims to explore the usage of intraocular pressure measurements as the early indicator of the increase in intra-abdominal pressure. Methods. In this prospective study, 40 patients undergoing elective surgery were included. Patients were divided into four groups of 10 patients. The control group (Group C was not subjected to laparoscopic intervention. Laparoscopic surgery was, respectively, performed with an intra-abdominal pressure of 9, 12, and 15 mmHg in Groups L (low, M (medium, and H (high pressure. Intraocular pressure was measured binocularly in each patient at three different times (before, during, and end of surgery using a contact tonometer. Results. Patients’ gender, age, body mass index (BMI, American Society of Anesthesiology (ASA class, and operative times were not different among the groups. No complications occurred with either the surgery or measurement of intraocular pressure. Intubation was associated with a severe rise in IOP (P<0.05. An increase in intraocular pressure was seen in groups M and H (P<0.05. Conclusion. Intraocular pressure was increased in the groups with an intra-abdominal pressure of 12 mmHg or more. Measuring the intraocular pressure might be a useful method to estimate the intra-abdominal pressure. This trial is registered with NCT02319213.

Intra-abdominal fat accumulation is a hypertension risk factor in young adulthood: A cross-sectional study.

Science.gov (United States)

Takeoka, Atsushi; Tayama, Jun; Yamasaki, Hironori; Kobayashi, Masakazu; Ogawa, Sayaka; Saigo, Tatsuo; Kawano, Hiroaki; Abiru, Norio; Hayashida, Masaki; Maeda, Takahiro; Shirabe, Susumu

2016-11-01

Accumulation of intra-abdominal fat is related to hypertension. Despite this, a relationship between hypertension and intra-abdominal fat in young adulthood is not clear. In this study, we verify whether intra-abdominal fat accumulation increases a hypertension risk in young adult subjects.In a cross-sectional study, intra-abdominal fat area was measured using a dual bioelectrical impedance analysis instrument in 697 university students (20.3 ± 0.7 years, 425 men). Blood pressure and anthropometric factors were measured. Lifestyle variables including smoking, drinking, physical activity, and eating behavior were assessed with questionnaire. High blood pressure risk (systolic blood pressure ≥130 mm Hg and/or diastolic blood pressure ≥85 mm Hg) with increasing intra-abdominal fat area was evaluated.Participants were divided into 5 groups according to their intra-abdominal fat area (≤24.9, 25-49.9, 50-74.9, 75-99.9, and ≥100 cm). As compared with the values of the smallest intra-abdominal fat area group, the crude and lifestyle-adjusted odds ratios (ORs) were elevated in larger intra-abdominal fat area groups [OR 1.31, 95% confidence interval (CI) 0.66-2.80; OR 3.38, 95% CI 1.60-7.57; OR 7.71, 95% CI 2.75-22.22; OR 18.74, 95% CI 3.93-105.64, respectively). The risk increase was observed only in men.Intra-abdominal fat accumulation is related to high blood pressure in men around 20 years of age. These results indicate the importance of evaluation and reduction of intra-abdominal fat to prevent hypertension.

Ectopic intra-abdominal fascioliasis

OpenAIRE

ÖNGÖREN, Ali Ulvi

2009-01-01

Human fascioliasis, caused by Fasciola hepatica, is emerging as an important chronic zoonotic disease in many areas of the world, including Turkey. It primarily involves the liver and may also cause severe damage in the tissue. Herein we report on a patient with ectopic intra-abdominal fascioliasis that presented to our clinic with abdominal pain and distention. Physical and radiological examination as well as an exploratory laparotomy revealed a 10 × 10-cm mass in the splenic flexura of the ...

Gallic Acid Attenuates Postoperative Intra-Abdominal Adhesion by Inhibiting Inflammatory Reaction in a Rat Model

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Wei, Guangbing; Wu, Yunhua; Gao, Qi; Shen, Cong; Chen, Zilu; Wang, Kang; Yu, Junhui

2018-01-01

Background Intra-abdominal adhesion is one of the most common complications after abdominal surgery. The efficacy of current treatments for intra-abdominal adhesion is unsatisfactory. In this study, we investigated the effect of gallic acid on the prevention and treatment of intra-abdominal adhesions after abdominal surgery using an intra-abdominal adhesion rat model. Material/Methods The experimental rats were randomly divided into the sham operation group, the control group, the chitosan group, and 3 gallic acid groups of different concentrations. All rats except those in the sham operation group received cecal abrasion to induce adhesion. From the first postoperative day, the rats in the gallic acid groups were administered different concentrations of gallic acid in a 2-ml gavage daily. All rats were sacrificed on postoperative day 7, and the degree of intra-abdominal adhesion was evaluated by the naked eye. The amount of collagen deposited between the injured peritoneal tissues was assessed by Sirius red staining. Serum levels of interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and transforming growth factor-β (TGF-β) were measured by ELISA. Western blot was used to detect the level of NF-κB phosphorylation in the injured peritoneal or adhesion tissues of the rats. Results Compared with the control group, the scores of intra-abdominal adhesions in the rats treated with larger doses of gallic acid were significantly decreased, and the degree of inflammation and fibrosis was also significantly decreased. Gallic acid significantly reduced IL-6, TNF-α, and TGF-β1 serum levels. NF-κB phosphorylation in the higher gallic acid groups was significantly reduced. Conclusions Gallic acid inhibits the formation of postoperative intra-abdominal adhesions in rats by inhibiting the inflammatory reaction and fibrogenesis. Gallic acid is a promising drug for preventing intra-abdominal adhesions. PMID:29429982

Effects of different tidal volumes in pulmonary and extrapulmonary lung injury with or without intraabdominal hypertension.

Science.gov (United States)

Santos, Cíntia L; Moraes, Lillian; Santos, Raquel S; Oliveira, Mariana G; Silva, Johnatas D; Maron-Gutierrez, Tatiana; Ornellas, Débora S; Morales, Marcelo M; Capelozzi, Vera L; Jamel, Nelson; Pelosi, Paolo; Rocco, Patricia R M; Garcia, Cristiane S N B

2012-03-01

We hypothesized that: (1) intraabdominal hypertension increases pulmonary inflammatory and fibrogenic responses in acute lung injury (ALI); (2) in the presence of intraabdominal hypertension, higher tidal volume reduces lung damage in extrapulmonary ALI, but not in pulmonary ALI. Wistar rats were randomly allocated to receive Escherichia coli lipopolysaccharide intratracheally (pulmonary ALI) or intraperitoneally (extrapulmonary ALI). After 24 h, animals were randomized into subgroups without or with intraabdominal hypertension (15 mmHg) and ventilated with positive end expiratory pressure = 5 cmH(2)O and tidal volume of 6 or 10 ml/kg during 1 h. Lung and chest wall mechanics, arterial blood gases, lung and distal organ histology, and interleukin (IL)-1β, IL-6, caspase-3 and type III procollagen (PCIII) mRNA expressions in lung tissue were analyzed. With intraabdominal hypertension, (1) chest-wall static elastance increased, and PCIII, IL-1β, IL-6, and caspase-3 expressions were more pronounced than in animals with normal intraabdominal pressure in both ALI groups; (2) in extrapulmonary ALI, higher tidal volume was associated with decreased atelectasis, and lower IL-6 and caspase-3 expressions; (3) in pulmonary ALI, higher tidal volume led to higher IL-6 expression; and (4) in pulmonary ALI, liver, kidney, and villi cell apoptosis was increased, but not affected by tidal volume. Intraabdominal hypertension increased inflammation and fibrogenesis in the lung independent of ALI etiology. In extrapulmonary ALI associated with intraabdominal hypertension, higher tidal volume improved lung morphometry with lower inflammation in lung tissue. Conversely, in pulmonary ALI associated with intraabdominal hypertension, higher tidal volume increased IL-6 expression.

Abdominal Tuberculosis Mimicking Intra-abdominal Malignancy: A ...

African Journals Online (AJOL)

TNHJOURNALPH

BACKGROUND. Abdominal TB usually presents with nonspecific findings and may thus m.,mw a multitude of gastrointestinal disorders. Abdominal tuberculosis may therefore present as large and palpable intra-abdominal masses usually arising from lymphadenopathy which may mimic lymphomas and other malignancies.

Abdominal tuberculosis mimicking intra-abdominal malignancy: A ...

African Journals Online (AJOL)

Background: Abdominal TB usually presents with nonspecific findings and may thus mimic a multitude of gastrointestinal disorders. Abdominal tuberculosis may therefore present as large and palpable intra-abdominal masses usually arising from lymphadenopathy which may mimic lymphomas and other malignancies.

Dynamics of albumin synthetic response to intra-abdominal abscess in patients with gastrointestinal fistula.

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

2014-04-01

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

WSES consensus conference: Guidelines for first-line management of intra-abdominal infections

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Leppaniemi Ari

2011-01-01

Full Text Available Abstract Intra-abdominal infections are still associated with high rate of morbidity and mortality. A multidisciplinary approach to the management of patients with intra-abdominal infections may be an important factor in the quality of care. The presence of a team of health professionals from various disciplines, working in concert, may improve efficiency, outcome, and the cost of care. A World Society of Emergency Surgery (WSES Consensus Conference was held in Bologna on July 2010, during the 1st congress of the WSES, involving surgeons, infectious disease specialists, pharmacologists, radiologists and intensivists with the goal of defining recommendations for the early management of intra-abdominal infections. This document represents the executive summary of the final guidelines approved by the consensus conference.

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

NARCIS (Netherlands)

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

2017-01-01

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

Noninvasive detection and mapping of intraabdominal adhesions

DEFF Research Database (Denmark)

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

2010-01-01

BACKGROUND: Adhesions are a well-known and very common complication to surgery. Their extent and severity varies according to type and number of surgeries, use of intraabdominal mesh, and presence of peritonitis. Adhesions cause increased morbidity and mortality, with subsequent socioeconomic con...

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.

El consumo regular de bebidas azucaradas incrementa el perfil lipídico-metabólico y los niveles de adiposidad en universitarios de Colombia

OpenAIRE

Robinson Ramírez-Vélez; Mónica L. Ojeda; M. Alejandra Tordecilla; Jhonatan C. Peña; José F. Meneses

2016-01-01

Objetivo: Examinar si el consumo de bebidas azucaradas se relaciona con alteraciones en el perfil lipídico-metabólico y con marcadores de adiposidad en una muestra de estudiantes universitarios de Colombia. Métodos: Estudio transversal en 280 voluntarios (73,9% varones) de 3 universidades de Colombia. El consumo de bebidas azucaradas se obtuvo mediante un cuestionario de frecuencia de ingesta en los últimos 7 días (BEVQ-15) en los dominios: bebidas azucaradas carbonatadas y refrescos de ju...

Original Research Intra-abdominal fat: Comparison of computed ...

African Journals Online (AJOL)

advantage for composition measurement of no radiation exposure ... Computed Tomography (CT) fat segmentation represents a defined method of quantifying intra-abdominal fat, with .... spiral CT scan with 3-mm slices covering the abdomen,.

Use of percutaneous image-guided coaxial core-needle biopsy for diagnosis of intraabdominal lymphoma

International Nuclear Information System (INIS)

Shimizu, Ikuo; Okazaki, Yoichi; Takeda, Wataru; Kirihara, Takehiko; Sato, Keijiro; Fujikawa, Yuko; Ueki, Toshimitsu; Hiroshima, Yuki; Sumi, Masahiko; Ueno, Mayumi; Ichikawa, Naoaki; Kobayashi, Hikaru

2014-01-01

Although pathological diagnosis is essential for managing malignant lymphoma, intraabdominal lesions are generally difficult to approach due to the invasiveness of abdominal surgery. Here, we report the use of percutaneous image-guided coaxial core-needle biopsy (CNB) to obtain intraabdominal specimens for diagnosing intraabdominal lymphomas, which typically requires histopathological and immunohistochemical evaluation. We retrospectively reviewed consecutive cases involving computed tomography (CT)- or ultrasonography (US)-guided CNB to obtain pathological specimens for intraabdominal lesions from 1999 to 2011. Liver, spleen, kidney, and inguinal node biopsies were excluded. We compared CNBs with laparotomic biopsies. A total of 66 CNBs were performed for 59 patients (32 males, 27 females; median age, 63.5), including second or third repeat procedures. Overall diagnostic rate was 88.5%. None of the patients required additional surgical biopsies. Notably, the median interval between recognition of an intraabdominal mass and biopsy was only 1 day. Forty-five procedures were performed for hematological malignancies. Adequate specimens were obtained for histopathological diagnosis in 86% of cases. Flow cytometry detected lymphoma cells in 79.5% of cases. Twelve patients (nine males, three females; median age, 60) were eligible for surgical biopsy. While every postoperative course was satisfactory, median duration from lesion recognition to therapy initiation for lymphoma cases was significantly shorter for CNB than for surgical biopsy (14 vs. 35 days). While one-fourth of the patients were not eligible for the procedures, CNB is safe and highly effective for diagnosis of intraabdominal lymphomas. This method significantly improves sampling and potentially helps attain immunohistological distinction, allowing for more timely therapy initiation

Ultrasonography and indium 111 white blood cell scanning for the detection of intraabdominal abscesses

International Nuclear Information System (INIS)

Carroll, B.; Silverman, P.M.; Goodwin, D.A.; McDougall, I.R.

1981-01-01

Ultrasound and indium 111 white blood cell scanning were performed on 163 patients with suspected intraabdominal abscesses. In all but one case, intraabdominal abscesses were correctly identified by one or both tests; conversely, no patient was falsely diagnosed by both tests to have an abscess. Sonography was useful in those patients with focal symptoms, and frequently identified nonabscess causes for fever. White cell scanning was valuable when focal signs were absent, and frequently identified extraabdominal sources of sepsis. The two imaging modalities are complementary and provide a highly accurate and sensitive means of intraabdominal abscess detection

[Prediction of intra-abdominal hypertension risk in patients with acute colonic obstruction under epidural analgesia].

Science.gov (United States)

Stakanov, A V; Potseluev, E A; Musaeva, T S

2013-01-01

Purpose of the study was to identify prediction possibility of direct current potential level for intra-abdominal hypertension risk in patients with acute colonic obstruction under preoperative epidural analgesia. Prospective analysis of the preoperative period was carried out in 140 patients with acute colonic obstruction caused by colon cancer. Relations between preoperative level of permanent capacity and risk of intra-abdominal hypertension was identified Direct current potential level is an independent predictor of intra-abdominal hypertension. Diagnostic significance increases from first to fifth hour of preoperative period according to AUROC data from 0.821 to 0.905 and calibration 6.9 (p > 0.37) and 4.7 (p > 0.54) by Hosmer-Lemeshou criteria. The use of epidural analgesia in the complex intensive preoperative preparation is pathogenically justified. It reduces intra-abdominal hypertension in patients with acute colonic obstruction.

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......Intra-abdominal panniculitis is a tumour-like inflammatory condition of adipose tissue. The aetiology and pathogenesis of the disease is unknown, but a number of associated diseases have been recorded. It has been customary to deal with only primary cases in the literature. This study...... was 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...

Intra-abdominal fat measurement by ultrasonography: association with anthropometry and metabolic syndrome in adolescents.

Science.gov (United States)

Novais, Rommel L R; Café, Ana Carolina C; Morais, Aisha A; Bila, Wendell C; Santos, Gilson D da S; Lopes, Carlos Alexandre de O; Belo, Vinícius S; Romano, Márcia Christina C; Lamounier, Joel A

2018-04-27

To associate intra-abdominal fat thickness measured by ultrasonography to the factors related to metabolic syndrome and to determine cutoff points of intra-abdominal fat measurement associated with a greater chance of metabolic syndrome in adolescents. This was a cross-sectional study, with 423 adolescents from public schools. Intra-abdominal fat was measured by ultrasonography. Anthropometric data were collected, and biochemical analyses were performed. Intra-abdominal fat was measured by ultrasonography, showing a statistically significant association with the diagnosis of metabolic syndrome (p=0.037), body mass index (p<0.001), elevated triglyceride levels (p=0.012), decreased plasma HDL levels (p=0.034), and increased systemic blood pressure values (p=0.023). Cutoff values of intra-abdominal fat thickness measurements were calculated by ultrasound to estimate the individuals most likely to develop metabolic syndrome. In the logistic regression models, the cutoff values that showed the highest association with metabolic syndrome in males were 4.50, 5.35, 5.46, 6.24, and 6.50cm for the ages of 14, 15, 16, 17, and 18/19 years, respectively. In the female gender, the cutoff values defined for the same age groups were 4.46, 4.55, 4.45, 4.90, and 6.46cm. In an overall analysis using the ROC curve, without gender and age stratification, the cut-off of 3.67cm showed good sensitivity, but low specificity. Ultrasonography is a useful method to estimate intra-abdominal adipose tissue in adolescents, which is associated with the main factors related to obesity and metabolic syndrome. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

The value of intra-abdominal pressure monitoring through ...

African Journals Online (AJOL)

hypertension after abdominal closure (8%) and only one of ... Ann Pediatr. Surg 13:69–73 c 2017 Annals of Pediatric Surgery. Annals of ... intra-abdominal hypertension ..... measurements as a guide in the closure of abdominal wall defects.

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

African Journals Online (AJOL)

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

Pleural space infections after image-guided percutaneous drainage of infected intraabdominal fluid collections: a retrospective single institution analysis.

Science.gov (United States)

Avella, Diego M; Toth, Jennifer W; Reed, Michael F; Gusani, Niraj J; Kimchi, Eric T; Mahraj, Rickeshvar P; Staveley-O'Carroll, Kevin F; Kaifi, Jussuf T

2015-04-11

Percutaneous drainage of infected intraabdominal fluid collections is preferred over surgical drainage due to lower morbidity and costs. However, it can be a challenging procedure and catheter insertion carries the potential to contaminate the pleural space from the abdomen. This retrospective analysis demonstrates the clinical and radiographic correlation between percutaneous drainage of infected intraabdominal collections and the development of iatrogenic pleural space infections. A retrospective single institution analysis of 550 consecutive percutaneous drainage procedures for intraabdominal fluid collections was performed over 24 months. Patient charts and imaging were reviewed with regard to pleural space infections that were attributed to percutaneous drain placements. Institutional review board approval was obtained for conduct of the study. 6/550 (1.1%) patients developed iatrogenic pleural space infections after percutaneous drainage of intraabdominal fluid collections. All 6 patients presented with respiratory symptoms and required pleural space drainage (either by needle aspiration or chest tube placement), 2 received intrapleural fibrinolytic therapy and 1 patient had to undergo surgical drainage. Pleural effusion cultures revealed same bacteria in both intraabdominal and pleural fluid in 3 (50%) cases. A video with a dynamic radiographic sequence demonstrating the contamination of the pleural space from percutaneous drainage of an infected intraabdominal collection is included. Iatrogenic pleural space infections after percutaneous drainage of intraabdominal fluid collections occur at a low incidence, but the pleural empyema can be progressive requiring prompt chest tube drainage, intrapleural fibrinolytic therapy or even surgery. Expertise in intraabdominal drain placements, awareness and early recognition of this complication is critical to minimize incidence, morbidity and mortality in these patients.

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

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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.

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

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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.

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

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Roberto de Cleva

2014-07-01

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

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

Science.gov (United States)

Cleva, Roberto de; Assumpção, Marianna Siqueira de; Sasaya, Flavia; Chaves, Natalia Zuniaga; Santo, Marco Aurelio; Fló, Claudia; Lunardi, Adriana C; Jacob Filho, Wilson

2014-07-01

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

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

OpenAIRE

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

2013-01-01

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 térm...

The comparative study of CT guided and ultrasound guided percutaneous ethanol injection in the treatment of intra-abdominal cyst

International Nuclear Information System (INIS)

Li Heping; Yang Jianyong; Chen Wei; Zhuang Wenquan; Huang Yulian; Chen Jianye

2005-01-01

Objective: An comparative study of the interventional approach of CT guided and ultiasound guided percutaneous ethanol injection(PEI) in the treatment of intra-abdominal cyst. Methods: CT guided PEI was performed in the treatment of intra-abdominal cyst in 38 patients while ultrasound guided PEI was performed in 45 cases. Results: The puncture procedure of CT guided PEI was totally performed 83 times in treating 56 intra-abdominal cysts in 38 patients and CT guided PEI was unsuccessful in 6 patients. The puncture procedure of ultrasound guided PEI were performed 87 times in treating 71 intra-abdominal cysts in 55 patients and ultrasound guided PEI only failed only in 1 patient. Conclusion: Ultrasound guided PEI is superior to CT guided PEI in the treatment of intra-abdominal cyst. (authors)

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. © 2015 American Heart Association, Inc.

Acute intestinal distress syndrome: the importance of intra-abdominal pressure.

Science.gov (United States)

Malbrain, M L N G; Vidts, W; Ravyts, M; De Laet, I; De Waele, J

2008-11-01

This review article will focus primarily on the recent literature on abdominal compartment syndrome (ACS) as well as the definitions and recommendations published by the World Society for the Abdominal Compartment Syndrome (WSACS, www.wsacs.org). The risk factors for intra-abdominal hypertension (IAH) and the definitions regarding increased intra-abdominal pressure (IAP) will be listed, followed by a brief but comprehensive overview of the different mechanisms of end-organ dysfunction associated with IAH. Measurement techniques for IAP will be discussed, as well as recommendations for organ function support in patients with IAH. Finally, noninvasive medical management options for IAH, surgical treatment for ACS and management of the open abdomen will be briefly discussed.

Intraabdominal abscessus of unknown etiology

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Čolović Radoje

2012-01-01

Full Text Available Introduction. Intraabdominal abscesses are in 98-99% cases the result of secondary and only in 1-2% of primary peritonitis. They are easy and successfully diagnosed. Abdominal abscesses of unknown cause are extremely rare. Case Outline. The authors present a 68-year-old man, without significant data in past history, who suddenly developed epigastric pain, nausea, vomiting and leukocytosis which was treated with antibiotics resulting in the alleviation of complaints and reduction of white blood cells count. After five days ultrasonography showed incapsulated collection of dense fluid in the epigastrium confirmed by CT scan two days later. Upper endoscopy excluded ulcer and/or perforation of the stomach and duodenum. Under local anesthesia, through the upper part of the left rectal muscle, puncture followed by incision was done, and about 50 ml of dense pus was removed. Finger exploration of the cavity showed no foreign body within the cavity. Using drainage, the recovery was quick and uneventful. By preoperative and postoperative abdominal investigations no cause of the abscess was found. Two and a half years after surgery the patient remained symptom-free with normal clinical, laboratory and ultrasonographic findings. Conclusion. The authors presented an intraabdominal abscess of unknown cause that was successfully treated with antibiotics, percutaneous puncture and drainage under local anaesthesia. In spite of all diagnostic methods the cause of the abscess could not be found. Thus, such a possibility, although being rare, should be taken into account.

Pylephlebitis: An Uncommon Complication of Intra-Abdominal Infection

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Salim R Surani

2011-05-01

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

[Antimicrobial treatment in complicated intraabdominal infections--current situation].

Science.gov (United States)

Vyhnánek, F

2009-04-01

Compared to other infections, intraabdominal infections include wide spectrum of infections of various severity, have different ethiology, which is frequently polymicrobial, show different microbiological results, which are difficult to interpret. The role of surgical intervention is essential. Intraabdominal infections are common causes of morbidity and mortality. Their prognosis is significantly improved with early and exact diagnosis, appropriate surgical or radiological intervention and timely effective antimicrobial therapy. Practitioners may choose between older or more modern antibiotics, between monotherapy or combination therapy, however, they should also consider clinical condition of the patient, the antibiotic's spectrum of activity, the treatment timing and its duration, the dose and dosing scheme of the particular antimicrobials. Furthermore, antimicrobial therapy should be used with caution, with the aim to prevent development of antimicrobial resistence. Inappropriate choice of antimicrobials in initial empiric therapy results in relapsing infections, surgical intervention and prolongation of hospitalization, and even death rates reflect adequate and timely empiric therapy.

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

International Nuclear Information System (INIS)

Usui, Akihito; Kawasumi, Yusuke; Hosokai, Yoshiyuki; Saito, Haruo; Igari, Yui; Funayama, Masato

2013-01-01

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

Intra-abdominal tuberculous peritonitis

International Nuclear Information System (INIS)

Schneider, G.; Ahlhelm, F.; Altmeyer, K.; Kramann, B.; Hennes, P.; Pueschel, W.; Karadiakos, N.

2001-01-01

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.)

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.)

Intra-abdominal gout mimicking pelvic abscess

International Nuclear Information System (INIS)

Chen, Chia-Hui; Chen, Clement Kuen-Huang; Yeh, Lee-Ren; Pan, Huay-Ban; Yang, Chien-Fang

2005-01-01

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.)

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.)

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

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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

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

OpenAIRE

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

2013-01-01

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

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

DEFF Research Database (Denmark)

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

2000-01-01

Intra-abdominal obesity may be crucial in the pathogenesis of the insulin-resistance syndrome, and training may alleviate this condition. We compared insulin-mediated glucose uptake in vivo in three intra-abdominal adipose tissues (ATs; retroperitoneal, parametrial, and mesenteric) and in subcuta......Intra-abdominal obesity may be crucial in the pathogenesis of the insulin-resistance syndrome, and training may alleviate this condition. We compared insulin-mediated glucose uptake in vivo in three intra-abdominal adipose tissues (ATs; retroperitoneal, parametrial, and mesenteric...

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.

Intra-abdominal solid organ injuries: an enhanced management algorithm.

Science.gov (United States)

Kokabi, Nima; Shuaib, Waqas; Xing, Minzhi; Harmouche, Elie; Wilson, Kenneth; Johnson, Jamlik-Omari; Khosa, Faisal

2014-11-01

The organ injury scale grading system proposed by the American Association for the Surgery of Trauma provides guidelines for operative versus nonoperative management in solid organ injuries; however, major shortcomings of the American Association for the Surgery of Trauma injury scale may become apparent with low-grade injuries, in which conservative management may fail. Nonoperative management of common intra-abdominal solid organ injuries relies increasingly on computed tomographic findings and other clinical factors, including patient age, presence of concurrent injuries, and serial clinical assessments. Familiarity with characteristic imaging features is essential for the prompt diagnosis and appropriate treatment of blunt abdominal trauma. In this pictorial essay, the spectrum of the American Association for the Surgery of Trauma organ injury scale grading system is illustrated, and a multidisciplinary management algorithm for common intra-abdominal solid organ injuries is proposed. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

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

OpenAIRE

Sartelli, Massimo; Chichom-Mefire, Alain; Labricciosa, Francesco M.; Hardcastle, Timothy; Abu-Zidan, Fikri M.; Adesunkanmi, Abdulrashid K.; Ansaloni, Luca; Bala, Miklosh; Balogh, Zsolt J.; Beltr?n, Marcelo A.; Ben-Ishay, Offir; Biffl, Walter L.; Birindelli, Arianna; Cainzos, Miguel A.; Catalini, Gianbattista

2017-01-01

Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide. The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important. In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelin...

[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.

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

Science.gov (United States)

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

2013-01-01

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

The effect of increased intra-abdominal pressure on orbital subarachnoid space width and intraocular pressure.

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Liu, Su-Meng; Wang, Ning-Li; Zuo, Zhen-Tao; Chen, Wei-Wei; Yang, Di-Ya; Li, Zhen; Cao, Yi-Wen

2018-02-01

In accordance with the trans-lamina cribrosa pressure difference theory, decreasing the trans-lamina cribrosa pressure difference can relieve glaucomatous optic neuropathy. Increased intracranial pressure can also reduce optic nerve damage in glaucoma patients, and a safe, effective and noninvasive way to achieve this is by increasing the intra-abdominal pressure. The purpose of this study was to observe the changes in orbital subarachnoid space width and intraocular pressure at elevated intra-abdominal pressure. An inflatable abdominal belt was tied to each of 15 healthy volunteers, aged 22-30 years (12 females and 3 males), at the navel level, without applying pressure to the abdomen, before they laid in the magnetic resonance imaging machine. The baseline orbital subarachnoid space width around the optic nerve was measured by magnetic resonance imaging at 1, 3, 9, and 15 mm behind the globe. The abdominal belt was inflated to increase the pressure to 40 mmHg (1 mmHg = 0.133 kPa), then the orbital subarachnoid space width was measured every 10 minutes for 2 hours. After removal of the pressure, the measurement was repeated 10 and 20 minutes later. In a separate trial, the intraocular pressure was measured for all the subjects at the same time points, before, during and after elevated intra-abdominal pressure. Results showed that the baseline mean orbital subarachnoid space width was 0.88 ± 0.1 mm (range: 0.77-1.05 mm), 0.77 ± 0.11 mm (range: 0.60-0.94 mm), 0.70 ± 0.08 mm (range: 0.62-0.80 mm), and 0.68 ± 0.08 mm (range: 0.57-0.77 mm) at 1, 3, 9, and 15 mm behind the globe, respectively. During the elevated intra-abdominal pressure, the orbital subarachnoid space width increased from the baseline and dilation of the optic nerve sheath was significant at 1, 3 and 9 mm behind the globe. After decompression of the abdominal pressure, the orbital subarachnoid space width normalized and returned to the baseline value. There was no significant difference in the

Excesso de peso e adiposidade central em adultos de Teresina-PI Overweight and abdominal fat in adult population of Teresina, PI

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Lorena Guimarães Martins Holanda

2011-02-01

Full Text Available OBJETIVO: Determinar a prevalência de excesso de peso e adiposidade abdominal em adultos residentes na zona urbana da cidade de Teresina-PI. MÉTODOS: Estudo transversal com amostra probabilística por conglomerados. Foram avaliados 464 adultos, entre 20 e 59 anos, residentes na zona urbana do município de Teresina-PI. O estado nutricional foi classificado com base no Índice de Massa Corporal (IMC, e o acúmulo de gordura abdominal foi estimado pela medida da circunferência da cintura. O nível de significância foi estabelecido em 5% (pOBJECTIVE: To determine prevalence of overweight and abdominal fat in adult population in the urban area of Teresina-PI. METHODS: Cross-sectional study with probabilistic sample by conglomerates. The study evaluated 464 adults, 20 to 59 years of age living in the urban area of Teresina-PI. Nutritional status was classified by the body mass index (BMI and abdominal fat accumulation was estimated according to waist circumference. The significance level was set at 5% (p<0.05. RESULTS: Prevalence of overweight and obesity according to nutritional status based on BMI was, respectively, 30.0% and 7.7%. There was an increase in the proportion of overweight and obesity among men with progressively higher family income. Highest rates of obesity were found among individuals 50 to 59 years of age with stable marriages and nonsmokers. No association was found between individual or family income and presence of abdominal fat in the population. CONCLUSION: Prevalence of overweight in the study population follows the Brazilian trend. Proportions of overweight and obesity were higher among men and increased with age. Women and married persons showed a greater tendency for abdominal obesity.

Intraabdominal actinomycosis resulting in a difficult to diagnose intraperitoneal mass: A case report.

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Tsujimura, Naoto; Takemoto, Hiroyoshi; Nakahara, Yujiro; Wakasugi, Masaki; Matsumoto, Takashi; Nishioka, Kiyonori; Takachi, Kou; Oshima, Satoshi; Yoshida, Kyotaro

2018-01-01

Actinomycosis is a chronic suppurative granulomatous disease caused by Actinomyces israelii. Preoperative confirmed diagnosis is very difficult, so most cases are diagnosed preoperatively as malignant tumors. We report a case of intraabdominal actinomycosis which was difficult to diagnose preoperatively. A woman, 60 years old, experienced discomfort in her lower right abdomen. She complained of nausea and anorexia and visited our hospital. Laboratory blood tests, abdominal CT, and abdominal MRI led to a diagnosis of a uterine sarcoma or primary intestinal mass, and she underwent surgery. Her histopathological diagnosis was intraabdominal actinomycosis. Actinomycosis is a chronic purulent granulomatous inflammation caused by Actinomyces israelii. No clinical symptoms or laboratory findings are characteristic of abdominal actinomycosis, so this disorder is very difficult to diagnose preoperatively. Therefore, many cases are diagnosed as malignant tumors and undergo surgery. After surgery, long-term antibiotic treatment (penicillin) is usually administered. We reported a case of intraabdominal actinomycosis that resulted in a difficult to diagnose intraperitoneal mass. When a large intraperitoneal mass is found, actinomycosis needs to be included as one of differential diagnoses. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Intraoperative ultrasonography in nine dogs with intra-abdominal neoplasm suspect

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Daniella Matos da Silva

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

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

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Park, Seongsik

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 pati...

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

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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.

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

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Fatih Dal

2017-12-01

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

Intra-abdominal hypertension in fulminant Clostridium difficile infection--an under-recognized treatable complication.

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Oud, Lavi

2010-09-01

Clostridium difficile is the most common cause of nosocomial infectious diarrhea in adults, with recent reports of increased severity and case fatality. Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are increasingly recognized and treatable complications of severe illness in medical patients, and are independent predictors of mortality. Patients with severe Clostridium difficile infection (CDI) are at increased risk for IAH and ACS. However, ACS has been only rarely described in this population. We report a case of a 61 year-old morbidly obese, chronically ill, ventilator dependent patient, who developed fulminant CDI, including progressive colonic distension, acute renal failure and intra-abdominal fluid sequestration. Her clinical course worsened abruptly, with new shock, worsening hypoxic respiratory failure, increased peak airway pressures and reduced tidal volumes. Intra-abdominal pressure was 30 mm Hg. The patient was not considered a surgical candidate, was refractory to escalating non-surgical support, and died following withdrawal of life support. Although patients with fulminant CDI share many risk factors for IAH and ACS, these conditions were rarely reported in this population and are likely under recognized, as was the case with the present patient. Increased vigilance for IAH is needed in this at-risk population.

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

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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. Copyright © 2015 Elsevier Ltd. All rights reserved.

Predicting intra-abdominal fatness from anthropometric measures : the influence of stature

NARCIS (Netherlands)

Han, T.S.; McNeill, G; Seidell, J C; Lean, M.E.J.

OBJECTIVE: To investigate the influence of height on the relationships between the intra-abdominal fat and anthropometric measures. SUBJECTS: Twenty healthy female volunteers aged 20-51 y from Aberdeen, and 71 men and 34 women aged 19-85 y from Nijmegen, The Netherlands. OUTCOME MEASURES:

Selective parasympathetic innervation of subcutaneous and intra-abdominal fat - functional implications

NARCIS (Netherlands)

Kreier, Felix; Fliers, Eric; Voshol, Peter J.; van Eden, Corbert G.; Havekes, Louis M.; Kalsbeek, Andries; van Heijningen, Caroline L.; Sluiter, Arja A.; Mettenleiter, Thomas C.; Romijn, Johannes A.; Sauerwein, Hans P.; Buijs, Ruud M.

2002-01-01

The wealth of clinical epidemiological data on the association between intra-abdominal fat accumulation and morbidity sharply contrasts with the paucity of knowledge about the determinants of fat distribution, which cannot be explained merely in terms of humoral factors. If it comes to neuronal

[Intraabdominal fat redistribution in long-term continuous positive airway pressure treatment in obstructive sleep apnea patients].

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Català, Raquel; Ferré, Raimón; Sangenís, Sandra; Cabré, Anna; Hernández-Flix, Salvador; Masana, Lluís

2016-06-03

Obesity is the main risk factor for obstructive sleep apnoea (OSA). The aim was to evaluate the long-term effect of continuous positive airway pressure (CPAP) on intraabdominal fat distribution in OSA patients. Fifty OSA patients with and 35 without CPAP treatment criteria were followed-up for 2 years. Visceral and subcutaneous adipose tissue (VAT and SAT) and preaortic intraabdominal fat (PIF) were assessed by sonography. In the non CPAP treated group, SAT and VAT mean values didn't change, while a significantly PIF growth was observed (55.19 [23.44] vs. 63.45 [23.94] mm, P=.021). In the CPAP treated group, VAT and PIF mean were not changed, while SAT decreased significantly (11.29 [5.69] vs. 10.47 [5.71] mm, P=.012). Long-term CPAP treatment produces intraabdominal fat redistribution and is associated with an anthropometric profile of lower cardiovascular risk in OSA patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

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

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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

Obesidad y síndrome metabólico en niños y adolescentes

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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.

Profiling of Candida albicans Gene Expression During Intra-abdominal Candidiasis Identifies Biologic Processes Involved in Pathogenesis

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

2013-01-01

Background. The pathogenesis of intra-abdominal candidiasis is poorly understood. Methods. Mice were intraperitoneally infected with Candida albicans (1 × 106 colony-forming units) and sterile stool. nanoString assays were used to quantitate messenger RNA for 145 C. albicans genes within the peritoneal cavity at 48 hours. Results. Within 6 hours after infection, mice developed peritonitis, characterized by high yeast burdens, neutrophil influx, and a pH of 7.9 within peritoneal fluid. Organ invasion by hyphae and early abscess formation were evident 6 and 24 hours after infection, respectively; abscesses resolved by day 14. nanoString assays revealed adhesion and responses to alkaline pH, osmolarity, and stress as biologic processes activated in the peritoneal cavity. Disruption of the highly-expressed gene RIM101, which encodes an alkaline-regulated transcription factor, did not impact cellular morphology but reduced both C. albicans burden during early peritonitis and C. albicans persistence within abscesses. RIM101 influenced expression of 49 genes during intra-abdominal candidiasis, including previously unidentified Rim101 targets. Overexpression of the RIM101-dependent gene SAP5, which encodes a secreted protease, restored the ability of a rim101 mutant to persist within abscesses. Conclusions. A mouse model of intra-abdominal candidiasis is valuable for studying pathogenesis and C. albicans gene expression. RIM101 contributes to persistence within intra-abdominal abscesses, at least in part through activation of SAP5. PMID:24006479

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

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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.)

IMAGING DIAGNOSIS-ECTOPIC SPLEEN MIMICKING HEPATIC TUMOR WITH INTRA-ABDOMINAL METASTASES INVESTIGATED VIA TRIPLE-PHASE HELICAL COMPUTED TOMOGRAPHY IN A DOG.

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Kutara, Kenji; Konno, Toshiaki; Kondo, Hirotaka; Aoki, Kotoyo; Yamazoe, Hinako; Matsunaga, Satoru

2017-05-01

A 10-year-old castrated male miniature dachshund was presented with an abdominal mass. The dog had a history of splenectomy. Triple-phase helical computed tomography was utilized, revealing a hepatic mass and multiple intra-abdominal solid masses. In triple-phase helical computed tomography the images, hepatic mass and two of four intra-abdominal masses were heterogenous in all phases. Therefore, we diagnosed a malignant hepatic tumor and presumed intra-abdominal metastases. The masses were surgically removed and were histologically composed of normal spleen tissues, findings which were consistent with ectopic spleen. © 2016 American College of Veterinary Radiology.

Postoperative intra-abdominal collections using a sodium hyaluronate-carboxymethylcellulose (HA-CMC) barrier at the time of laparotomy for uterine or cervical cancers.

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Leitao, Mario M; Byrum, Graham V; Abu-Rustum, Nadeem R; Brown, Carol L; Chi, Dennis S; Sonoda, Yukio; Levine, Douglas A; Gardner, Ginger J; Barakat, Richard R

2010-11-01

A prior analysis of patients undergoing laparotomy for ovarian malignancies at our institution revealed an increased rate of intra-abdominal collections using HA-CMC film during debulking surgery. The primary objective of the current study was to determine whether the use of HA-CMC is associated with the development of postoperative intra-abdominal collections in patients undergoing laparotomy for uterine or cervical malignancies. We retrospectively identified all laparotomies performed for these malignancies from 3/1/05 to 12/31/07. We identified cases involving the use of HA-CMC via billing records and operative reports. Intra-abdominal collections were defined as localized intraperitoneal fluid accumulations in the absence of re-accumulating ascites. We noted incidences of intra-abdominal collections, as well as other complications. Appropriate statistical tests were applied using SPSS 15.0. We identified 169 laparotomies in which HA-CMC was used and 347 in which HA-CMC was not used. The following were statistically similar in both cohorts: age, body mass index (BMI), primary site, surgery for recurrent disease, prior intraperitoneal surgery, and extent of current surgery. Intra-abdominal collections were seen in 6 (3.6%) of 169 HA-CMC cases compared to 10 (2.9%) of 347 non-HA-CMC cases (p=0.7). The rate of infected collections was similar in both groups (1.2% vs. 1.4%). In the subgroup that underwent tumor debulking, intra-abdominal collections were seen in 3 (11.5%) of 26 HA-CMC cases compared to 2 (5.4%) of 37 non-HA-CMC cases (p=0.6). HA-CMC use does not appear to be associated with postoperative intra-abdominal collections in patients undergoing laparotomy for uterine or cervical cancer. Copyright © 2010 Elsevier Inc. All rights reserved.

Analysis of Urobilinogen and Urine Bilirubin for Intra-Abdominal Injury in Blunt Trauma Patients

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Gorchynski, Julie

2009-05-01

Full Text Available OBJECTIVE: To determine the point prevalence of urine bilirubin, urine hemoglobin and urobilinogen in blunt trauma patients, and to evaluate its utility as a screening tool for intra-abdominal injury.METHODS: Data analysis of 986 consecutive trauma patients of which 698 were adult blunt trauma patients. Five-hundred sixteen subjects had a urinalysis and a CT scan of the abdomen/pelvis or exploratory laparotomy. We reviewed initial urinalysis results from trauma patients in the emergency department (ED for the presence of urine hemoglobin, uroblinogen and urine bilirubin. Computed tomography (CT scan results and operative reports were reviewed from the trauma registry for evidence of liver laceration, spleen laceration, bowel or mesenteric injuries.RESULTS: There were 73 injuries and 57/516 patients (11% with intra-abdominal injury. Urinalysis was positive for urobilinogen in 28/516 (5.4% patients, urine bilirubin in 15/516 (2.9% patients and urine hemoglobin in 313/516 (61% patients. Nineteen/forty-seven (4% subjects had liver lacerations, 28/56 (5% splenic lacerations, and 15/5 (3% bowel or mesenteric injury. Comparing the proportion of patients that had urobilinogen detected in the group with and without intra-abdominal injury, 8/28 (29% subjects with urobilinogen, 5/15 (33% subjects with bilirubin and 47/313 (15% subjects with urine hemoglobin were found to have liver lacerations, spleen lacerations, or bowel/mesenteric injuries. Preexisting liver or biliary conditions were not statistically associated with elevation of urine bilirubin, urine hemoglobin or urobilinogen on initial urinalysis after blunt abdominal trauma. Point prevalence for urobilinogen, urine bilirubin and urine hemoglobin are 5.43% (28/516, 2.91% (15/516 and 60.7% (313/516 respectively.CONCLUSIONS: The utility of the initial routine urinalysis in the ED for adult blunt abdominal trauma patients should not be used as a screening tool for the evaluation of intra-abdominal

Analysis of urobilinogen and urine bilirubin for intra-abdominal injury in blunt trauma patients.

Science.gov (United States)

Gorchynski, Julie; Dean, Kevin; Anderson, Craig L

2009-05-01

To determine the point prevalence of urine bilirubin, urine hemoglobin and urobilinogen in blunt trauma patients, and to evaluate its utility as a screening tool for intra-abdominal injury. Data analysis of 986 consecutive trauma patients of which 698 were adult blunt trauma patients. Five-hundred sixteen subjects had a urinalysis and a CT scan of the abdomen/pelvis or exploratory laparotomy. We reviewed initial urinalysis results from trauma patients in the emergency department (ED) for the presence of urine hemoglobin, uroblinogen and urine bilirubin. Computed tomography (CT) scan results and operative reports were reviewed from the trauma registry for evidence of liver laceration, spleen laceration, bowel or mesenteric injuries. There were 73 injuries and 57/516 patients (11%) with intra-abdominal injury. Urinalysis was positive for urobilinogen in 28/516 (5.4%) patients, urine bilirubin in 15/516 (2.9%) patients and urine hemoglobin in 313/516 (61%) patients. Nineteen/forty-seven (4%) subjects had liver lacerations, 28/56 (5%) splenic lacerations, and 15/5 (3%) bowel or mesenteric injury. Comparing the proportion of patients that had urobilinogen detected in the group with and without intra-abdominal injury, 8/28 (29%) subjects with urobilinogen, 5/15 (33%) subjects with bilirubin and 47/313 (15%) subjects with urine hemoglobin were found to have liver lacerations, spleen lacerations, or bowel/mesenteric injuries. Preexisting liver or biliary conditions were not statistically associated with elevation of urine bilirubin, urine hemoglobin or urobilinogen on initial urinalysis after blunt abdominal trauma. Point prevalence for urobilinogen, urine bilirubin and urine hemoglobin are 5.43% (28/516), 2.91% (15/516) and 60.7% (313/516) respectively. The utility of the initial routine urinalysis in the ED for adult blunt abdominal trauma patients should not be used as a screening tool for the evaluation of intra-abdominal injury.

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

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Sartelli Massimo

2012-11-01

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

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

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Bin LIANG

2012-05-01

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

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

International Nuclear Information System (INIS)

Simms, H.H.; D'Amico, R.; Monfils, P.; Burchard, K.W.

1991-01-01

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

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

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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.)

The Accuracy of Urinalysis in Predicting Intra-Abdominal Injury Following Blunt Traumas.

Science.gov (United States)

Sabzghabaei, Anita; Shojaee, Majid; Safari, Saeed; Hatamabadi, Hamid Reza; Shirvani, Reza

2016-01-01

In cases of blunt abdominal traumas, predicting the possible intra-abdominal injuries is still a challenge for the physicians involved with these patients. Therefore, this study was designed, to evaluate the accuracy of urinalysis in predicting intra-abdominal injuries. Patients aged 15 to 65 years with blunt abdominal trauma who were admitted to emergency departments were enrolled. Abdominopelvic computed tomography (CT) scan with intravenous contrast and urinalysis were requested for all the included patients. Demographic data, trauma mechanism, the results of urinalysis, and the results of abdominopelvic CT scan were gathered. Finally, the correlation between the results of abdominopelvic CT scan, and urinalysis was determined. Urinalysis was considered positive in case of at least one positive value in gross appearance, blood in dipstick, or red blood cell count. 325 patients with blunt abdominal trauma were admitted to the emergency departments (83% male with the mean age of 32.63±17.48 years). Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of urinalysis, were 77.9% (95% CI: 69.6-84.4), 58.5% (95% CI: 51.2-65.5), 56% (95% CI: 48.5-63.3), 79.6% (95% CI: 71.8-85.7), 1.27% (95% CI: 1.30-1.57), and 0.25% (95% CI: 0.18-0.36), respectively. The diagnostic value of urinalysis in prediction of blunt traumatic intra-abdominal injuries is low and it seems that it should be considered as an adjuvant diagnostic tool, in conjunction with other sources such as clinical findings and imaging.

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

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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

Curvas de crecimiento de la circunferencia de la cintura en niños y adolescentes habaneros

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Mercedes Esquivel Lauzurique

2011-03-01

Full Text Available INTRODUCCIÓN. En los últimos decenios, el sobrepeso y la obesidad han aumentado en los niños y adolescentes cubanos, por lo que son necesarios instrumentos sencillos que permitan analizar en la práctica asistencial las características y evolución de la obesidad. Por esta razón, se decidió desarrollar curvas de crecimiento de la circunferencia de la cintura en niños y adolescentes habaneros, dimensión que muestra una alta correlación con la masa grasa intraabdominal y, por ende, con un perfil lipídico aterogénico. MÉTODOS. Se estimaron valores de percentiles de esta circunferencia según grupos de edad y sexo, utilizando el método de transformación de potencia de tipo Box-Cox (BCPE, en 4 360 niños y adolescentes entre 7,5 y 19,0 años, que integraron las muestras de los estudios transversales de crecimiento y desarrollo efectuados en La Habana durante los años 1998 y 2005. RESULTADOS. La circunferencia de la cintura aumentó de forma significativa con la edad en uno y otro sexo. Los niños mostraron cifras superiores a las de las niñas y los valores que se obtuvieron tienden a ser inferiores a los reportados en otros estudios. CONCLUSIONES. Estas curvas podrían usarse provisionalmente con propósitos clínicos y epidemiológicos hasta que se disponga de referencias de carácter nacional para la identificación de niños escolares y adolescentes con riesgo de desarrollar trastornos relacionados con la adiposidad visceral.

Leisure-time physical activity and intra-abdominal fat in young adulthood: A monozygotic co-twin control study.

Science.gov (United States)

Rottensteiner, Mirva; Leskinen, Tuija; Järvelä-Reijonen, Elina; Väisänen, Karoliina; Aaltonen, Sari; Kaprio, Jaakko; Kujala, Urho M

2016-05-01

To investigate differences in abdominal fat compartments between young adult monozygotic twin pairs discordant for leisure-time physical activity. Ten young adult male monozygotic twin pairs (age range 32-36 years) discordant for leisure-time physical activity during the past 3 years were systematically selected from a population-based Finnish twin cohort. Magnetic resonance image at the level of the L2-L3 intervertebral disc was used to predict intra-abdominal and subcutaneous abdominal fat masses. Dietary intake was assessed with a 4-day food diary. Inactive twins had 31% more intra-abdominal fat than their active co-twins (mean difference 0.52 kg, 95% CI 0.12 to 0.91, P = 0.016), whereas the difference in subcutaneous abdominal fat was only 13% (P = 0.21) and 3% in body mass index (P = 0.28). Intraperitoneal fat mass was 41% higher among inactive twins compared to their active co-twins (mean difference 0.41 kg, 95% CI 0.11 to 0.70, P = 0.012). Dietary intake did not differ between co-twins. A lower level of physical activity is related to greater accumulation of intra-abdominal fat among healthy adult males in their mid-30s. The findings highlight the importance of leisure-time physical activity independent of genes and diet in the prevention of intra-abdominal fat accumulation from early adulthood onward. © 2016 The Obesity Society.

The Accuracy of Urinalysis in Predicting Intra-Abdominal Injury Following Blunt Traumas

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Anita Sabzghabaei

2016-01-01

Full Text Available Introduction: In cases of blunt abdominal traumas, predicting the possible intra-abdominal injuries is still a challenge for the physicians involved with these patients. Therefore, this study was designed, to evaluate the accuracy of urinalysis in predicting intra-abdominal injuries. Methods: Patients aged 15 to 65 years with blunt abdominal trauma who were admitted to emergency departments were enrolled. Abdominopelvic computed tomography (CT scan with intravenous contrast and urinalysis were requested for all the included patients. Demographic data, trauma mechanism, the results of urinalysis, and the results of abdominopelvic CT scan were gathered. Finally, the correlation between the results of abdominopelvic CT scan, and urinalysis was determined. Urinalysis was considered positive in case of at least one positive value in gross appearance, blood in dipstick, or red blood cell count. Results: 325 patients with blunt abdominal trauma were admitted to the emergency departments (83% male with the mean age of 32.63±17.48 years. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of urinalysis, were 77.9% (95% CI: 69.6-84.4, 58.5% (95% CI: 51.2-65.5, 56% (95% CI: 48.5-63.3, 79.6% (95% CI: 71.8-85.7, 1.27% (95% CI: 1.30-1.57, and 0.25% (95% CI: 0.18-0.36, respectively. Conclusion: The diagnostic value of urinalysis in prediction of blunt traumatic intra-abdominal injuries is low and it seems that it should be considered as an adjuvant diagnostic tool, in conjunction with other sources such as clinical findings and imaging.

Laparoscopic Stephen-Fowler stage procedure: appropriate management for high intra-abdominal testes.

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Agrawal, Amit; Joshi, Milind; Mishra, Pankaj; Gupta, Rahul; Sanghvi, Beejal; Parelkar, Sandesh

2010-03-01

The length of testicular vessels is the main length-limiting factor to bring down the testes in the scrotum. Fowler and Stephen proposed the division of testicular vessels, high and as far from the testes as possible to maintain collateral blood supply, to treat high intra-abdominal testes. Cortesi introduced the diagnostic laparoscopy and Jorden first did the laparoscopic orchiopexy for nonpalpable testes. We had done Fowler-Stephen staged orchiopexy for high intra-abdominal testes, in which both stages were done laparoscopically. In total, 17 testes of 13 patients had undergone laparoscopic staged Fowler-Stephen orchiopexy. The decision to perform a staged Fowler-Stephen orchiopexy was based on the distance of the testis from the deep inguinal ring on laparoscopy. If distance was more than 2.5 cm, then we proceeded to a laparoscopic staged Fowler-Stephen orchiopexy. In the first stage, testicular vessels were cauterized by bipolar diathermy. Laparoscopic second-stage Fowler-Stephen procedure was done 6 months after the first stage. Patients were regularly followed, and the success of the procedure was assessed by the size of the testes and the position in the scrotum. Testicular vascularity was assessed by color Doppler ultrasonography. There was no testicular atrophy on second stage and on follow-up. All testes were in the scrotum with good size on follow-up. There was no complication related to laparoscopy. In cases of high intra-abdominal testes, the staged Fowler-Stephen procedure should be the procedure of choice. This procedure yields a high success rate. Transaction of vessels by bipolar diathermy is a very safe, cost-effective method.

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

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Concepción Blasco Cabañas

2012-06-01

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

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

Intra-abdominal cryptococcosis in two dogs.

Science.gov (United States)

Malik, R; Hunt, G B; Bellenger, C R; Allan, G S; Martin, P; Canfield, P J; Love, D N

1999-08-01

Intra-abdominal cryptococcosis was diagnosed in two young dogs. The first, an entire male border collie, was presented with vomiting. An abdominal mass detected during physical examination proved to be cryptococcal mesenteric lymphadenitis on exploratory laparotomy. The second dog, a female neutered giant schnauzer, was presented with neurological signs suggestive of encephalopathy. Intestinal cryptococcal granulomas were detected in an extensive diagnostic investigation which included abdominal ultrasonography. The gastrointestinal tract was considered the most likely portal of entry for cryptococcal organisms in both cases. Both dogs were treated using surgery and multiagent antifungal chemotherapy. The first case succumbed despite therapy, while the second dog was treated successfully as gauged by return to clinical normality and a substantial decline in the cryptococcal antigen titre which continued to fall after cessation of treatment.

Clinics in diagnostic imaging (133). Retained placenta from an intra-abdominal pregnancy.

Science.gov (United States)

Win, T; Tang, P H; Lim, T Y

2011-01-01

A 29-year-old Indonesian woman presented with abdominal pain seven months after an intra-abdominal pregnancy. Ultrasonography revealed a cystic mass in the pelvis and magnetic resonance imaging showed an umbilical stump within it, indicating a retained placenta. This was removed surgically, and on histology, an infarcted placenta was confirmed.

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)....

Urethral pressure reflectometry during intra-abdominal pressure increase—an improved technique to characterize the urethral closure function in continent and stress urinary incontinent women

DEFF Research Database (Denmark)

Saaby, Marie-Louise; Klarskov, Niels; Lose, Gunnar

2013-01-01

to assess the urethral closure function by urethral pressure reflectometry (UPR) during intra-abdominal pressure-increase in SUI and continent women.......to assess the urethral closure function by urethral pressure reflectometry (UPR) during intra-abdominal pressure-increase in SUI and continent women....

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.

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

NARCIS (Netherlands)

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

Adiposidad corporal y bienestar psicológico: efectos de la actividad física en universitarios de Valencia, España Adiposity and psychological well-being: effects of physical activity on university students in Valencia, Spain

OpenAIRE

Isabel Castillo; Javier Molina-García

2009-01-01

OBJETIVO: Determinar mediante un modelo de ecuaciones estructurales la relación que existe entre la actividad física, la adiposidad corporal, la competencia física percibida y tres indicadores del bienestar psicológico en una muestra de estudiantes universitarios españoles. MÉTODOS: Estudio transversal descriptivo en 639 estudiantes de 18 a 29 años representativos de las universidades de Valencia, España, en el curso 2005-2006. La práctica de actividad física se evaluó mediante el inventario ...

Intra-abdominal desmoplastic small cell tumor in a girl : a case report

International Nuclear Information System (INIS)

Lee, Young Seok

1998-01-01

Desmoplastic small cell tumor is a rare primary intra-abdominal disease with a predilection for the adolescent boy. This aggressive tumor involved multiple intraperitoneal organs, peritoneal, mesentery and omental seedings, and sometimes retroperitoneal extension. The author reports a case of this rare tumor, demonstrated by CT, MRI and US, in a 14-year-old girl. (author). 9 refs., 2 figs

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

Science.gov (United States)

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

2015-10-20

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

Regression of sporadic intra-abdominal desmoid tumour following administration of non-steroidal anti-inflammatory drug

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Fujiwara Yoshinori

2008-02-01

Full Text Available Abstract Background Desmoid tumours or fibromatoses are rare entities characterized by the benign proliferation of fibroblasts, which can be life-threatening due to their locally aggressive properties. Surgery is widely accepted as the first line of treatment for extra-abdominal desmoids; however, it is not recommended for intra-abdominal desmoids because of the high-risk of recurrence and difficulties with the operation. Here, we report on a patient with sporadic intra-abdominal desmoid tumours, who showed partial response following the intake of non-steroidal anti-inflammatory drugs. Case presentation A 73-year-old man presented with swelling and pain of the right leg. Computed tomography showed an abnormal multilocular soft-tissue mass (95 × 70 mm in the right pelvis, which was revealed by biopsy to be a desmoid tumour. Immunohistochemical analysis showed that the tumour cells expressed vimentin, but not smooth-muscle actin, CD34, or desmin. Very few Ki-67-positive cells were found. Non-cytotoxic treatment with etodolac (200 mg/day was chosen because of the patient's age, lack of bowel obstruction, and the likelihood of prostate cancer. Two years after the commencement of non-steroidal anti-inflammatory drug administration, computed tomography showed a decrease in tumour size (63 × 49 mm, and the disappearance of intratumoural septa. Conclusion Our case report suggests that non-steroidal anti-inflammatory drug treatment should be taken into consideration for use as first-line treatment in patients with sporadic intra-abdominal desmoid tumours.

Regression of sporadic intra-abdominal desmoid tumour following administration of non-steroidal anti-inflammatory drug

Science.gov (United States)

Tanaka, Keita; Yoshikawa, Reigetsu; Yanagi, Hidenori; Gega, Makoto; Fujiwara, Yoshinori; Hashimoto-Tamaoki, Tomoko; Hirota, Syozo; Tsujimura, Tohru; Tomita, Naohiro

2008-01-01

Background Desmoid tumours or fibromatoses are rare entities characterized by the benign proliferation of fibroblasts, which can be life-threatening due to their locally aggressive properties. Surgery is widely accepted as the first line of treatment for extra-abdominal desmoids; however, it is not recommended for intra-abdominal desmoids because of the high-risk of recurrence and difficulties with the operation. Here, we report on a patient with sporadic intra-abdominal desmoid tumours, who showed partial response following the intake of non-steroidal anti-inflammatory drugs. Case presentation A 73-year-old man presented with swelling and pain of the right leg. Computed tomography showed an abnormal multilocular soft-tissue mass (95 × 70 mm) in the right pelvis, which was revealed by biopsy to be a desmoid tumour. Immunohistochemical analysis showed that the tumour cells expressed vimentin, but not smooth-muscle actin, CD34, or desmin. Very few Ki-67-positive cells were found. Non-cytotoxic treatment with etodolac (200 mg/day) was chosen because of the patient's age, lack of bowel obstruction, and the likelihood of prostate cancer. Two years after the commencement of non-steroidal anti-inflammatory drug administration, computed tomography showed a decrease in tumour size (63 × 49 mm), and the disappearance of intratumoural septa. Conclusion Our case report suggests that non-steroidal anti-inflammatory drug treatment should be taken into consideration for use as first-line treatment in patients with sporadic intra-abdominal desmoid tumours. PMID:18257933

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.

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

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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...

Effects of norepinephrine on tissue perfusion in a sheep model of intra-abdominal hypertension

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Ferrara, Gonzalo; Kanoore Edul, Vanina S.; Caminos Eguillor, Juan F.; Martins, Enrique; Canullán, Carlos; Canales, Héctor S.; Ince, Can; Estenssoro, Elisa; Dubin, Arnaldo

2015-01-01

The aim of the study was to describe the effects of intra-abdominal hypertension (IAH) on regional and microcirculatory intestinal blood flow, renal blood flow, and urine output, as well as their response to increases in blood pressure induced by norepinephrine. This was a pilot, controlled study,

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

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

2010-01-01

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

Sonographic evaluation of intra-abdominal adhesions during the third trimester of pregnancy: a novel technique in women undergoing repeated cesarean section.

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Baron, Joel; Tirosh, Dan; Mastrolia, Salvatore Andrea; Ben-Haroush, Yigal; Schwartz, Shoshana; Kerner, Yoav; Hershkovitz, Reli

2018-03-25

Intra-abdominal adhesions may result in an increased risk of major complications in case of a repeated cesarean section, such as bladder and bowel injury, hemorrhage, infection, and hysterectomy. In an attempt to predict intra-abdominal adhesions before a repeated cesarean delivery, we suggest the use of a novel technique employing a simple and feasible ultrasound imaging technique. The study included pregnant women who underwent one or more cesarean deliveries in their obstetric history and were evaluated during the third trimester of the ongoing pregnancy. In order to diagnose intra-abdominal adhesions, we used a sonographic sliding sign of the uterus under the inner part of the fascia of the abdominal muscles, and considered women 1) at high risk for severe adhesions in the absence of sonographic uterine sliding; or 2) at a low risk for severe adhesions in the presence of an obvious or moderate uterine sliding. A comparison between sonographic findings and intra-abdominal adhesions as evaluated by the surgeons during surgery was performed. We examined 63 patients with one or more previous cesarean delivery. Out of these 63 patients, 59 had completed the study and underwent repeated cesarean section at our Institution. In 16 out of the19 cases assigned to the high risk for severe adhesions group, the suspicion was confirmed at surgery, with a sensitivity of 76.2%. In addition, the suspicion for low risk for adhesions was confirmed in 35 out of 40 patients, with a specificity of 92.1%. The inter and intra-observer correlation using Cohen's Kappa (k) coefficient were 0.52 and 0.77 respectively. Our data show that a simple sonographic sign might predict both high and low risk for intra-abdominal adhesions in patients who underwent previous cesarean delivery. This technique may aid clinical decisions regarding repeated cesarean section approach. This article is protected by copyright. All rights reserved.

Evaluation and treatment of intraabdominal bilomas

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

1985-01-01

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

Evaluation and treatment of intraabdominal bilomas

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

1985-05-01

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

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

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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

INTRA-ABDOMINAL HYPERTENSION AS A RISK FACTOR FOR ACUTE KIDNEY INJURY IN CRITICALLY ILL PATIENTS

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Sreelatha

2016-05-01

Full Text Available BACKGROUND AND AIMS Increased intra-abdominal pressure (IAP, also referred to as intra-abdominal hypertension (IAH, affects organ function in critically ill patients. The prevalence of IAH is between 32% - 65% in intensive care units. Normal IAP is ≈ 5–7 mmHg. According to WSACS definition, IAH = IAP ≥12 mmHg and is divided into 4 grades. They are Grade I (12-15 mmHg, Grade II (16-20 mmHg, Grade III (21-25 mmHg, Grade IV (>25 mmHg. Transvesical measurement of IAP currently is the most popular technique. Several systems with or without the need for electronic equipment are available that allow IAP measurement. The aim is to study the incidence of IAH in critically ill patients, to assess the risk factors for development of IAH, to study the role of IAH as a risk factor for Acute Kidney Injury (AKI, to assess the role of IAH as a risk factor for increased (Intensive Care Unit ICU mortality. SUBJECTS AND METHODS This is a prospective observational study. Study period was six months. The study included 52 patients admitted to Medical ICU in Government Medical College, Kozhikode, Kerala. RESULTS AND CONCLUSION There was a very high incidence of intra-abdominal hypertension in critically ill patients. IAH was significantly associated with risk factors like sepsis, mechanical ventilation, pancreatitis, capillary leak, ascites, cumulative fluid balance and cirrhosis. IAH is an independent risk factor for development of acute kidney injury. IAH is an independent predictor of mortality in critically ill patients.

Untargeted antifungal therapy in adult patients with complicated intra-abdominal infection

DEFF Research Database (Denmark)

Petersen, Marie Warrer; Perner, Anders; Sjövall, Fredrik

2017-01-01

who are critically ill have provided conflicting results, and clinical equipoise exists. Accordingly, we aim to assess patient-important benefits and harms of untargeted antifungal therapy versus placebo or no treatment in adult patients with complicated intra-abdominal infection. Methods and analysis......-cause mortality, and secondary outcomes include adverse events, duration of mechanical ventilation and inotropic support, need for renal replacement therapy, emergence of antibiotic resistance and intensive care unit and hospital length-of-stay. Conventional meta-analysis, including sensitivity and subgroup...

Further evidence of the etiology of prune belly syndrome provided by a transient massive intraabdominal cyst in a female.

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Wijesinghe, Uddaka S; Muthucumaru, Mathievathaniy; Beasley, Spencer W

2016-08-01

We present a female neonate born with prune belly syndrome (PBS) in whom a large intraabdominal cyst was diagnosed at 12weeks of gestation. Rapid and exponential growth of the cyst caused pressure effects on the intraabdominal organs and stretching of the anterior abdominal wall by 19weeks of gestation. This led to drainage of the massive cyst at 20weeks of gestation to prevent fetal demise. This case provides further clues to the likely etiology of PBS: transient stretching and attenuation of the fetal abdominal wall secondary to gross fetal abdominal distension - from any cause. Copyright © 2016 Elsevier Inc. All rights reserved.

Morphology-Independent Virulence of Candida Species during Polymicrobial Intra-abdominal Infections with Staphylococcus aureus.

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Nash, Evelyn E; Peters, Brian M; Fidel, Paul L; Noverr, Mairi C

2016-01-01

Intra-abdominal polymicrobial infections cause significant morbidity and mortality. An experimental mouse model of Candida albicans-Staphylococcus aureus intra-abdominal infection (IAI) results in 100% mortality by 48 to 72 h postinoculation, while monomicrobial infections are avirulent. Mortality is associated with robust local and systemic inflammation without a requirement for C. albicans morphogenesis. However, the contribution of virulence factors coregulated during the yeast-to-hypha transition is unknown. This also raised the question of whether other Candida species that are unable to form hyphae are as virulent as C. albicans during polymicrobial IAI. Therefore, the purpose of this study was to evaluate the ability of non-albicans Candida (NAC) species with various morphologies and C. albicans transcription factor mutants (efg1/efg1 and cph1/cph1) to induce synergistic mortality and the accompanying inflammation. Results showed that S. aureus coinoculated with C. krusei or C. tropicalis was highly lethal, similar to C. albicans, while S. aureus-C. dubliniensis, S. aureus-C. parapsilosis, and S. aureus-C. glabrata coinoculations resulted in little to no mortality. Local and systemic interleukin-6 (IL-6) and prostaglandin E2 (PGE2) levels were significantly elevated during symptomatic and/or lethal coinfections, and hypothermia strongly correlated with mortality. Coinoculation with C. albicans strains deficient in the transcription factor Efg1 but not Cph1 reversed the lethal outcome. These results support previous findings and demonstrate that select Candida species, without reference to any morphological requirement, induce synergistic mortality, with IL-6 and PGE2 acting as key inflammatory factors. Mechanistically, signaling pathways controlled by Efg1 are critical for the ability of C. albicans to induce mortality from an intra-abdominal polymicrobial infection. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis – a case report

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Oke V

2015-09-01

Full Text Available Vikram Oke, Frances Schmidt, Bikash Bhattarai, Md Basunia, Chidozie Agu, Amrit Kaur, Danilo Enriquez, Joseph Quist, Divya Salhan, Vijay Gayam, Prajakta Mungikar Department of Pulmonary Medicine, Interfaith Medical Center, NY, USA Abstract: Clozapine is the preferred antipsychotic used for the treatment of resistant schizophrenia with suicidal ideation. The drug is started at a low dose and gradually increased to a target dose of 300–450 mg/day. It is well known to cause agranulocytosis and neutropenia. Several cases of fatal sepsis have been reported in neutropenic patients and emphasis is placed on monitoring for agranulocytosis; however, clozapine also causes intestinal hypomotility and constipation, which if unrecognized can lead to intestinal obstruction, bowel necrosis, and intra-abdominal sepsis. Reduced behavioral pain reactivity in schizophrenics may alter the ability to express pain, potentially leading to a delay in the presentation for medical attention. We report a case of fatal intra-abdominal sepsis secondary to an unrecognized case of clozapine-related constipation. Keywords: antipsychotics, clozapine, schizophrenia, syncope, constipation, sepsis

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

DEFF Research Database (Denmark)

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

2012-01-01

The association between waist circumference (WC) and mortality is particularly strong and direct when adjusted for body mass index (BMI). One conceivable explanation for this association is that WC adjusted for BMI is a better predictor of the presumably most harmful intra-abdominal fat mass (IAFM......) than WC alone. We studied the prediction of abdominal subcutaneous fat mass (ASFM) and IAFM by WC alone and by addition of BMI as an explanatory factor....

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.

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

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

2018-01-01

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

Increased intra-abdominal fat may lower HDL levels by increasing the fractional catabolic rate of Lp A-I in postmenopausal women.

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Vajo, Zoltan; Terry, James G; Brinton, Eliot A

2002-02-01

High-density lipoprotein (HDL) particles without apolipoprotein A-II (Lp A-I) may be more anti-atherogenic than HDL with apo A-II (Lp A-I/AII) and Lp A-I is reported selectively to be reduced in cases of intra-abdominal obesity. We explored the mechanisms of this reduction by studying the turnover of Lp A-I and Lp A-I/A-II in postmenopausal women well characterized for total body, regional and sub-regional adiposity by body mass index (BMI), truncal girth ratio, and abdominal magnetic resonance imaging (MRI), respectively. We tested for possible cause-effect relationships by measuring inter-correlations among these variables. Intra-abdominal fat area correlated strongly and positively with the fractional catabolic rate (FCR) of Lp A-I (r=0.98, P=0.003). Intra-abdominal fat only showed a non-significant trend toward correlation with the FCR of Lp A-I/A-II (r=0.84, P=0.07), and had no correlation with the production or transport rate (TR) of either Lp A-I or Lp A-I/A-II (r=0.48 and 0.02, respectively, P>0.1). Subjects were studied both with and without estrogen replacement, allowing exploration of a possible interaction of adiposity with estrogen effects on HDL turnover. Response of HDL turnover to estrogen did not correlate with adiposity, except for a parameter of waist to hip ratio (WHR), which predicted the increase in LP A-I TR with estrogen (r=0.84, P=0.04). We conclude that intra-abdominal fat may lower HDL levels by increasing the FCR of Lp A-I, suggesting a mechanism by which central adiposity may be proatherogenic.

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.

Evaluation of intra-abdominal vasectomy in llamas and alpacas.

Science.gov (United States)

Bravo, P W; Sumar, J

1991-11-01

A method of intra-abdominal vasectomy (deferentectomy), using a laparoscopic technique in llamas and alpacas, was evaluated. Food was withheld from 14 animals for 24 hours before sedation and laparoscopy. The ductus deferens was located close to the bladder, and a 2- to 3-cm section of ductus deferens was resected with the aid of a pair of hook scissors. The procedure was completed in 5 to 8 minutes, and animals did not have any adverse effects. Forty-five days after vasectomy, animals were used for detecting sexually receptive females or inducing ovulation during reproductive physiologic studies. The procedure did not impair libido and had no effect on male sexual behavior for many years. The technique is simpler, safer, and faster than the traditional external approach.

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

DEFF Research Database (Denmark)

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

1999-01-01

PURPOSE: Laparoscopy is a well described modality that provides an accurate visual diagnosis upon which further management of intra-abdominal testes may be based. Laparoscopic ligation of spermatic vessels as stage 1 of the procedure is a natural extension of laparoscopy. A staged approach provides...... studied 17 nonpalpable testes in 10 patients 1 year and 7 months to 13(1/2) years old. Results of testicular biopsies of 13 intra-abdominal testes taken at stages 1 and 2 of surgery were available for histological comparison. RESULTS: Median number of spermatogonia per tubular cross section...... of the biopsies taken at stage 2 was slightly lower (0.03) compared to the median number at stage 1 (0.06) of the operation but this difference was not significant (p = 0.2031). CONCLUSIONS: Our study shows that the spermatogonia may survive clipping and division of the spermatic vessels, although the number...

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

DEFF Research Database (Denmark)

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

1999-01-01

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

Radiological evaluation of the intraabdominal masses in childhood

International Nuclear Information System (INIS)

Kim, Y. J.; Oh, K. K.; Park, C. Y.

1980-01-01

The spectrum of types of cancer in childhood differs strikingly from that in adults. Leukemia, central nervous system tumors, embryonal tumors, and sarcomas are much more common in children than are adenocarcinoma and carcinomas, which constitute the majority of cancers in adults. In children under 15 years of age, intraabdominal tumors are the third most common one, preceded only by leukemia and brain tumors. It is well recognized that these tumors remain silent until they assume huge size, and early detection and treatment are important. X-ray examination is the most important method among diagnostic approaches. 150 cases of intraabdominal masses were reviewed in respect of age, sex, incidence, site of origin and radiographic findings. The results are summarized as follows; 1. The most common site was retroperitoneum (80 cases: 53.3%), followed by intraperitoneum (47 cases: 31.3%), and pelvic cavity (23 cases: 15.4%). The kidney was the single most common site of origin (33%). 2. Hydronephrosis was most common (23 cases: 15.3%) and Wilms' tumor (22 cases: 14.7%), teratoma (21 cases: 14.0%), and neuroblastoma (18 cases: 12.0%) were descending order of frequency. One renal cell carcinoma in 9 year old female patient and bilateral duplications of pelvis with ureteroceles in 5 month old twin infants were found. 3. Male outnumbered female in most childhood abdominal diseases, however female was predominant in teratoma (1:20) and choledochal cyst (3:7). 97 cases were under the age of 5 years. 4. Radiographic findings were as follow, a. Simple abdomen: In retroperitoneal tumors, mass shadows were the most common finding (89.7%) and obliteration of psoas shadows was noted in 73%. Calcifications were seen in 6 cases (100%) of teratoma as bone, teeth or amorphous, 1 case (4.5%) of Wilms' tumor as amorphous, and 5 cases (33%) or neuroblastoma as amorphous or psammomatous. Fat shadow was seen in 5 cases (83%) of teratoma. In intraperitoneal tumors, mass was the most common

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

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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.

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

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Koichiro Mandai

2017-01-01

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

Increased pressure within the abdominal compartment: intra-abdominal hypertension and the abdominal compartment syndrome.

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Roberts, Derek J; Ball, Chad G; Kirkpatrick, Andrew W

2016-04-01

This article reviews recent developments related to intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) and clinical practice guidelines published in 2013. IAH/ACS often develops because of the acute intestinal distress syndrome. Although the incidence of postinjury ACS is decreasing, IAH remains common and associated with significant morbidity and mortality among critically ill/injured patients. Many risk factors for IAH include those findings suggested to be indications for use of damage control surgery in trauma patients. Medical management strategies for IAH/ACS include sedation/analgesia, neuromuscular blocking and prokinetic agents, enteral decompression tubes, interventions that decrease fluid balance, and percutaneous catheter drainage. IAH/ACS may be prevented in patients undergoing laparotomy by leaving the abdomen open where appropriate. If ACS cannot be prevented with medical or surgical management strategies or treated with percutaneous catheter drainage, guidelines recommend urgent decompressive laparotomy. Use of negative pressure peritoneal therapy for temporary closure of the open abdomen may improve the systemic inflammatory response and patient-important outcomes. In the last 15 years, investigators have better clarified the pathogenesis, epidemiology, diagnosis, and appropriate prevention of IAH/ACS. Subsequent study should be aimed at understanding which treatments effectively lower intra-abdominal pressure and whether these treatments ultimately affect patient-important outcomes.

Pancreaticojejunal bridge-anastomosis: a novel option for surgeon to preserve pancreatic body and tail in urgent reoperation for intra-abdominal massive hemorrhage after pancreaticoduodenectomy.

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Xu, Jin; Dai, Xianwei; Bu, Xianmin; Gao, Feng; Zhang, Xiaobo

2010-10-01

Postoperative intra-abdominal massive bleeding is a rare and life-threatening complication associated with pancreaticoduodenectomy. Completion pancreatectomy (CP) was usually performed during reexploration for the complication. The management could decrease the complications, such as the pancreatic leakage or intraluminal infection after reexploration, but could increase mortality during the perioperative period. It also could result in loss of pancreatic function forever. This study evaluated an alternative surgical management for intra-abdominal massive hemorrhage to prevent pancreas function, simplify the surgical processes, and decrease the mortality of relaparotomy. Outcome after pancreaticojejunal bridge-anastomosis (PJBA) performed between January 2006 and June 2009 was compared with that after CP performed between February 1984 and December 2005. Between February 1984 and June 2009, 963 patients underwent the Whipple procedure (PD) or pylorus-preserving pancreaticoduodectomy (PPPD). Pancreatic leakage occurred in 103 patients (10.7%); 22 cases (21.4%) developed into intra-abdominal massive bleeding. Nonsurgical procedures of transarterial embolization (TAE) were performed in ten (45.45%) patients, of whom one died (10%). Twelve (54.55%) underwent reoperation. Five had CP with one death (20%). Pancreatic remnant was preserved by pancreaticojejunal bridge-anastomosis (PJBA) in seven patients with no deaths. The reexploration time was 340 +/- 48.2 min vs. 247.9 +/- 40.8 min (P endocrine insufficiency ("brittle" diabetes) and diarrhea (exocrine insufficiency). There were no evidences of exocrine and endocrine insufficiency in patients with PJBA. Pancreaticojejunal bridge-anastomosis is an easy, simple, and safe procedure for intra-abdominal massive hemorrhage associated with pancreaticoduodenectomy. It could decrease the mortality of reoperation and preserve the pancreatic function.

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

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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.

Ejercicios de fuerza, glucocorticoides y composición corporal en pacientes diabéticos de la tercera edad

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Yolanda Cedeño Almaguer

2010-01-01

Full Text Available Se presentaron los resultados obtenidos a través de un cuasi- experimento que reveló los efectos del entrenamiento de fuerza sobre la composición corporal de pacientes diabéticos de la tercera edad, sometidos a tratamientos con glucocorticoides. La muestra estuvo constituida por 13 pacientes (8 mujeres y 5 hombres los cuales comenzaron, por prescripción médica, tratamiento con glucocorticoides. Por medio de mediciones antropométricas se determinaron indicadores de adiposidad y masa muscular en tres ocasiones, entre las que se incluye la etapa después de aplicado un programa de entrenamiento de 12 semanas sobre la base de ejercicios de fuerza.

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

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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.

Prevalencia de sobrepeso y obesidad en Guaraní-Mbya de Misiones

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Orden, Alicia Bibiana

2005-01-01

Full Text Available El objetivo de este trabajo es evaluar las prevalencias de sobrepeso y obesidad y patrón de adiposidad en niños y adultos Mbyá-Guaraní. Estatura, peso, perímetro braquial y pliegues subcutáneos tricipital y subescapular fueron medidos en 197 individuos de 2 a 60 años de edad, residentes en las comunidades de Kaaguy Poty e Yvy Pytá, Aristóbulo del Valle (provincia de Misiones. Se calcularon el índice de masa corporal (IMC, las áreas muscular y adiposa y el índice subescapular/tricipital. Los datos fueron estandarizados a puntaje z empleando NHANES I & II. El sobrepeso y la obesidad fueron definidos por los valores de IMC comprendidos entre los percentiles 85 y 95 ó los superiores al percentil 95, respectivamente. Comparados con la referencia, los Mbyá tuvieron menor peso y talla, y mayor IMC. No hubo diferencias marcadas en la masa adiposa y muscular. Las prevalencias de sobrepeso y obesidad fueron de 16.2 y 14.7% respectivamente y no difirieron entre sexos. El 60% de los individuos con sobrepeso y obesidad mostraron distribución centralizada de la adiposidad y 49% de ellos tuvieron alto riesgo de adiposidad abdominal. Los presentes resultados aportan nuevas evidencias sobre el incremento de la obesidad en Amerindios, como parte del proceso de transición nutricional. Los cambios en el estilo de vida pueden explicar parte de la tendencia observada.

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

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

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Chin-Fan Chen

2008-08-01

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

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.

Impact of Prolonged Periods Classroom Settings in Intra-abdominal fat area and its Consequence on Posture/Balance Control among Algerian Childhood College Preparatory School.

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Zerf Mohammed

2017-08-01

Full Text Available The play has been shown to help children adjust to the school setting and to enhance children's learning [1]. Since this theory, the current study was designed to examine the significance of mechanical effects of intra-abdominal on posture/balance control among the Algerian Childhood Primary Schools. Since our teachers emphasise the good classroom settings as a discipline pedagogical aspect of success learning. While High-quality educational programs for children in preschool and kindergarten have play at the centre of the curriculum [2]. Our interventions in this study aimed to examine Impact of Prolonged Periods Classroom Settings in Intra-abdominal fat area and its Consequence on Posture/Balance Control among Algerian Childhood Preparatory Schools. for the purpose, a total of 61 schoolboys of Slimane provinces Naama, Municipality Mecheria, Algeria male gender their average age 5±1.52 years distributed into two homogeneous groups, according to them, school attendance (kindergarten School (29 boys - preschool (32 boys. Tested by saving tests (Body Fat Percentage-Abdominal circumference - Modified Bass Test of Dynamic Balance and standing balance. Based on the analysis statistics, we confirm: • Prolonged periods classroom settings increase Intra-Abdominal Fat which represents big risk posture/balance control. • Primary schools posture needs an interactive play method Learning classroom to improve body imbalance as health benefits physical activities. Based on the differences acquired by the research team, we emphasise that prolonged periods classroom settings Primary Schools increase the intra-abdominal which owing to the weakness of skeletal muscle fatigue and abnormal pathological alignment. While as a recommendation pedagogy practised, we suggested to our teachers, who work with these children to know that the balanced posture requires more energy in the class, Considering that our student seat more than 6 hours a day, 30 per week, and

Antimicrobial susceptibility of intra-abdominal infection isolates from a tertiary care hospital in karachi

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Saad, U.; Anwar, S.; Kahara, U.Z.; Saeed, H.

2016-01-01

Intra-abdominal infections are associated with significant morbidity and mortality. The most frequent pathogens involved are the gastrointestinal flora which can cause poly-microbial infections. Microbiological diagnosis is required to determine the aetiology and antimicrobial susceptibility of the organisms involved. Prompt initiation of antimicrobials is essential for improving patient's outcome. Knowledge of local trends of antimicrobial resistance in nosocomial isolates is essential for empiric therapy. Methods: A total of 190 clinical isolates collected from intra-abdominal infections during July 2013 to July 2014 were included in the study. Organism identification and Antimicrobial sensitivity testing using standard biochemical tests and CLSI recommended criteria was carried out. Result: Of the total 190 isolates from abdominal infection sources 52% were from fluid sources (peritoneal and ascitic fluid), 41% were from gall bladder and 6.5% were from other abdominal sources. E. coli (46.8%) was the most frequently isolated gram negative and Enterococcus (13.1%) was the most frequently isolated gram positive organism. Carbapenem (imipenem) was the most active agent against enterobacteraceae exhibiting, 94.4% and 91.3% sensitivity against E. coli and Klebsiella respectively. While vancomycin was the most active agent against gram positive organisms. Eighty-four percent of the Enterococci isolated were sensitive to vancomycin. Most isolates exhibited resistance to one or more antibiotics. Conclusion: Continuous evolution of antimicrobial resistance patterns in bacteria necessitates updating of local data on antimicrobial susceptibility profiles to ensure the safety and efficacy of pathogen specific antimicrobial therapies. (author)

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

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Lucimara Zambon

2009-10-01

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

Surgical removal of intra-abdominal intrauterine devices at one center in a 20-year period.

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Ertopcu, Kenan; Nayki, Cenk; Ulug, Pasa; Nayki, Umit; Gultekin, Emre; Donmez, Aysegul; Yildirim, Yusuf

2015-01-01

To review 20 years of experience of the removal of intra-abdominal intrauterine devices (IUDs) and to compare the surgical methods used. In a retrospective study, charts dating from between September 1, 1992, and August 31, 2012, were reviewed. Patients were eligible for inclusion when they had an IUD surgically removed by minilaparotomy or laparoscopy at a tertiary referral center in Izmir, Turkey. Among the 36 eligible women, 18 (50%) had undergone laparoscopy and 18 (50%) had undergone minilaparotomy. Mean operation length was 55.3±6.3 minutes in the laparoscopy group and 29.1±4.2 minutes in the minilaparotomy group (P=0.008). Conversion to full laparotomy was necessary in 4 (22%) women in the laparoscopy group and 1 (6%) in the minilaparotomy group (P=0.02). Perioperative complications were observed in 5 (14%) women, with no difference in frequency between groups (P=0.09). Total cost of medical/surgical procedures was US$436.4±35.4 for the laparoscopy group and $323.4±21.3 for the minilaparotomy group (P=0.04). Minilaparotomy seems to be an important alternative to laparoscopy for the removal of intra-abdominal IUDs. This procedure should be an integral part of gynecologic surgical training. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Image-guided drainage of multiple intraabdominal abscesses in children with perforated appendicitis: an alternative to laparotomy

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McCann, Jeffrey W.; Krishnamurthy, Ganesh; Connolly, Bairbre L. [Hospital for Sick Children, Image Guided Therapy, Department of Diagnostic Imaging, Toronto, Ontario (Canada); Maroo, Sanjay; Amaral, Joao G.; Parra, Dimitri; Temple, Michael; John, Philip [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Wales, Paul [Hospital for Sick Children, Department of Surgery, Toronto (Canada)

2008-06-15

Appendicitis is the most common cause of an acute abdomen in children. With perforation, multiple intraperitoneal collections can be seen at presentation. In this situation, surgical treatment alone is rarely effective. To determine the role of image-guided drainage in treating patients with acute appendicitis complicated by multiple intraabdominal collections. A retrospective review of patient charts and interventional radiology records was performed to identify all patients with acute complicated appendicitis treated by multiple image-guided drainage procedures. Data reviewed included the number of drainages and aspirations performed, drain dwell time, the clinical course and temperature profile, and the length of inpatient hospital stay and any complications experienced. The study population comprised 42 children with a mean age of 107.6 months. A total of 100 drainage catheters were inserted and 56 aspirations were performed. Of the 42 children, 24 were successfully treated at a single sitting, while 18 returned for further intervention. The mean drain dwell time was 8.18 days. The mean inpatient stay was 15.02 days. Treatment of the acute presentation with image-guided intervention was successful in 92.3% of children. Successful management of acute perforated appendicitis with multiple intraabdominal abscesses can be achieved with multiple minimally invasive image-guided drainage procedures. (orig.)

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

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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

Intra-abdominal hypertension in acute pancreatitis.

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De Waele, Jan J; Leppäniemi, Ari K

2009-06-01

The incidence of intra-abdominal hypertension (IAH) in patients with severe acute pancreatitis (SAP) is approximately 60-80%. It is usually an early phenomenon, partly related to the effects of the inflammatory process, causing retroperitoneal edema, fluid collections, ascites, and ileus, and partly iatrogenic, resulting from aggressive fluid resuscitation. It also can manifest at a later stage, often associated with local pancreatic complications. IAH is associated with impaired organ dysfunction, especially of the cardiovascular, respiratory, and renal systems. Using current definitions, the incidence of the clinical manifestation, abdominal compartment syndrome (ACS), has been reported as 27% in the largest study so far. Despite several intervention options, the mortality in patients developing ACS remains high: 50-75%. Prevention with judicious use of crystalloids is important, and nonsurgical interventions, such as nasogastric decompression, short-term use of neuromuscular blockers, removal of fluid by extracorporeal techniques, and percutaneous drainage of ascites should be instituted early. The indications for surgical decompression are still not clearly defined, but undoubtedly some patients benefit from it. It can be achieved with full-thickness laparostomy (midline or transverse subcostal) or through a subcutaneous linea alba fasciotomy. Despite the improvement in physiological variables and significant decrease in IAP, the effects of surgical decompression on organ function and outcome are less clear. Because of the significant morbidity associated with surgical decompression and the management of the ensuing open abdomen, more research is needed to define better the appropriate indications and techniques for surgical intervention.

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

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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.

[Not Available].

Science.gov (United States)

Pacheco-Herrera, Javier Darío; Ramírez-Vélez, Robinson; Correa-Bautista, Jorge Enrique

2016-06-30

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 relacionóinversamente 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.

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

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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

Curvas de crecimiento de la circunferencia de la cintura en niños y adolescentes habaneros Growth curves of waist circumference in Havana children and adolescents

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Mercedes Esquivel Lauzurique

2011-03-01

Full Text Available INTRODUCCIÓN. En los últimos decenios, el sobrepeso y la obesidad han aumentado en los niños y adolescentes cubanos, por lo que son necesarios instrumentos sencillos que permitan analizar en la práctica asistencial las características y evolución de la obesidad. Por esta razón, se decidió desarrollar curvas de crecimiento de la circunferencia de la cintura en niños y adolescentes habaneros, dimensión que muestra una alta correlación con la masa grasa intraabdominal y, por ende, con un perfil lipídico aterogénico. MÉTODOS. Se estimaron valores de percentiles de esta circunferencia según grupos de edad y sexo, utilizando el método de transformación de potencia de tipo Box-Cox (BCPE, en 4 360 niños y adolescentes entre 7,5 y 19,0 años, que integraron las muestras de los estudios transversales de crecimiento y desarrollo efectuados en La Habana durante los años 1998 y 2005. RESULTADOS. La circunferencia de la cintura aumentó de forma significativa con la edad en uno y otro sexo. Los niños mostraron cifras superiores a las de las niñas y los valores que se obtuvieron tienden a ser inferiores a los reportados en otros estudios. CONCLUSIONES. Estas curvas podrían usarse provisionalmente con propósitos clínicos y epidemiológicos hasta que se disponga de referencias de carácter nacional para la identificación de niños escolares y adolescentes con riesgo de desarrollar trastornos relacionados con la adiposidad visceral.INTRODUCTION. In past decades, the excess weight and obesity have increased in Cuban children and adolescents, thus, are necessaries simple tools allowing analyzing in health practice the characteristics and evolution of obesity. By this reason, we decide to develop growth curves of waist circumference in Havanan children and adolescents, a dimension showing a high correlation with the intra-abdominal fatty mass and consequently, with an atherogenic lipid profile. METHODS. Authors estimated the percentile

Hyperandrogenism Accompanies Increased Intra-Abdominal Fat Storage in Normal Weight Polycystic Ovary Syndrome Women.

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Dumesic, Daniel A; Akopians, Alin L; Madrigal, Vanessa K; Ramirez, Emmanuel; Margolis, Daniel J; Sarma, Manoj K; Thomas, Albert M; Grogan, Tristan R; Haykal, Rasha; Schooler, Tery A; Okeya, Bette L; Abbott, David H; Chazenbalk, Gregorio D

2016-11-01

Normal weight polycystic ovary syndrome (PCOS) women may have altered adipose structure-function underlying metabolic dysfunction. This study examines whether adipose structure-functional changes exist in normal weight PCOS women and correlate with hyperandrogenism and/or hyperinsulinemia. This is a prospective cohort study. The setting was an academic medical center. Six normal weight PCOS women and 14 age- and body mass index-matched normoandrogenic ovulatory (NL) women were included. All women underwent circulating hormone and metabolic measurements; frequently sampled intravenous glucose tolerance testing; total body dual-energy x-ray absorptiometry; abdominal magnetic resonance imaging; and SC abdominal fat biopsy. Circulating hormones and metabolites, body fat and its distribution, and adipocyte size were compared between PCOS and NL women, and were correlated with each other in all women. Circulating LH and androgen levels were significantly greater in PCOS than NL women, as were fasting insulin levels, pancreatic β-cell responsiveness to glucose, and total abdominal fat mass. Intra-abdominal fat mass also was significantly increased in PCOS women and was positively correlated with circulating androgen, fasting insulin, triglyceride, and non-high-density lipoprotein cholesterol levels in all women. SC abdominal fat mass was not significantly increased in PCOS women, but contained a greater proportion of small SC abdominal adipocytes that positively correlated with serum androgen levels in all women. Hyperandrogenism in normal weight PCOS women is associated with preferential intra-abdominal fat deposition and an increased population of small SC abdominal adipocytes that could constrain SC adipose storage and promote metabolic dysfunction.

Avaliação metabólica de mulheres jovens com hiperplasia adrenal congênita

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Gabrielle Sormanti Schnaider Rezek

2011-01-01

Resumo: Introdução: Pacientes adultos com hiperplasia adrenal congênita (HAC) por deficiência de 21-hidroxilase apresentam maior incidência de obesidade, adiposidade visceral, hiperinsulinismo, resistência insulínica e hiperandrogenismo que indivíduos normais. A disfunção adrenomedular e o hipercortisolismo intermitente parecem estar associados a estas anormalidades, o que predispõe estes pacientes a um risco aumentado de desenvolvimento de síndrome metabólica e doença aterosclerótica. Objeti...

Open abdomen management of intra-abdominal infections: analysis of a twenty-year experience.

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Rausei, Stefano; Dionigi, Gianlorenzo; Boni, Luigi; Rovera, Francesca; Minoja, Giulio; Cuffari, Salvatore; Dionigi, Renzo

2014-06-01

No conclusive results on the efficacy and timing of open abdomen (OA) are available, particularly in the setting of intra-abdominal infections. We analyzed outcomes and risk factors retrospectively in a large series of patients managed with an OA during the past 20 y in an effort to clarify this issue. We reviewed the records of 133 patients who underwent treatment with an OA, considering factors related to patient, disease, medical management, and surgical treatment. The end points of the bi-variable analysis were 1-y mortality, calculated from the time of an initial OA procedure, and definitive fascial closure. Most patients (112/133) managed with an OA had one of several types of peritonitis. Many patients had severe clinical conditions (mean Acute Physiology and Chronic Health Evaluation [APACHE] II score was almost 9 points for the study population). With regard to surgical management, the mean (+SD) number of abdominal revisions was 5.9+9.3 during a mean duration of treatment with an OA of 14.3+11.6 d. The overall mortality in the study was 26% (35/133). Bi-variable analysis revealed factors associated with overall mortality to be age, renal and respiratory co-morbidities, edema on an initial chest radiograph, blood pressure, blood glucose and creatinine concentrations; and APACHE II score. The rate of definitive fascial closure was 75% (100/133). Factors associated negatively with fascial closure were respiratory co-morbidity, edema on a first chest radiograph, post-operative mesenteric ischemia as an indication for OA, blood glucose and creatinine concentrations, and duration of an OA. Patients' pre-operative clinical status influences strongly their response to surgical treatment. The management of OA does not affect adversely the survival of patients with intra-abdominal infections, but factors related to the management of OA (duration of OA) seem to affect the possibility of definitive fascial closure.

Adiposidad corporal y bienestar psicológico: efectos de la actividad física en universitarios de Valencia, España Adiposity and psychological well-being: effects of physical activity on university students in Valencia, Spain

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Isabel Castillo

2009-10-01

Full Text Available OBJETIVO: Determinar mediante un modelo de ecuaciones estructurales la relación que existe entre la actividad física, la adiposidad corporal, la competencia física percibida y tres indicadores del bienestar psicológico en una muestra de estudiantes universitarios españoles. MÉTODOS: Estudio transversal descriptivo en 639 estudiantes de 18 a 29 años representativos de las universidades de Valencia, España, en el curso 2005-2006. La práctica de actividad física se evaluó mediante el inventario de conductas de salud en escolares. Se aplicaron las escalas de competencia física percibida, autoestima, satisfacción con la vida y vitalidad subjetiva. La adiposidad corporal se expresó mediante el porcentaje de masa grasa (PMG. Se elaboró un modelo teórico con las seis variables medidas. RESULTADOS: El nivel de actividad física de los participantes era moderado, se percibían físicamente competentes, tenían una alta autoestima, se encontraban satisfechos con su vida y se sentían con alta vitalidad. La actividad física se relacionó negativamente con el PMG tanto en los varones como en las mujeres; el PMG se asoció negativamente con la percepción de competencia física; y la competencia física percibida se asoció positivamente con la autoestima, la satisfacción con la vida y la vitalidad subjetiva. El efecto de la práctica de actividad física sobre la competencia percibida estaba mediado parcialmente por el PMG en los varones; en las mujeres, la práctica de actividad física se relacionó directamente tanto con el PMG como con la percepción de competencia, sin la mediación del PMG. CONCLUSIONES: El aumento de la actividad física tiene un gran valor para la salud pública, ya que además de contribuir a tener menos grasa corporal, aumenta el bienestar psicológico y mejora la autopercepción.OBJECTIVE: To determine, through the use of a structural equation model, the relationships that exist between physical activity, body

Hyperandrogenism Accompanies Increased Intra-Abdominal Fat Storage in Normal Weight Polycystic Ovary Syndrome Women

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Akopians, Alin L.; Madrigal, Vanessa K.; Ramirez, Emmanuel; Margolis, Daniel J.; Sarma, Manoj K.; Thomas, Albert M.; Grogan, Tristan R.; Haykal, Rasha; Schooler, Tery A.; Okeya, Bette L.; Abbott, David H.; Chazenbalk, Gregorio D.

2016-01-01

Context: Normal weight polycystic ovary syndrome (PCOS) women may have altered adipose structure-function underlying metabolic dysfunction. Objective: This study examines whether adipose structure-functional changes exist in normal weight PCOS women and correlate with hyperandrogenism and/or hyperinsulinemia. Design: This is a prospective cohort study. Setting: The setting was an academic medical center. Patients: Six normal weight PCOS women and 14 age- and body mass index-matched normoandrogenic ovulatory (NL) women were included. Intervention(s): All women underwent circulating hormone and metabolic measurements; frequently sampled intravenous glucose tolerance testing; total body dual-energy x-ray absorptiometry; abdominal magnetic resonance imaging; and SC abdominal fat biopsy. Main Outcome Measure(s): Circulating hormones and metabolites, body fat and its distribution, and adipocyte size were compared between PCOS and NL women, and were correlated with each other in all women. Results: Circulating LH and androgen levels were significantly greater in PCOS than NL women, as were fasting insulin levels, pancreatic β-cell responsiveness to glucose, and total abdominal fat mass. Intra-abdominal fat mass also was significantly increased in PCOS women and was positively correlated with circulating androgen, fasting insulin, triglyceride, and non-high-density lipoprotein cholesterol levels in all women. SC abdominal fat mass was not significantly increased in PCOS women, but contained a greater proportion of small SC abdominal adipocytes that positively correlated with serum androgen levels in all women. Conclusion: Hyperandrogenism in normal weight PCOS women is associated with preferential intra-abdominal fat deposition and an increased population of small SC abdominal adipocytes that could constrain SC adipose storage and promote metabolic dysfunction. PMID:27571186

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

The role of invasive sonography in the differential diagnosis and treatment of intraabdominal fluid collections.

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Regöly-Mérei, J; Ihász, M; Szeberin, Z; Záborszky, A

Sixty-nine ultrasound-guided interventions (23 punctures and 46 drainages) were performed on 51 patients with the suspicion of intraabdominal abscess or another type of fluid collection in a prospective-controlled study. Of the procedures, 58.8% were carried out following surgery, while in 41.2% the indication were not related to prior surgical intervention. Repeated procedures were done in 10 patients. In the group of punctures the procedure was therapeutic in 3 cases and diagnostic in 16 patients. The drainage was technically successful in 92.7%. The drain was displaced or blocked in 27% (n = 10), but reinterventions were necessary in only 5 cases for this reason. The total number of redrainages was 18.9%. The percutaneous (pc) drainage was insufficient in 8 patients (21.6%), all these patients were operated on. 62.2% of the patients recovered after pc drainage, 13.5% following redrainage (total 75.5%). In 8.1% of the cases after pc drainage and in 5.4% after pc redrainage open surgery became necessary. There was only one complication due to the procedure. Seven patients (14.3%) died of the disease which indicated the procedure. There were no fatal outcomes on the account of the intervention. Ultrasound-guided puncture is a suitable method to indicate or contraindicate open surgery in the case of intraabdominal fluid collection. The diagnostic puncture may be followed by sonographically guided drainage or in selected cases by therapeutic puncture, but if the pc drainage is insufficient, open surgery should be performed in time.

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

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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.

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

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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

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

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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.

Intra-abdominal hypertension and abdominal compartment syndrome in association with ruptured abdominal aortic aneurysm in the endovascular era: vigilance remains critical.

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Bozeman, Matthew C; Ross, Charles B

2012-01-01

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are common complications of ruptured abdominal aortoiliac aneurysms (rAAAs) and other abdominal vascular catastrophes even in the age of endovascular therapy. Morbidity and mortality due to systemic inflammatory response syndrome (SIRS) and multiple organ failure (MOF) are significant. Recognition and management of IAH are key critical care measures which may decrease morbidity and improve survival in these vascular patients. Two strategies have been utilized: expectant management with prompt decompressive laparotomy upon diagnosis of threshold levels of IAH versus prophylactic, delayed abdominal closure based upon clinical parameters at the time of initial repair. Competent management of the abdominal wound with preservation of abdominal domain is also an important component of the care of these patients. 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.

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

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Ratan Konjengbam

2017-07-01

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

PCR-based detection of resistance genes in anaerobic bacteria isolated from intra-abdominal infections.

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Tran, Chau Minh; Tanaka, Kaori; Watanabe, Kunitomo

2013-04-01

Little information is available on the distribution of antimicrobial resistance genes in anaerobes in Japan. To understand the background of antimicrobial resistance in anaerobes involved in intra-abdominal infections, we investigated the distribution of eight antimicrobial resistance genes (cepA, cfiA, cfxA, ermF, ermB, mefA, tetQ, and nim) and a mutation in the gyrA gene in a total of 152 organisms (Bacteroides spp., Prevotella spp., Fusobacterium spp., Porphyromonas spp., Bilophila wadsworthia, Desulfovibrio desulfuricans, Veillonella spp., gram-positive cocci, and non-spore-forming gram-positive bacilli) isolated between 2003 and 2004 in Japan. The cepA gene was distributed primarily in Bacteroides fragilis. Gene cfxA was detected in about 9 % of the Bacteroides isolates and 75 % of the Prevotella spp. isolates and did not appear to contribute to cephamycin resistance. Two strains of B. fragilis contained the metallo-β-lactamase gene cfiA, but they did not produce the protein product. Gene tetQ was detected in about 81, 44, and 63 % of B. fragilis isolates, other Bacteroides spp., and Prevotella spp. isolates, respectively. The ermF gene was detected in 25, 13, 56, 64, and 16 % of Bacteroides spp., Prevotella spp., Fusobacterium spp., B. wadsworthia, and anaerobic cocci, respectively. Gene mefA was found in only 10 % of the B. fragilis strains and 3 % of the non-B. fragilis strains. Genes nim and ermB were not detected in any isolate. Substitution at position 82 (Ser to Phe) in gyrA was detected in B. fragilis isolates that were less susceptible or resistant to moxifloxacin. This study is the first report on the distribution of resistance genes in anaerobes isolated from intra-abdominal infections in Japan. We expect that the results might help in understanding the resistance mechanisms of specific anaerobes.

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

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Yavuz Savas Koca

2016-01-01

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

Immune Protection against Lethal Fungal-Bacterial Intra-Abdominal Infections.

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Lilly, Elizabeth A; Ikeh, Melanie; Nash, Evelyn E; Fidel, Paul L; Noverr, Mairi C

2018-01-16

Polymicrobial intra-abdominal infections (IAIs) are clinically prevalent and cause significant morbidity and mortality, especially those involving fungi. Our laboratory developed a mouse model of IAI and demonstrated that intraperitoneal inoculation with Candida albicans or other virulent non- albicans Candida (NAC) species plus Staphylococcus aureus resulted in 70 to 80% mortality in 48 to 72 h due to robust local and systemic inflammation (sepsis). Surprisingly, inoculation with Candida dubliniensis or Candida glabrata with S. aureus resulted in minimal mortality, and rechallenge of these mice with lethal C. albicans / S. aureus (i.e., coninfection) resulted in >90% protection. The purpose of this study was to define requirements for C. dubliniensis / S. aureus -mediated protection and interrogate the mechanism of the protective response. Protection was conferred by C. dubliniensis alone or by killed C. dubliniensis plus live S. aureus S. aureus alone was not protective, and killed S. aureus compromised C. dubliniensis -induced protection. C. dubliniensis / S. aureus also protected against lethal challenge by NAC plus S. aureus and could protect for a long-term duration (60 days between primary challenge and C. albicans/S. aureus rechallenge). Unexpectedly, mice deficient in T and B cells (Rag-1 knockouts [KO]) survived both the initial C. dubliniensis/S. aureus challenge and the C. albicans/S. aureus rechallenge, indicating that adaptive immunity did not play a role. Similarly, mice depleted of macrophages prior to rechallenge were also protected. In contrast, protection was associated with high numbers of Gr-1 hi polymorphonuclear leukocytes (PMNLs) in peritoneal lavage fluid within 4 h of rechallenge, and in vivo depletion of Gr-1 + cells prior to rechallenge abrogated protection. These results suggest that Candida species can induce protection against a lethal C. albicans / S. aureus IAI that is mediated by PMNLs and postulated to be a unique form of

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

International Nuclear Information System (INIS)

Go, H.L.S.; Baarslag, H.J.; Vermeulen, H.; Lameris, J.S.; Legemate, D.A.

2005-01-01

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 κ 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

Experimental intra-abdominal hypertension influences airway pressure limits for lung protective mechanical ventilation.

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Cortes-Puentes, Gustavo A; Cortes-Puentes, Luis A; Adams, Alexander B; Anderson, Christopher P; Marini, John J; Dries, David J

2013-06-01

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) may complicate monitoring of pulmonary mechanics owing to their impact on the respiratory system. However, recommendations for mechanical ventilation of patients with IAH/ACS and the interpretation of thoracoabdominal interactions remain unclear. Our study aimed to characterize the influence of elevated intra-abdominal pressure (IAP) and positive end-expiratory pressure (PEEP) on airway plateau pressure (PPLAT) and bladder pressure (PBLAD). Nine deeply anesthetized swine were mechanically ventilated via tracheostomy: volume-controlled mode at tidal volume (VT) of 10 mL/kg, frequency of 15, inspiratory-expiratory ratio of 1:2, and PEEP of 1 and 10 cm H2O (PEEP1 and PEEP10, respectively). A tracheostomy tube was placed in the peritoneal cavity, and IAP levels of 5, 10, 15, 20, and 25 mm Hg were applied, using a continuous positive airway pressure system. At each IAP level, PBLAD and airway pressure measurements were performed during both PEEP1 and PEEP10. PBLAD increased as experimental IAP rose (y = 0.83x + 0.5; R = 0.98; p < 0.001 at PEEP1). Minimal underestimation of IAP by PBLAD was observed (-2.5 ± 0.8 mm Hg at an IAP of 10-25 mm Hg). Applying PEEP10 did not significantly affect the correlation between experimental IAP and PBLAD. Approximately 50% of the PBLAD (in cm H2O) was reflected by changes in PPLAT, regardless of the PEEP level applied. Increasing IAP did not influence hemodynamics at any level of IAP generated. With minimal underestimation, PBLAD measurements closely correlated with experimentally regulated IAP, independent of the PEEP level applied. For each PEEP level applied, a constant proportion (approximately 50%) of measured PBLAD (in cm H2O) was reflected in PPLAT. A higher safety threshold for PPLAT should be considered in the setting of IAH/ACS as the clinician considers changes in VT. A strategy of reducing VT to cap PPLAT at widely recommended values may not be

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

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Simón Barquera

2009-01-01

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

Aptidão física associada às medidas antropométricas de escolares do ensino fundamental

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Viviane Andreasi

2010-12-01

Full Text Available OBJETIVO: Analisar a associação da aptidão física relacionada à saúde com os indicadores demográficos e antropométricos de crianças de três escolas do município de Botucatu (SP. MÉTODOS: A amostra deste estudo transversal foi de 988 escolares do ensino fundamental, do 2º ao 9º ano (faixa etária de 7 a 15 anos. As avaliações realizadas foram antropométricas (peso, estatura, circunferência abdominal e dobras cutâneas tricipital e subescapular e de aptidão física relacionada à saúde (flexibilidade: teste de sentar e alcançar; força/resistência abdominal: teste abdominal em 1 minuto; e resistência aeróbia: teste de correr/andar por 9 minutos. Para a análise dos dados, utilizou-se estatística descritiva, teste t de Student, qui-quadrado ou exato de Fisher e regressão logística com nível de significância de 5%. RESULTADOS: As aptidões físicas estudadas foram significativamente influenciadas por idade (todas, sexo (força/resistência abdominal, obesidade (todas, adiposidade corpórea (flexibilidade, força/resistência abdominal e adiposidade abdominal (força/resistência abdominal e resistência aeróbia. O sexo feminino mostrou-se mais propenso à inaptidão de força/resistência abdominal, enquanto que a obesidade e a hiperadiposidade abdominal predispõem os escolares à inaptidão de força/resistência abdominal e resistência aeróbia. O excesso de adiposidade corpórea aumentou as chances de ocorrência da flexibilidade do tronco fraca. CONCLUSÕES: As inaptidões físicas foram relacionadas ao sexo feminino, à obesidade e à hiperadiposidade abdominal. Programas de mudança do estilo de vida nas escolas, voltados à aptidão física e à adequação alimentar, preencheriam os objetivos de promoção da eutrofia e da maior aptidão física desses escolares.

Associação entre marcadores antropométricos de adiposidade corporal e hipertensão arterial na população adulta de Cuiabá, Mato Grosso Association between anthropometric markers of body adiposity and hypertension in an adult population of Cuiabá, Mato Grosso

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Larissa Silva Barbosa

2009-06-01

Full Text Available OBJETIVO: Avaliar a associação entre marcadores antropométricos de adiposidade corporal (índice de massa corporal e circunferência da cintura e hipertensão arterial. MÉTODOS: Estudo de corte transversal, de base populacional, realizado no período de 2003 a 2004, com 1.298 indivíduos de 20 a 59 anos. Foram considerados hipertensos os indivíduos com pressão arterial > 140/90 mmHg ou em uso de medicação anti-hipertensiva. As associações entre os indicadores antropométricos e a hipertensão arterial foram analisadas por regressão de Poisson, ajustada por potenciais fatores de confusão (sexo, idade, escolaridade, tabagismo, consumo de bebida alcoólica e atividade física no lazer. A curva ROC foi utilizada para determinar o melhor ponto de corte do IMC para detecção da hipertensão arterial. RESULTADOS: A prevalência de hipertensão arterial foi de 28,3%, sendo 33,5% no sexo masculino e 23,5% no feminino. Após ajuste para o IMC e potenciais fatores de confusão, a circunferência da cintura perdeu associação com o desfecho avaliado, permanecendo apenas o IMC com poder de explicação para a hipertensão arterial (RP = 1,05, p = 0,001. O melhor ponto de corte para o IMC no sexo masculino foi de 25,6 Kg/m², e no sexo feminino 25,7 Kg/m². CONCLUSÕES: A associação observada entre a circunferência da cintura e a hipertensão arterial em muitos estudos pode estar relacionada à ausência de controle de potenciais fatores de confusão nas análises, bem como à não remoção do efeito da adiposidade total. Novas investigações devem ser conduzidas na população brasileira, a fim de se verificar as verdadeiras associações entre indicadores antropométricos e vários desfechos, estudando-se também os melhores pontos de corte desses indicadores.OBJECTIVE: To assess the association between the anthropometric indexes of body adiposity (body mass index - BMI and waist circumference and hypertension. METHODS: This is a

Intra-abdominal fibrosis in a recent cohort of patients with neuroendocrine ('carcinoid') tumours of the small bowel.

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Druce, M R; Bharwani, N; Akker, S A; Drake, W M; Rockall, A; Grossman, A B

2010-03-01

Fibrosis is a hallmark of neuroendocrine tumours (NETs) arising in the jejunum and ileum and may manifest in the mesentery and elsewhere. It is clinically important and once-established, there are few effective therapies. To examine the frequency, radiological manifestations and clinical significance of intra-abdominal fibrosis in a patient cohort using modern cross-sectional imaging. Current prevalence is compared to historical series and correlation with cardiac fibrosis evaluated. Cross-sectional, retrospective survey of a cohort of patients with mid-gut NETs from a single centre. Review of clinical features, biochemistry and imaging of patients with sporadic mid-gut NET and available imaging between 2002 and 2008. Thirty-one patients were included: 26 (83.9%) had liver metastases and 11 (35.4%) had small-bowel wall thickening; 17 patients (55%) had mesenteric involvement, with a mass, which contained coarse calcification in seven patients and fine calcification in a further two. There was soft-tissue stranding in 13 patients (plus in a further patient with no mass) and 'indrawing' of tissues in 11 patients. Two patients had a 'misty' mesentery and two had early retroperitoneal fibrosis. Mesenteric involvement was unrelated to gender and urinary 5HIAA excretion. Intra-abdominal fibrosis can be detected radiologically in around half of patients with mid-gut NET using contemporary cross-sectional imaging. Although not statistically significant, small-bowel obstruction was seen more frequently in the group with fibrosis. There was no relationship with cardiac fibrosis. Prospective studies are needed to evaluate predictors of fibrosis onset and clinical course and determine optimal methods of prevention and treatment.

[Surgical correction of the intraabdominal hypertension in patients with colon cancer].

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Aliev, S A

2012-01-01

The experience of treatment of 48 patients with colon cancer, complicated with bowe obstruction, colon perforation, abdominal sepsis and intraabdominal hypertension was analyzed. Men were 18, women - 30. Patients' age ranged 24-85 years. 31 patients (64.6%) had the 3rd stage (T4N2M0) of the disease by the time of the diagnosis. Tumor perforation was registered in 35 patients, the rest 13 had suprastenotic perforation. 39 patients developed SIRS and abdominal sepsis. The method of intraoperative "closed" colon decompression and intraluminar colon irrigation with the original modification of vacuum aspiration-irrigation device was introduced, as well as the modified method of end colostomy. Radical treatment was performed in 36 (78.3%) patients, 10 patients received palliative treatment and 2 patients could not be operated on. The postoperative lethality rate was 45.6%, the overall - 47.9%. The suggested method of colon decompression allowed to decrease the postoperative lethality rate from 47.7 to 45.6%, and the overall lethality rate from 50 to 47.9%.

Estado nutricional e distribuição de gordura corporal em crianças e adolescentes com Fibrose Cística

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Célia Regina Moutinho de Miranda Chaves

2015-11-01

Full Text Available O objetivo deste estudo é avaliar o estado nutricional e a distribuição da gordura corporal em crianças e adolescentes com fibrose cística. Foram realizadas avaliação da distribuição de gordura corporal por meio da absorciometria de duplo feixe de energia, do estado nutricional por estatura/idade e índice de massa corporal/idade e a ingestão dietética pelo recordatório alimentar de 24horas, em 56 pacientes com idade entre 8 e 18 anos. Aproximadamente 50% da amostra apresentou estado nutricional adequado. A maioria apresentou a ingestão calórica e de lipídios inadequadas. O IMC/I foi o indicador nutricional que melhor evidenciou o aumento do percentual de gordura do tronco, razão androide/ginecoide e razão gordura tronco/gordura total. Os pacientes com Insuficiência Pancreática e os eutróficos apresentaram razão mediana androide/ginecoide maior. O aumento da adiposidade abdominal foi evidenciado pela DXA. O IMC/I não identificou a diminuição da massa magra corporal, mas quando aumentado foi significativo para adiposidade abdominal. Pacientes com fibrose cística devem associar a avaliação antropométrica à composição corporal e à distribuição de gordura corporal para um diagnóstico mais precoce de desnutrição e fatores de risco cardiometabólico.

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

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Stojanović Maja

2017-01-01

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

Intra-abdominal sepsis following pancreatic resection: incidence, risk factors, diagnosis, microbiology, management, and outcome.

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Behrman, Stephen W; Zarzaur, Ben L

2008-07-01

Intra-abdominal sepsis (IAS) following pancreatectomy is associated with the need for therapeutic intervention and may result in mortality. We retrospectively reviewed patients developing IAS following elective pancreatectomy. Risk factors for the development of sepsis were assessed. The microbiology of these infections was ascertained. The number and type of therapeutic interventions required and infectious-related mortality were recorded. One hundred ninety-six patients had a pancreatectomy performed, 32 (16.3%) of who developed IAS. Infected abdominal collections were diagnosed and therapeutically managed at a mean of 11.8 days after the index procedure (range, 4-33). Eleven of 32 (34%) of these infections were diagnosed on or before postoperative day 6, 10 of who had Whipple procedures. Statistically significant risk factors included an overt pancreatic fistula (18.8% vs 5.5%) and a soft pancreatic remnant (74.2% vs 42.3%), but not the lack of intra-abdominal drainage, an antecedent immunocompromised state, postoperative hemorrhage, or the preoperative placement of a biliary stent. Fifty-five per cent had polymicrobial infections and 26 per cent of isolates were resistant organisms. Nineteen per cent and 48 per cent of patients had an isolate positive for fungus and a Gram-positive organism, respectively. Forty-seven therapeutic interventions were used, including 10 reoperations. Length of stay was significantly prolonged in those with IAS (28.5 vs 15.2 days) and mortality was higher (15.6% vs 1.8%). We conclude: 1) septic morbidity after pancreatectomy is associated with a soft pancreatic remnant and an overt pancreatic fistula and in this series resulted in a prolonged length of stay and a significant increase in procedure-related mortality; 2) infected fluid collections may occur very early in the postoperative period before frank abscess formation, and an early threshold for diagnostic imaging and/or therapeutic intervention should be entertained in those

Removal of an intra-abdominal desmoplastic small round cell tumor by repetitive debulking surgery: A case report and literature review

OpenAIRE

SHIMAZAKI, JIRO; MOTOHASHI, GYO; NISHIDA, KIYOTAKA; TABUCHI, TAKANOBU; UBUKATA, HIDEYUKI; TABUCHI, TAKAFUMI

2014-01-01

In the current study, a case of recurrent desmoplastic small round cell tumor (DSRCT) is presented, which was successfully treated by repetitive debulking surgery. In May 2010, a 39-year-old male, with a history of surgical resection of intra-abdominal DSRCT, visited the Ibaraki Medical Center, Tokyo Medical University Hospital (Ami, Japan) with severe lower abdominal discomfort. Abdominal computed tomography revealed a large tumor in the pouch of Douglas with a small number of nodules in the...

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

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Anja Moss

2016-04-01

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

Intra-abdominal vacuum-assisted closure (VAC) after necrosectomy for acute necrotising pancreatitis: preliminary experience.

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Sermoneta, D; Di Mugno, M; Spada, P L; Lodoli, C; Carvelli, M E; Magalini, S C; Cavicchioni, C; Bocci, M G; Martorelli, F; Brizi, M G; Gui, D

2010-12-01

Infection of pancreatic necrosis, although present in less than 10% of acute pancreatitis, carries a high risk of mortality; debridment and drainage of necrosis is the treatment of choice, followed by 'open' or 'close' abdomen management. We recently introduced the use of intra-abdominal vacuum sealing after a classic necrosectomy and laparostomy. Two patients admitted to ICU for respiratory insufficiency and a diagnosis of severe acute pancreatitis developed pancreatic necrosis and were treated by necrosectomy, lesser sac marsupialisation and posterior lumbotomic opening. Both of the patients recovered from pancreatitis and a good healing of laparostomic wounds was obtained with the use of the VAC system. Most relevant advantages of this technique seem to be: the prevention of abdominal compartment syndrome, the simplified nursing of patients and the reduction of time to definitive abdominal closure. © 2010 The Authors. Journal Compilation © 2010 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

Urinary bladder incarceration and infarction by an intra-abdominal fat pad in a Virginia opossum (Didelphis virginiana).

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De Voe, Ryan S; Spaulding, Kathy A; Rotstein, Jack; Rotstein, David S

2004-01-01

A 2.5-year-old, female opossum had acute stranguria. Based on radiography and ultrasonographic examination a cystic structure was identified in the caudal abdomen associated with bilateral hydroureter and hydronephrosis. This structure contained a neutrophilic fluid, determined to be urine. There was a neutrophilic leukocytosis. Serum chemistry values were within normal limits. The opossum was euthanized. An intra-abdominal fat pad incarceration of the urinary bladder above the trigone was present, resulting in complete obstruction of the urinary bladder and partial obstruction of the ureters. Vessels to the bladder were involved in the incarceration which resulted in vascular compromise and infarction of the bladder. Mild to moderate hydroureter and hydronephrosis were present.

Fatores que influenciam a prevalência de sobrepeso e obesidade em estudantes adolescentes

OpenAIRE

Camelo, Eduardo de Moura

2013-01-01

O sobrepeso e a obesidade têm apresentado hoje no mundo um problema de saúde pública na população adulta, mas também com uma alta prevalência em jovens e adolescentes. Nas últimas décadas, as crianças tornaram-se menos ativas, fazendo uso da tecnologia. Uma relação entre a inatividade, como por exemplo, o tempo gasto assistindo televisão e o aumento da adiposidade em escolares vem sendo observada. A atividade física ajuda a diminuir o risco de obesidade, atuando na regulação do balanço energé...

Centripetal obesity and metabolics malfunctions: patogeny, measurement and prophylatic role of physical exercise Obesidade centrípeta e disfunções metabólicas: patogenia, mensuração e papel profilático do exercício físico

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Joana E. Ribeiro Pinto Guedes

2002-11-01

ólica, também conhecida como síndrome plurimetabólica ou simplesmente “síndrome X”. Tal síndrome caracteriza-se por uma gama de disfunções endócrinometabólicas, induzindo seu portador a queda acentuada da qualidade de vida, devido a morbi-mortalidade decorrente. A prevalência da obesidade visceral e possíveis conseqüências degenerativas aparentam ser resultantes principalmente de distúrbios genéticos e endócrinos, podendo o diagnóstico ser realizado por intermédio de estimativas mediante medidas antropométricas ou por métodos de diagnóstico por imagem. Dentre os meios utilizados para a prevenção e tratamento dos altos níveis de adiposidade centrípeta, balanço energético negativo mediante reeducação alimentar e exercício físico demonstram alta eficiência, podendo a gordura localizada no tronco e no abdome, e principalmente a gordura visceral serem mobilizadas preferencialmente como fonte energética ao se confrontar com a gordura localizada em outras regiões do corpo. No que diz respeito ao exercício físico, não se observa consenso com relação ao tipo, à intensidade, à freqüência e à duração ideais, apesar de os exercícios aeróbios demonstrarem ser os mais efetivos.  

Intra-Abdominal Desmoplastic Small Round Cell Tumor with Elevated Serum CA 125: A Case Report

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Sheau-Fang Yang

2003-10-01

Full Text Available Desmoplastic small round cell tumor (DSRCT is a rare and highly aggressive tumor usually involving the peritoneum. It occurs more commonly in young males and is characterized by distinctive clinical, histologic, and immunophenotypic features. The histogenesis of DSRCT remains unknown. Coexpression of epithelial, mesenchymal, and neural antigens in the same cell provides evidence that DSRCT may arise from a primitive pluripotent stem cell with divergent differentiation. Recently, according to cytogenetic studies, some authors have proposed that the divergent differentiation of DSRCT may be the result of the fusion of Ewing's sarcoma gene and Wilms' tumor suppressor gene. Clinically, an elevated serum CA 125 concentration is found in some patients with DSRCT. We present the case of a 29-year-old man with diffuse intra-abdominal DSRCT and elevated serum CA 125 concentration and briefly review the relevant literature.

Intestinal fatty acid binding protein as a marker for intra-abdominal pressure-related complications in patients admitted to the intensive care unit; study protocol for a prospective cohort study (I-Fabulous study)

NARCIS (Netherlands)

K.D. Strang; O.J.F. van Waes (Oscar); B. van der Hoven (Ben); S. Ali (Samir); M.H.J. Verhofstad (Michiel); P. Pickkers (Peter); E.M.M. van Lieshout (Esther)

2015-01-01

textabstractBackground: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have detrimental effects on all organ systems and are associated with increased morbidity and mortality in critically ill patients admitted to an intensive care unit. Intra-bladder measurement of the

Intestinal fatty acid binding protein as a marker for intra-abdominal pressure-related complications in patients admitted to the intensive care unit; study protocol for a prospective cohort study (I-Fabulous study)

NARCIS (Netherlands)

Strang, S.G.; Waes, O.J. van; Hoven, B. van der; Ali, S.; Verhofstad, M.H.J.; Pickkers, P.; Lieshout, E.M. van

2015-01-01

BACKGROUND: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have detrimental effects on all organ systems and are associated with increased morbidity and mortality in critically ill patients admitted to an intensive care unit. Intra-bladder measurement of the

Intraabdominal pressure in women during CrossFit exercises and the effect of age and parity.

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Gephart, Laura Faye; Doersch, Karen M; Reyes, Michelle; Kuehl, Thomas J; Danford, Jill M

2018-07-01

To determine intraabdominal pressure (IAP) in women during CrossFit and to determine whether parity, age, or CrossFit experience affects IAP during CrossFit exercises, we evaluated 10 women: 5 experienced and active CrossFitters and 5 who were not regularly engaged in CrossFit. A Laborie urodynamics abdominal pressure probe with the Goby wireless system measured IAP during 10 repetitions of 13 different CrossFit exercises. Women had a mean age of 36 years. A significant difference was found between mean peak IAP of the 5 parous vs the 5 nulliparous women ( P = 0.009). Experience with CrossFit did not affect mean peak IAP achieved with exercise. In some exercises, there was a significant change in IAP as participants progressed through repetitions ( P = 0.003 for back squats and 0.04 for sit-ups). Participants achieved IAP values that were markedly higher than those previously published.

The Effects of Dexmedetomidine on Secondary Acute Lung and Kidney Injuries in the Rat Model of Intra-Abdominal Sepsis

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Uğur Koca

2013-01-01

Full Text Available In the present study, the effects of dexmedetomidine on secondary lung and kidney injuries were studied in the rat model of intra-abdominal sepsis by immunohistological and biochemical examinations. We measured serum creatinine, kidney tissue malondialdehide and plasma neutrophil gelatinase-associated lipocalin levels. In order to evaluate tissue injury we determined kidney tissue mononuclear cell infiltration score, alveolar macrophage count, histological kidney and lung injury scores and kidney and lung tissue immunoreactivity scores. We demonstrated that dexmedetomidine attenuates sepsis-induced lung and kidney injuries and apoptosis in the rat model of sepsis. There is still need for comparative studies in order to determine the effects of dexmedetomidine on organ functions in early human sepsis.

Cardiorespiratory effects of balancing PEEP with intra-abdominal pressures during laparoscopic cholecystectomy.

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Kundra, Pankaj; Subramani, Yamini; Ravishankar, M; Sistla, Sarath C; Nagappa, Mahesh; Sivashanmugam, T

2014-06-01

Applying appropriate positive end-expiratory pressure (PEEP) to corresponding intra-abdominal pressure (IAP) can improve gas exchange during capnoperitoneum without any hemodynamic effects. A total of 75 patients were randomly allocated to group 0PEEP (n=25), group 5PEEP (n=25), and group 10PEEP (n=25) according to the level of PEEP, in whom capnoperitoneum was created with IAP of 14, 8, and 14 mm Hg, respectively. Hemodynamic and respiratory parameters were recorded up to 30 minutes after capnoperitoneum. In 0PEEP group, mean end-tidal carbon dioxide demonstrated significant rise 2 minutes after capnoperitoneum and plateaued at about 15 minutes but remained at high level for up to 30 minutes when compared with the 5PEEP and 10PEEP groups (Phigher at 30 minutes when compared with 5PEEP (37.8±2.7 mm Hg) and 10PEEP (37.2±3.9 mm Hg) groups. The oxygenation was better preserved in 5PEEP and 10PEEP groups with significantly higher PaO2/Fio2 ratio. Heart rate, mean arterial pressure, and cardiac output remained stable throughout the study in all the 3 groups. Application of appropriate PEEP corresponding to the IAP helped maintain CO2 elimination and improved oxygenation without any hemodynamic disturbance in patients undergoing laparoscopic cholecystectomy.

Immune Protection against Lethal Fungal-Bacterial Intra-Abdominal Infections

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Lilly, Elizabeth A.; Ikeh, Melanie; Nash, Evelyn E.; Fidel, Paul L.

2018-01-01

ABSTRACT Polymicrobial intra-abdominal infections (IAIs) are clinically prevalent and cause significant morbidity and mortality, especially those involving fungi. Our laboratory developed a mouse model of IAI and demonstrated that intraperitoneal inoculation with Candida albicans or other virulent non-albicans Candida (NAC) species plus Staphylococcus aureus resulted in 70 to 80% mortality in 48 to 72 h due to robust local and systemic inflammation (sepsis). Surprisingly, inoculation with Candida dubliniensis or Candida glabrata with S. aureus resulted in minimal mortality, and rechallenge of these mice with lethal C. albicans/S. aureus (i.e., coninfection) resulted in >90% protection. The purpose of this study was to define requirements for C. dubliniensis/S. aureus-mediated protection and interrogate the mechanism of the protective response. Protection was conferred by C. dubliniensis alone or by killed C. dubliniensis plus live S. aureus. S. aureus alone was not protective, and killed S. aureus compromised C. dubliniensis-induced protection. C. dubliniensis/S. aureus also protected against lethal challenge by NAC plus S. aureus and could protect for a long-term duration (60 days between primary challenge and C. albicans/S. aureus rechallenge). Unexpectedly, mice deficient in T and B cells (Rag-1 knockouts [KO]) survived both the initial C. dubliniensis/S. aureus challenge and the C. albicans/S. aureus rechallenge, indicating that adaptive immunity did not play a role. Similarly, mice depleted of macrophages prior to rechallenge were also protected. In contrast, protection was associated with high numbers of Gr-1hi polymorphonuclear leukocytes (PMNLs) in peritoneal lavage fluid within 4 h of rechallenge, and in vivo depletion of Gr-1+ cells prior to rechallenge abrogated protection. These results suggest that Candida species can induce protection against a lethal C. albicans/S. aureus IAI that is mediated by PMNLs and postulated to be a unique form of

Immune Protection against Lethal Fungal-Bacterial Intra-Abdominal Infections

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Elizabeth A. Lilly

2018-01-01

Full Text Available Polymicrobial intra-abdominal infections (IAIs are clinically prevalent and cause significant morbidity and mortality, especially those involving fungi. Our laboratory developed a mouse model of IAI and demonstrated that intraperitoneal inoculation with Candida albicans or other virulent non-albicans Candida (NAC species plus Staphylococcus aureus resulted in 70 to 80% mortality in 48 to 72 h due to robust local and systemic inflammation (sepsis. Surprisingly, inoculation with Candida dubliniensis or Candida glabrata with S. aureus resulted in minimal mortality, and rechallenge of these mice with lethal C. albicans/S. aureus (i.e., coninfection resulted in >90% protection. The purpose of this study was to define requirements for C. dubliniensis/S. aureus-mediated protection and interrogate the mechanism of the protective response. Protection was conferred by C. dubliniensis alone or by killed C. dubliniensis plus live S. aureus. S. aureus alone was not protective, and killed S. aureus compromised C. dubliniensis-induced protection. C. dubliniensis/S. aureus also protected against lethal challenge by NAC plus S. aureus and could protect for a long-term duration (60 days between primary challenge and C. albicans/S. aureus rechallenge. Unexpectedly, mice deficient in T and B cells (Rag-1 knockouts [KO] survived both the initial C. dubliniensis/S. aureus challenge and the C. albicans/S. aureus rechallenge, indicating that adaptive immunity did not play a role. Similarly, mice depleted of macrophages prior to rechallenge were also protected. In contrast, protection was associated with high numbers of Gr-1hi polymorphonuclear leukocytes (PMNLs in peritoneal lavage fluid within 4 h of rechallenge, and in vivo depletion of Gr-1+ cells prior to rechallenge abrogated protection. These results suggest that Candida species can induce protection against a lethal C. albicans/S. aureus IAI that is mediated by PMNLs and postulated to be a unique form of

Effects of Streptokinase and Normal Saline on the Incidence of Intra-abdominal Adhesion 1 Week and 1 Month after Laparotomy in Rats

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Ali Hosseini

2018-01-01

Full Text Available Background: Intra-abdominal adhesions after surgery are usually in the form of bands and can annoy the patient throughout life causing repeated surgical procedures. Therefore, any action to prevent adhesions after surgery can increase longevity and quality of life. For this aim, this study investigates the effect of streptokinase and normal saline on the 7th day and 1 month after laparotomy. Materials and Methods: Experimental study was conducted on thirty healthy male Wistar rats weighing 200–250 g with age of 3 months divided into three groups of 10. Group I: No treatment, Group II: Received normal saline, and Group III: Received normal saline and streptokinase at the same time. One week and 1 month after laparotomy, the frequency of the presence or absence of adhesion bands was performed by a person who was unaware of the sample grouping. The collected information was analyzed with the SPSS software (version 16; SPSS Inc., Chicago, IL, USA. Results: Adhesion frequency was found to be 20% on the 7th day (early and 1 month after laparotomy (late for Group 1, and it was 40% on early and late for Group II, while 0% on the early and late for Group III. Hence, in the group receiving streptokinase, no early or late adhesion was observed; therefore, it had a significant role in the prevention of intra-abdominal adhesions (P 0.05. Conclusion: According to the results of our study, we believe that streptokinase could be a good antiadhesive agent considering its effectiveness.

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

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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

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

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Benigno Filgueiras Ramos

2001-03-01

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

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

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Shojaee, Majid; Faridaalaee, Gholamreza; Yousefifard, Mahmoud; Yaseri, Mehdi; Arhami Dolatabadi, Ali; Sabzghabaei, Anita; Malekirastekenari, Ali

2014-01-01

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 diagnosis of IAI after blunt trauma. 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. Chi-square 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 β of each factor. 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 (scoretool for BAT detection and has the potential to reduce unnecessary CT scan and cut unnecessary costs.

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

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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.

Intra-abdominal Pressure during Pilates: Unlikely to Cause Pelvic Floor Harm

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Coleman, Tanner J.; Holder, Dannielle N.; Egger, Marlene J.; Hitchcock, Robert

2015-01-01

Aims To describe intra-abdominal pressures (IAP) generated during Pilates Mat and Reformer activities, and determine whether these activities generate IAP above a sit-to-stand threshold. Methods 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. Results There were no statistically significant differences in mean max 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 max 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). Conclusion 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. PMID:25672647

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.

Waist Circumference Adjusted for Body Mass Index and Intra-Abdominal Fat Mass

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Berentzen, Tina Landsvig; Ängquist, Lars; Kotronen, Anna; Borra, Ronald; Yki-Järvinen, Hannele; Iozzo, Patricia; Parkkola, Riitta; Nuutila, Pirjo; Ross, Robert; Allison, David B.; Heymsfield, Steven B.; Overvad, Kim; Sørensen, Thorkild I. A.; Jakobsen, Marianne Uhre

2012-01-01

Background 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) than WC alone. We studied the prediction of abdominal subcutaneous fat mass (ASFM) and IAFM by WC alone and by addition of BMI as an explanatory factor. Methodology/Principal Findings WC, BMI and magnetic resonance imaging data from 742 men and women who participated in clinical studies in Canada and Finland were pooled. Total adjusted squared multiple correlation coefficients (R2) of ASFM and IAFM were calculated from multiple linear regression models with WC and BMI as explanatory variables. Mean BMI and WC of the participants in the pooled sample were 30 kg/m2 and 102 cm, respectively. WC explained 29% of the variance in ASFM and 51% of the variance in IAFM. Addition of BMI to WC added 28% to the variance explained in ASFM, but only 1% to the variance explained in IAFM. Results in subgroups stratified by study center, sex, age, obesity level and type 2 diabetes status were not systematically different. Conclusion/Significance The prediction of IAFM by WC is not improved by addition of BMI. PMID:22384179

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

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N. E. Wester

2013-01-01

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

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.

Inhibition of skeletal muscle protein synthesis in septic intra-abdominal abscess

International Nuclear Information System (INIS)

Vary, T.C.; Siegel, J.H.; Tall, B.D.; Morris, J.G.; Smith, J.A.

1988-01-01

Chronic sepsis is always associated with profound wasting leading to increased release of amino acids from skeletal muscle. Net protein catabolism may be due to decreased rate of synthesis, increased rate of degradation, or both. To determine whether protein synthesis is altered in chronic sepsis, the rate of protein synthesis in vivo was estimated by measuring the incorporation of [ 3 H]-phenylalanine in skeletal muscle protein in a chronic (5-day) septic rat model induced by creation of a stable intra-abdominal abscess using an E. coli + B. fragilis-infected sterile fecal-agar pellet as foreign body nidus. Septic rats failed to gain weight at rates similar to control animals, therefore control animals were weight matched to the septic animals. The skeletal muscle protein content in septic animals was significantly reduced relative to control animals (0.18 +/- 0.01 vs. 0.21 +/- 0.01 mg protein/gm wet wt; p less than 0.02). The rate of incorporation of [ 3 H]-phenylalanine into skeletal muscle protein from control animals was 39 +/- 4 nmole/gm wet wt/hr or a fractional synthetic rate of 5.2 +/- 0.5%/day. In contrast to control animals, the fractional synthetic rate in septic animals (2.6 +/- 0.2%/day) was reduced by 50% compared to control animals (p less than 0.005). The decreased rate of protein synthesis in sepsis was not due to an energy deficit, as high-energy phosphates and ATP/ADP ratio were not altered. This decrease in protein synthesis occurred even though septic animals consumed as much food as control animals

Modulação da pressão intracraniana em um modelo experimental de hipertensão abdominal e lesão pulmonar aguda

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Zampieri,Fernando Godinho; Almeida,Juliana Roberta; Schettino,Guilherme Pinto de Paula; Park,Marcelo; Machado,Fabio Santana; Azevedo,Luciano Cesar Pontes

2011-01-01

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;...

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

International Nuclear Information System (INIS)

Nelson, O.D.; Keller, G.M.

1997-01-01

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

Mortality indicators and risk factors for intra-abdominal hypertension in severe acute pancreatitis.

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Zhao, J G; Liao, Q; Zhao, Y P; Hu, Y

2014-01-01

This study assessed the risk factors associated with mortality and the development of intra-abdominal hypertension (IAH) in patients with severe acute pancreatitis (SAP). To identify significant risk factors, we assessed the following variables in 102 patients with SAP: age, gender, etiology, serum amylase level, white blood cell (WBC) count, serum calcium level, Acute Physiology and Chronic Health Evaluation II (APACHE-II) score, computed tomography severity index (CTSI) score, pancreatic necrosis, surgical interventions, and multiple organ dysfunction syndrome (MODS). Statistically significant differences were identified using the Student t test and the χ (2) test. Independent risk factors for survival were analyzed by Cox proportional hazards regression. The following variables were significantly related to both mortality and IAH: WBC count, serum calcium level, serum amylase level, APACHE-II score, CTSI score, pancreatic necrosis, pancreatic necrosis >50%, and MODS. However, it was found that surgical intervention had no significant association with mortality. MODS and pancreatic necrosis >50% were found to be independent risk factors for survival in patients with SAP. Mortality and IAH from SAP were significantly related to WBC count, serum calcium level, serum amylase level, APACHE-II score, CTSI score, pancreatic necrosis, and MODS. However, Surgical intervention did not result in higher mortality. Moreover, MODS and pancreatic necrosis >50% predicted a worse prognosis in SAP patients.

Associação entre o nível de atividade física e a área de gordura visceral em mulheres pós-menopáusicas

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Cristiano Penas Seara Pitanga

2014-08-01

Full Text Available INTRODUÇÃO: O aumento da gordura visceral abdominal está associado à redução dos níveis de atividade física habitual e gera na mulher pós-menopáusica, o surgimento da doença da inatividade física, caracterizada pela manifestação de um conjunto de patologias, entre as quais se incluem diabetes mellitus do tipo 2 e doenças cardiovasculares. Por outro lado, a atividade física regular parece ter impacto significativo na prevenção tanto da gordura intra-abdominal quanto das complicações metabólicas e cardiovasculares.OBJETIVO: Verificar a associação entre a caminhada e a atividade física de moderada intensidade com a área de gordura intra-abdominal em mulheres pós-menopáusicas.MÉTODOS: A amostra foi composta por 239 mulheres com média de idade de 57,4 ± 6,6 anos participantes do programa "Menopausa em Forma". Para análise da atividade física foi utilizado o IPAQ versão longa. Consideraram-se os valores de 1.601 kcal/semana na caminhada e 2.283 kcal/semana na atividade física de moderada intensidade como suficientes para prevenção do excesso de gordura intra-abdominal. Utilizou-se a análise de regressão logística para estimar a odds ratio (OR, com intervalo de confiança de 95%.RESULTADOS: Após análise multivariada observou-se que a caminhada ofereceu proteção contra o excesso de gordura intra-abdominal, principalmente nas mulheres com períodos menstruais regulares, OR = 0,22 (0,08-0,62 e que não fazem reposição hormonal, OR = 0,05 (0,01-0,49. Já o nível de atividade física de intensidade moderada ofereceu proteção contra a gordura intra-abdominal independentemente da reposição hormonal ou dos períodos menstruais regulares, OR = 0,37 (0,14-0,66.CONCLUSÃO: A caminhada e principalmente o nível de atividade física de moderada intensidade podem ser importantes para prevenção do excesso de gordura intra-abdominal e suas complicações metabólicas e cardiovasculares em mulheres pós-menopaúsicas.

Urethral pressure reflectometry during intra-abdominal pressure increase-an improved technique to characterize the urethral closure function in continent and stress urinary incontinent women.

Science.gov (United States)

Saaby, Marie-Louise; Klarskov, Niels; Lose, Gunnar

2013-11-01

to assess the urethral closure function by urethral pressure reflectometry (UPR) during intra-abdominal pressure-increase in SUI and continent women. Twenty-five urodynamically proven SUI women and eight continent volunteer women were assessed by ICIQ-SF, pad-weighing test, incontinence diary, and UPR. UPR was conducted during resting and increased intra-abdominal pressure (P(Abd)) by straining. Related values of P(Abd) and urethral opening pressure (P(o)) were plotted into an abdomino-urethral pressuregram. Linear regression of the values was conducted, and the slope of the line ("APIR") and the intercept with the y-axis found. By the equation of the line, Po was calculated for various values of P(Abd), for example, 50 cm H2O (P(o-Abd 50)). The resting P(o) (P(o-rest)) and APIR, respectively, significantly differed in SUI and continent women but could not separate the two groups. The urethral closure equation (UCE) based on P(o-rest) and APIR provided a more detailed characterization of a woman's closure function based on the permanent closure forces (primarily generated by the urethral sphincteric unit) and the adjunctive closure forces (primarily generated by the support system). P(o-Abd 50) and UCE, respectively, which express the combined permanent and adjunctive closure forces and estimate the efficiency of the closure function, separated SUI and continent women and were highly significantly negatively correlated with ICIQ-SF, pad test, and the number of incontinence episodes. New parameters for characterization of the urethral closure function and possible dysfunctions and its efficiency were provided. P(o-Abd 50) and UCE may be used as diagnostic tests and severity measures. © 2013 Wiley Periodicals, Inc.

Celulitis por citomegalovirus

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A. Ruiz Lascano

2002-12-01

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

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

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

Science.gov (United States)

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

2017-10-01

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

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

Science.gov (United States)

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

2013-09-01

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

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

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Fernando Henrique Oliveira Carmo Rodrigues

2005-03-01

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

Portable exhauster POR-007/Skid E and POR-008/Skid F storage plan

International Nuclear Information System (INIS)

Nelson, O.D.

1998-01-01

This document provides storage requirements for 1,000 CFM portable exhausters POR-O07/Skid E and POR-008/Skid F. These requirements are presented in three parts: preparation for storage, storage maintenance and testing, and retrieval from storage. The exhauster component identification numbers listed in this document contain the prefix POR-007 or POR-008 depending on which exhauster is being used

Intra-abdominal fluid extravasation during hip arthroscopy: a survey of the MAHORN group.

Science.gov (United States)

Kocher, Mininder S; Frank, Jeremy S; Nasreddine, Adam Y; Safran, Marc R; Philippon, Marc J; Sekiya, Jon K; Kelly, Bryan T; Byrd, J W Thomas; Guanche, Carlos A; Martin, Hal D; Clohisy, John C; Mohtadi, Nick G; Griffin, Damian R; Sampson, Thomas G; Leunig, Michael; Larson, Christopher M; Ilizaliturri, Victor M; McCarthy, Joseph C; Gambacorta, Peter G

2012-11-01

The purpose of this study was to survey experts in the field of hip arthroscopy from the Multicenter Arthroscopy of the Hip Outcomes Research Network (MAHORN) group to determine the frequency of symptomatic intra-abdominal fluid extravasation (IAFE) after arthroscopic hip procedures, identify potential risk factors, and develop preventative measures and treatment strategies in the event of symptomatic IAFE. A survey was sent to all members of the MAHORN group. Surveys collected data on general hip arthroscopy settings, including pump pressure and frequency of different hip arthroscopies performed, as well as details on cases of symptomatic IAFE. Responses to the survey were documented and analyzed. Fifteen hip arthroscopists from the MAHORN group were surveyed. A total of 25,648 hip arthroscopies between 1984 and 2010 were reviewed. Arthroscopic procedures included capsulotomies, labral reattachment after acetabuloplasty, peripheral compartment arthroscopy, and osteoplasty of the femoral head-neck junction. Of the arthroscopists, 7 (47%) had 1 or more cases of IAFE (40 cases reported). The prevalence of IAFE in this study was 0.16% (40 of 25,650). Significant risk factors associated with IAFE were higher arthroscopic fluid pump pressure (P = .004) and concomitant iliopsoas tenotomy (P arthroscopy is a rare occurrence, with an approximate prevalence of 0.16%. Prevention of IAFE should include close intraoperative and postoperative monitoring of abdominal distention, core body temperature, and hemodynamic stability. Concomitant iliopsoas tenotomy and high pump pressures may be risk factors leading to symptomatic IAFE. Level IV, therapeutic case series. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

SUPLEMENTAÇÃO COM AMÊNDOA DE BACURI NA COMPOSIÇÃO CORPORAL DE RATOS SUBMETIDOS AO EXERCÍCIO

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Marília de Lima Mendes Ramos

Full Text Available RESUMO Introdução: A proteína da amêndoa do bacuri (Attalea phalerata Mart. Ex Spreng e da whey protein (WP têm quantidades relevantes de aminoácidos essenciais e são de boa digestibilidade, características que têm sido buscadas por atletas para auxílio para melhorar a composição corporal, particularmente quando associadas a exercícios. Objetivo: Avaliar o efeito de dietas com teor proteico vegetal e animal sobre a composição corporal de ratos Wistar submetidos ao exercício resistido em escada. Métodos: Quarenta ratos machos recém-desmamados foram submetidos a um período de adaptação com dieta comercial (4 semanas e treinamento resistido durante oito semanas (três vezes por semana, recebendo dietas com farinha de bacuri e whey protein. Foram distribuídos randomicamente em seis grupos: G1 (bacuri sedentário, G2 (bacuri exercitado, G3 (WP sedentário, G4 (WP exercitado, G5 (controle sedentário e G6 (controle exercitado. Avaliou-se consumo da dieta, peso corporal, comprimento, circunferências torácica e abdominal para calcular o índice de Lee e o índice de massa corporal; os sítios com gordura foram retirados após eutanásia. A análise estatística foi realizada por ANOVA e Teste de Tukey, considerando 5% de significância. Resultados: O peso final do G3 (372 ± 8,86 g foi superior ao do G2 (326,83 ± 15,03 g e do G6 (316,75 ± 5,90 g; os grupos que receberam dieta com farinha de bacuri consumiram quantidade superior de dieta, porém, tiveram menor peso final; não diferiram no índice de Lee e no IMC, sítios com gordura e índice de adiposidade com relação aos grupos tratados com WP, apresentando valores inferiores das circunferências torácica e abdominal. Com relação às gorduras e índice de adiposidade, não houve diferença entre os grupos sedentários e exercitados. Conclusão: A proteína da amêndoa de bacuri mostrou-se de boa qualidade quando comparada com a whey protein, havendo possibilidade de

Risk factors and outcome of intra-abdominal hypertension in patients with severe acute pancreatitis.

Science.gov (United States)

Ke, Lu; Ni, Hai-Bin; Sun, Jia-Kui; Tong, Zhi-Hui; Li, Wei-Qin; Li, Ning; Li, Jie-Shou

2012-01-01

Intra-abdominal hypertension (IAH) is common in patients with severe acute pancreatitis (SAP). The aim of the present study was to investigate the risk factors of IAH in SAP patients and assess the prognosis of SAP combined with IAH. To analyze the data from patients with SAP, both univariate and multivariate logistic regression analyses were applied, using 16 indices, including age, gender, Acute Physiology and Chronic Health Evaluation II scores (APACHE II), 24 h fluid balance, hematocrit, serum calcium level, and so on. Clinical prognosis such as mortality, hospital duration, of SAP patients with or without IAH was also compared. First 24 h fluid balance (Odds Ratio [OR], 1.003; 95% Confidence Interval [CI], 1.001-1.006), number of fluid collections (OR, 1.652; 95% CI, 1.023-2.956), and serum calcium level (OR, 0.132; 95% CI, 0.012-0.775) were found to be independent risk factors for IAH in patients with SAP. Moreover, patients with SAP and IAH had significantly longer average length of stay, both in the hospital and in the intensive care unit, higher rates of systemic and local complications, and more invasive treatments. The significant risk factors for IAH in patients with SAP include 24 h fluid balance (first day), number of fluid collections, and serum calcium level. Additionally, IAH is associated with extremely poor prognosis, evidenced by high rates of mortality, morbidity, and the need for invasive interventions.

DESAJUSTE EDUCATIVO POR REGIONES EN COLOMBIA: ¿COMPETENCIA POR SALARIOS O POR PUESTOS DE TRABAJO?

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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.

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.

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

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Tze Shien Lo

2009-06-01

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

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...... 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...... mass (P=0.006) and was increased in subjects with impaired glucose tolerance (41 vs 27 ml, P=0.001). The lithogenic index was > 1 in all subjects and correlated with total fat mass (P=0.04). CONCLUSION: Gallstone pathogenesis in obesity seems to be influenced by the total body fat mass and its regional...

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

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Shojaee Majid

2014-02-01

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

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

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Castillo Caicedo Maribel

2007-08-01

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

Body adiposity and nutritional status among indigenous children in villages of Kaxinawá tribe in Southwest Amazon rain forest, State of Acre, Brazil

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Orivaldo Florêncio de Souza

2005-12-01

subescapular. E, o estado nutricional foi observado através dos indicadores peso para idade (P/I, estatura para idade (E/I e peso para estatura (P/E, utilizando-se os pontos de corte do escores Z conforme sugerido pela Organização Mundial da Saúde. Para a comparação entre os sexos realizouse por meio do teste “t” de student. No nível de adiposidade corporal foi observado prevalência de baixo nível de gordura no sexo masculino (83,7% e feminino (62%. Houve diferenças entre os sexos na adiposidade corporal aos 8 e 10 anos na dobra cutânea tricipital e somatório de dobras cutâneas e somente aos 8 anos na dobra cutânea subescapular. Em relação ao estado nutricional, observou-se desnutrição pregressa e crônica, em ambos os sexos, da E/I de 76,3%, seguida de 47,3% para o P/I; e, desnutrição aguda de 14% para o P/E. Os meninos mostraram nos indicadores E/I e no P/I maior desnutrição crônica, enquanto as meninas apresentaram maior desnutrição aguda no indicador P/E. Conclui-se que existe elevado contingente percentual de desnutrição e baixa adiposidade corporal nas crianças indígenas Kaxinawa do estado do Acre, Brasil.

Structural Insights into the PorK and PorN Components of the Porphyromonas gingivalis Type IX Secretion System.

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Dhana G Gorasia

2016-08-01

Full Text Available The type IX secretion system (T9SS has been recently discovered and is specific to Bacteroidetes species. Porphyromonas gingivalis, a keystone pathogen for periodontitis, utilizes the T9SS to transport many proteins including the gingipain virulence factors across the outer membrane and attach them to the cell surface via a sortase-like mechanism. At least 11 proteins have been identified as components of the T9SS including PorK, PorL, PorM, PorN and PorP, however the precise roles of most of these proteins have not been elucidated and the structural organization of these components is unknown. In this study, we purified PorK and PorN complexes from P. gingivalis and using electron microscopy we have shown that PorN and the PorK lipoprotein interact to form a 50 nm diameter ring-shaped structure containing approximately 32-36 subunits of each protein. The formation of these rings was dependent on both PorK and PorN, but was independent of PorL, PorM and PorP. PorL and PorM were found to form a separate stable complex. PorK and PorN were protected from proteinase K cleavage when present in undisrupted cells, but were rapidly degraded when the cells were lysed, which together with bioinformatic analyses suggests that these proteins are exposed in the periplasm and anchored to the outer membrane via the PorK lipid. Chemical cross-linking and mass spectrometry analyses confirmed the interaction between PorK and PorN and further revealed that they interact with the PG0189 outer membrane protein. Furthermore, we established that PorN was required for the stable expression of PorK, PorL and PorM. Collectively, these results suggest that the ring-shaped PorK/N complex may form part of the secretion channel of the T9SS. This is the first report showing the structural organization of any T9SS component.

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.

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

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Maxence S Vincent

2016-08-01

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

Sensibilidade e especificidade de classificação de sobrepeso em adolescentes, Rio de Janeiro

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Vera Chiara

2003-04-01

Full Text Available OBJETIVO: Avaliar a prevalência, sensibilidade e especificidade em detectar adolescentes em risco de obesidade, baseada no Índice de Massa Corporal (IMC. MÉTODOS: Foram avaliados 502 adolescentes de 12 a 18 anos, participantes da pesquisa Nutrição e Saúde do Município do Rio de Janeiro, desenvolvida em 1996. As variáveis do estudo foram: peso, estatura, IMC e dobra subescapular, de acordo com sexo e idade. As classificações para IMC foram comparadas com a classificação pela dobra subescapular no percentil 90 (excesso de adiposidade da população de adolescentes americanos. RESULTADOS: A prevalência de excesso de adiposidade foi mais elevada com a dobra subescapular (P<0,0001 comparada com as classificações do IMC que apresentaram valores aproximados. A especificidade foi superior à sensibilidade com as duas propostas do IMC. O ponto de equilíbrio entre sensibilidade e especificidade foi próximo ao percentil 70 para meninas e meninos menores de 14 anos. Em meninos maiores de 15 anos, o ponto de corte aproximou-se do percentil 50 do IMC. CONCLUSÃO: Ambas classificações do IMC foram mais adequadas para identificar adolescentes sem obesidade, não sendo sensíveis para rastrear excesso de adiposidade.

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

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

2016-01-01

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

Utilização de medidas antropométricas para a avaliação do acúmulo de gordura visceral The use of anthropometric measures to assess visceral fat accumulation

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Ana Carolina Junqueira Vasques

2010-02-01

Full Text Available A obesidade visceral tem sido associada ao desenvolvimento de doenças cardiovasculares e a alguns tipos de câncer. Nesse sentido, é crescente o interesse na avaliação da adiposidade intra-abdominal, de forma a se analisarem o risco de doenças e alterações metabólicas, como intolerância à glicose, hiperinsulinemia, diabetes mellitus tipo 2, dislipidemias e hipertensão arterial. Técnicas de imagem, como a tomografia computadorizada e a ressonância magnética, permitem a mensuração acurada e precisa da gordura visceral..Contudo, ambas são dispendiosas e inaplicáveis na prática clínica de rotina e nos estudos epidemiológicos..Parâmetros antro-pométricos surgem como uma opção para a avaliação da gordura visceral nessas situações, por serem inócuos, de fácil aplicação e de baixo custo. À luz dessas questões, este trabalho objetivou analisar criticamente estudos que avaliaram a pertinência em empregar parâmetros antropométricos como indicadores da gordura visceral. Realizou-se um levantamento bibliográfico, no qual foram consultados periódicos nacionais e internacionais disponíveis nas seguintes bases científicas: Portal de periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Scientific Electronic Library Online, Science Direct e Pubmed, abrangendo publicações entre os anos de 1947 e 2007. Procurou-se dar ênfase aos parâmetros antropométricos, como o índice de massa corporal, a circunferência da cintura, a relação cintura-quadril e o diâmetro abdominal sagital.Visceral obesity has been associated with the development of cardiovascular diseases and some types of cancer. Therefore, there is an increasing interest in quantifying intra-abdominal adiposity in order to assess the risk of metabolic disorders, such as glucose intolerance, hyperinsulinemia, type 2 diabetes, dyslipidemia and hypertension. Imaging techniques such as computed tomography and magnetic resonance provide an

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 managed via DCS.

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

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Mirza de Souza Conceição

2015-03-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-07-15

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

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

International Nuclear Information System (INIS)

Lee, Megan H.; Eutsler, Eric P.; Khanna, Geetika; Sheybani, Elizabeth F.

2017-01-01

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

Effects of intra-abdominal sepsis on atherosclerosis in mice.

Science.gov (United States)

Kaynar, Ata Murat; Yende, Sachin; Zhu, Lin; Frederick, Daniel R; Chambers, Robin; Burton, Christine L; Carter, Melinda; Stolz, Donna Beer; Agostini, Brittani; Gregory, Alyssa D; Nagarajan, Shanmugam; Shapiro, Steven D; Angus, Derek C

2014-09-03

and vascular cell adhesion molecule 1) and the adhesion assay, a functional measure of endothelial activation, were elevated at 72 hours and 120 hours in mice that underwent CLP versus sham-operations (all at P <0.05). Using a combination of existing murine models for atherosclerosis and sepsis, we found that CLP, a model of intra-abdominal sepsis, accelerates atheroma development. Accelerated atheroma burden was associated with prolonged systemic, endothelial and intimal inflammation and was not explained by ongoing infection. These findings support observations in humans and demonstrate the feasibility of a long-term follow-up murine model of sepsis.

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

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.

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.

Encefalopatía por priones

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Carlos Colegial

1999-01-01

Full Text Available Las encefalopatías espongiformes por priones son enfermedades neurodegenerativas que pueden ser esporádicas o transmisibles, ya sea por mecanismos infecciosos o hereditarios. Su investigación ha planteado enormes retos y en el recorrido histórico en busca de su causa dos médicos han recibido el premio Nobel de Medicina: Carleton Gajdusek, por sus trabajos en Nueva Guinea donde describió la transmisión infecciosa por ritos canibalísticos, que llevó a estudios de transmisión experimental en chimpancés y a su teoría de los "virus lentos" (por el largo período de incubación de la enfermedad.

Accuracy of the abdominal examination for identifying children with blunt intra-abdominal injuries.

Science.gov (United States)

Adelgais, Kathleen M; Kuppermann, Nathan; Kooistra, Joshua; Garcia, Madelyn; Monroe, David J; Mahajan, Prashant; Menaker, Jay; Ehrlich, Peter; Atabaki, Shireen; Page, Kent; Kwok, Maria; Holmes, James F

2014-12-01

To determine the accuracy of complaints of abdominal pain and findings of abdominal tenderness for identifying children with intra-abdominal injury (IAI) stratified by Glasgow Coma Scale (GCS) score. This was a prospective, multicenter observational study of children with blunt torso trauma and a GCS score ≥13. We calculated the sensitivity of abdominal findings for IAI with 95% CI stratified by GCS score. We examined the association of isolated abdominal pain or tenderness with IAI and that undergoing acute intervention (therapeutic laparotomy, angiographic embolization, blood transfusion, or ≥2 nights of intravenous fluid therapy). Among the 12 044 patients evaluated, 11 277 (94%) had a GCS score of ≥13 and were included in this analysis. Sensitivity of abdominal pain for IAI was 79% (95% CI, 76%-83%) for patients with a GCS score of 15, 51% (95% CI, 37%-65%) for patients with a GCS score of 14, and 32% (95% CI, 14%-55%) for patients with a GCS score of 13. Sensitivity of abdominal tenderness for IAI also decreased with decreasing GCS score: 79% (95% CI, 75%-82%) for a GCS score of 15, 57% (95% CI, 42%-70%) for a GCS score of 14, and 37% (95% CI, 19%-58%) for a GCS score of 13. Among patients with isolated abdominal pain and/or tenderness, the rate of IAI was 8% (95% CI, 6%-9%) and the rate of IAI undergoing acute intervention was 1% (95% CI, 1%-2%). The sensitivity of abdominal findings for IAI decreases as GCS score decreases. Although abdominal computed tomography is not mandatory, the risk of IAI is sufficiently high that diagnostic evaluation is warranted in children with isolated abdominal pain or tenderness. Copyright © 2014 Elsevier Inc. All rights reserved.

Removal of an intra-abdominal desmoplastic small round cell tumor by repetitive debulking surgery: A case report and literature review.

Science.gov (United States)

Shimazaki, Jiro; Motohashi, Gyo; Nishida, Kiyotaka; Tabuchi, Takanobu; Ubukata, Hideyuki; Tabuchi, Takafumi

2014-05-01

In the current study, a case of recurrent desmoplastic small round cell tumor (DSRCT) is presented, which was successfully treated by repetitive debulking surgery. In May 2010, a 39-year-old male, with a history of surgical resection of intra-abdominal DSRCT, visited the Ibaraki Medical Center, Tokyo Medical University Hospital (Ami, Japan) with severe lower abdominal discomfort. Abdominal computed tomography revealed a large tumor in the pouch of Douglas with a small number of nodules in the abdominal cavity. The recurrent DSRCT was diagnosed and removed via lower anterior resection; however, complete resection was impossible due to multiple peritoneal metastases. One year later, the patient developed pain in the right groin due to the growth of metastasized tumor cells in the groin lymph nodes. The affected lymph nodes were removed utilizing an extra-peritoneal approach. At the time of writing, the patient continues to survive without any symptoms 60 months since the initial surgery. In conclusion, surgical debulking is a significant procedure for relieving patient symptoms as well as improving the survival time of patients with metastatic and recurrent DSRCT.

Intra-abdominal pressure alterations after large pancreatic pseudocyst transcutaneous drainage

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Papavramidis Theodossis S

2009-06-01

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

Aplicación del modelo trans teórico en los padres y encargados legales de los niños que participan en las escuelas deportivas y recreativas de la Universidad de Costa Rica

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Yamileth Chacón Araya

2005-01-01

Full Text Available El propósito del siguiente estudio es describir las características físicas y el nivel de intención de cambio hacia la actividad física de los padres o encargados de los niños que asistieron a los cursos de verano en la Universidad de Costa Rica. Participaron 52 personas quienes aceptaron responder un cuestionario. Se encontró que un 28.9% presentaba problemas de adiposidad; el 60% realizaba ejercicios físicos variados y el 36% no participaba de un programa de ejercicios regulares. Se halló que el 53.8% tenía disposición de hacer ejercicio en los próximos 6 meses, aunque el 46.1% no pretendía o no sabía si lo realizaría. Se logró clasificar el 40.4% de los sujetos, dentro de las etapas del modelo trans-teórico de cambio de comportamiento. Además este estudio permitió determinar que existe una proporción importante de personas que presenta adiposidad o sobrepeso y que existe también una falta de motivación para mejorar el estilo de vida, en los sujetos que no pretenden o no saben si van a hacer ejercicio en los próximos meses. Por último, el 10% de los participantes nunca ha practicado ejercicio físico de forma regular, lo que implica posibles riesgos en su salud. El modelo transteórico podría utilizarse no solo para tamizar a la población, sino también para proponer objetivos y metas que ayuden en la adherencia al ejercicio físico.

Casipoemas por Navidad : (1969-2010)

OpenAIRE

Sena Medina, Guillermo

2011-01-01

PRESENTACIÓN AL AIRE DE LA POESÍA RELIGIOSA Y NAVIDEÑA DE GUILLERMO SENA MEDINA Constituye un gran honor hacer la presentación de Guillermo Sena Medina por un doble motivo; por la larga y sincera amistad que nos une desde hace muchos años al socaire de nuestra común afición por la Historia, como cronistas oficiales de nuestros municipios; y, sobre todo y particularmente, por su rica y profunda personalidad como hombre de letras, nacida de su aún más rica y profunda personalidad humana. A...

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

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Madonia Simona

2011-09-01

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

Do obese but metabolically normal women differ in intra-abdominal fat and physical activity levels from those with the expected metabolic abnormalities? A cross-sectional study

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Walker Mark

2010-11-01

Full Text Available Abstract Background Obesity remains a major public health problem, associated with a cluster of metabolic abnormalities. However, individuals exist who are very obese but have normal metabolic parameters. The aim of this study was to determine to what extent differences in metabolic health in very obese women are explained by differences in body fat distribution, insulin resistance and level of physical activity. Methods This was a cross-sectional pilot study of 39 obese women (age: 28-64 yrs, BMI: 31-67 kg/m2 recruited from community settings. Women were defined as 'metabolically normal' on the basis of blood glucose, lipids and blood pressure. Magnetic Resonance Imaging was used to determine body fat distribution. Detailed lifestyle and metabolic profiles of participants were obtained. Results Women with a healthy metabolic profile had lower intra-abdominal fat volume (geometric mean 4.78 l [95% CIs 3.99-5.73] vs 6.96 l [5.82-8.32] and less insulin resistance (HOMA 3.41 [2.62-4.44] vs 6.67 [5.02-8.86] than those with an abnormality. The groups did not differ in abdominal subcutaneous fat volume (19.6 l [16.9-22.7] vs 20.6 [17.6-23.9]. A higher proportion of those with a healthy compared to a less healthy metabolic profile met current physical activity guidelines (70% [95% CIs 55.8-84.2] vs 25% [11.6-38.4]. Intra-abdominal fat, insulin resistance and physical activity make independent contributions to metabolic status in very obese women, but explain only around a third of the variance. Conclusion A sub-group of women exists who are metabolically normal despite being very obese. Differences in fat distribution, insulin resistance, and physical activity level are associated with metabolic differences in these women, but account only partially for these differences. Future work should focus on strategies to identify those obese individuals most at risk of the negative metabolic consequences of obesity and on identifying other factors that

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

The NADPH-dependent cytochrome P450 oxidoreductase (POR) is the obligate electron donor to eukaryotic microsomal cytochromes P450 enzymes. The number of PORs within plant species is limited to one to four isoforms, with the most common being two PORs per plant. These enzymes provide electrons to ...... (available from the SRA at NCBI). All three genes were shown to be functional upon reconstitution into nanodiscs, confirming that none of the isoforms are pseudogenes....

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; Universitat Autònoma de Barcelona. Departament de Medicina

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...

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

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...

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

OpenAIRE

Conceição, Mirza de Souza; Centro Universitário de Volta Redonda – UniFOA.; Ferreira, Célia Cristina Diogo; UFRJ; Nascimento, Kamila de Oliveira do; UFRRJ

2015-01-01

O chá é uma das bebidas mais consumidas no mundo, vem sendo utilizado pela população como coadjuvante no tratamento da redução de peso, uma vez que aumenta a termogênese e em muitos casos promove a saciedade. O objetivo deste trabalho foi mostrar como as catequinas do chá verde auxiliam no tratamento da obesidade. Foram realizadas buscas por artigos científicos nas bases de dados Science Direct, Google Acadêmico, Scielo, BVS, Medline e Wilson. Os artigos escolhidos foram publicados no período...

Osteomalacia inducida por tumor: hemangiopericitoma rinosinusal

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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.

Dietas hiperglicídicas: efeitos da substituição isoenergética de gordura por carboidratos sobre o metabolismo de lipídios, adiposidade corporal e sua associação com atividade física e com o risco de doença cardiovascular

OpenAIRE

Polacow, Viviane O.; Lancha Junior, Antonio H.

2007-01-01

Há vários anos, vem sendo recomendada à população em geral a diminuição da gordura dietética, a fim de se prevenir doenças cardiovasculares, obesidade, diabetes mellitus tipo 2, dentre outras doenças crônicas. A conseqüência desta recomendação tem sido a substituição de gorduras por carboidratos, resultando na adoção de dietas hiperglicídicas. Porém, ainda é muito discutido se dietas hiperglicídicas devem ser recomendadas à população geral. Pesquisas apontam controvérsias a respeito da associ...

Moxifloxacin in Pediatric Patients with Complicated Intra-Abdominal Infections: Results of the MOXIPEDIA Randomized Controlled Study.

Science.gov (United States)

Wirth, Stefan; Emil, Sherif G S; Engelis, Arnis; Digtyar, Valeri; Criollo, Margarita; DiCasoli, Carl; Stass, Heino; Willmann, Stefan; Nkulikiyinka, Richard; Grossmann, Ulrike

2018-01-18

This study was designed to evaluate primarily the safety and also the efficacy of moxifloxacin (MXF) in children with complicated intra-abdominal infections (cIAIs). In this multicenter, randomized, double-blind, controlled study, 451 pediatric patients aged 3 months to 17 years with cIAIs were treated with intravenous/oral MXF (N = 301) or comparator (COMP, intravenous ertapenem followed by oral amoxicillin/clavulanate; N = 150) for 5 to 14 days. Doses of MXF were selected based on the results of a Phase 1 study in pediatric patients (NCT01049022). The primary endpoint was safety, with particular focus on cardiac and musculoskeletal safety; clinical and bacteriological efficacy at test of cure were also investigated. The proportion of patients with adverse events (AEs) was comparable between the two treatment arms (MXF: 58.1% and COMP: 54.7%). The incidence of drug-related AEs was higher in the MXF arm than the COMP arm (14.3% and 6.7%, respectively). No cases of QTc interval prolongation-related morbidity or mortality were observed. The proportion of patients with musculoskeletal AEs was comparable between treatment arms; no drug-related events were reported. Clinical cure rates were 84.6% and 95.5% in the MXF and COMP arms, respectively, in patients with confirmed pathogen(s) at baseline. MXF treatment was well tolerated in children with cIAIs. However, a lower clinical cure rate was observed with MXF treatment compared with COMP. This study does not support a recommendation of MXF for children with cIAIs when alternative more efficacious antibiotics with better safety profile are available.

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)....

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

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A. Yaghoobi Notash

2004-06-01

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

Relação espacial entre a falange distal e o estojo córneo em éguas Campolinas jovens com e sem sinais de obesidade

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Jéssica F. Magalhães

Full Text Available RESUMO: Estudos prévios têm demonstrado alterações radiográficas em cascos de equinos obesos. Os objetivos foram estudar, com avaliação radiográfica, a relação espacial entre estojo córneo e falange distal de éguas jovens da raça Campolina com e sem obesidade. Foram utilizadas 22 éguas entre três e cinco anos de idade, sendo analisadas varáveis de adiposidade e medidas radiográficas dos cascos dos membros torácicos de éguas com escore corporal de 5 a 7/9 (Grupo Controle e de 8 a 9 (Grupo Obeso. Foram feitas comparações entre os grupos e correlacionaram-se as variáveis de adiposidade entre si, variáveis adiposidade com variáveis casco e variáveis de casco entre si. Utilizou-se o teste t de Student para variáveis paramétricas e o teste Mann-Whitney para as não-paramétricas, para as medidas de correlação, utilizou o teste de Pearson para duas amostras paramétricas e o teste de Spearman para comparações que envolvam pelo menos uma variável não paramétrica (P<0,05. Os resultados demonstraram que éguas Campolinas obesas, ainda jovens, já apresentam indícios de alteração na relação espacial entre estojo córneo e falange distal.

Verdad por definición

OpenAIRE

Garrido Garrido, Julián

1997-01-01

Not available.La verdad por definición es un tipo peculiar de verdad científica, distinguible de las verdades lógicas, matemáticas y empíricas. La definición, por su parte, designa diversos procedimientos de asignación de significado, cuyas diferencias exigen una adjetivación cuidadosa: definiciones ostensivas y operacionales, definiciones de diccionario y definiciones teóricas. Pero sólo las del último tipo son verdaderas por definición. En el presente artículo se precisa el concepto formal ...

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...

The subcutaneous abdominal fat and not the intraabdominal fat compartment is associated with anovulation in women with obesity and infertility.

Science.gov (United States)

Kuchenbecker, Walter K H; Groen, Henk; Zijlstra, Tineke M; Bolster, Johanna H T; Slart, Riemer H J; van der Jagt, Erik J; Kobold, Anneke C Muller; Wolffenbuttel, Bruce H R; Land, Jolande A; Hoek, Annemieke

2010-05-01

Abdominal fat contributes to anovulation. We compared body fat distribution measurements and their contribution to anovulation in obese ovulatory and anovulatory infertile women. Seventeen ovulatory and 40 anovulatory women (age, 30 +/- 4 yr; body mass index, 37.7 +/- 6.1 kg/m(2)) participated. Body fat distribution was measured by anthropometrics, dual-energy x-ray absorptiometry, and single-sliced abdominal computed tomography scan. Multiple logistic regression analysis was applied to determine which fat compartments significantly contributed to anovulation. Anovulatory women had a higher waist circumference (113 +/- 11 vs. 104 +/- 9 cm; P fat (23.0 +/- 5.3 vs. 19.1 +/- 4.2 kg; P abdominal fat (4.4 +/- 1.3 kg vs. 3.5 +/- 0.9 kg; P fat on single-sliced abdominal computed tomography scan was not significantly different between the two groups (203 +/- 56 vs. 195 +/- 71 cm(3); P = 0.65), but anovulatory women had significantly more sc abdominal fat (SAF) (992 +/- 198 vs. 864 +/- 146 cm(3); P fat, abdominal fat, and SAF were associated with anovulation. Abdominal fat is increased in anovulatory women due to a significant increase in SAF and not in intraabdominal fat. SAF and especially abdominal and trunk fat accumulation are associated with anovulation.

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

L-lysine escinat, thiotriazolin, gordox and mydocalm influence on oxygen tension in the intestinal wall and acid-base balance and limited proteolysis in intestinal venous blood in terms of intraabdominal hypertension modeling

Directory of Open Access Journals (Sweden)

Sapegin V.I.

2014-11-01

Full Text Available In acute experiments on rabbits there were studied changes in oxygen tension in the intestinal wall tissues, acid-base balance and limited proteolysis and its inhibitors in intestinal venous blood, protective action of L-lysine escinat (0,15 mg/kg / single dose, thiotriazolin (25 mg/kg / single dose, aprotinin (gordox (10,000 units/kg / single dose in sequential modeling of standard levels increasing of intra-abdominal hypertension (IAH — 50, 100, 150, 200, 250, 300, 350 m H2O, and also of tolperison (mydocalm (5 mg/kg / single dose on modeling of stable 3-hour IAH 200 m H2O. The IAH modeling was performed by means of stand of our construction. Under the influence of IAH the compensated metabolic acidosis in intestinal venous blood with a compensative hyperpnoe develops, decline of oxygen tension in tissues and activating of a limited proteolysis as well as decline of its inhibitors activity in intestinal venous blood occur. By the degree of metabolic acidosis prevention investigational preparations were distributed as follows gordox > thiotriazolin = L-lysine escinat = mydocalm, and by prevention of decline of oxygen tension in tissues — thiotriazolin > L-lysine escinat > mydocalm > gordox, it is is connected with different rate of methabolic products excretion into the blood, due to the influence on blood circulation and transcapilary exchange. By the degree of prevention of proteolytic activity and inhibitory potential changes, investigational preparations were distributed as follows: gordox > mydocalm > thiotriazolin > L-lysine escinat, this is connected with inhibition of proteolysis in gordox, and in other ones – with reduction of ischemic damage of tissues. Owing to different mechanism of action thiotriazolin, L-lysine escinat and mydocalm may be simultaneously recommended for a conservative treatment of patients with intraabdominal hypertension syndrome.

Tendencia de la mortalidad por cáncer en Chile según diferencias por nivel educacional, 2000-2010

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Cristian A. Herrera Riquelme

2015-01-01

Full Text Available Objetivo. Caracterizar la tendencia de la mortalidad por cáncer en Chile según diferencias por nivel educacional en el período 2000-2010 en la población mayor de 20 años. Métodos. Cálculo de las tasas de mortalidad específica por cáncer ajustadas por edad para diferentes niveles educacionales (NE, para el período 2000-2010. Las tasas obtenidas se analizaron con un modelo de regresión de Poisson, calculando el índice de desigualdad relativa (IDR y el índice de desigualdad de la pendiente (IDP para cada año. Resultados. Se registraron 232 541 muertes por cáncer en el período 2000-2010. Los tipos de cáncer más frecuentes fueron de mama, estómago y vesícula biliar en mujeres; y estómago, próstata y pulmón en hombres. Las tasas de mortalidad por cáncer estandarizadas por edad fueron mayores en los NE más bajos, excepto para el de mama en mujer y el de pulmón en hombres. Las mayores diferencias se encontraron en el de vesícula biliar en mujeres y el de estómago en hombres, con mayores tasas de mortalidad específica de hasta 49 y 63 veces respectivamente, para NE bajo respecto al NE alto. Entre 2000 y 2010, las diferencias en mortalidad por NE se redujeron para todos los cánceres combinados en ambos géneros, mama en mujeres, y pulmón y estómago en hombres. Conclusiones. Durante el período estudiado, la mortalidad por cáncer en Chile estuvo fuertemente asociada al NE de la población. Esta información debe ser considerada al definir estrategias nacionales para reducir la mortalidad específica por cáncer en los grupos más desprotegidos.

Intra-abdominal and subcutaneous abdominal fat as predictors of cardiometabolic risk in a sample of Mexican children.

Science.gov (United States)

González-Álvarez, C; Ramos-Ibáñez, N; Azprioz-Leehan, J; Ortiz-Hernández, L

2017-09-01

Few studies in Latin American paediatric populations have differentiated fat deposits in specific areas, such as intra-abdominal fat (IAF) and subcutaneous abdominal fat (SAF). Research in diverse populations is needed, as patterns of fat accumulation vary by ethnicity. The aim of this study was to determine whether IAF and/or SAF are related to cardiometabolic risk factors, independent of total body fat (TBF), in a group of Mexican schoolchildren. A cross-sectional study was conducted in Mexico City with 94 children aged between 5 and 11 years. IAF and SAF were assessed by magnetic resonance using two different estimation methods: (a) at the midpoint of lumbar vertebras 4 and 5 (L4-L5) and (b) the sum of the areas of four slices (L1-L2, L2-L3, L3-L4 and L4-L5, which will be referred to as 'total' IAF and SAF). TBF was measured by dual-energy X-ray absorptiometry. The following cardiometabolic risk factors were assessed: total cholesterol, low-density lipoprotein-cholesterol, triglycerides, glucose, insulin, high-density lipoprotein-cholesterol, blood pressure, insulin resistance, number of risk factors and metabolic syndrome score. After adjusting for sex, age and TBF, total SAF was related to the number of cardiometabolic risk factors and metabolic syndrome score. Although IAF at L4-L5 was also related to the number of cardiometabolic risk factors, there was evidence of collinearity with TBF. In this sample of Mexican schoolchildren, TBF and SAF, but not IAF, were associated with higher cardiometabolic risk.

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

Science.gov (United States)

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

2016-10-01

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

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

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Sartelli Massimo

2012-05-01

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

Muerte materna por malaria grave por Plasmodium vivax

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Nancy Arróspide

Full Text Available Se presenta el caso de una mujer de 19 años con 29 semanas de gestación, procedente de Llumpe (Ancash con antecedentes de viajes a las localidades de Chanchamayo (Junín y Rinconada (Ancash. Ingresó al Hospital de Chacas (Ancash por presentar mal estado general, deshidratación, dificultad respiratoria, ictericia, sensación de alza térmica y dolor abdominal, tuvo reporte de: hemoparásitos 60% en frotis sanguíneo. Fue transferida al Hospital Ramos Guardia (Huaraz donde presentó mayor dificultad respiratoria, coluria, hematuria, disminución del débito urinario y reporte de Plasmodium (+, luego fue transferida al Hospital Cayetano Heredia (Lima donde ingresó a la Unidad de Cuidados Intensivos (UCI, con evolución a falla multiorgánica, óbito fetal y muerte materna. Se confirmó infección por Plasmodium vivax. Destacamos la importancia de mejorar nuestras capacidades de diagnóstico y manejo para brindar un tratamiento adecuado y oportuno.

Desenvolvimento de um kit de irrigação por microtubos com moto-bomba propulsionada por energia solar

OpenAIRE

Luiz Ricardo Sobenko

2016-01-01

O bombeamento de água por meio da energia solar vem se mostrando uma alternativa para localidades onde outras fontes de energia não estão disponíveis ou são limitadas. Torna-se interessante aliar essa alternativa a um sistema de irrigação que opera com vazão e pressão relativamente baixas, como a irrigação localizada por microtubos, possibilitando assim a obtenção de alta eficiência. No presente trabalho teve-se por objetivo dimensionar e avaliar um kit de irrigação por microtubos, alimentado...

Tendencia de la mortalidad por cáncer en Chile según diferencias por nivel educacional, 2000-2010

OpenAIRE

Cristian A. Herrera Riquelme; Lucy Kuhn-Barrientos; Roberto Rosso Astorga; Jorge Jiménez de la Jara

2015-01-01

Objetivo. Caracterizar la tendencia de la mortalidad por cáncer en Chile según diferencias por nivel educacional en el período 2000-2010 en la población mayor de 20 años. Métodos. Cálculo de las tasas de mortalidad específica por cáncer ajustadas por edad para diferentes niveles educacionales (NE), para el período 2000-2010. Las tasas obtenidas se analizaron con un modelo de regresión de Poisson, calculando el índice de desigualdad relativa (IDR) y el índice de desigualdad de la pendiente (ID...

Polución por material particulado fino (PM 2,5) incrementa las hospitalizaciones por insuficiencia cardiaca

OpenAIRE

Castro, Pablo; Vera, Jeanette; Cifuentes, Luis; Wellenius, Gregory; Verdejo, Hugo; Sepúlveda, Luis; Vukasovic, José Luis; Llevaneras, Silvana

2010-01-01

Antecedentes: Estudios recientes han reportado una asociación entre la contaminación ambiental por material particulado (PM) y el riesgo de hospitalizaciones de pacientes con insuficiencia cardiaca (IC). La región metropolitana de nuestro país constituye un área geográfica en la cual la contaminación es especialmente relevante, asociándose a incrementos periódicos en la morbimortalidad por causa respiratoria. Sin embargo el efecto de la polución por PM en la morbilidad de pacientes con IC no ...

Excesso de peso e gordura abdominal para a síndrome metabólica em nipo-brasileiros

Directory of Open Access Journals (Sweden)

Lerario Daniel D G

2002-01-01

Full Text Available OBJETIVO: A obesidade, especialmente de distribuição abdominal, associa-se a fatores de risco cardiovasculares como a dislipidemia, a hipertensão arterial (HA e o diabetes mellitus (DM. A importância desses fatores em nipo-brasileiros foi previamente demonstrada, apesar de a obesidade não ser característica marcante dos migrantes japoneses. Realizou-se estudo com o objetivo de avaliar a prevalência de excesso de peso e a adiposidade central (AC em nipo-brasileiros e suas relações com distúrbios metabólicos. MÉTODOS: A amostra incluiu 530 nipo-brasileiros (40-79 anos de primeira e segunda gerações, submetidos a medidas antropométricas de pressão arterial, perfil lipídico e teste oral de tolerância à glicose. A prevalência (por ponto e intervalo de confiança de excesso de peso foi calculada pelo valor de corte >26,4 kg/m². O diagnóstico de AC foi baseado na razão entre as circunferências da cintura e do quadril (RCQ, sendo que valores > ou = 0,85 e > ou = 0,95, para mulheres e homens, respectivamente, firmavam esse diagnóstico. RESULTADOS: A prevalência de excesso de peso foi de 22,4% (IC95%-- 20,6-28,1, e a de AC, de 67,0% (IC95% -- 63,1-70,9. Além de maiores prevalências de DM, HA e dislipidemia, estratificando-se pelo índice de massa corporal (IMC e RCQ, indivíduos com excesso de peso e adiposidade central apresentaram pior perfil metabólico: a pressão arterial foi significantemente maior naqueles com excesso de peso, sem e com AC; indivíduos com AC apresentaram maiores índices de glicemia, triglicerídeos, colesterol total e LDL e menor HDL quando comparados aos sem excesso de peso e sem AC; a insulinemia de jejum foi significantemente maior em indivíduos com excesso de peso (sem e com AC do que naqueles sem excesso de peso e sem AC. CONCLUSÃO: A comparação de subgrupos com e sem adiposidade central foi compatível com a hipótese de que a deposição abdominal de gordura representa fator de risco para

Excesso de peso e gordura abdominal para a síndrome metabólica em nipo-brasileiros

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Daniel D G Lerario

2002-02-01

Full Text Available OBJETIVO: A obesidade, especialmente de distribuição abdominal, associa-se a fatores de risco cardiovasculares como a dislipidemia, a hipertensão arterial (HA e o diabetes mellitus (DM. A importância desses fatores em nipo-brasileiros foi previamente demonstrada, apesar de a obesidade não ser característica marcante dos migrantes japoneses. Realizou-se estudo com o objetivo de avaliar a prevalência de excesso de peso e a adiposidade central (AC em nipo-brasileiros e suas relações com distúrbios metabólicos. MÉTODOS: A amostra incluiu 530 nipo-brasileiros (40-79 anos de primeira e segunda gerações, submetidos a medidas antropométricas de pressão arterial, perfil lipídico e teste oral de tolerância à glicose. A prevalência (por ponto e intervalo de confiança de excesso de peso foi calculada pelo valor de corte >26,4 kg/m². O diagnóstico de AC foi baseado na razão entre as circunferências da cintura e do quadril (RCQ, sendo que valores > ou = 0,85 e > ou = 0,95, para mulheres e homens, respectivamente, firmavam esse diagnóstico. RESULTADOS: A prevalência de excesso de peso foi de 22,4% (IC95%-- 20,6-28,1, e a de AC, de 67,0% (IC95% -- 63,1-70,9. Além de maiores prevalências de DM, HA e dislipidemia, estratificando-se pelo índice de massa corporal (IMC e RCQ, indivíduos com excesso de peso e adiposidade central apresentaram pior perfil metabólico: a pressão arterial foi significantemente maior naqueles com excesso de peso, sem e com AC; indivíduos com AC apresentaram maiores índices de glicemia, triglicerídeos, colesterol total e LDL e menor HDL quando comparados aos sem excesso de peso e sem AC; a insulinemia de jejum foi significantemente maior em indivíduos com excesso de peso (sem e com AC do que naqueles sem excesso de peso e sem AC. CONCLUSÃO: A comparação de subgrupos com e sem adiposidade central foi compatível com a hipótese de que a deposição abdominal de gordura representa fator de risco para

Tumor desmoplásico de pequenas células redondas abdominal da infância: relato de caso Abdominal desmoplastic small round cell tumor of childhood: case report

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Ulysses dos Santos Torres

2010-02-01

Full Text Available O tumor desmoplásico de pequenas células redondas (TDPCR é uma neoplasia rara e altamente agressiva, que afeta predominantemente jovens do sexo masculino. Relata-se um caso de TDPCR em um paciente do sexo masculino, de 11 anos, com acometimento intra-abdominal marcado por volumosa massa retroperitoneal em hipocôndrio esquerdo. O estudo histológico da massa revelou presença de blocos de pequenas células tumorais redondas e azuis, envoltas por estroma desmoplásico; a análise imuno-histoquímica evidenciou positividade para desmina, WT-1 e citoceratinas. Após o diagnóstico, o paciente foi submetido a tratamento quimiorradioterápico, tendo evoluído a óbito durante o 24º mês de acompanhamento.Desmoplastic small round cell tumor (DSRCT is a rare and highly aggressive neoplasm, which predominantly affects young males. We report a case of DSRCT affecting an 11-year-old male patient, with intra-abdominal involvement characterized by a large retroperitoneal mass in left hypochondrium. Histological examination of the mass showed the presence of clusters of small blue round tumor cells surrounded by a dense desmoplastic stroma. Immunohistochemical analysis disclosed a positive reaction to desmin, WT-1 and cytokeratins. After diagnosis, the patient underwent chemo radiotherapy treatment, but died at the 24th month of follow-up.

Síndrome de Munchausen por mandato

OpenAIRE

Esteban, Miguel A.; Pérez, Miriam R.; Bracco, Anahí

2006-01-01

El Síndrome de Munchausen por mandato, "un trastorno ficticio, por el cual la enfermedad del niño es inducida, promovida o provocada por la persona más próxima a él, generalmente su madre", es todavía mal conocido y su génesis imperfectamente comprendida. Esta comunicación está destinada a esclarecer al pediatra esta patología, con elevada morbilidad y secuelas, como así también de altísima mo...

Fatores de risco cardiovascular em alcoolistas em tratamento

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Mayla Cardoso Fernandes Toffolo

2013-06-01

Full Text Available OBJETIVO: Avaliar a presença de fatores de risco cardiovascular, com ênfase na hipertensão e na adiposidade corporal, em alcoolistas abstinentes ou não abstinentes em tratamento. MÉTODO: Trata-se de um estudo transversal com 65 pacientes alcoolistas em tratamento no CAP-Sad. O grau de dependência do álcool foi avaliado pelo SADD (Short Alcohol Dependence Data e o uso de outras drogas, pelo ASSIST (Alcohol Smoking and Substance Involvement Screening Test. Foram avaliados o perfil bioquímico e o antropométrico dos usuários. RESULTADOS: Participaram do estudo 42 homens e 23 mulheres. A maioria dos participantes (67,74% apresentou dependência alcoólica grave, com uso de álcool associado principalmente a cigarro (66,15%. A média da circunferência da cintura (CC foi significativamente maior entre os abstinentes, em comparação aos não abstinentes (AB: 88,15 ± 15,95 x NA: 81,04 ± 9,86; p = 0,03. Pacientes abstinentes há mais tempo tiveram maior sobrepeso/obesidade e adiposidade abdominal (CC do que os não abstinentes e abstinentes recentes, com razão de chances de 5,25. Os abstinentes apresentaram razão de chances de 3,38 para %GC acima da média, independente do tempo de abstinência. CONCLUSÃO: Pacientes alcoolistas abstinentes apresentam mais sobrepeso/ obesidade, adiposidade corporal (%GC e abdominal (CC do que os não abstinentes. É importante o acompanhamento multiprofissional no tratamento de alcoolistas com abordagem para fatores de risco cardiovasculares, principalmente evitando o ganho de peso.

DESGASTE POR ABRASIÓN DEL ACERO API 5L X65 REVESTIDO CON NIOBIO POR ASPERSIÓN TÉRMICA A PLASMA Y CON INCONEL 625 POR SOLDADURA

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JOSE MATOS

2012-01-01

Full Text Available El objetivo de este trabajo fue evaluar y caracterizar el comportamiento mecánico en desgaste del acero API 5L X65, revestido con niobio en comparación al desempeño del revestimiento de la aleación de inconel 625 empleados en la industria de petróleo y gas. El revestimiento de niobio fue obtenido por el proceso de aspersión térmica a plasma de arco no transferido y el revestimiento inconel 625 por soldadura con electrodo revestido. La resistencia al desgaste por abrasión fue evaluada según la norma Petrobras N-2568, en un tribómetro CTER, la rugosidad y el volumen de material desgastado se determinó a través de perfilometría y la dureza de los revestimientos por microscopia Vickers. Los revestimientos obtenidos fueron caracterizados respecto a su morfología por microscopia electrónica de barrido (MEB y microscopía óptica (MO. La mayor dureza del revestimiento con niobio obtenido puede haber contribuido a reducir la tasa de desgaste en comparación con el revestimiento de inconel 625.

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

OpenAIRE

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

2010-01-01

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

Eficacia del entrenamiento muscular en el aumento de la fuerza del suelo pélvico

OpenAIRE

González Morán, Janire

2014-01-01

RESUMEN: Introducción: La gimnasia abdominal hipopresiva (GAH) fue creada en los años 80 por el Doctor Marcel Caufriez. Surge como alternativa para tonificar la faja abdominal de las mujeres en el postparto, logrando una disminución de la presión intraabdominal (1). Los ejercicios de Kegel consisten en el fortalecimiento del suelo pélvico mediante contracciones voluntarias (2,3). Objetivo: Comparar la eficacia de los ejercicios Kegel y la Gimnasia Abdominal Hipopresiva en la me...

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.

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.

Intra-Abdominal Hydatid Cyst: Sociodemographics, Clinical Profiles, and Outcomes of Patients Operated on at a Tertiary Hospital in Addis Ababa, Ethiopia

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Engida Abebe

2017-01-01

Full Text Available Background. Hydatid cyst is caused by the tapeworm Echinococcus granulosus. The abdomen, specifically the liver, is the most common site affected. Objective. Determine the presentation patterns, types of surgical management, and outcomes of patients operated for intra-abdominal hydatid cyst (IAHC. Methodology. A retrospective descriptive study of patients admitted and operated for IAHC from September 1, 2011, to August 31, 2015. Results. Forty-two patients whose age ranged from 10 to 65 (mean of 37 years were operated on. Females comprised 27 (64.3% of the patients. The commonest presenting complaint was abdominal pain (41, 97.6%. Abdominal mass was documented in 23 (54.7% cases. Abdominal ultrasound (AUS and CT were the main imaging studies done on 38 (90.5% and 24 (57.1% patients, respectively. Cysts measuring more than 10 cm in diameter were the most common finding in both studies. Liver was the primary site involved, 30 (71.4% cases, the right lobe being the main side, 73%. Thirty-eight (90.5% patients underwent deroofing, evacuation, marsupialization, and omentoplasty (DEMO. There was no perioperative death, but 4 (9.5% of the patients had post-op complications. Conclusion. Abdominal pain was the most common presenting complaint. AUS and CT remain the preferred imaging. DEMO was the most common surgery.

Uso das diretrizes para tratamento da úlcera por pressão por enfermeiros de um hospital geral

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Elaine Maria Leite Rangel

2009-03-01

Full Text Available Este estudo objetivou identificar a freqüência do uso das diretrizes para o tratamento da úlcera por pressão(UP por enfermeiros de um hospital geral no interior do estado de São Paulo. É transversal de caráterdescritivo com análise quantitativa de dados. Amostra de 25 enfermeiros. Para a coleta de dados utilizou-se uminstrumento, construído a partir das diretrizes para o tratamento da UP. As questões foram relacionadas aostipos de intervenções usadas pelos enfermeiros para o tratamento da UP em estágio I, II, com necrose e comtecido de granulação. Para UP em estágio I, 24 (96% enfermeiros sempre realizavam a mudança de decúbito.Nas úlceras em estágio II a utilização de óleos vegetais na ferida era realizada sempre por 10 (40%enfermeiros e o curativo de hidrocolóide nunca era utilizado por 12 (57,1% enfermeiros. Em UP com necrose alimpeza com povidine era realizada por 4 (17,4% enfermeiros às vezes. Para o desbridamento, 16 (64% àsvezes utilizavam papaína e 15 (71,4% às vezes utilizavam colagenase. Em úlceras com tecido de granulaçãosempre era utilizado o soro fisiológico por 25 (100% enfermeiros. Houve variação nas práticas para otratamento da UP e falta de adesão às diretrizes.

Mortalidad por causas externas en Medellín, 1999-2006

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Doris Cardona Arango

2008-01-01

Full Text Available Caracterizar el comportamiento de la mortalidad por causas externas en la ciudad de Medellín, Colombia, entre 1999-2006, según sexo, edad y causa básica de muerte fue el objetivo de este estudio descriptivo longitudinal, con fuente de información secundaria de 22 128 registros de defunción por causas externas. El análisis realizado es univariado y bivariado por sexo, grupos de edad y causa de muerte. Las causas externas registradas en el periodo fueron: 72.9 por ciento por homicidio; 15.3 por ciento, accidente de transporte; 7.3 por ciento, traumatismos; 4.2 por ciento, por suicidio, y por otras causas, 0.4 por ciento. La mayor tasa de mortalidad se presentó en el grupo de edad de 20 a 24 años (27.6 por cien mil habitantes, hecho que merece especial consideración por las implicaciones sociales, familiares y laborales que representa el fallecimiento de una persona en su etapa productiva.

Reference curves of the body fat index in adolescents and their association with anthropometric variables

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Renata Rago Frignani

2015-05-01

Full Text Available Objectives: To develop reference curves for the body fat index (BFI in the pediatric population, in adolescents from the city of São Paulo, Brazil, and verify their association with body mass index and body fat percentage. Methods: The study is part of the research project “Nutritional Profile of Adolescents from Public and Private Schools of São Paulo” that was performed in 2004-2005. A total of 4,686 adolescents (2,130 boys and 2,556 girls aged 10-15 years were divided into two groups: 10-12 and 13-15 years of age. Body mass, height, body mass index, hip circumference, body fat percentage, body fat index, and sexual maturation performed by the self-assessment method (prepubertal, pubertal, and postpubertal were analyzed. ANOVA was performed, as well as percentile distribution, Pearson's correlation, and Bland-Altman plot. Results: In boys, there was an increase in body mass, height, body mass index, and hip circumference with advancing age and Tanner stage. In girls, there was an increase in body fat index and body fat percentage with advancing age and stage of sexual maturation. An association was found between body fat index and body mass index (r = 0.67 in boys and 0.80 in girls, p < 0.001 and body fat percentage (r = 0.71 in boys and 0.68 in girls, p < 0.001. Conclusion: The body fat index seems to reflect well the phenomena of sexual dimorphism in adolescence, is easy to perform, and represents a method that should be used in population samples. Resumo: Objetivos: Desenvolver curvas de referência do índice de adiposidade corporal para população pediátrica, em adolescentes da cidade de São Paulo, Brasil, e verificar a sua relação com o índice de massa corporal e percentual de gordura corporal. Métodos: O estudo faz parte do projeto de pesquisa “Perfil Nutricional de Adolescentes de escolas Públicas e Privadas de São Paulo” realizado em 2004/2005. 4.686 adolescentes (2.130 meninos e 2.556 meninas de 10-15 anos

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

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

Science.gov (United States)

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

2018-03-01

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

Melatonin prevents secondary intra-abdominal hypertension in rats possibly through inhibition of the p38 MAPK pathway.

Science.gov (United States)

Chang, Mingtao; Li, Yang; Liu, Dong; Zhang, Lianyang; Zhang, Hongguang; Tang, Hao; Zhang, Huayu

2016-08-01

Exogenous administration of melatonin has been demonstrated to down-regulate inflammatory responses and attenuate organ damage in various models. However, the salutary effect of melatonin against secondary intra-abdominal hypertension (IAH) remains unclear. This study sought to test the influence of melatonin on secondary IAH in a pathophysiological rat model and the underlying mechanisms involved. Before resuscitation, male rats underwent a combination of induced portal hypertension, applying an abdominal restraint device, and hemorrhaging to mean arterial pressure (MAP) of 40mmHg for 2h. After blood reinfusion, the rats were treated with lactated Ringer solution (LR) (30mL/h), melatonin (50mg/kg) +LR, and SB-203580 (10μmol/kg)+LR. LR was continuously infused for 6h. MAP, the inferior vena cava pressure and urine output were monitored. Histopathological examination, immunofluorescence of tight junction proteins, and transmission electron microscopy were administered. Intestinal permeability, myeloperoxidase activity, malondialdehyde, glutathione peroxidase, and levels of TNF-a, IL-2, and IL-6, were assessed. The expression of extracellular signal-regulated kinase, p38, c-Jun NH2-terminal kinase, translocation of nuclear factor kappa B subunit, signal transducers and activators of transcription and tight junction proteins were detected by Western blot. We found that melatonin inhibited the inflammatory responses, decreased expression of p38 MAPK, attenuated intestinal injury, and prevented secondary IAH. Moreover, administration of SB203580 abolished the increase in p38 MAPK and also attenuated intestinal injury. These data indicate that melatonin exerts a protective effect in intestine in secondary IAH primarily by attenuating the inflammatory responses which are in part attributable to p38 MAPK inhibition. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Genetic variations in toll-like receptor 4 in Mexican-Mestizo patients with intra-abdominal infection and/or pneumonia.

Science.gov (United States)

Rodriguez-Osorio, Carlos A; Lima, Guadalupe; Herrera-Caceres, Jaime O; Villegas-Torres, Beatriz E; Zuñiga, Joaquin; Ponce-de-Leon, Sergio; Llorente, Luis; Sifuentes-Osornio, Jose

2013-06-01

Sepsis is a leading cause of death around the world, and 73-83% of all sepsis cases requiring attention in intensive care units are linked to intra-abdominal infection (IAI) or pneumonia. The activation of innate immunity is central to the manifestation of sepsis, and toll-like receptor (TLR) 4 plays an important role in this activation process. The 299G and 399I alleles of TLR4 have been linked with an increased risk of Gram-negative bacteria (GNB) infections and septic shock in some populations. This case-control study evaluated the prevalence of D299G/T399I polymorphisms in Mexican patients with IAI and/or pneumonia and in healthy controls. Genotyping revealed that 1 in 44 patients (2.3%; CI 95%: 0.05-12.0%) and 4 in 126 controls (3.2%; CI 95%: 0.9-7.9%) were heterozygous for both the D299G and T399l polymorphisms (OR: 0.71, CI 95%: 0.01-7.44, p = NS), confirming the co-segregation of these alleles in this population. Furthermore, the patients with a GNB infection and severe sepsis were not carriers of the risk alleles. In summary, this report shows that the frequency of the D299G and T399I polymorphisms in Mexican-Mestizos is lower than anticipated in comparison with other ethnic groups, emphasizing the variable distribution of TLR4 polymorphisms among different populations. Consequently, this study was not able to detect associations between TLR4 polymorphisms and sepsis in this population. Copyright © 2013 Elsevier B.V. All rights reserved.

Variabilidad del índice de conicidad en la adolescencia: Análisis comparativos de poblaciones de Argentina, Venezuela y España

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Pacheco, José L.

2007-01-01

Full Text Available El objetivo del presente trabajo –que se enmarca en un proyecto común denominado “Condición nutricional y biodiversidad en las poblaciones humanas”- es determinar el modelo de distribución de grasa corporal existente durante las edades de la adolescencia, y si existen diferencias entre poblaciones española e iberoamericanas. La muestra está formada por 1452 jóvenes entre 12 y 17 años, argentinos (Catamarca y Jujuy, españoles (Comunidad de Madrid, y venezolanos (Caracas y Mérida. Se analizó la distribución de grasa corporal haciendo especial énfasis en el Índice de Conicidad (IC. Al analizar este índice respecto a edad se observa que cambia en mayor grado que otros indicadores de adiposidad. Cada serie presenta, además, su propio patrón de variación. Los resultados obtenidos se interpretan en función de parámetros geográficos y socioeconómicos en los que se desenvuelven las poblaciones analizadas.

Tatuaje por amalgama. Reporte de un caso

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Luis Fang Mercado

2012-01-01

Full Text Available El tatuaje por amalgama se origina por el depósito en el tejido conectivo subepitelial de fragmentos de amalgama resultado de procedimientos iatrogénicos por parte del operador. La profundidad a la que se encuentren albergados los residuos de este material influye en la presentación clínica de las lesiones. Radiográficamente se pueden identificar los fragmentos mientras tengan diámetros razonables; histológicamente se pueden observar las partículas de amalgama como gránulos oscuros, sólidos e irregulares dispuesto entre los haces de colágeno y vasos sanguíneos. Este artículo refiere el caso clínico de un paciente que presentó pigmentación por amalgama en mucosa vestibular, originada por una porción de amalgama usada como material obturador en una apicectomía del 11 realizada con anterioridad. Teniendo en cuenta las consideraciones clínicas y radiográficas se optó por realizar una segunda apicectomía con obturación retrógrada con MTA del 11. Durante el procedimiento quirúrgico se cureteó y adelgazó la cara interna del colgajo mucoperióstico para tratar de disminuir el grado de pigmentación.

La pintura vista por un pintor joven

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Fuentes Pozo, Pedro

2000-01-01

Full Text Available Not available

El pintor se define a lo largo del tiempo como un artista en mutación influenciado por la sociedad de su momento y por su propio mundo interior Esto ha contribuido a la creación de distintos estilos pictóricos y a una evolución que conlleva la despreocupación por el aspecto formal en aras de una introspección al mundo interior En el cambio constante se refleja la búsqueda del artista que valida la intemporalidad del arte. Así, el verdadero artista sobrevive al aplauso o rechazo de la crítica, convirtiéndose en un verdadero hombre renancentista preocupado por el hallazgo del conocimiento universal.

Experiência inicial com terapia por pressão negativa por instilação em feridas complexas

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Dimas André Milcheski

Full Text Available RESUMO Objetivo: relatar a experiência inicial com a terapia por pressão negativa por instilação em feridas complexas infectadas ou contaminadas. Métodos: a terapia por pressão negativa por instilação utilizada foi o V.A.C. Ulta com instilação Veraflo (Kinetic Concepts, Inc. O modo de operação foi contínuo com pressão sub-atmosférica ajustada em 125 mmHg por duas horas e instilação entre as pausas. O tempo de instilação foi de 20 minutos (tempo de contato do agente tópico com a ferida e a substância instilada foi solução salina padrão a 0,9%. Após obtenção de preparo adequado da ferida, ela foi coberta com enxerto ou retalho. Resultados: foram operados dez pacientes com feridas complexas contaminadas ou infectadas. O número médio de trocas da TPNi foi 1,4, o número médio total de cirurgias foi de 2,4, o intervalo até a cobertura da ferida foi de 6,3 dias e o intervalo até a alta foi de 11,4 dias. Conclusão: a comparação da terapia por pressão negativa por instilação com dois estudos prévios (controle histórico evidenciou um tempo de internação menor, favorecendo a TPNi. Este estudo teve um caráter inicial, fazendo-se necessário conduzir um trabalho randomizado e controlado para confirmar a eficácia desta terapia e verificar a sua custo-efetividade.

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

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Edison Matos Nóvak

1984-09-01

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

Ptose palpebral causada por Paquidermoperiostose

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Patricia Regina de Pinho Tavares

2014-08-01

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

Estado nutricional e composição corporal de pacientes hospitalizados: reflexos da transição nutricional -

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Kátia Cristina Portero-McLellan

2012-01-01

Full Text Available Objetivos: Investigar o reflexo da transição nutricional sobre o estado nutricional e a composição corporal de pacientes hospitalizados. Métodos: Avaliaram-se 819 pacientes hospitalizados (435 homens e 384 mulheres sob aspectos clínicos, antropométricos e dietéticos. As variáveis antropométricas estudadas foram: peso atual (PA, altura (A, circunferência da cintura (CC, circunferência do quadril (CQ, circunferência braquial (CB, prega cutânea triciptal (PCT, e prega cutânea subescapular (PCSE. A partir destas medidas foram calculados: o índice de massa corporal (IMC, a relação entre a cintura e o quadril (RCQ, a relação entre a cintura e a altura (RCA, a circunferência muscular do braço (CMB, a área muscular do braço (AMB e a área adiposa do braço (AAB. Para o diagnóstico da adiposidade central utilizou-se a relação entre a circunferência da cintura e a do quadril. Resultados: A idade média da população foi de 53,7±16,0 anos, com permanência hospitalar de 8 dias, sendo maior entre os idosos (p<0,01. Parte dos pacientes (47,8% apresentou sobrepeso/obesidade, 48,6% valores alterados de circunferência da cintura e 76,4% adiposidade central. As doenças cardiovasculares representaram 45,4% do total de internações, sendo 60,4% entre os idosos. Conclusão: Esse estudo mostrou elevada prevalência de obesidade e adiposidade central entre os pacientes hospitalizados independente do gênero, da idade, e do motivo de internação, tornando evidente o reflexo da transição nutricional na população estudada.

Intestinal fatty acid binding protein as a marker for intra-abdominal pressure-related complications in patients admitted to the intensive care unit; study protocol for a prospective cohort study (I-Fabulous study).

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Strang, Steven G; Van Waes, Oscar J F; Van der Hoven, Ben; Ali, Samir; Verhofstad, Michael H J; Pickkers, Peter; Van Lieshout, Esther M M

2015-01-16

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have detrimental effects on all organ systems and are associated with increased morbidity and mortality in critically ill patients admitted to an intensive care unit. Intra-bladder measurement of the intra-abdominal pressure (IAP) is currently the gold standard. However, IAH is not always indicative of intestinal ischemia, which is an early and rapidly developing complication. Sensitive biomarkers for intestinal ischemia are needed to be able to intervene before damage becomes irreversible. Gut wall integrity loss, including epithelial cell disruption and tight junctions breakdown, is an early event in intestinal damage. Intestinal Fatty Acid Binding Protein (I-FABP) is excreted in urine and blood specifically from damaged intestinal epithelial cells. Claudin-3 is a specific protein which is excreted in urine following disruption of intercellular tight junctions. This study aims to investigate if I-FABP and Claudin-3 can be used as a diagnostic tool for identifying patients at risk for IAP-related complications. In a multicenter, prospective cohort study 200 adult patients admitted to the intensive care unit with at least two risk factors for IAH as defined by the World Society of the Abdominal Compartment Syndrome (WSACS) will be included. Patients in whom an intra-bladder IAP measurement is contra-indicated or impossible and patients with inflammatory bowel diseases that may affect I-FABP levels will be excluded. The IAP will be measured using an intra-bladder technique. During the subsequent 72 hours, the IAP measurement will be repeated every six hours. At these time points, a urine and serum sample will be collected for measurement of I-FABP and Claudin-3 levels. Clinical outcome of patients during their stay at the intensive care unit will be monitored using the Sequential Organ Failure Assessment (SOFA) score. Successful completion of this trial will provide evidence on the eventual

Suppression of cytochrome P450 reductase (POR) expression in hepatoma cells replicates the hepatic lipidosis observed in hepatic POR-null mice.

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Porter, Todd D; Banerjee, Subhashis; Stolarczyk, Elzbieta I; Zou, Ling

2011-06-01

Cytochrome P450 reductase (POR) is a microsomal electron transport protein essential to cytochrome P450-mediated drug metabolism and sterol and bile acid synthesis. The conditional deletion of hepatic POR gene expression in mice results in a marked decrease in plasma cholesterol levels counterbalanced by the accumulation of triglycerides in lipid droplets in hepatocytes. To evaluate the role of cholesterol and bile acid synthesis in this hepatic lipidosis, as well as the possible role of lipid transport from peripheral tissues, we developed a stable, small interfering RNA (siRNA)-mediated cell culture model for the suppression of POR. POR mRNA and protein expression were decreased by greater than 50% in McArdle-RH7777 rat hepatoma cells 10 days after transfection with a POR-siRNA expression plasmid, and POR expression was nearly completely extinguished by day 20. Immunofluorescent analysis revealed a marked accumulation of lipid droplets in cells by day 15, accompanied by a nearly 2-fold increase in cellular triglyceride content, replicating the lipidosis seen in hepatic POR-null mouse liver. In contrast, suppression of CYP51A1 (lanosterol demethylase) did not result in lipid accumulation, indicating that loss of cholesterol synthesis is not the basis for this lipidosis. Indeed, addition of cholesterol to the medium appeared to augment the lipidosis in POR-suppressed cells, whereas removal of lipids from the medium reversed the lipidosis. Oxysterols did not accumulate in POR-suppressed cells, discounting a role for liver X receptor in stimulating triglyceride synthesis, but addition of chenodeoxycholate significantly repressed lipid accumulation, suggesting that the absence of bile acids and loss of farnesoid X receptor stimulation lead to excessive triglyceride synthesis.

Consanguinidad por isonimia en Salta

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Albeza, María V.

2007-01-01

Full Text Available Se estimó el coeficiente de parentesco por isonimia para localidades de la Puna, Valle Calchaquí y Valle de Lerma, a fin de evaluar diferentes factores evolutivos que podrían estar afectando la composición genética de la población. A partir de los apellidos de las parejas consignadas en fuentes primarias de información, se estimó la isonimia conyugal o marital, el coeficiente total Ft y sus componentes Fr (inbreeding azaroso y Fn (inbreeding no azaroso. De las localidades estudiadas, en la Puna se ha detectado sólo una pareja isónima en una de ellas, en el Valle Calchaquí, tres y ninguna en el Valle de Lerma. Tanto en el Valle Calchaquí como en el de Lerma, se han estimado valores negativos de Ft, y en la Puna se registran los valores más elevados. En las localidades estudiadas no se cumple el supuesto de transmisión patrilineal de apellidos por lo que los valores de Fr y por ende de Ft podrían estar subestimados. Es por ello que sería necesario contar con información desde otras vertientes metodológicas para corroborar, complementar y manejar cuidadosamente el análisis de los datos y las conclusiones que se obtienen.

Nefrectomía simple por puerto único (LESS) asistida por robot (da Vinci)

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CASTILLO C,OCTAVIO A; VIDAL M,IVAR; SEPÚLVEDA T,FRANCISCO

2011-01-01

Introducción: La cirugía mínimamente invasiva en urología avanza rápidamente y la cirugía laparo-endoscópica a través de puerto único (LESS) no es la excepción. Esta técnica por vía laparoscópica presenta mucha dificultad y requiere de un cirujano laparoscópico experimentado debido a la falta de triangulación y el cruce de los instrumentos. Los beneficios del sistema quirúrgico da Vinci® han sido introducidos recientemente en LESS. Presentamos dos casos de nefrectomía LESS asistida por robot....

Análisis de costos por ausentismo laboral atribuibles a licencias médicas por enfermedad. Hospital Nacional Arzobispo Loayza 2015

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Jave Escalante, Gladys Lizeth

2015-01-01

Determina el costo generado por el ausentismo laboral atribuible a licencias médicas por enfermedad en el Hospital Nacional Arzobispo Loayza 2015. METODOLOGÍA: Estudio no experimental. La muestra estuvo conformada por 118 médicos asistenciales y personal de enfermería. Para el análisis de los costos se utilizó el costo de tiempo perdido del paciente, ingresos dejados de percibir por el hospital y descuento económico al trabajador. Además se realizó un análisis económico y de sensibilidad. ...

Indice por Materias

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Montoya H Luz Marina

1982-09-01

Full Text Available Un índice es una lista de palabras o frases indicadores asociados que permite la ubicación de material al interior de un libro o una publicación, en este caso será por el nombre de la materia.

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

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

2016-05-01

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

Mortalidad intrahospitalaria por accidente cerebrovascular

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Federico Rodríguez Lucci; Virginia Pujol Lereis; Sebastián Ameriso; Guillermo Povedano; María F. Díaz; Alejandro Hlavnicka; Néstor A. Wainsztein; Sebastián F. Ameriso

2013-01-01

La mortalidad global por accidente cerebrovascular (ACV) ha disminuido en las últimas tres décadas, probablemente debido a un mejor control de los factores de riesgo vascular. La mortalidad hospitalaria por ACV ha sido tradicionalmente estimada entre 6 y 14% en la mayoría de las series comunicadas. Sin embargo, los datos de ensayos clínicos recientes sugieren que esta cifra sería sustancialmente menor. Se revisaron datos de pacientes internados con diagnóstico de ACV del Banco de Datos de Str...

Estresse oxidativo como fator de risco cardiometabólico emergente = Oxidative stress as an emergent cardiometabolic risk factor

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Gottlieb, Maria Gabriela Valle

2010-01-01

Conclusões: a associação do estresse oxidativo com adiposidade e resistência insulínica sugere sua influência na manifestação da síndrome metabólica. Sedentarismo e hábitos alimentares inadequados parecem contribuir com o aumento do estresse oxidativo e consequente risco para surgimento de doenças cardiovasculares

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

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KELLY LINHARES VASCONCELOS

2010-01-01

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

Antropometria de atletas culturistas em relação à referência populacional Anthropometry of body builders in relation to the population standard

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Naílza MAESTÁ

2000-08-01

Full Text Available Atletas de culturismo têm como alvo de treinamento a hipertrofia muscular e a redução da adiposidade. A falta de referências antropométricas apropriadas pode levar esses indivíduos a serem erroneamente considerados em situação de sobrepeso ou desnutrição. Portanto, objetivamos comparar a composição corporal de atletas de culturismo com os padrões populacionais. Foram avaliados 36 atletas, de ambos os sexos, 26 do sexo masculino (27,2 ± 7,2 anos e 10 do sexo feminino (30,0 ± 6,1 anos, por ocasião da competição nacional, quanto aos indicadores antropométricos de peso, estatura, índice de massa corpórea, pregas cutâneas, adiposidade corpórea e circunferência muscular do braço. Os resultados foram referidos quanto à posição percentual ou de desvios-padrão (pelo escore Z tendo como referências padrões populacionais locais. Como resultado, encontramos que os indicadores com menor contraste com os padrões adotados foram peso e estatura e os maiores contrastes foram encontrados na circunferência muscular do braço para os homens, e pregas cutâneas tricipital para as mulheres. Pelo indicador muscular todos foram classificados como obesos ou sobrepeso, enquanto que pela prega cutânea tricipital e adiposidade corpórea, a desnutrição esteve presente em 100,0% das mulheres e 88,5% dos homens. Fica evidenciada a inadequação da utilização do padrão antropométrico populacional para a classificação nutricional de atletas de força, em particular culturistas, sendo assim necessário o estabelecimento de padrões próprios para esse tipo de treinamento (modalidade.Body builders have as their training goals the maximum muscle hypertrophy with minimum adiposity. However, the scarcity of specific standards implies often in framing wrongly those athletes either as overweight (by their BMI or energy malnourished (by their fat stores. The objective of this study was to compare the body composition of body builders with

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

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BLANCA CECILIA VANEGAS DE AHOGADO

2009-12-01

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

Pedro Teixeira y su viaje por Mesopotamia

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Fuente del Pilar, José Javier

2005-04-01

Full Text Available Pedro Teixeira es un integrante notable de la ilustre nómina de los viajeros portugueses que, a finales del s, XVI y principios del XVII, ensancharon para Occidente las fronteras del mundo. Su conocimiento en España se debe a la publicación en 1994 de su obra «Relaciones del Origen, Descendencia y Sucesión de los Reyes de Persia, y de Harmuz, y de un viaje hecho por el autor dende la India hasta Italia por tierra», en edición realizada por el profesor Eduardo Barajas Sala, lamentablemente fallecido en 1997. En este artículo se ofrece una reseña biográfica de Pedro Teixeira, y un análisis del viaje narrado por el autor en la última parte de sus «Relaciones »: el que desde Ormuz le conducirá, a través de Mesopotamia, hasta la costa del Mediterráneo.…

Violência e mortes por causas externas

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Graciete Oliveira Vieira

2003-02-01

Full Text Available Através de um estudo ecológico caracterizou-se a violência e as mortes por causas externas em Salvador e Bahia utilizando-se dados da Fundação Nacional de Saúde-Ministério da Saúde, dos registros de mortalidade e das estimativas populacionais do IBGE. O risco de morrer por homicídio no Brasil é 3 vezes o do Estados Unidos, chegando a ser 40 vezes superior ao do Japão. Homicídio foi a primeira causa de anos potenciais de vidas perdidos (13,4% no Brasil (1997, seguido por acidentes de trânsito (10,6%. Causas externas foi a segunda causa de morte em Salvador e Bahia (1996. A violência tem raízes sócio-culturais e político-ideológicas e pode ser prevenida por ações intersetoriais e multidisciplinares.

Associação entre violência por parceiro íntimo contra a mulher e infecção por HIV

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Claudia Barros

2011-04-01

Full Text Available OBJETIVO: Analisar a associação entre a violência por parceiro íntimo contra mulheres e a infecção ou suspeita de infecção pelo vírus da imunodeficiência humana (HIV. MÉTODOS: Estudo transversal com base em dados de questionários aplicados face-a-face e de prontuários médicos de 2.780 mulheres de 15 a 49 anos, atendidas em unidades do sistema único de saúde da Grande São Paulo, SP, em 2001-2002. As mulheres foram categorizadas em: usuárias em tratamento por serem "soropositivas para o HIV", com "suspeita de HIV" e aquelas que procuraram os serviços por outros motivos. A violência por parceiro íntimo contra mulheres na vida foi categorizada por gravidade e recorrência dos episódios de violência. A associação com o desfecho foi testada pelo modelo de Poisson com variância robusta e ajustada por variáveis sociodemográficas, sexuais e reprodutivas. RESULTADOS: A prevalência de violência foi de 59,8%. Sofrer violência reiterada e grave apresentou maior associação de infecção confirmada pelo HIV (RP = 1,91. A violência independente da gravidade e da recorrência dos episódios apresentou maior associação para a suspeita de infecção por HIV (RP = 1,29. CONCLUSÕES: A violência por parceiro íntimo contra mulheres tem papel relevante nas situações de suspeita e confirmação da infecção pelo HIV, sendo essencial incluir sua detecção, controle e prevenção como parte da atenção integral à saúde das mulheres.

Predominant porB1A and porB1B genotypes and correlation of gene mutations with drug resistance in Neisseria gonorrhoeae isolates in Eastern China

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Tang Renxian

2010-11-01

Full Text Available Abstract Background Variations of porB1A and porB1B genes and their serotypes exist in Neisseria gonorrhoeae isolates from different geographical areas, and some site mutations in the porB1B gene correlate with drug resistance. Methods The β-lactamase production of N. gonorrhoeae isolates was determined by paper acidometric test and nitrocefin discs. The porB1A and porB1B genes of 315 non-penicillinase-producting N. gonorrhoeae (non-PPNG strains were amplified by PCR for sequencing to determine serotypes and site mutations. A duplex PCR was designed to simultaneously detect both porB1A and porB1B genes. Penicillin and tetracycline resistance was assessed by an in vitro drug sensitivity test. Results Of the N. gonorrhoeae isolates, 31.1% tested positive for porB1A and 68.9% for porB1B genes. All the 98 porB1A+ isolates belonging to IA6 serotype with either no mutation at the 120 and 121 sites (88.8% or a D120G (11.2% mutation and were no resistance to both penicillin and tetracycline. Among the 217 porB1B+ isolates, 26.7%, 22.6% and 11.5% belonged to IB3, IB3/6 and IB4 serotypes, respectively. Particularly, two novel chimeric serotypes, IB3/6-IB2 and IB2-IB4-IB2, were found in 77 and 8 porB1B+ isolates. Two hundred and twelve (97.7% of the porB1B+ isolates were presented G120 and/or A121 mutations with 163 (76.9% at both sites. Interestingly, within the 77 porB1B+ isolates belonging to IB3/6-IB2 serotype, 15 were discovered to possess novel deletions at both A121 and N122 sites. All the replacement mutations at these sites in PorB1B were correlated with resistance and the deletion mutation showed the highest resistance. Conclusion N. gonorrhoeae isolates circulating in Eastern China include a sole PorB1A serotype (IA6 and five PorB1B serotypes. Multiple mutations in porB1B genes, including novel A121 and N122 deletions, are correlated with high levels of penicillin and tetracycline resistance.

Conservación por calor

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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 ...

Las cosas por su nombre

OpenAIRE

Storani, Emilia

2017-01-01

El artículo propone indagar sobre los modos y diferentes formatos que se utilizan tanto en la escritura como en la lectura, para articular con las luchas por la identidad de género. La Ley de Identidad de Género ha sido un puntapié clave para pensarnos a nosotros mismos culturalmente y para pensar a los demás. Pero, ¿cómo mencionamos, escribimos y leemos las diferentes identidades? La escritura, también es un mundo transformador para quienes bregan por una sociedad más libre y sin prejuicios....

Diverticulitis yeyunal perforada por enterolito.

OpenAIRE

Marenco De la Cuadra, Beatriz; Gomez-Rosado, Juan-Carlos; Capitan-Morales, Luis-Cristobal; Valdés Hernández, Javier; Reyes-lopera, N.J. De los

2012-01-01

La diverticulosis yeyunal es una enfermedad adquirida rara. Casi el 60-70% keeps asymptomátic or Con síntomas crónicos inespecíficos, aunque puede presentarse como un abdomen agudo. La perforación debida a enterolitos es una causa extremadamente rara do complicación, y puede producirse por la impactación de ésta contra la pared intestinal. Presentamos caso de un varón de 82 años que acude a urgencias por un dolor súbito abdominal, difuso, con irritación peritoneal, leucocitosis con neutro...

Por y para en los manuales de ELE

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Sidoti, Rossana

2008-12-01

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

Pronóstico de la diarrea por rotavirus

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Mota-Hernández Felipe

2001-01-01

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

Miasis cutanea por cordylobia anthropophaga

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Alkorta Gurrutxaga Miriam

2001-01-01

Full Text Available El incremento progresivo en el número de personas que viajan a países tropicales ha hecho que las enfermedades importadas adquieran una relevancia cada vez mayor. Las miasis (o infestaciones por larvas de moscas cutáneas se encuentran entre este tipo de enfermedades siendo especialmente frecuentes en países tropicales. A propósito de la observación de un caso de miasis cutánea masiva por Cordylobia antropophaga, que ocurrió en una mujer de 34 años de edad al volver de un viaje a Senegal, se ha efectuado una revisión de los casos de miasis cutáneas forunculoides importadas publicados en España, así como de la biología, patología, tratamiento y prevención de la miasis humana por Cordylobia anthropophaga. El caso referido, se caracterizó por la infestación con un número inusualmente elevado de larvas, no sospechándose su etiología hasta la fase final de la enfermedad. La emergencia continuada de larvas (se recogieron 91 generó en la paciente un estado de ansiedad importante. Finalmente, la eliminación de las larvas provocó una rápida mejoría de la paciente. Aunque los casos de miasis cutánea no tienen la gravedad de otras enfermedades importadas, su conocimiento es necesario desde el punto de vista preventivo, diagnóstico y terapeútico. Es importante proceder a la identificación morfológica de las larvas diferenciándolas de otro tipo de miasis con implicaciones terapéuticas diferentes.

Associação entre violência por parceiro íntimo contra a mulher e infecção por HIV Asociación entre violencia contra la mujer por pareja íntima e infección por VIH Association between intimate partner violence against women and HIV infection

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Claudia Barros

2011-04-01

Full Text Available OBJETIVO: Analisar a associação entre a violência por parceiro íntimo contra mulheres e a infecção ou suspeita de infecção pelo vírus da imunodeficiência humana (HIV. MÉTODOS: Estudo transversal com base em dados de questionários aplicados face-a-face e de prontuários médicos de 2.780 mulheres de 15 a 49 anos, atendidas em unidades do sistema único de saúde da Grande São Paulo, SP, em 2001-2002. As mulheres foram categorizadas em: usuárias em tratamento por serem "soropositivas para o HIV", com "suspeita de HIV" e aquelas que procuraram os serviços por outros motivos. A violência por parceiro íntimo contra mulheres na vida foi categorizada por gravidade e recorrência dos episódios de violência. A associação com o desfecho foi testada pelo modelo de Poisson com variância robusta e ajustada por variáveis sociodemográficas, sexuais e reprodutivas. RESULTADOS: A prevalência de violência foi de 59,8%. Sofrer violência reiterada e grave apresentou maior associação de infecção confirmada pelo HIV (RP = 1,91. A violência independente da gravidade e da recorrência dos episódios apresentou maior associação para a suspeita de infecção por HIV (RP = 1,29. CONCLUSÕES: A violência por parceiro íntimo contra mulheres tem papel relevante nas situações de suspeita e confirmação da infecção pelo HIV, sendo essencial incluir sua detecção, controle e prevenção como parte da atenção integral à saúde das mulheres.OBJETIVO: Analizar la asociación entre la violencia contra mujeres por pareja íntima y la infección o sospecha de infección por el virus de inmunodeficiencia humana (VIH. MÉTODOS: Estudio transversal con base en datos de cuestionarios aplicados cara-a cara y de prontuarios médicos de 2.780 mujeres de 15 a 49 años, atendidas en unidades del sistema único de salud de la Gran Sao Paulo, Sureste de Brasil, en 2001-2002. Las mujeres fueron categorizadas en: usuarias en tratamiento por ser

Associations of maximal voluntary isometric hip extension torque with muscle size of hamstring and gluteus maximus and intra-abdominal pressure.

Science.gov (United States)

Tayashiki, Kota; Hirata, Kosuke; Ishida, Kiraku; Kanehisa, Hiroaki; Miyamoto, Naokazu

2017-06-01

Muscle size of the hamstring and gluteus maximus (GM) as well as intra-abdominal pressure (IAP) are considered as factors affecting the torque development during hip extension. This study examined the associations of torque development during maximal voluntary isometric hip extension with IAP and muscle size of the hamstring and GM. Anatomical cross-sectional area (ACSA) of the hamstring and thickness of GM were determined in 20 healthy young males using an ultrasonography apparatus (Experiment 1). Torque and IAP were simultaneously measured while subjects performed maximal voluntary isometric hip extension. The IAP was measured using a pressure transducer placed in the rectum and determined at the time at which the developed torque reached to the maximal. In Experiment 2, torque and IAP were measured during maximal voluntary isometric hip flexion in 18 healthy young males. The maximal hip extension torque was significantly correlated with the IAP (r = 0.504, P = 0.024), not with the ACSA of the hamstring (r = 0.307, P = 0.188) or the thickness of GM (r = 0.405, P = 0.076). The relationship was still significant even when the ACSA of the hamstring and the thickness of GM were adjusted statistically (r = 0.486, P = 0.041). The maximal hip flexion torque was not significantly correlated with the IAP (r = -0.118, P = 0.642). The current results suggest that IAP can contribute independently of the muscle size of the agonists to maximal voluntary hip extension torque.

Pulmonary atelectasis in patients with neurological or muscular disease. Gravity-related lung compression by the heart and intra-abdominal organs on persistent supine position

International Nuclear Information System (INIS)

Toyoshima, Mitsuo; Maeoka, Yukinori; Kawahara, Hitoshi; Maegaki, Yoshihiro; Ohno, Kousaku

2006-01-01

We report 10 cases of pulmonary atelectasis diagnosed by chest computed tomography in patients with neurological or muscular disease. Atelectasis was frequently seen in hypotonic patients who could not roll over on their own. The atelectases located mostly in the dorsal bronchopulmonary segments, adjacent to the heart or diaphragm. Atelectasis diminished in two patients after they became able to roll themselves over. Gravity-related lung compression by the heart and intra-abdominal organs on persistent supine position can cause pulmonary atelectasis in patients with neurological or muscular disease who can not roll over by their own power. To confirm that the prone position reduces compression of the lungs, chest computed tomography was performed in both the supine and the prone position in three patients. Sagittal images with three-dimensional computed tomographic reconstruction revealed significant sternad displacements of the heart and caudal displacements of the dorsal portion of the diaphragm on prone position compared with supine position. The prone position, motor exercises for rolling over, and biphasic cuirass ventilation are effective in reducing gravity-related lung compression. Some patients with intellectual disabilities were also able to cooperate in chest physiotherapy. Chest physiotherapy is useful in preventing atelectasis in patients with neurological or muscular disease. (author)

Itinerarios Didácticos por la isla de Lanzarote

OpenAIRE

Becerra-Ramírez, Rafael; González Cárdenas, Elena; Gosálvez, Rafael U.; Escobar Lahoz, Estela; Dóniz-Páez, Javier

2013-01-01

Con la confección de esta guía de itinerarios didácticos por la isla de Lanzarote pretendemos contribuir a un mayor conocimiento de las características geográficas de este espacio dominado por las formas volcánicas que caracterizan un paisaje modificado por la mano del hombre que convive con los volcanes y los usa, tradicionalmente como soporte de sus cultivos, y modernamente como base de la industria turística. Los itinerarios didácticos por la isla de Lanzarote son la adaptación de los t...

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

Centers for Disease Control (CDC) Podcasts

2015-01-06

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

Topoplastia de Cvintal assistida por laser de femtossegundo

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Alexandre Takayoshi Ishizaki

2013-06-01

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

Micetoma por Nocardia brasiliensis: reporte de caso

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Miriam Guevara R

2003-07-01

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

Mortalidad por envenenamiento en niños

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Híjar Martha

1998-01-01

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

Selección de Recursos Humanos por Competencias

OpenAIRE

Sánchez Domingo, Cristina

2013-01-01

Los objetivos de este trabajo son, por un lado conocer en qué consisten los procesos de valoración y selección de personas desde el enfoque de las competencias laborales. Para ello, ha sido preciso profundizar en el estudio del concepto de “competencia laboral”, y comprender qué es la Gestión de Recursos Humanos por Competencias, en cuyo seno se encuentra la propia Selección de Recursos Humanos. Por otra parte, un segundo objetivo del trabajo es conocer el grado de implantación de la Selecció...

Tallado de hélices por el método de copiado por proyección

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José Vicente Fierro Vasco

1983-01-01

Full Text Available Este dispositivo fue diseñado como parte de la investigación sobre Aerogeneradores que se está llevando a cabo en el Departamento de Ingeniería Mecánica, cuyo investigador principal es el Ing. Julio Mario Rodríguez Devis. Como parte inicial de la investigación se adecuó un túnel situado en el Laboratorio de Hidráulica para hacer las pruebas de modelos. En la construcción de dichos modelos se requiere una buena precisión en la hechura de las aspas del molino, en especial por el tamaño reducido de liste. Se debe garantizar que el perfil aerodinámico se conserve a lo largo del aspa, por lo que se requiere de un dispositivo capaz de tallar los álabes con la precisión y rapidez necesarias. Los resultados del trabajo fueron presentados al concurso del premio Worthington de la Ingeniería Colombiana 1982 (Categoría estudiantes, por los estudiantes que trabajaron en el proyecto, siendo acreedores al primer puesto.

CARACTERIZAÇÃO ESPECTRAL DA CANA-DE-AÇÚCAR INFECTADA POR NEMATOIDES E MIGDOLUS FRYANUS POR ESPECTRORRADIOMETRIA DE CAMPO

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George Deroco Martins

Full Text Available O cultivo da cana-de-açúcar no Brasil, embora assistido por técnicas modernas de plantio, é alvo constante de parasitas do sistema radicular. Por registrar seletivamente o fluxo espectral da radiação eletromagnética refletida pela vegetação, o sensoriamento remoto tornou-se uma poderosa ferramenta na detecção das plantas infectadas por patógenos do solo. Com o objetivo de caracterizar espectralmente a cana-de-açúcar sadia e infectada por nematoides e pela larva do besouro Migdolus fryanus, foram tomadas medidas radiométricas in situ e geradas curvas hiperespectrais de plantas sadias e infectadas. Técnicas específicas de análise espectral, como a determinação da posição da borda do vermelho limítrofe (Red Edge Position Determination - REPD e diferentes índices espectrais foram avaliados para discriminar as três ocorrências. As curvas de reflectância mostraram diferenças em magnitude principalmente nos comprimentos de onda do vermelho e infravermelho próximo e, assim como a determinação do REP e os índices de clorofila b, NDVI, MCARI e TCARI, permitiram distinguir apenas entre plantas sadias e infectadas. As razões espectrais sensíveis aos pigmentos clorofila a e carotenoides, porém, discriminaram as três ocorrências, inclusive plantas infectadas por nematoides e Migdolus fryanus. A melhor discriminação foi obtida com o índice de carotenoides, um pigmento fortemente relacionado com estresse da planta

Efeitos de um programa de exercicios fisicos sobre a pressao arterial e medidas antropometricas

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Andrigo Zaar

2014-01-01

Full Text Available INTRODUÇÃO: O número de pessoas com sobrepeso ou obesidade tem alcançado índices alarmantes no Brasil. Condutas não-medicamentosas devem ser a estratégia inicial para o tratamento de indivíduos com sobrepeso e hipertensão leve a moderada. OBJETIVO: Analisar os efeitos de um programa de condicionamento físico realizado por um período de 24 meses sobre pressão arterial e composição corporal em indivíduos normotensos e pré-hipertensos. MÉTODOS: Participaram do estudo 35 indivíduos randomizados como: (GI normotensos (n = 16, 51 ± 1 anos, pressão arterial sistólica (PAS < 120 e diastólica (PAD < 80 mmHg; e (GII pré-hipertensos (n = 19, 54 ± 1 anos, PAS de 139 e PAD de 89 mmHg. RESULTADOS: Após 24 meses de programa de condicionamento físico, os indivíduos do GII apresentaram redução na PAS (-3,6 ± 0,94 e -10 ± 0,94 mmHg, p < 0,05, respectivamente e PAD (-6,5 ± 1 e -7,1 ± 0,9 mmHg, p < 0,05. Em ambos os grupos houve redução do perímetro de cintura (-1,74 ± 3,5 e -1,91 ± 4 cm, p < 0,05 e índice de adiposidade (-1,21 ± 2,6 e -1,35 ± 3,1%, p < 0,05, aumento da massa corporal (+1,27 ± 3 e +1,32 ± 3,8 kg, p < 0,05, IMC (+0,72 ± 0,4 e +0,54 ± 0,60 kg/m2, p < 0,05 e massa corporal isenta de gordura (+0,91 ± 0,5 e +0,77 ± 4,8 kg p < 0,05. CONCLUSÃO: Este programa reduziu PA, o perímetro de cintura e o índice de adiposidade em indivíduos pré-hipertensos, constituindo-se, portanto, numa estratégia segura e de baixo custo na prevenção de doenças cardiovasculares e melhoria da condição de saúde da população.

Osteoporosis secundaria y Osteoporosis inducida por glucocorticoides (OIG

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Elías Forero Illera

2006-01-01

Full Text Available La osteoporosis es un problema de salud pública importante a nivel mundial, y su prevalencia está aumentando. La osteoporosis secundaria se puede producir por varias patologías y el uso de ciertos medicamentos. Los glucocorticoides son un grupo de fármacos usados extensamente en la práctica médica debido a su indiscutible utilidad. La osteoporosis inducida por glucocorticoides es un problema de salud pública. Aunque la patogénesis de la pérdida producida por los glucocorticoides en el hueso no se conoce totalmente, investigaciones recientes han proporcionado nuevas conocimientos en los mecanismos de estos fármacos a nivel celular y molecular. Diversas guías han sido propuestas por diversos grupos para el tratamiento de la OIG; desafortunadamente, las guías del tratamiento no se utilizan adecuadamente en los pacientes.

Principais gestos esportivos executados por jogadores de handebol

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Luiz Carlos Hespanhol Junior

2012-09-01

Full Text Available Este estudo teve como objetivo quantificar os principais gestos esportivos executados por jogadores profissionais de handebol. Para a mensuração quantitativa dos principais movimentos executados por cada jogador de handebol avaliado foram realizadas gravações de vídeo em todos os jogos. Foram realizados em média 1288,0 (DP = 190,7 gestos esportivos por jogo. Os armadores centrais realizaram em média 375,0 (DP = 83,7 gestos esportivos, e a posição de pivô 63,3 (DP = 21,2 gestos por jogo. As recepções e os passes foram os gestos mais executados, e a posição que mais realizou gestos esportivos na equipe de handebol avaliada foi o armador central, seguido do armador esquerdo e direito. O pivô foi a posição que menos realizou gestos esportivos.

Higiene mental: conferencia dictada por la Radiodifusora Nacional

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Francisco Gómez Pinzón

1941-01-01

tiene extraordinaria trascendencia para el país por sus vastas repercusiones sobre el futuro de nuestro pueblo, y que, sin embargo ha sido negligentemente olvidado por las autoridades y deliberadamente ignorado por los sectores cultos e ilustrados de nuestra sociedad. Me refería entonces a la curva ascendente que, no sólo entre nosotros sino en todos los países civilizados, han seguido en su propagación las enfermedades nerviosas y mentales, y que hace contraste con la disminución progresiva de las demás afecciones y en especial de las infecto-contagiosas, que están a punto de ser dominadas por la técnica cada día más perfecta de la medicina preventiva. Hoy quiero ocuparme de algunos aspectos de este mismo tema que apenas alcanzaron a ser esbozados en mi conferencia anterior.

Efeitos do exercício crônico sobre a concentração circulante da leptina e grelina em ratos com obesidade induzida por dieta Effects of the chronic exercise on the circulating concentration of leptin and ghrelin in rats With diet-induced obesity

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Ricardo Eguchi

2008-06-01

Full Text Available A obesidade vem se tornando uma das maiores epidemias mundiais, dessa forma, conhecer sua etiologia e mecanismos que regulam seu desenvolvimento é de grande relevância para o seu Tratamento. Portanto, o objetivo do presente estudo foi avaliar os efeitos da obesidade exógena induzida pela dieta de cafeteria e da atividade física crônica em ratos, sobre a adiposidade e a concentração sérica dos hormônios reguladores do balanço energético (leptina e grelina. Foram utilizados 32 ratos Wistar machos, divididos em quatro grupos: Sedentário alimentado com dieta padrão (SN, sedentário alimentado com dieta de cafeteria (SC, treinado alimentado com dieta padrão (TN e treinado alimentado com dieta de cafeteria (TC. A dieta de cafeteria aumentou significativamente a adiposidade central (RET e visceral (EPI (pObesity is becoming one of the biggest worldwide epidemics. Therefore, knowing its etiology and mechanisms that regulate its development is of great relevance for its treatment. Thus, the aim of the present study was to evaluate the effects of obesity induced by the palatable hyperlipidic diet and of the chronic physical activity in rats, on the adiposity and the serum concentration of regulating hormones of the energy balance (leptin and ghrelin. 32 male Wistar rats were divided in four groups: Sedentary fed with chow diet (SN, sedentary fed with cafeteria diet (SC, trained fed with chow diet (TN and trained fed with cafeteria diet (TC. The cafeteria diet led to a significant increase of central (RET and visceral (EPI adiposity (p<0.05. Conversely,the exercise training minimized the effect of the cafeteria diet, diminishing the central and visceral adiposity. Leptin was also increased in the groups fed with the cafeteria diet, suggesting increase of the resistance to the action of this hormone. Chronic physical activity did not hinder the development of hyperleptinemia. Reduction in the serum ghrelin concentration was observed only in

Diagnóstico del abdomen agudo en el consultorio del Médico de Familia

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Caridad Soler Morejón1

2001-08-01

Full Text Available El diagnóstico de afecciones abdominales agudas es a menudo complejo y difícil para el médico práctico, pero más aún si contamos con los recursos diagnósticos limitados de un consultorio médico en el nivel de atención primaria. Es por ello que resulta de utilidad poder disponer de métodos simples y eficaces que permitan mejorar la certeza del diagnóstico y que puedan ser implementados con facilidad en este medio. Tal es el caso de la medición transuretral de la presión intraabdominal.Summary The diagnosis of acute abdominal affections is complex and difficult for practitioners, but it is even more complicated when the diagnostic tools are limited, as it is the case of the family physician’s office at the primary health care level. That’s why, it is useful to have simple and effective methods that allow to improve the accuracy of diagnosis and that may be applied in this setting. That’s what happens with the transurethral measurement of intraabdominal pressure

La mortalidad por enfermedades del corazón y por reumatismo en la ciudad de bogotá

OpenAIRE

Bejarano, Jorge

2012-01-01

La alta cifra de mortalidad por enfermedades cardio-vasculares está indicando la urgencia de una campana para contener sus avances. De todas las adquisiciones sanitarias, ninguna ha tenido el alcance y los resultados admirables de los centros o dispensarios destinados al tratamiento de una enfermedad y a la educación del enfermo. Nadie podrá pues, dudar que los dispensarios o consultorios de enfermedades cardio-vasculares, sea una de las armas más eficaces en la lucha contra la mortalidad por...

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

OpenAIRE

Mayele-Rodríguez, Luz

2013-01-01

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

Alarma activada por control remoto selectivo.

OpenAIRE

Eguíluz Morán, Luis Ignacio; Lara Santillán, Pedro María; Mañana Canteli, Mario

1995-01-01

La finalidad de esta invención consiste en disponer de una alarma que bien evite el robo de objetos ligeros y portátiles por el procedimiento que se conoce como "del tirón" --es decir, arrebatar algo y salir corriendo--, bien permita identificar un equipaje entre otros. La originalidad del dispositivo reside en la activación/desactivación del dispositivo de sonido por control remoto, así como la posibilidad de seleccionar el sonido de salida dependiendo de su finalidad. Se reivindica como de ...

San Sebastian, vista por Paret y Alcázar

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María Castilla Albisu

2013-07-01

Full Text Available Luis Paret y Alcázar pintó una serie de vistas panorámicas de puertos del litoral Cantábrico, por encargo del rey Carlos III. El objetivo de este trabajo es ahondar en la vida de este pintor para así comprender mejor su obra. A pesar de los estudios realizados por algunos historiadores quedan todavía incógnitas por descubrir relativas a la vida y al trabajo de este artista. Al acercarse a la figura de Paret y Alcázar hay que preguntarse por qué habiendo sido uno de los pintores más prometedores de su tiempo, su figura ha caído en un triste olvido.

Trisegmentectomia hepática direita por videolaparoscopia

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Marcel Autran C. Machado

Full Text Available INTRODUÇÃO: Em 2007 os autores descreveram a primeira hepatectomia direita por videolaparoscopia realizada no Brasil. Hepatectomia direita ampliada, também conhecida como trisegmentectomia direita, é procedimento altamente complexo e implica em grande retirada do volume hepático. Os autores descrevem a primeira trisegmentectomia direita por videolaparoscopia realizada no Brasil. TÉCNICA: O paciente é colocado em posição supina em decúbito lateral esquerdo. O cirurgião se coloca entre as pernas da paciente. Utilizamos cinco trocartes, três de 12 mm e dois de 5 mm. Devido à embolização prévia da veia porta direita, o hilo hepático não é dissecado. O pedículo portal direito é seccionado com grampeador laparoscópico de carga vascular por meio de acesso intra-hepático, segundo técnica previamente descrita pelos autores. A seguir procede-se a mobilização do fígado direito seguido de dissecção da veia cava retro-hepática e secção da veia hepática direita. Estes passos são realizados sem manobra de Pringle. O fígado é seccionado com combinação de bisturi harmônico e grampeador endoscópico. O pedículo do segmento 4 é seccionado dentro do fígado. O espécime é retirado por meio de incisão supra-púbica e a área cruenta é revista para verificar hemostasia. O procedimento é encerrado e dreno de sistema fechado é posicionado junto à área cruenta. CONCLUSÃO: Trisegmentectomia hepática direita por videolaparoscopia é procedimento factível e seguro e deve ser considerado para pacientes selecionados. Este procedimento deve ser realizado em centros especializados e por cirurgiões com experiência tanto em cirurgia hepática como cirurgia laparoscópica avançada.

Análisis Competitivo por parte de los talleres de servicio automotriz, mediante el uso del valor percibido por el cliente

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Jaime Baby Moreno

2015-06-01

Full Text Available Este artículo trata del uso del Valor Percibido por el Cliente (VPC como herramienta para el análisis competitivo por parte de talleres de reparación y mantenimiento automotriz. Se muestra cómo se determinan tanto la importancia relativa de los atributos que los compradores tienen en cuenta para evaluar el desempeño de un taller automotriz, como la evaluación de desempeño, realizada por los compradores de los "Talleres de los concesionarios" y de aquellos que son propiedad de individuos. Posteriormente, se ilustra la manera como unos y otros visualizan su posición competitiva. También muestra la brecha entre los valores ideales esperados y los percibidos por el mercado, la cual se constituye en una especie de "mapa" de oportunidades para las firmas actualmente presentes en el mercado y para nuevos participantes.

Malnutrición por defecto de un recién nacido por psicosis puerperal materna: presentación de un caso

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Gavilla González, Bárbara; Díaz Cabrera, Leticia

2011-01-01

En el siguiente trabajo se realizó el seguimiento de un niño desde la etapa de recién nacido hasta el año de edad por malnutrición por defecto, de causa materna por psicosis puerperal. En este caso, la madre rechazaba a su hijo, negándose a alimentarlo, privando al bebé de algo tan importante en esta etapa de la vida como la lactancia materna exclusiva, requiriendo de alimentación complementaria en edad temprana para lograr un aumento de peso adecuado y un desarrollo psicomotor que se igualar...

Malnutrición por defecto de un recién nacido por psicosis puerperal materna: presentación de un caso

OpenAIRE

Gavilla González, Bárbara; Díaz Cabrera, Leticia

2012-01-01

En el siguiente trabajo se realizó el seguimiento de un niño desde la etapa de recién nacido hasta el año de edad, por malnutrición por defecto, de causa materna por psicosis puerperal. En este caso, la madre rechazaba a su hijo, negándose a alimentarlo, privando al bebé de algo tan importante en esta etapa de la vida como la lactancia materna exclusiva, requiriendo de alimentación complementaria en edad temprana para lograr un aumento de peso adecuado y un desarrollo psicomotor que se iguala...

Transmisión de Anaplasma marginale por garrapatas

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Kelly A. Brayton

2012-01-01

Full Text Available Anaplasma marginale, patógeno de distribución mundial, es transmitido por garrapatas Ixódidas. Comprender su complejo desarrollo dentro de la garrapata vector, permitirá la predicción de brotes y ofrecerá oportunidades para controlar su transmisión. En este trabajo se revisa su ciclo básico de desarrollo junto con los estudios recientes acerca de las diferencias de transmisión entre cepas, que delinean aspectos de la interacción patógeno - vector. Bacterias, virus o protozoarios transmitidos por artrópodos causan enfermedades severas, tanto en humanos como en animales. Las enfermedades infecciosas transmitidas por garrapatas, entre las que incluimos a la Anaplasmosis (A. marginale, babesiosis (Babesia bigemina, B. bovis, B. divergens y Theileriosis (Theileria annulata, T. parva, se encuentran entre las más importantes en el ámbito mundial, con pérdidas cercanas a los siete mil millones de dólares anualmente; y, a pesar de su impacto, permanecen escasamente bajo control, basado primordialmente en la aplicación de acaricidas, para interrumpir su transmisión. La aparición de garrapatas resistentes a múltiples sustancias acaricidas, representa una amenaza en este tipo de control y, como resultado, hay un resurgimiento de la investigación para el desarrollo de nuevas estrategias para su control. Nuevas opciones para prevenir la transmisión de patógenos de animales por garrapatas, será el resultado de entender las interacciones garrapata patógeno; proceso que culmina con el desarrollo de la infección y transmisión exitosa. En todos los casos de patógenos transmitidos por garrapatas, el desarrollo de la infección se realiza coordinamente a los momentos de adhesión y alimentación del vector sobre el animal. Esto sucede por la interdependencia en la señalización entre el patógeno y el vector al alimentarse y, por ello, será susceptible de intervención.

Del significado responsabilidad de los socios en las compañías mercantiles por acciones y por cuotas.

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Jorge Payome Suárez

2003-01-01

Full Text Available El comentario presentado, además de constituir una guía útil para los socios de compañías mercantiles por acciones y por cuotas, en un aspecto de indudable importancia para ellos, cual es el de su eventual responsabilidad, se erige como una herramienta provechosa para estudiantes y profesionales interesados en el tema. La experiencia académica y docente del autor del ensayo aseguran un análisis autorizado de la materia.

Consumo Voluntario de Forraje por Rumiantes en Pastoreo Consumo Voluntario de Forraje por Rumiantes en Pastoreo

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José Mejía Haro

2012-02-01

Full Text Available The variation in voluntary forage intake is undoubtedly the major dietary factor determining level and efficiency of ruminant production. This variation is bigger and least predictable for grazing ruminants. Range ruminant productivity and efficiency is relatively low due, partly, to intake limitations; productivity could probably be increased most by increasing intake. Distension of the reticulo-rumen wall is the primary intake regulation mechanism of low-quality roughages in range ruminants, digestibility and rate of ingest passage also affect voluntary intake. Body size and metabolic bodysize as well affect intake of grazing animals. Kind and amount of supplementation, forage availability, and grazing intensity have been related to voluntary forage intake. La variación en el consumo voluntario de forraje es indudablemente el principal factor dietario que determina el nivel y eficiencia de producción en un rumiante. Esta variación es mayor y muy difícil de predecir bajo condiciones de pastoreo. La productividad y eficiencia de rumiantes en pastoreo es relativamente baja debido, en parte, a las limitaciones en el consumo; la productividad probablemente se podrá incrementar si se incrementa el consumo. La distensión de la pared del rumenretículo es el principal mecanismo de regulación del consumo de forrajes de baja calidad en rumiantes en pastoreo, aunque la digestibilidad y la tasa de pasaje también afectan el consumo voluntario. Igualmente, el consumo se ve afectado por el tamaño corporal y peso metabólico del animal, por la cantidad y tipo de suplemento ofrecido, por la disponibilidad de forraje y por la intensidad del pastoreo.

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.

Evaluación del riesgo ambiental por metales pesados, generados por la actividad minera artesanal en los ríos Quiroz y Chira – Piura por el método de especiación secuencial

OpenAIRE

Loaiza Choque, Leonardo Edwin

2016-01-01

Determina el riesgo ambiental que representan los metales pesados dispuestos en los sedimentos de los ríos Quiroz y Chira ubicados en el departamento de Piura generados por la minería artesanal. Determina las formas químicas en las que se dispersan los metales pesados ambos ríos. Demuestra que el estudio por extracción secuencial puede ser usado como componente de herramienta de gestión ambiental. Realiza el análisis de extracción secuencial por el método BCR el mismo que permite determinar l...

Baseline estradiol concentration in community-dwelling Japanese American men is not associated with intra-abdominal fat accumulation over 10 years.

Science.gov (United States)

Kocarnik, Beverly M; Boyko, Edward J; Matsumoto, Alvin M; Fujimoto, Wilfred Y; Hayashi, Tomoshige; Leonetti, Donna L; Page, Stephanie T

The role of plasma estradiol in the accumulation of intra-abdominal fat (IAF) in men is uncertain. Cross-sectional studies using imaging of IAF have shown either a positive or no association. In contrast, a randomised controlled trial using an aromatase inhibitor to suppress estradiol production found an association between oestrogen deficiency and short-term IAF accumulation. No longitudinal study has been conducted to examine the relationship between plasma estradiol concentration and the change in IAF area measured using direct imaging. This is a longitudinal observational study in community-dwelling Japanese-American men (n=215, mean age 52 years, BMI 25.4kg/m 2 ). IAF and subcutaneous fat areas were assessed using computerized tomography (CT) at baseline, 5 and 10 years. Baseline plasma estradiol concentrations were measured using liquid chromatography-tandem mass spectrometry. Univariate analysis found no association between baseline estradiol concentration and baseline IAF, or 5- or 10-year changes in IAF area (r=-0.05 for both time points, p=0.45 and p=0.43, respectively). Multivariate linear regression analysis of the change in IAF area by baseline estradiol concentration adjusted for age, baseline IAF area, and weight change found no association with either the 5- or 10-year IAF area change (p=0.52 and p=0.55, respectively). Plasma estradiol concentration was not associated with baseline IAF nor with change in IAF area over 5 or 10 years based on serial CT scans in community-dwelling Japanese-American men. These results do not support a role for oestrogen deficiency in IAF accumulation in men. Copyright © 2015 Asia Oceania Association for the Study of Obesity. All rights reserved.

Retinitis por citomegalovirus en un paciente con VIH

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Alena de los Ángeles Vejerano Duany

Full Text Available La retinitis por citomegalovirus es la infección ocular más frecuente en pacientes con un recuento de linfocitos CD4 inferior a 200 por µL. El aspecto oftalmoscópico de las lesiones se caracteriza, en la mayoría de los casos, por infiltrados retinianos resultados de la necrosis retiniana producida por citomegalovirus y el edema en asociación con hemorragias. Estas lesiones se disponen, por lo general, siguiendo las arcadas vasculares temporales con invasión hacia la mácula. Se presentó una paciente de 24 años de edad, femenina, blanca, ama de casa, con antecedentes patológicos personales oculares sin datos de interés, y antecedentes patológicos personales generales de ser diagnosticadas con VIH. Hace cuatro años que comenzó con tratamiento antirretroviral, y tuvo cambios de tratamiento en dos ocasiones. El último fue impuesto en mayo del año 2011, con el cual presentó mala adherencia terapéutica, y comenzó desde entonces a presentar disminución de su peso corporal de forma marcada en breve período de tiempo. Refiere que desde hace unos meses comenzó a presentar una disminución progresiva de la agudeza visual en el ojo derecho, acompañado de visión borrosa. Adquiere gran importancia este caso, ya que ante la supervivencia de los pacientes con sida, va a ser cada vez más frecuente la aparición de las afecciones oculares relacionadas con esta enfermedad. Dentro de ellas se encuentran las infecciones oportunistas mayores como la retinitis por citomegalovirus.

Diferenciales salariales por género y región en Colombia: Una aproximación con regresión por cuantiles

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Luis Armando Galvis

2010-12-01

Full Text Available La existencia de brechas salariales por género es un fenómeno que, al igual que en muchos otros países, está presente en el mercado laboral colombiano.Esas brechas no son homogéneas en todo el territorio, lo que justifica un análisis detallado de lo que ocurre en cada una de las regiones del país. Los resultados muestran diferenciales de salarios positivos en favor de los hombres en la mayoría de las ciudades principales. Sin embargo, no todo este fenómeno puede ser atribuido a la existencia de discriminación, por cuanto existen variados factores que explican parte de la brecha salarial. Para identificarlos se emplea la descomposición de Blinder-Oaxaca (BO en el contexto de regresión por cuantiles. Los resultadosde la aplicación de esta metodología sugieren que las brechas salariales no están explicadas por los atributos observables de los individuos. Dichas disparidades son en su mayoría explicadas por el efecto de las diferencias en la remuneración de atributos tales como la educación, además de elementos no observados. Por ciudades,el estudio muestra patrones que revelan una mayor brecha salarial en las regiones periféricas en comparación con Bogotá, Cali, Medellín, Manizales y Pereira.Dado que el efecto remuneración comprende, entre otros, la posible existencia de discriminación por género, es importante que se le otorgue la debida atención a este resultado para efectos de formular políticas en este sentido.

Mortalidad por meningitis por Pasteurella canis. Oportunidades de aprendizaje

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Ana Rosa Ropero Vera

2016-01-01

Full Text Available La meningitis bacteriana es una enfermedad importante de distribución mundial, causa mayor y sustancial de mortalidad y morbilidad en países en desarrollo. La Organización Mundial de la Salud (OMS sostiene que la meningitis es una de las diez afecciones principales del ser humano y debe ser considerada como una emergencia infectológica; por eso es fundamental reconocer que esta enfermedad es causa de muerte en niños de todo el mundo, sin distinción de raza, nivel económico o sociocultural. Se realizó una investigación de caso en menor de 53 días de nacido, que cumplía con los criterios clínicos y de laboratorio compatible con meningitis bacteriana, con el propósito de analizar y fortalecer la toma de decisiones en salud pública por parte de la secretaría local de salud del municipio de Valledupar (Colombia. Entre los hallazgos se encontró antecedentes infecciosos en el menor, coloración de Gram y cultivo de LCR, en el que se identificó cocobacilos Gram negativos, que fueron aislados como agente causal Pasteurella canis. Este estudio pretende sensibilizar a los prestadores de salud para que cuenten con personal altamente capacitado para brindar tratamientos adecuados y prevenir complicaciones en la meningitis bacteriana en niños, y así disminuir la posibilidad de secuelas o muerte, tanto en pacientes con compromiso inmunológico o sin este.

Por un humor ético

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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.

Escolhas Associadas ao Automóvel por Homens e por Mulheres: confluência ou divergência? Choices associated with automobiles for Men and Women: convergence or divergence? Opciones relacionadas con el Automóvil por Hombres y por Mujeres: ¿convergencia o divergencia?

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LICHT, René Henrique Götz

2009-03-01

Full Text Available RESUMOO aumento do poder de compra das mulheres tem levado empresas a adotarem estratégias de diferenciação de produtos e a produzirem produtos específicos para o público feminino. A indústria automobilística não está imune a este fenômeno, uma vez que as mulheres representam aproximadamente metade das vendas de automóvel no país. Considerando as diferenças de consumo e de comportamento entre mulheres e homens é colocada a seguinte questão: há diferenças entre escolhas associadas ao automóvel por homens e mulheres? Foram apresentados aos participantes itens presentes no dia-a-dia das pessoas, e que são por elas valorizados; e foi solicitado aos participantes que escolhessem e associassem estes itens ao automóvel. A análise dos resultados revelou haver mais semelhanças do que diferenças entre escolhas associadas ao automóvel por homens e escolhas associadas ao automóvel por mulheres. A semelhança entre as escolhas sugere que as representações, os significados e valores atribuídos ao automóvel por homens e por mulheres são similares e, desta forma, a estratégia de diferenciação de produtos não se aplica à indústria automobilística.ABSTRACTThe increase of the women purchase power has led some companies to adopt strategies of products differentiation as well as to produce specific products to the female public. The auto industry is not immune to this phenomenon, once the women represent, approximately, half of the automobile sales in the country. Considering the consumption and the behavior differences between women and men, it has set the following question: are there differences between the choices associated to the automobile by men and the choices associated to the automobile by women? It has been presented to the participants items found in the people’s day-by-day, which are valorized by them, and the participants have been asked to choose and associate these items to the automobile. The results analysis

Acuerdo por la discreción

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Yeny Serrano

2006-01-01

Full Text Available En este artículo se propone un análisis del texto del Acuerdo por la discreción firmado en 1999 por 32 directores de medios de comunicación para “elevar el nivel de calidad y responsabilidad en el cubrimiento y difusión de hechos violentos”. Se analizan los factores que impiden que este Acuerdo produzca cambios efectivos en la práctica profesional informativa y se presenta un modelo (Lemieux, 2000 que tiene en cuenta las variables que influyen en la producción del discurso informativo mediático.

Clonación humana: las preguntas «por qué no» y «por qué sí»

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Velayos Castelo, Carmen

2002-12-01

Full Text Available Why not cloning us is a relevant question for contemporary ethics. The question why not, when it refers to a technology (or to some of its applications, is the question for its moral limits. In other words, it is the question for the universal dangers that a technology entails or could entail in some of its applications. The sphere of the moral evaluation of a technology has to do with the public elimination of the possible harms that are inherent or supervenient to its utilisation. If we focus on the relevant normative questions of the justice sphere, it couldn´t be relevant to answer the question why, that is, why a person or a group of them would wish the technology was applied The question why is related to vital options and ways of create ourselves that needn´t be binding on someone nor are characteristic of the moral point of view. However, the suspicion of this article is the following: the specific character of contemporary technological innovation (of which cloning is a paradigmatic case stimulates and makes relevant the debate about the good (given the collective or global implications of the answers.

Por qué no clonarnos es una pregunta relevante para la ética actual. El por qué no de una técnica -o de determinadas aplicaciones de la misma- es la pregunta por los límites morales. O, de otro modo, es la pregunta por los daños objetivos que ésta supone, o supondría en una determinada aplicación. El marco de evaluación moral de una técnica tiene que ver, pues, con la desestimación pública y universal de posibles daños inherentes o sobrevenibles a su uso. Circunscritas las cuestiones normativas relevantes al ámbito de la justicia, no parecería relevante clarificar cuál sea el por qué -o el por qué sí- un individuo o un conjunto de ellos buscarían la aplicación o puesta en marcha de una técnica. Ésta es la pregunta por opciones vitales y

Orlando Castellanos. La pasión por la radio

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Castellanos Molina, Orlando, 1930-1998

2004-01-01

Documento sonoro en el que se recogen entrevistas realizadas a Orlando Castellanos por Miguel Ángel de la Guardia, Miladys Ochoa, Fernando Rodríguez Sánchez (Ciego de Ávila), Ángel Ferrera, Boshmonar, Jaime Almiral, Radio Umbral de Santiago de Chile, Franco Carbón, Luis Toledo Sande y Estrella Díaz. Esta grabación pertenece a la colección Palabra Viva, desarrollada por el Centro Cultural Pablo de la Torriente Brau, a partir de las entrevistas realizadas por el periodista Orlando Castellanos. ...

MIASIS CUTÁNEA POR CORDYLOBIA ANTHROPOPHAGA

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Miriam Alkorta Gurrutxaga

2001-01-01

Full Text Available El incremento progresivo en el número de personas que viajan a países tropicales ha hecho que las enfermedades importadas adquieran una relevancia cada vez mayor. Las miasis (o infestaciones por larvas de moscas cutáneas se encuentran entre este tipo de enfermedades siendo especialmente frecuentes en países tropicales. A propósito de la observación de un caso de miasis cutánea masiva por Cordylobia antropophaga, que ocurrió en una mujer de 34 años de edad al volver de un viaje a Senegal, se ha efectuado una revisión de los casos de miasis cutáneas forunculoides importadas publicados en España, así como de la biología, patología, tratamiento y prevención de la miasis humana por Cordylobia anthropophaga. El caso referido, se caracterizó por la infestación con un número inusualmente elevado de larvas, no sospechándose su etiología hasta la fase final de la enfermedad. La emergencia continuada de larvas (se recogieron 91 generó en la paciente un estado de ansiedad importante. Finalmente, la eliminación de las larvas provocó una rápida mejoría de la paciente. Aunque los casos de miasis cutánea no tienen la gravedad de otras enfermedades importadas, su conocimiento es necesario desde el punto de vista preventivo, diagnóstico y terapeútico. Es importante proceder a la identificación morfológica de las larvas diferenciándolas de otro tipo de miasis con implicaciones terapéuticas diferentes.

Mortalidade por leucemias relacionada à industrialização

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Leal Carmen Helena Seoane

2002-01-01

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

Perspectivas mecanisticas de reações organicas catalisadas por paladio : Heck, oxa-Heck e acoplamento de Buchwald-Hartwig por ESI-MS/MS

OpenAIRE

Boniek Gontijo Vaz

2009-01-01

Resumo: A espectrometria de Massas por eletronspray (ESI-MS) tornou-se um método prático para o estudo de mecanismos reacionais em solução. Neste trabalho importantes reações catalisadas por paládio: reação de Heck-Mizoroki, oxa-Heck e o acoplamento de Buchwald-Hartwig foram monitoradas por ESI-MS visando interceptar espécies que comprovam as atuais propostas mecanísticas ou que abram caminho para novas propostas para estas reações. O monitoramento das reações foi realizado no modo off-line, ...

DE ACUMULACIÓN POR DESPOSESIÓN

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Sebastián Gómez Lende

2015-01-01

Full Text Available Omnipresente, la acumulación por desposesión es uno de los elementos centrales del orden global contemporáneo. Observados desde una perspectiva crítica, los usos extractivos del territorio constituyen una de las principales expresiones de ese proceso. A la luz de ese sistema de ideas, este artículo procura demostrar que el modelo sojero actualmente vigente en la Argentina es una de las formas más completas, exhaustivas, actuales y sofisticadas, de acumulación por desposesión en el país. En ese sentido, el artículo analiza el boom de la soja transgénica y sus vínculos con las formas tanto seculares (endeudamiento financiero, concentración de la propiedad rural, usurpación de la tierra y actuales de desposesión (degradación de la naturaleza, despojo del derecho a la salud, pillaje de recursos genéticos efectuadas por los grandes agricultores, el capital financiero, las agroindustrias y las corporaciones biotecnológicas, en detrimento de los pequeños productores, los campesinos, los pueblos aborígenes y la población en general.

La compra por impulso de productos de alimentación

DEFF Research Database (Denmark)

Luna-Arocas, Roberto; Bech-Larsen, Tino

2004-01-01

El consumo de productos de alimentación muestra una serie de matices diferenciales en su análisis si lo comparamos con otros productos de compra por impulso. En este sentido, se relaciona la compra por impulso de productos de alimentación con una baja importancia de la imagen fisica, y con las de...... descrepancias personales entre lo que un individuo es y quiere ser. Como resultado en una mestra de estudisantes, la compra por impulso de productes de alimentación se relaciona con imagen fisica pero no con las discrepanacias personales.......El consumo de productos de alimentación muestra una serie de matices diferenciales en su análisis si lo comparamos con otros productos de compra por impulso. En este sentido, se relaciona la compra por impulso de productos de alimentación con una baja importancia de la imagen fisica, y con las...

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. Copyright © 2012 Elsevier B.V. All rights reserved.

Itinerarios didácticos por la isla de Tenerife

OpenAIRE

Becerra Ramírez, María Carmen; Javier Dóniz-Páez; González Cárdenas, Elena; Gosálvez, Rafael U.; Becerra-Ramírez, Rafael; Escobar Lahoz, Estela

2013-01-01

Con la elaboración de esta guía de Itinerarios Didácticos por la isla de Tenerife pretendemos contribuir a un mayor conocimiento de las características geográficas de un espacio dominado por las formas y formaciones volcánicas que caracterizan un paisaje fuertemente modificado por la actividad humana. El hombre convive y usa lo que los volcanes le ofrecen, tradicionalmente como soporte de sus cultivos o de su actividad ganadera,y modernamente como base de la industria turística. Los itiner...

¿Por qué estudiar en la Universidad EAN?

OpenAIRE

2013-01-01

Razones para estudiar en la Universidad EAN: 1. Por ser la Universidad No.1 en Latinoamérica y No. 28 en el mundo, según el ranking mundial de Escuelas de Negocios que lidera el Consejo Superior de Investigaciones Científicas – Laboratorio de Cibermetría de España. 2. Por la flexibilidad en los planes de estudio que permite adelantar unidades y cursar la carrera en un tiempo menor. 3. Por la formación académica en dos ciclos semestrales, favoreciendo el aprendizaje y la concentrac...

"Efecto del ingreso obtenido por el socio industrial por concepto de alimentos en la sociedad en nombre colectivo"

OpenAIRE

Adame Alba, Nayzeth

2011-01-01

Hoy en día la excesiva carga tributaria en nuestro país, nos obliga a buscar alternativas factibles y seguras, en el cumplimiento de las obligaciones fiscales, por ello, debemos aprovechar la existencia de figuras jurídicas útiles para la optimización de recursos financieros dentro del marco de ley, es el caso de la sociedad en nombre colectivo, que nos permite la existencia de socios industriales que a su vez, el ingreso que perciben por concepto de alimentos se encuentra exento de impuestos...

ANTIOXIDANTES: MICRONUTRIENTES EN LUCHA POR LA SALUD

OpenAIRE

Zamora S, Juan Diego

2007-01-01

Los antioxidantes son sustancias químicas que se caracterizan por impedir o retrasar la oxidación de diversas sustancias principalmente de los ácidos grasos cuyas reacciones se producen tanto en los alimentos como en el organismo humano, en el cual puede provocar alteraciones fisiológicas importantes desencadenantes de diversas enfermedades. Otra de las funciones de los antioxidantes es facilitar el uso fisiológico del oxígeno por parte de las mitocondrias celulares, ayudando a reducir los ef...

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.

Análise Sazonal das Regiões do Rio Grande do Sul Atingidas por Eventos Severos Gerados por SCM no Período de 2004 a 2008

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Gustavo Rasera

2012-07-01

Full Text Available ntos Severos (ES, como por exemplo, vendaval, granizo e enchente, têm sido estudados com frequência devido à gravidade dos danos que estes causam à sociedade. Um dos sistemas meteorológicos que é bastante comum no Rio Grande do Sul (RS, e que frequentemente está associado aos ES são os Sistemas Convectivos de Mesoescala (SCM. Como a economia do RS é voltada majoritariamente para a agricultura, que é bastante suscetível às mudanças do tempo, é frequente no Estado a ocorrência de prejuízos econômicos causados por ES. Diante disso, o objetivo deste trabalho foi analisar a distribuição sazonal das regiões atingidas por ES gerados por SCM que afetaram o RS (ESSCMRS no período de 2004 a 2008. Foram utilizados, para o período de estudo, dados de ocorrências de ES e municípios atingidos por ES (MAES obtidos no banco de dados da Coordenadoria Estadual de Defesa Civil do RS; trajetórias dos SCM que afetaram o RS (SCMRS geradas a partir de informações fornecidas pela ferramenta ForTrACC (Forecasting and Tracking of Active Cloud Clusters e imagens brutas do satélite GOES 10 e 12 do canal 4. Os resultados obtidos mostraram que: i ~45% dos ES observados foram gerados por SCMRS; ii ~58% dos MAES foram atingidos por SCMRS; iii a porção norte do RS foi a mais atingida por ESSCMRS; iv vendaval e granizo foram os tipos de ESSCMRS que atingiram o maior número de municípios e v JAS (jul-ago-set foi o trimestre que apresentou o maior número de municípios atingidos por ESSCMRS (MAES-SCMRS.

El aprendizaje visto por los estudiantes venezolanos

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Berta Elena Barrios

2015-01-01

Full Text Available En el siguiente trabajo se presentan los resultados de un estudio sobre las con-cepciones del aprendizaje de un grupo de estudiantes venezolanos de educa-ción primaria y media. Se trató de replicar el instrumento y procedimiento deanálisis utilizado por los investigadores Berry y Sahlberg (1996, con el objetivode caracterizar cómo conciben el aprendizaje estudiantes venezolanos entre 11y 15 años de edad y compararlo con sus pares ingleses y finlandeses. El análi-sis de resultados se basó en los criterios propuestos por dichos autores, deno-minados Pasos para un Buen Aprendizaje. Los hallazgos indican que los estu-diantes venezolanos conciben el aprendizaje como memorizar conocimientos,básicamente escolares, enseñados por los docentes. Las concepciones deambas poblaciones se ubican en una visión pasiva del aprendizaje. Se discutela vinculación de las concepciones del aprendizaje con las prácticas de la escuela.

Epidemiologia das infecções hematogênicas por Candida spp

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Colombo Arnaldo Lopes

2003-01-01

Full Text Available O gênero Candida spp é responsável por cerca de 80% das infecções fúngicas no ambiente hospitalar e constitui causa relevante de infecções de corrente sanguínea. Nos Estados Unidos da América, Candida spp é a quarta causa mais comum de infecções de corrente sanguínea, respondendo por cerca de 8% dos casos das infecções documentadas neste sítio. Espécies não-albicans respondem hoje por ao menos 50% das infecções invasivas por Candida spp, apresentando peculiaridades de história natural e sensibilidade a antifúngicos. A mortalidade geral de fungemias por Candida spp é da ordem de 40 a 60%, tornado esta complicação infecciosa um grande desafio para os clínicos que trabalham em hospitais terciários em diferentes países.

Neumonitis por hipersensibilidad en la ciudad de México

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Carrillo-Rodríguez José G.

2000-01-01

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

PANORAMA LATINOAMERICANO DEL PAGO POR SERVICIOS AMBIENTALES

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González T. Ángela

2008-07-01

Full Text Available Este documento busca proveer al lector de algunos elementos para el análisis y reflexión en torno al pago por servicios ambientales. Para ello, en primera instancia, aborda algunos conceptos básicos relacionados con economía ambiental, seguido de temas como la valoración económica de servicios ambientales y la implementación de mecanismos de pago por algunos de ellos. Lo anterior esta enriquecido con experiencias o estudios de caso a nivel latinoamericano y colombiano.

Efeito protetor da melatonina sobre intoxicações por herbicidas

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Lécio L. de Almeida

2016-03-01

Full Text Available Resumo: O uso inadequado de herbicidas pode resultar em intoxicações agudas e, às vezes, crônicas por exposição em longo prazo a baixos níveis desses agentes tóxicos, podendo o herbicida atuar também como agentes teratogênicos, mutagênicos, cancerígenos e desreguladores endócrinos, com o aparecimento de doenças neurodegenerativas e distúrbios reprodutivos. Estudos têm revelado que a melatonina tem propriedades antioxidantes, anti-inflamatórias e imunomoduladoras e atua na reprodução. Essa indolamina está entre os agentes que têm se mostrado benéfico em intoxicações por herbicidas, porém não há relatos do uso de melatonina contra intoxicações por Glifosato-Roundup®, muito menos em associação com o Paraquat. Dessa forma, o maior interesse no tratamento das intoxicações por herbicidas, tem-se concentrado em medidas que impeçam ou minimizem as lesões celulares provocadas nos diversos sistemas biológicos. Assim, a melatonina, como antioxidante conhecido, pode ser mais uma alternativa contra as intoxicações por herbicidas associados e/ou individuais.

Eficacia del Albendazol en dosis única sobre las infecciones por helmintos transmitidos por el suelo en escolares de una comunidad de Iquitos, Perú

Directory of Open Access Journals (Sweden)

Theresa W Gyorkos

Full Text Available Objetivos. Determinar la eficacia en dosis única del albendazol sobre las infecciones por helmintos transmitidos por el suelo (HTS en escolares de una comunidad de la ciudad de Iquitos en Perú. Materiales y métodos. Dentro del contexto de un ensayo controlado aleatorizado realizado en una comunidad periurbana de escasos recursos, situada en Iquitos, en la Amazonía de Perú, se obtuvieron muestras de heces de escolares del quinto grado de primaria en 18 escuelas y se analizó la prevalencia y la intensidad de HTS. Un total de 1193 escolares fueron desparasitados con albendazol en dosis única (400 mg. De los 909 escolares que fueron encontrados positivos con al menos una infección por HTS, una muestra aleatoria de 385 fue seguida dos semanas más tarde, cuando se recolectó y analizó una segunda muestra de heces. Resultados. La eficacia del albendazol fue satisfactoria para las infecciones por Ascaris lumbricoides con una tasa de reducción de huevos (TRH de 99,8%; IC 95: 99,3-100 y por anquilostomideos con una TRH de 93,6%, IC 95%: 88,2-96,6 y por Trichuris trichiura con una TRH de 72,7%, IC 95: 58,5-79,1. Conclusiones. Estos resultados son indicativos de niveles satisfactorios de eficacia y son congruentes con datos publicados sobre la eficacia del albendazol y directivas de la Organización Mundial de la Salud. Futuras investigaciones deben centrarse en mejorar la eficacia de las estrategias de tratamiento para la infección por Trichuris trichiura.

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.

ENSAYOS DE CREEP POR TORSIÓN Y TRACCIÓN

OpenAIRE

Daniela Alessio; Sandra Robles; Lilian Moro; René Molina

2017-01-01

En este estudio se efectúa el análisis de dos metodologías de ensayo para evaluar el comportamiento de un material al creep o fluencia por activación térmica o termofluencia. Se realizaron en laboratorio dos tipos de ensayos, por torsión y por tracción, bajo combinaciones de temperatura y tensión comparables, de un acero austenítico, de uso habitual en los equipos de la industria petroquímica de la región. Con los registros adquiridos, se graficaron las diferentes curvas deformación-tiempo de...

Premian record transmision de datos a 5,44 gigabits por segundo

CERN Multimedia

2003-01-01

"El Laboratorio Europeo para la Fisica de Particulas (CERN) y el Instituto de Tecnologia de California (EEUU) seran galardonados con un premio por haber conseguido batir el record de velocidad de transmision por Internet a 5,44 gigabits por segundo, informaron hoy, miercoles, fuentes de ambos organismos" (1/2 page).

Multiple mechanisms of phase variation of PorA in Neisseria meningitidis

NARCIS (Netherlands)

van der Ende, A.; Hopman, C. T.; Dankert, J.

2000-01-01

Previously, we reported that PorA expression in Neisseria meningitidis is modulated by variation in the length of the homopolymeric tract of guanidine residues between the -35 and -10 regions of the promoter or by deletion of porA. To reveal additional mechanisms of variation in PorA expression, the

Celulitis por Microascus trigonosporus(anamorfo Scopulariopsis trigonospora

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DELIA CANLE CORTIÑAS

2013-06-01

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

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

2017-05-01

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

System design description for portable 1,000 CFM exhauster Skids POR-007/Skid E and POR-008/Skid F

International Nuclear Information System (INIS)

Nelson, O.D.

1998-01-01

The primary purpose of the two 1,000 CFM Exhauster Skids, POR-007-SKID E and POR-008-SKID F, is to provide backup to the waste tank primary ventilation systems for tanks 241-C-106 and 241-AY-102, and the AY-102 annulus in the event of a failure during the sluicing of tank 241-C-106 and subsequent transfer of sluiced waste to 241-AY-102. This redundancy is required since both of the tank ventilation systems have been declared as Safety Class systems

Variabilidad estacional de hospitalizaciones por varicela en el INSN, Lima-Perú

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Edwin Miranda-Choque

2013-04-01

Full Text Available Objetivo: Determinar las variabilidad estacional de hospitalizaciones por varicela. Diseño: Serie de casos. Institución: Instituto Nacional de Salud del Niño (INSN del Perú. Participantes: Niños hospitalizados por varicela. Intervenciones: Se estudió las hospitalizaciones por varicela de niños atendidos en el INSN del Perú desde el año 2001 hasta el 2011, país sin implementación de la vacunación contra la varicela; se identificó a los pacientes de la oficina de estadística. Principales medidas de resultados: Variabilidad estacional de hospitalizaciones de los niños atendidos por varicela. Resultados: Se estudió a 1 566 niños hospitalizados por varicela, siendo la mediana de edad de 2 años 6 meses, 46,4% (727/1 466 de sexo femenino, mediana de estancia hospitalaria seis días (RIQ:9,4. El grupo etario más afectado fue de 0 a 2 años, correspondiendo al 55% (864/1 566. En la curva de frecuencias de hospitalizaciones por varicela por meses evidenciamos la distribución estacional, con una tendencia al incremento cada vez mayor por año. Las hospitalizaciones por varicelas con al menos alguna complicación correspondieron a 68,5%(1 073/1 566. El porcentaje de fallecidos fue 0,83% (13/1 493. Conclusiones: Las hospitalizaciones por varicela en el INSN es una causa importante de morbilidad, con una tendencia estacional, siendo más frecuente en los meses de noviembre a febrero, con el incremento cada vez mayor por año y supone una importante carga económica.

Mortalidad por paludismo en Colombia, 1979-2008

OpenAIRE

Pablo Chaparro; Julio Padilla

2012-01-01

Introducción. En Colombia, el paludismo representa un grave problema de salud pública. Se estima que, aproximadamente, 60 % de la población se encuentra en riesgo de enfermar o de morir por esta causa. Objetivo. Describir la tendencia de la mortalidad por paludismo en Colombia desde 1979 hasta 2008. Materiales y métodos. Se llevó a cabo un estudio descriptivo para determinar la tendencia de las tasas de mortalidad. Las fuentes de información fueron las bases de datos de las defunciones...

El estrés por temperatura provoca necrosis en tabaco negro; cuantificación por análisis de imágenes

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Eduardo Ortega

2008-07-01

de imágenes ImageJ. Este programa es capaz de adquirir, mostrar, editar, resaltar y analizar imágenes. Se demostró que las hojas sometidas a 4 ºC, independientemente del tiempo de exposición, presentaron una mayor área necrosada (35% en comparación con el resto de los tratamientos. Las áreas con acumulación de H2O2 in situ fueron mayores en los tratamientos de estrés por temperaturas altas (45 y 60 oC. La detección y cuantificación de la necrosis producida por temperaturas extremas, combinando el método del azul de tripano con el análisis de imágenes, es una herramienta útil para valorar los daños producidos por estrés de temperaturas y pudiera ser utilizado para valorar los daños celulares provocados por otros tipos de estrés.Palabras clave: variedad-Habana-2000; especies reactivas de oxígeno; H2O2;; Habana-2000-variety; reactive oxygen species.

ESTUDIO DEL IMPACTO TÉCNICO DE MEZCLAS DE CONCRETO HIDRÁULICO POR LA SUSTITUCIÓN PARCIAL DE CEMENTO POR ZEOLITA

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I. Miranda Pasos

2014-06-01

Full Text Available La industria de la construcción cada vez más consciente de la necesidad de ejecutar obras con materiales que se obtengan y/o utilicen procesos industriales que minimicen la contaminación y, que contribuyan en el comportamiento de un producto como lo es el concreto hidráulico en la construcción, ha estado buscando alternativas de materiales que sustituyan total o parcialmente al cemento por otro cementante que contamine menos en su procesos de obtención y que conserve las propiedades o las mejore. Una alternativa para sustitución parcial del cemento es la zeolita, es un mineral que se obtiene por proceso de excavación y molienda de puzolana. La norma ASTM-618, define a las puzolanas como materiales silíceo o aluminio-silíceo que por sí solo poseen poco a ningún valor cementante, pero cuando se han dividido finamente y en presencia de agua e hidróxido de calcio (Cal reaccionan químicamente a temperatura ambiente para formar cementantes (Miranda, 2008. Recientemente se ha estudiado el efecto de adicionar mineral Cal-Zeolita para la elaboración del concreto, cuyos resultados son favorables al comportamiento mecánico y su durabilidad (Dopico J.J., et al. 2009. Para la elaboración de morteros para recubrimientos al incorporar arenas zeolíticas como sustituto de la arena tradicional (Tiburcio et al. 2008. El presente proyecto evaluó el comportamiento del concreto hidráulico en estado fresco y endurecido al sustituir de manera parcial cemento por zeolita. Se enfocó a la evaluación del comportamiento mecánico como al diseño de la mezcla de concreto hidráulico fabricado con cemento normal y con cemento-zeolita. Tomando en cuenta los resultados obtenidos, la zeolita incorporada en porcentajes entre el 5% y 10 % tiende a valores de resistencias muy cercanos al concreto normal, los modelos obtenidos así lo corroboran, por lo que se puede concluir la factibilidad de sustitución parcial de cemento por zeolita tomando en cuenta el

PERFIL DOS ATENDIMENTOS POR CAUSAS EXTERNAS EM HOSPITAL PÚBLICO

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Marlos Victor Fonsêca de Lima

2012-01-01

Full Text Available El objetivo fue identificar el perfil de los atendimientos por causas externas en la urgencia de un hospital público de referencia del Estado. Investigación descriptiva documental, con enfoque cuantitativo. En el análisis de datos, el período de enero a diciembre de 2009 se realizó 4.464 atendimientos por causas externas. La mayor frecuencia de las lesiones ocurrió en personas entre 21 y 40 años (37,70% y hombres (68,6%. Cuanto a las causas, las caídas (29% fue la mayor variable, seguido por accidente de motocicleta (17,98%, accidentes domiciliario (16,53%, agresión física (10,43% y accidente de motocicleta (8,84%. Se observó que 23,3% de los atendimientos realizados en la urgencia fueron de la población procedente de municipios aledaños. Hay, por lo tanto, la necesidad de mejorar la calidad de las informaciones acerca de las quejas motivadas por causas externas, principales causas de hospitalización y gastos en salud.

Abdominal fat-evaluation by use of single scan computed tomography

International Nuclear Information System (INIS)

Jacobi, V.; Steinkamp, M.; Kirchner, J.; Fischer, H.; Diedrich, C.F.; Kollath, J.

1997-01-01

Purpose: Several studies emphasised the importance of the relationship between intraabdominal and total body adipose tissue as a risk factor for the development of metabolic or cardiovascular diseases. Therefore, the aim of the present study was to examine whether a single scan computed tomography is able to determine the whole intraabdominal fat volume with high accuracy and reproducibility. Materials and methods: Regions of interests (ROIs) were drawn manually for measuring intraabdominal fat in 51 unsuspicious abdominal CT. Results: The sexual differentiation of adipose tissue already described in a lot of studies could be confirmed in this study. Fat still predominates in females in lower half of the body (gynoid obesity). In men it predominates in the upper half (android obesity). Significant correlation concerning measuring the whole intraabdominal fat volume could be found in L1-level in women (r=0.992) and in L2-level in men (r=0.992). Measurement of a single scan enables us to assess whole intraabdominal fat volume due to a special formula. Conclusion: The determination of intraabdominal fat measured by a single scan computed tomography is a procedure associated with high accuracy and reproducibility. (orig.) [de

Associação entre o nível de atividade física e a área de gordura visceral em mulheres pós-menopáusicas

OpenAIRE

Pitanga, Cristiano Penas Seara; Pitanga, Francisco José Gondim; Gabriel, Ronaldo Eugénio Calçada Dias; Moreira, Maria Helena Rodrigues

2014-01-01

INTRODUÇÃO: O aumento da gordura visceral abdominal está associado à redução dos níveis de atividade física habitual e gera na mulher pós-menopáusica, o surgimento da doença da inatividade física, caracterizada pela manifestação de um conjunto de patologias, entre as quais se incluem diabetes mellitus do tipo 2 e doenças cardiovasculares. Por outro lado, a atividade física regular parece ter impacto significativo na prevenção tanto da gordura intra-abdominal quanto das complicações metabólica...

Hematoma epidural espinal espontâneo durante a gravidez: registro de um caso

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Ivan Hack

1984-03-01

Full Text Available Registro de caso de paciente no oitavo mês de gestação que desenvolveu hematoma epidural espinal espontâneo dorsolombar. A gravidez, determinando aumento da pressão intra-abdominal e, como consequência, aumento da pressão venosa no plexo epidural, poderia ter sido o fator desencadeante no hematoma- A paciente foi submetida a cirurgia precocemente, porém não apresentou recuperação do déficit sensitivo-motor. São discutidos aspectos clínicos, do tratamento cirúrgico, da evolução e da etiologia dos hematomas epidurals espinais espontâneos.

Justicia social y ambiental: mujeres por la soberanía alimentaria

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Angelica Velasco Sesma

2010-05-01

Full Text Available Dada la situación de crisis alimentaria, climática, energética y financiera a nivel internacional y el aumento del hambre en el mundo, numerosos movimientos sociales se han unido para luchar por la soberanía alimentaria y por la agricultura campesina. Las mujeres, como sujetos que desempeñan un rol fundamental en la actividad agraria, han manifestado, en la Declaración de las mujeres por la Soberanía Alimentaria, Nyéléni, Mali, 2007, que pretenden unir su lucha por la sostenibilidad con la reivindicación de sus derechos.

Escenarios de costos generados por el uso del costeo variable

OpenAIRE

Zea Lourido, Felipe

2013-01-01

Este trabajo demuestra cómo el costeo absorbente, considerado por expertos en la materia, uno de los métodos de costeo usado frecuentemente por las organizaciones, con el propósito de determinar el valor de los inventarios y del costo de productos vendidos que intervienen en el estado de resultados para usuarios externos (stakeholders), al compararlo con el costeo variable, preferido por algunos administradores para toma de decisiones internas y usado en la preparación del estado de resultado...

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

Science.gov (United States)

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

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. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

Abdominal Compartment Syndrome

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Pınar Zeyneloğlu

2015-04-01

Full Text Available Intraabdominal hypertension and Abdominal compartment syndrome are causes of morbidity and mortality in critical care patients. Timely diagnosis and treatment may improve organ functions. Intra-abdominal pressure monitoring is vital during evaluation of the patients and in the management algorithms. The incidence, definition and risk factors, clinical presentation, diagnosis and management of intraabdominal hypertension and Abdominal compartment syndrome were reviewed here.

Elasticidad precio de la demanda por autopistas interurbanas en Chile

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Rodrigo Sanes

2013-01-01

transporte depende de la información que se disponga respecto a la elasticidad precio de la demanda por el uso de puentes, túneles y carreteras. El objetivo de este trabajo es estimar la elasticidad precio de la demanda por el uso de autopistas interurbanas en Chile utilizando el método de regresiones aparentemente no relacionadas (SUR y un panel de 48 datos mensuales obtenidos a partir de 21 plazas de peajes (48 x 21. Nuestros resultados muestran que, aún controlando por el precio de la gasolina y el nivel de actividad económica, la demanda por el uso de carreteras resulta ser muy inelástica al precio del peaje, con valores que oscilan entre -0,17 para automóviles y -0,05 para camiones.

Perfil nutricional e cardiovascular de ratos normotensos e hipertensos sob dieta hiperlipídica Perfil nutricional y cardiovascular de ratas normotensas e hipertensos bajo dieta hiperlipídica Nutritional and cardiovascular profiles of normotensive and hypertensive rats kept on a high fat diet

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Silvio A. Oliveira Júnior

2009-11-01

Full Text Available FUNDAMENTO: Embora dietas hiperlipídicas (DH promovam distúrbios nutricionais e cardíacos, poucos estudos avaliaram sua influência em ratos normotensos Wistar-Kyoto (WKY e espontaneamente hipertensos (SHR. OBJETIVO: Avaliar e comparar o perfil nutricional e cardiovascular de WKY e SHR tratados com DH. MÉTODOS: 20 WKY e 20 SHR foram distribuídos em quatro grupos: WKY-controle (WKY-C, WKY-DH, SHR-controle (SHR- C e SHR-DH. Os grupos C e DH receberam, respectivamente, dieta normocalórica e DH durante 20 semanas. Foram avaliados: peso corporal (PC, adiposidade, glicemia, lípides séricos, com dosagens de colesterol total e triacilglicerol, insulina e leptina. O estudo cardiovascular contemplou a pressão arterial sistólica (PAS, avaliação cardiopulmonar anatômica, ecocardiograma e histologia cardíaca. RESULTADOS: Os SHRs apresentaram menor PC, adiposidade, glicose, colesterol, triacilglicerol, leptina e insulina, quando comparados aos WKYs. Nos SHR, a ingestão calórica aumentou com a DH. Já nos WKYs, a DH elevou a eficiência energética, a adiposidade e a leptina e reduziu a glicemia. Na avaliação cardiovascular, os SHR apresentaram maior PAS, umidade pulmonar, hipertrofia e fibrose intersticial miocárdica em relação aos WKYs (pFUNDAMENTO: Embora dietas hiperlipídicas (DH promovam distúrbios nutricionais e cardíacos, poucos estudos avaliaram sua influência em ratos normotensos Wistar-Kyoto (WKY e espontaneamente hipertensos (SHR. OBJETIVO: Evaluar y comparar el perfil nutricional y cardiovascular de WKY y SHR tratadas con DH. MÉTODOS: Un total de 20 WKY y 20 SHR se distribuyó en cuatro grupos: WKY-control (WKY-C, WKY-DH, SHR-control (SHR-C y SHR-DH. Los grupos C y DH recibieron, respectivamente, dieta normocalórica y DH durante 20 semanas. Se evaluaron: peso corporal (PC, adiposidad, glucemia, lípidos séricos, con dosificaciones de colesterol total y triacilglicerol, insulina y leptina. El estudio cardiovascular

Mortalidad por defectos del tubo neural en México, 1980-1997

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Ramírez-Espitia José A

2003-01-01

Full Text Available OBJETIVO: Describir la mortalidad en México por defectos del tubo neural, durante el periodo 1980-1997. MATERIAL Y MÉTODOS: Las tasas anuales de mortalidad estatales y nacionales, por defectos del tubo neural, se calcularon por 10 000 nacidos vivos. La tendencia temporal fue evaluada por el porcentaje de cambio anual obtenido mediante un modelo de regresión de Poisson. Se calculó la razón de mortalidad, tomando la media nacional como referencia. Las tasas y las razones se representaron gráficamente en mapas. RESULTADOS: Durante el periodo la tasa bruta de mortalidad por defectos del tubo neural fue de 5.8 por 10 000 nacidos vivos. La anencefalia fue el tipo de defecto más frecuente (37.7%, seguida de la espina bífida sin hidrocefalia (31.6%. La tendencia nacional de la mortalidad por defectos del tubo neural fue ascendente entre 1980 y 1990 (porcentaje de cambio anual 7.5 IC 95% 6.5, 8.6 y descendente entre 1990-1997 (porcentaje de cambio anual -2.3 IC 95% -3.6, -0.9. CONCLUSIONES: Las altas tasas de mortalidad por defectos del tubo neural fueron debidas principalmente a la elevada frecuencia de las anencefalias. El incremento observado parece no ser sólo atribuible a cuestiones puramente diagnósticas o de mejora en los registros. La influencia de factores asociados a estos defectos, como determinados polimorfismos genéticos, la deficiencia de ácido fólico, la obesidad materna, la exposición laboral a plaguicidas y la pobreza deberán evaluarse mediante estudios específicos.

Ependimoma celular parcialmente resecado complicado con meningoependimocoroiditis bacteriana por Pseudomonas aeruginosa e infección sistémica por citomegalovirus

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Francisco Javier Otero-Mendoza

2017-06-01

Full Text Available Niño de 1 año 10 meses de edad, originario de Irapuato, Guanajuato, sin antecedentes de importancia para el padecimiento actual. Inició dos meses previos a su ingreso con crisis convulsivas tónico-clónicas generalizadas de 15 segundos de duración durante el sueño. Se realizó electroencefalograma que reportó actividad epileptiforme, por lo que se dio tratamiento con ácido valproico. Una semana previa al ingreso se agregó ataxia troncal impidiendo la marcha, por lo que se realizó una tomografía axial computarizada de cráneo en la que se observó un tumor en fosa posterior con densidad heterogénea y áreas de necrosis central que obliteraba el cuarto ventrículo, ocasionando efecto de masa y desplazamiento ventral del tallo cerebral. Por tal motivo, fue referido a nuestra institución.

Higiene alimentaria para la prevención de trastornos digestivos infecciosos y por toxinas

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G. Manuel Moreno, Dr.

2010-09-01

Full Text Available El principal factor que interviene en el origen y prevención de las enfermedades trasmitidas por los alimentos es la higiene alimentaria. Dichas enfermedades son causadas por la ingestión de alimentos o agua contaminados con microorganismos patógenos ocasionando una infección o por la ingestión de alimentos contaminados con toxinas. Los principales agentes involucrados son Escherichia Coli, Campylobacter, Salmonella, Shigella, Listeria Monocytogenes, Norovirus, virus Hepatitis A, Astrovirus, Rotavirus, y Virus Coxsackie. Toxinas producidas por hongos o por microflora marina y los contaminantes orgánicos persistentes pueden también causar serios problemas de salud. La inocuidad alimentaría ha tomado relevancia debido a una mayor exigencia por consumidores cada día más informados y por las demandas del comercio exterior. Medidas que aseguren una adecuada higiene alimentaría nos permitirá prevenir enfermedades, principalmente digestivas, causadas por variados agentes en los alimentos. Esto se logra por la implementación de las medidas propuestas por la Comisión Internacional conocida como Codex Alimentarius.

Endoftalmitis poscirugía de catarata por Sphingomonas paucimobilis

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Omar Mauri Garrido

Full Text Available Se presenta la caracterización y manejo terapéutico de un caso de endoftalmitis bacteriana posoperatoria causada por el germen Sphingomonas paucimobilis. La endoftalmitis es la inflamación de los tejidos intraoculares, considerada como la más devastadora de las complicaciones posoperatorias; posee pronóstico visual muy reservado y un elevado riesgo de secuela. Las Sphingomonas paucimobilis son bacterias gramnegativas con forma de bacilo, quimioheterótrofa y estrictamente aerobias que causan enfermedades en los seres humanos, principalmente infecciones hospitalarias que típicamente son tratadas fácilmente con antibióticos. Por sus capacidades biodegradantes y biosintéticas, son pocos los reportes hallados de infección intraocular por este germen. El pronóstico visual es favorable con un diagnóstico precoz y la aplicación del tratamiento adecuado. En este artículo se presentan un caso de endoftalmitis poscirugía de catarata por Sphingomonas paucimobilis reportado en Cuba en el mes de septiembre de 2009.

Eritema multiforme mayor desencadenado por antimicrobianos

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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.

Tendencias de la mortalidad por fiebre amarilla, Colombia, 1998-2009

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Ángela María Segura

2013-08-01

Full Text Available Introducción. La fiebre amarilla es una enfermedad tropical desatendida, razón por la cual el conocer las tendencias de mortalidad por fiebre amarilla en Colombia, constituye una importante fuente de información para la toma de decisiones y las intervenciones en salud pública. Objetivo. Analizar las tendencias de mortalidad fiebre amarilla en Colombia (1998-2009 y las diferencias que presentan las fuentes de información de morbilidad y mortalidad en el país, que afectan indicadores como el de letalidad. Materiales y métodos. Es un estudio descriptivo de las muertes por fiebre amarilla, según el Departamento Administrativo Nacional de Estadística, y de la incidencia de la enfermedad, según el Instituto Nacional de Salud. Se usaron fuentes secundarias de información en el cálculo de proporciones de las características sociodemográficas de los fallecidos y las medidas epidemiológicas de letalidad, incidencia y mortalidad por fiebre amarilla, por departamento de residencia de los fallecidos. Resultados. Las muertes por fiebre amarilla se presentan principalmente en hombres, en edad de trabajar, residentes en zonas rurales dispersas, afiliados al régimen vinculado, residentes en las zonas oriental, suroriental, norte y central del país. Se observaron inconsistencias en los informes reportados que afectan el análisis comparativo. Conclusión. Los habitantes de los departamentos ubicados en los territorios nacionales y en Norte de Santander presentan mayor riesgo de enfermar y de morir por fiebre amarilla, pero esta información pudiera estar subestimada, según la fuente de información utilizada en su cálculo.   doi: http://dx.doi.org/10.7705/biomedica.v33i0.698

Industrial refrigeration by absorption/compression; Refrigeracion industrial por absorcion/compresion

Energy Technology Data Exchange (ETDEWEB)

Ayala Delgado, Ramon; Heard, Christopher Lionel [Instituto de Investigaciones Electricas, Cuernavaca (Mexico)

1996-12-31

The use of the absorption/compression refrigeration in the industrial area is analyzed. It is estimated than in Mexico 50% of the food is wasted for lack of refrigeration in the producing centers and by the inefficient distribution system, as well as for the hot climate. The functioning of the absorption refrigeration and the hybrid system absorption/compression which can operate with the two thermodynamic cycles in variable proportions, depending on the specific application, looking for operational advantages and energy efficiency is described. This type of technology could be applied in Mexico due to the lack of industrial refrigeration and to the need of substituting compressors in some companies which have up to 20 years of use [Espanol] Se analiza el uso de la refrigeracion por absorcion/compresion en el area industrial. En Mexico se estima que se desperdicia el 50% de los alimentos por falta de refrigeracion en los centros productores y por el deficiente sistema de distribucion, asi como por el clima calido. Se describe el funcionamiento de la refrigeracion por absorcion y la refrigeracion por absorcion/compresion o sistema hibrido, el cual puede funcionar con los dos tipos de ciclos termodinamicos, en proporciones variables, dependiendo de la aplicacion especifica, buscando ventajas de operacion y eficiencia energetica. Este tipo de tecnologia podria aplicarse en Mexico debido a la falta de refrigeracion industrial y a la necesidad de sustituir compresores en algunas empresas los cuales tienen hasta 20 anos de uso

Industrial refrigeration by absorption/compression; Refrigeracion industrial por absorcion/compresion

Energy Technology Data Exchange (ETDEWEB)

Ayala Delgado, Ramon; Heard, Christopher Lionel [Instituto de Investigaciones Electricas, Cuernavaca (Mexico)

1997-12-31

The use of the absorption/compression refrigeration in the industrial area is analyzed. It is estimated than in Mexico 50% of the food is wasted for lack of refrigeration in the producing centers and by the inefficient distribution system, as well as for the hot climate. The functioning of the absorption refrigeration and the hybrid system absorption/compression which can operate with the two thermodynamic cycles in variable proportions, depending on the specific application, looking for operational advantages and energy efficiency is described. This type of technology could be applied in Mexico due to the lack of industrial refrigeration and to the need of substituting compressors in some companies which have up to 20 years of use [Espanol] Se analiza el uso de la refrigeracion por absorcion/compresion en el area industrial. En Mexico se estima que se desperdicia el 50% de los alimentos por falta de refrigeracion en los centros productores y por el deficiente sistema de distribucion, asi como por el clima calido. Se describe el funcionamiento de la refrigeracion por absorcion y la refrigeracion por absorcion/compresion o sistema hibrido, el cual puede funcionar con los dos tipos de ciclos termodinamicos, en proporciones variables, dependiendo de la aplicacion especifica, buscando ventajas de operacion y eficiencia energetica. Este tipo de tecnologia podria aplicarse en Mexico debido a la falta de refrigeracion industrial y a la necesidad de sustituir compresores en algunas empresas los cuales tienen hasta 20 anos de uso

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

Science.gov (United States)

Kuchenbecker, Walter K H; Groen, Henk; van Asselt, Sophie J; Bolster, Johanna H T; Zwerver, J; Slart, Riemer H J; Vd Jagt, Erik J; Muller Kobold, Anneke C; Wolffenbuttel, Bruce H R; Land, Jolande A; Hoek, Annemieke

2011-09-01

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 subcutaneous abdominal fat (SAF) between a group of anovulatory women with PCOS and obesity who resume ovulation (RO+) to those who remain anovulatory (RO-) during a lifestyle program. In a prospective pilot cohort study, anovulatory women with PCOS underwent a 6 month lifestyle program in a tertiary fertility clinic. Body fat distribution was assessed by anthropometrics, dual-energy X-ray absorptiometry (DEXA) and single slice abdominal CT scan at intake, after 3 months and after 6 months. Baseline-corrected changes over time were analysed using generalized estimating equations longitudinal regression analysis. In 32 anovulatory women with PCOS (age, 28 ± 4 years; BMI, 37.5 ± 5.0 kg/m²), there were no significant baseline differences in anthropometrics and biochemical assessment between 14 RO+ participants and 18 RO- participants. RO+ women lost more weight (6.3 versus 3.0%) and abdominal fat on DEXA (15.0 versus 4.3%) compared with RO- women. Resumption of ovulation was associated with early and consistent loss of IAF (12.4 versus 5.0% at 3 months and 18.5 versus 8.6% at 6 months). Loss of SAF between the RO+ women and the RO- women was similar at 3 months (6.2 versus 6.1%) but did not change any further in RO- women (6.1%) as it did in RO+ women (11.4%) at 6 months. In anovulatory women with PCOS and obesity undergoing a lifestyle program, RO+ women lose more body weight and abdominal fat on DEXA than RO- women. In addition, this study shows that early and consistent loss of IAF is associated with resumption of ovulation. Future studies should address the mechanisms behind these changes and should assess interventions aimed at loss of IAF to facilitate resumption of ovulation.

¿Por qué hay canciones que perduran?

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Josune Albisu Barandiaran

2015-11-01

Full Text Available El principal objetivo de este artículo es analizar una canción, Txoria txori, para deducir cuales han sido las principales características que la han convertido en “Himno popular”, permitiéndola perdurar en el tiempo. Dentro de las principales características, dos han sido verdaderamente reseñables: por una parte, la plasticidad, y por otra, la sencillez y estructura clara de la canción.

Manifestaciones oftalmológicas por virus de Epstein-Barr

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Adrianne MayulySuñetÁlvarez

Full Text Available Se trata de un paciente masculino de 26 años que acude por disminución brusca de la visión del ojo derecho. Seingresó como una uveítis posterior dada por exudación extensa en área macular del ojo derecho, acompañada de edema del disco óptico, vasculitis aledaña a la lesión y hemorragias dispersas en llama en el polo posterior. La etiología era controversial y, el tratamiento más apropiado era debatible, por lo que se le realizaron estudios como retinografías seriadas, angiografías fluoresceínicas y reacción en cadena de polimerasa a una muestra del humor acuoso, que confirmó la etiología viral; lo que resultó en una agudeza visual final de 0,1. Posterior a 6 meses del cuadro inicial, el paciente presentó queratitis intraestromal en forma numular -que recurre ante episodios de stress-, para desaparecer luego de terapia tópica con antiinflamatorios no esteroideos y esteroideos.La baja incidencia de casos reportados con uveítis posterior por virus de Epstein Barr resulta de un pobre conocimiento de la presentación de la enfermedad, por tanto un retraso en la instauración del tratamiento. En estos casos la prueba de oro es la reacción de cadena de polimerasa.

LUCHA POR LA TIERRA EN EL NORTE DE URUGUAY

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Gabriel Oyhantçabal Benelli

2011-12-01

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

Riesgos antrópicos generados por la actividad minera

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Ana Violeta Argüello Mejía

2013-10-01

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

Effect of Gender on the Total Abdominal Fat, Intra-Abdominal Adipose Tissue and Abdominal Sub-Cutaneous Adipose Tissue among Indian Hypertensive Patients.

Science.gov (United States)

Sahoo, Jaya Prakash; Kumari, Savita; Jain, Sanjay

2016-04-01

Abdominal obesity is a better marker of adverse metabolic profile than generalized obesity in hypertensive subjects. Further, gender has effect on adiposity and its distribution. Effect of gender on obesity and the distribution of fat in different sub-compartments of abdomen among Indian hypertensive subjects. This observational study included 278 adult subjects (Males-149 & Females-129) with essential hypertension from a tertiary care centre in north India over one year. A detailed history taking and physical examination including anthropometry were performed in all patients. Total Abdominal Fat (TAF) and abdominal adipose tissue sub-compartments like Intra-Abdominal Adipose Tissue (IAAT) and Sub-Cutaneous Adipose Tissue (SCAT) were measured using the predictive equations developed for Asian Indians. Female hypertensive subjects had higher Body Mass Index (BMI) with more overweight (BMI ≥ 23kg/m(2)), and obesity (BMI≥ 25 kg/m(2)). Additionally, they had higher prevalence of central obesity based on both Waist Circumference (WC) criteria (WC≥ 90 cm in males and WC≥ 80 cm in females) and TAF criteria {≥245.6 cm(2) (males) and ≥203.46 cm(2) (females)} than male patients. But there was no difference in the prevalence of central obesity based on Waist Hip Ratio (WHR) criteria (WHR ≥0.90 in males and WHR ≥ 0.85 in females) between two genders. High TAF & IAAT were present in more females although there was no difference in the distribution of high SCAT between two genders. Female hypertensive subjects were more obese with higher abnormal TAF & IAAT compared to male patients. However, there was no difference in the distribution of high SCAT among them.

Clinical and economic outcomes associated with community-acquired intra-abdominal infections caused by extended spectrum beta-lactamase (ESBL) producing bacteria in China.

Science.gov (United States)

Hu, Bijie; Ye, Huifeng; Xu, Yingchun; Ni, Yuxing; Hu, Yunjian; Yu, Yunsong; Huang, Zhenfei; Ma, Larry

2010-06-01

To compare clinical and economic outcomes in patients with community-acquired intra-abdominal infection (IAI) due to extended spectrum beta-lactamase (ESBL) producing (ESBL-positive) bacteria versus non-ESBL-producing (ESBL-negative) bacteria in China. This was a retrospective chart review study of patients hospitalized with community-acquired IAI due to ESBL-positive or ESBL-negative infections caused by Escherichia coli or Klebsiella spp. Data were collected from six hospitals in China that participated in the Study for Monitoring Antibiotic Resistance Trends (SMART) during 2006-2007. Outcomes included clinical response at discharge and following first-line antibiotic, number of antibiotic agents and classes, duration of hospitalization, and overall hospitalization and intravenous antibiotic costs. Of the 85 patients included in the study, 32 (37.6%) had ESBL-positive and 53 (62.4%) had ESBL-negative infections; E. coli was responsible for 77.6% of infections. Infection resolved at discharge in 30 (93.8%) ESBL-positive and 48 (90.6%) ESBL-negative patients (P = NS). Fewer ESBL-positive patients achieved complete response following first-line antibiotics (56.3% versus 83.0%; P = 0.01). ESBL-positive patients required longer antibiotic treatment, more antibiotics, longer hospitalization (24.3 versus 14.6 days; 1.67-fold ratio; P = 0.001), and incurred higher hospitalization costs ( yen24,604 vs. yen13,788; $3604 vs. $2020; 1.78-fold ratio; P < 0.001). Patients with ESBL-positive infection had similar resolution rates at discharge compared to those with ESBL-negative infection, despite poorer first-line antibiotic response. However, ESBL-positive infection led to significantly greater hospitalization cost and intravenous antibiotic cost, and longer hospital stay.

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.

Oral administration of recombinant Neisseria meningitidis PorA genetically fused to H. pylori HpaA antigen increases antibody levels in mouse serum, suggesting that PorA behaves as a putative adjuvant.

Science.gov (United States)

Vasquez, Abel E; Manzo, Ricardo A; Soto, Daniel A; Barrientos, Magaly J; Maldonado, Aurora E; Mosqueira, Macarena; Avila, Anastasia; Touma, Jorge; Bruce, Elsa; Harris, Paul R; Venegas, Alejandro

2015-01-01

The Neisseria meningitidis outer membrane protein PorA from a Chilean strain was purified as a recombinant protein. PorA mixed with AbISCO induced bactericidal antibodies against N. meningitidis in mice. When PorA was fused to the Helicobacter pylori HpaA antigen gene, the specific response against H. pylori protein increased. Splenocytes from PorA-immunized mice were stimulated with PorA, and an increase in the secretion of IL-4 was observed compared with that of IFN-γ. Moreover, in an immunoglobulin sub-typing analysis, a substantially higher IgG1 level was found compared with IgG2a levels, suggesting a Th2-type immune response. This study revealed a peculiar behavior of the purified recombinant PorA protein per se in the absence of AbISCO as an adjuvant. Therefore, the resistance of PorA to proteolytic enzymes, such as those in the gastrointestinal tract, was analyzed, because this is an important feature for an oral protein adjuvant. Finally, we found that PorA fused to the H. pylori HpaA antigen, when expressed in Lactococcus lactis and administered orally, could enhance the antibody response against the HpaA antigen approximately 3 fold. These observations strongly suggest that PorA behaves as an effective oral adjuvant.

Choque cardiogênico por dissulfiram Shockcardiogénico por disulfiram Cardiogenic shock caused by disulfiram

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Ana Jerónimo

2009-03-01

Full Text Available A intoxicação medicamentosa por dissulfiram é uma situação rara, mas, que pode se apresentar com manifestações cardiovasculares graves e potencialmente fatais, como choque cardiogênico. É apresentado o caso de uma paciente com choque refratário, após intoxicação voluntária por dissulfiram. A avaliação clínica e bioquímica, junto à avaliação ecocardiográfica e à monitorização invasiva, confirmaram tratar-se de um choque cardiogênico associado a esse fármaco. São discutidos os mecanismos de ação conhecidos do dissulfiram e descritos os principais efeitos colaterais, especialmente os cardiovasculares, alertando para a importância da suspeição diagnóstica e da abordagem terapêutica imediata mais adequada nesse contexto.La intoxicación medicamentosa por disulfiram es una situación rara, aunque puede presentarse con manifestaciones cardiovasculares graves y potencialmente fatales, como el shock cardiogénico. Este relato presenta el caso de una paciente con shock refractario, tras intoxicación voluntaria por disulfiram. La evaluación clínica y bioquímica, junto a la evaluación ecocardiográfica y el monitoreo invasivo, confirmaron tratarse de un shock cardiogénico asociado a ese fármaco. A lo largo del presente relato se discuten los mecanismos de acción del disulfiram conocidos, así como se describen los principales efectos colaterales, específicamente los cardiovasculares. En este sentido, también se alerta para la importancia de la sospecha diagnóstica y del abordaje terapéutico inmediato más adecuado a este contexto.Drug intoxication with disulfiram is a rare condition that may lead to severe and potentially fatal cardiovascular manifestations such as cardiogenic shock. We report the case of a female patient with refractory shock after deliberate self-poisoning with disulfiram. Clinical, biochemical and echocardiographic assessment, as well as invasive monitoring confirmed cardiogenic shock

Elasticidad precio de la demanda por autopistas interurbanas en Chile

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Rodrigo Saens

2013-07-01

Full Text Available La efectividad de un esquema de tarificación vial para optimizar el uso de infraestructura de transporte depende de la información que se disponga respecto a la elasticidad precio de la demanda por el uso de puentes, túneles y carreteras. El objetivo de este trabajo es estimar la elasticidad precio de la demanda por el uso de autopistas interurbanas en Chile utilizando el método de regresiones aparentemente no relacionadas (SUR y un panel de 48 datos mensuales obtenidos a partir de 21 plazas de peajes (48 x 21. Nuestros resultados muestran que, aún controlando por el precio de la gasolina y el nivel de actividad económica, la demanda por el uso de carreteras resulta ser muy inelástica al precio del peaje, con valores que oscilan entre -0,17 para automóviles y -0,05 para camiones.

Fiebres hemorrágicas por Arenavirus en Latinoamérica

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Ella Soto

2010-01-01

Full Text Available Las fiebres hemorrágicas virales producidas por Arenavirus incluyen a los virus endémicos en África (Lassa y el virus de la coriomeningitis linfocítica (LCMV, de distribución mundial, y los Arenavirus del Nuevo Mundo o Complejo Tacaribe, que incluye a los virus endémicos en las Américas (Junín, Machupo, Guanarito, Sabiá, Pichinde, entre otros. Los huéspedes naturales son los roedores y la infección en humanos se produce por el contacto con la orina y excretas. Las manifestaciones clínicas inicialmente son indistinguibles de otras fiebres hemorrágicas producidas por bacterias, parásitos y otros virus, constituyéndose esto en un problema de salud pública, por lo que se requiere realizar el diagnóstico diferencial utilizando técnicas serológicas y moleculares.

Itinerario de la Patria: por tierras del golfo lejano

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Adel López Gómez

1965-06-01

Full Text Available Veinticinco años atrás solo primaba en estas infinitudes el imperio de la selva. Desde Dabeiba tórrido hasta Turbo sudoroso y lacustre se empleaba casi una semana a lomo de mula o a quimba de peatón, por una sombría trocha de miasmas y de lodo, abierta a machete por entre la áspera e interminable manigua. Por allí pasaron una y otra vez los pálidos hombres de nuestros enganches, cuando en 1939 iniciamos, a la orilla del Golfo de Urabá, la ingente tarea de construír una carretera hacia el interior para poner al alcance de las llantas antioqueñas la orilla salvaje del Atlántico maicero.

2015. 2. Por qué celebrar primarias

OpenAIRE

Sanz Díaz, Benito

2015-01-01

¿Por qué celebrar primarias? ¿Beneficia o perjudica a las organizaciones y partidos que las promueven?, ¿Mejora la participación?, ¿La elección de los dirigentes evita la oligarquización y la Ley de Hierro de los partidos políticos que enunció Robert Michels? Un sistema de selección de candidatos con origen en la política norteamericana, fue adaptado por el PSOE, y a continuación iría extendiéndose su práctica a los todos los partidos políticos. Ignacio Urquizu señalaba sobre l...

14 Nobel, preocupados por el CERN

CERN Multimedia

Rivera, A

2003-01-01

"E l presidente del Consejo del CERN (Laboratorio Europeo de Fisica de Particulas, junto a Ginebra), Maurice Bourquin, ha recibido una carta firmada por un grupo de cientificos muy especiales: 14 premios Nobel de Fisica" (1 page).

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.

¿Por qué el satélite Cóndor?

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Leonardo Ferrerira

2015-01-01

Full Text Available Estados Unidos y Rusia representan el 15 por ciento de la población mundial sin embargo utilizan el 50 por ciento de la órbita geoestacionaria, mientras todo el Tercer Mundo emplea menos del 10 por ciento. Los países del Pacto Andino se encuentran trabajando conjuntamente en el uso compartido de un solo sistemas satelital CONDOR. Pero los críticos norteamericanos consideran que es una manera ineficiente e irracional congestionar el espectro orbital. El artículo se centra en describir este proyecto y la lógica Andina, la soberanía

Hipoglucemia inducida por carcinoma adrenal

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Jimena Soutelo

2013-08-01

Full Text Available El carcinoma suprarrenal es una neoplasia maligna infrecuente y de mal pronóstico. La presentación clínica más común es originada por la producción hormonal excesiva, mientras que el desarrollo de hipoglucemia sintomática es excepcional. Presentamos el caso de una mujer de 37 años que ingresó al hospital por síntomas de hipoglucemias graves, hipertensión arterial, hipopotasemia y amenorrea secundaria. En el laboratorio se halló hipoglucemia con insulina inhibida y niveles de andrógenos en rango tumoral. La tomografía computarizada (TC de abdomen y pelvis mostró voluminosa formación heterogénea de aspecto sólido sin plano de clivaje con respecto al parénquima hepático e intenso realce con contraste. Luego de la extirpación de la masa retroperitoneal, evolucionó con valores de glucemia y potasemia normales, estabilizó la presión arterial y recuperó los ciclos menstruales.

Cefaleia por uso excessivo de medicamentos

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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.

Primer reporte de un caso importado de Malaria por Plasmodium ovale curtisi en Paraguay, confirmado por diagnóstico molecular

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Florencia del Puerto

2015-04-01

Full Text Available En países donde el Plasmodium ovale no es común, los microscopistas tienden a identificarlo de manera errónea como Plasmodium vivax. En este trabajo reportamos la identificación de la especie P. ovale curtisi por el método de PCR múltiple semianidada (SnM-PCR y la secuenciación de la subunidad pequeña del gen del ARN 18S, en un paciente paraguayo de 44 años de edad que vino en el 2.013 de Guinea Ecuatorial, África Occidental, a quien se le diagnosticó una infección por P. vivax por microscopía convencional. El empleo de métodos moleculares para la identificación de casos importados de infección con especies del género Plasmodium es uno de los objetivos principales en el control y la prevención de la malaria en Paraguay, teniendo en cuenta que el país se encuentra en fase de pre-eliminación de la enfermedad.

Contractura axilar por quemadura tratada con Integra®

OpenAIRE

Roa G,Ricardo; Las Heras F,Rocío; Piñeros B,José L; Correa S,Gerardo; Norambuena B,Hernán; Marré N,Diego

2011-01-01

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

¿Por qué fracasan las campañas?

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Andrea Castelnuovo

2015-01-01

Full Text Available Analiza tres experiencias en las que puede evidenciarse por qué fracasan las campañas sociales: por la misma razón, fueron concebidas con mensajes destinados a una población que vive y percibe el mundo desde el nivel económico y socio-cultural distinto, el emisor no empata con los perfiles del receptor. Es fundamental empezar por definir qué se debe decir, a quién, y cómo, para luego encontrar los medios más adecuados para su difusión. La espectacularidad y etnocentrismo, las campañas sociales seguirán sirviendo exclusivamente para mejorar las finanzas de los medios de comunicación masivos y secundariamente, para brindar materia prima a humoristas y contestarios.

Estudo dos linfócitos circulantes por anticorpos monoclonais na miastenia grave

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Paulo E. Marchiori

1988-09-01

Full Text Available Os autores avaliam os linfócitos T (CD3, CD4, CD8, CD4/8 por anticorpos monoclonais e rosácea em 20 pacientes e linfócitos B por Fab' por imunofluorescência em 9 pacientes com miastenia grave. Observam elevação significante na população de linfócito B e redução nos linfócitos T totais CD3+ por rosáceas. Não foram observadas modificações nas subpopulações celulares com timectomia e corticosteróides.

México en la segunda Guerra Mundial visto por la Diplomacia venezolana

OpenAIRE

Silva L, Dómel

2013-01-01

Partiendo del análisis de una serie de documentos concernientes a las comunicaciones entre la llamada “Legación de Venezuela” en México y la Cancillería de Venezuela durante los años de la Segunda Guerra Mundial (1939-1945), se esbozará las estrategias en común para ambas naciones; como fue la política de seguridad de cada Estado, enmarcada dentro de la política de seguridad continental. México por su importancia geoestratégica; por el petróleo, por su cercanía con los Estados Unidos y por la...

Osteomalacia inducida por tumor: hemangiopericitoma rinosinusal Tumor-induced osteomalacia: rhinosinusal hemangiopericytoma

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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.Tumor-induced osteomalacia is a rare disease of bone metabolism. The characteristic of this disease is an increase in phosphate excretion followed by hypophosphatemia, due to phosphaturic agents produced by different types of tumors. Tumor resection results in complete resolution of clinical, biochemical and radiological abnormalities. We present the case of a 61 year old man with signs, symptoms and laboratory findings consistent with oncogenic osteomalacia due to a rhino-sinusal mesenchymal tumor. The histological diagnosis showed a vascular neoplasm: hemangiopericytoma.

Disfunção ventricular esquerda transitória por cardiomiopatia induzida por estresse Transient left ventricular dysfunction due to stress-induced cardiomyopathy

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Marcus Vinicius Simões

2007-10-01

Full Text Available Apresenta-se o caso de uma paciente de 71 anos que preencheu os critérios diagnósticos para cardiomiopatia induzida por estresse que foi desencadeada por intenso estresse emocional após atropelamento por bicicleta. O quadro clínico mimetizou o infarto agudo do miocárdio, manifestando-se com dor precordial, supradesnivelamento do segmento ST, seguido por ondas T profundas e prolongamento do intervalo QT, elevação discreta de enzimas cardíacas e cursando com disfunção sistólica apical do ventrículo esquerdo e hipercinesia das porções basais (conferindo o aspecto de "abaloamento apical", mas na ausência de obstrução coronariana subepicárdica. A função ventricular normalizou-se após a segunda semana de evolução.The case presented here is of a 71-yr-old female patient who met the diagnostic criteria for stress-induced cardiomyopathy, which was triggered by intense emotional stress after being hit by a bicycle. The clinical picture mimicked that of an acute myocardial infarction, manifesting as precordial pain, ST-segment depression followed by deep negative T waves and prolonging of the QT interval, slight increase in cardiac enzymes and coursing with transient apical ballooning of the left ventricle and hyperkinesis of the basal walls (conferring the aspect of "apical ballooning", although in the absence of subepicardial coronary obstruction. Ventricular function normalized after the second week of clinical evolution.

Mortalidad por suicidio en la provincia de Pinar del Río

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Ana Carmen Valdés Vento

2003-02-01

Full Text Available Se trata de una investigación descriptiva y retrospectiva sobre el comportamiento de la mortalidad por suicidio en la provincia Pinar del Río durante el año 2001, de acuerdo con una serie de variables seleccionadas. Se estudiaron todos los fallecidos por esa causa en el período señalado, que fueron un total de 110 para una tasa de 14,9 por 100 000 habitantes, por lo que es la séptima causa de muerte en la provincia. Llama la atención el amplio predominio del sexo masculino, de la incidencia en la tercera edad, y el hecho de no haber tenido este año el municipio Sandino fallecido alguno por esta causa, así como que el municipio de mayor número de fallecidos por este motivo fue Viñales con una tasa de 26,0 por 100 000 habitantes.A retrospective descriptive research work on the situation of mortality from suicide in Pinar del Río province during 2001 was carried out based on a group of selected variables. All the deaths form this cause, which amounted to 110 persons for a rate of 14.9 per 100 000 pop, were studied. Suicide was the seventh cause of death in the province. It should be underlined that males prevailed, the incidence of the elderly was high and that Sandino municipality had no death from suicide in this year whereas Viñales municipality showed the highest number of deceased, with a mortality rate of 26 per 100 000 pop.

Lucro por ação

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Gabriel Moreira Campos

2001-08-01

Full Text Available Este trabalho tem por objetivo demonstrar os principais conceitos acerca do Lucro por Ação (Earnings per Share, o qual se apresenta como um quociente de grande utilidade nas entidades. Serão demonstrados aspectos sobre o assunto presentes no Brasil, bem como as normas aplicáveis nos Estados Unidos, emanadas do Financial Accounting Standards Board (FASB, e as normas internacionais, emanadas do International Accounting Standards Committee (IASC. De forma a possibilitar uma visualização mais completa dos conceitos envolvidos, serão desenvolvidos exemplos de sua aplicação. O Lucro (Resultado por Ação pode ser calculado em sua forma básica e em sua forma diluída. Na forma básica, não são considerados os efeitos dos instrumentos potencialmente dilutivos, ao passo que, no cálculo do Lucro (Resultado por Ação Diluído, são. Como instrumentos financeiros potencialmente dilutivos temos as ações preferenciais conversíveis, as debêntures conversíveis e os bônus de subscrição, que podem ser convertidos em ações ordinárias, caracterizando, assim, o próprio potencial dilutivo desses instrumentos. Dessa forma, o trabalho em questão foi dividido em três partes principais, sendo que nas duas últimas constam os referidos exemplos de cálculo do Lucro por Ação em sua forma básica e em sua forma diluída: • aspectos observados no Brasil; • normas emanadas do FASB; • normas emanadas do IASC.The objective of this paper is to demonstrate the principal concepts about Earnings per Share, which is presented as a quotient of great usefulness for the companies. The subject is presented in three parts: in the first part, we will demonstrate relevant aspects that are present in Brazil. In the second part, the applicable standards in the United States will be discussed, which are issued by the Financial Accounting Standards Board (FASB. In the third part, the international standards are dealt with, which are issued by the

Síndrome oculoglandular de Parinaud causada por esporotricose

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

2010-01-01

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

Por qué todas las cuentas son falsas

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Aerde, Michel van

1994-01-01

Los principales criterios para evaluación y decisión, en la sociedad actual, son inspirados por cálculos económicos. Mucho nos preocupamos de cuentas pero muy poco nos preguntamos de lo que es el dinero. Muy poco reflexionamos filosóficamente, ontológicamente, sobre la naturaleza misma del dinero. ¿Qué es esto que pretende ser la base de nuestra sociedad? El dinero es mentiroso por naturaleza. Es una representación de mucha vida, que no puede ser representada. El dinero es peligroso, se convi...

Perfil nutricional dos indígenas Xukuru-Kariri, Minas Gerais, de acordo com diferentes indicadores antropométricos e de composição corporal Nutritional profile of the Xukuru-Kariri indigenous people in the state of Minas Gerais in accordance with different anthropometric and body composition indicators

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Bárbara dos Santos Simões

2013-02-01

Full Text Available O objetivo deste artigo foi avaliar o perfil nutricional dos indígenas Xukuru-Kariri entre 7 anos e 78 anos aldeados em Minas Gerais de acordo com os diferentes indicadores antropométricos e de composição corporal . As medidas aferidas foram: peso, estatura, circunferência da cintura (CC e percentual de gordura corporal (%GC. Foram calculadas a sensibilidade e a especificidade para os índices antropométricos com intervalo de confiança de 95% e o valor preditivo positivo (VPP e negativo (VPN. A população foi constituída por 58 indivíduos, sendo 56,9% (n = 33 do sexo masculino e 43,1% (n = 25 do sexo feminino. A especificidade foi superior à sensibilidade em relação a todos os índices. Observou-se que 29% dos indivíduos foram classificados com excesso de adiposidade corporal quando avaliados pelo IMC e pela bioimpedância mão a mão e 50% dos indivíduos apresentaram alta adiposidade corporal em relação ao IMC e a CC. É necessário que sejam realizados estudos com diferentes etnias a fim de se construir indicadores nutricionais específicos para orientação de serviços de saúde indígenas.The scope of this study was to evaluate the nutritional profile of indigenous Xukuru-Kariri villagers in the state of Minas Gerais between seven and seventy-eight years of age in accordance with the different anthropometric and body composition indicator. The measurements were: weight, height, waist circumference (WC and body fat percentage (BF%. The sensitivity and specificity of anthropometric indices were calculated with a confidence interval of 95% and positive predictive value (PPV and negative predictive value (NPV. A total of 58 individuals was evaluated, of which 56.9% (n =33 were male and 43.1% (n =25 were female. Specificity was greater than sensitivity in all indices. It was seen that 29% of individuals were classified as having excess body fat as assessed by BMI and hand-to-hand bioimpedance and 50% of subjects had high body

Alteraciones hepáticas inducidas por la nutrición parenteral

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J Salas Salvado; A Recaséns Garica

1993-01-01

Liver disorders induced by parenteral nutrition Alteraciones hepáticas inducidas por la nutrición parenteral Liver disorders induced by parenteral nutrition Alteraciones hepáticas inducidas por la nutrición parenteral

Úlceras por presión causadas por dispositivos clínicos

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Iglesias Ruisánchez, Sandra

2017-01-01

Las úlceras por presión (UPP) son lesiones comunes en los pacientes hospitalizados, especialmente en las unidades de cuidados intensivos (UCI). Los enfermos críticos tienen un riesgo elevado de desarrollar UPP, debido principalmente a la limitación de la movilidad, disminuyendo su capacidad para cambiar activamente su posición en la cama o asiento. Además, el efecto de fármacos anestésicos y sedantes, puede causar una pérdida de la percepción sensorial cutánea. Los diferentes dispositivos clí...

Análise da prevenção e tratamento das úlceras por pressão propostos por enfermeiros Análisis de la prevención y del tratamiento de las úlceras por presión propuesto por enfermeros Analysis of prevention and treatment of the pressure ulcers proposed by nurses

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Adriana Bessa Fernandes Medeiros

2009-03-01

Full Text Available A úlcera por pressão ainda é considerada um problema grave, especialmente em pessoas idosas e nas situações de adoecimento crônico-degenerativo. O objetivo do estudo consistiu em identificar as produções bibliográficas sobre ações de prevenção e tratamento realizadas por enfermeiros publicadas no período de 1999 a 2004, descrevendo o conhecimento produzido na temática. Trata-se de levantamento bibliográfico descritivo de periódicos de enfermagem indexados na LILACS e MEDLINE, acerca da temática no período de 1999 a 2004. A coleta de dados ocorreu entre os meses de maio a junho de 2005. Procedeu-se o exame do material que compreendeu leitura exaustiva, o que proporcionou a identificação de três aspectos estudados: prevenção das úlceras por pressão, tratamento das úlceras por pressão e cuidados de enfermagem às úlceras por pressão. Concluiu-se ainda a necessidade de pesquisas envolvendo a atuação do enfermeiro na avaliação clínica do cliente e no desenvolvimento de programas de prevenção sistematizados.La úlcera por presión, es todavía considerado un problema grave, especialmente en personas ancianas y en las situaciones de enfermedades crónicas degenerativas. El objetivo del estudio consistió en identificar las producciones bibliográficas sobre las acciones de prevención y tratamiento realizadas por enfermeros y publicadas en el período de 1999 a 2004, describiendo el conocimiento producido sobre el tema. Se trata de levantamiento bibliográfico descriptivo de periódicos de enfermería indexados en el LILACS y MEDLINE, acerca de la temática, en el período de 1999 a 2004. La recolección de datos se realizó entre los meses de mayo a junio de 2005. Se procedió a examinar el material con una lectura exhaustiva, lo que proporcionó la identificación de tres aspectos estudiados: prevención de las úlceras por presión, tratamiento de las úlceras por presión y cuidados de enfermería de las

Intoxicação por monofluoroacetato em animais

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Vivian Assunção Nogueira

2011-10-01

Full Text Available O monofluoroacetato (MF ou ácido monofluoroacético é utilizado na Austrália e Nova Zelândia no controle populacional de mamíferos nativos ou exóticos. O uso desse composto é proibido no Brasil, devido ao risco de intoxicação de seres humanos e de animais, uma vez que a substância permanece estável por décadas. No Brasil casos recentes de intoxicação criminosa ou acidental têm sido registrados. MF foi identificado em diversas plantas tóxicas, cuja ingestão determina "morte súbita"; de bovinos na África do Sul, Austrália e no Brasil. O modo de ação dessa substância baseia-se na formação do fluorocitrato, seu metabólito ativo, que bloqueia competitivamente a aconitase e o ciclo de Krebs, o que reduz produção de ATP. As espécies animais têm sido classificadas nas quatro Categorias em função do efeito provocado por MF: (I no coração, (II no sistema nervoso central (III sobre o coração e sistema nervoso central ou (IV com sintomatologia atípica. Neste trabalho, apresenta-se uma revisão crítica atualizada sobre essa substância. O diagnóstico da intoxicação por MF é realizado pelo histórico de ingestão do tóxico, pelos achados clínicos e confirmado por exame toxicológico. Uma forma peculiar de degeneração hidrópico-vacuolar das células epiteliais dos túbulos uriníferos contorcidos distais tem sido considerada como característica dessa intoxicação em algumas espécies. O tratamento da intoxicação por MF é um desafio, pois ainda não se conhece um agente capaz de reverte-la de maneira eficaz; o desfecho geralmente é fatal

positivismo por su reduccionismo epistemológico

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Ignacio M. Ibarzábal

2007-01-01

Full Text Available A lo largo de la historia humana puede observarse la constante oscilación entre diversas teorías científicas. Esto puede demostrarse, por ejemplo, a partir de una reflexión sobre la evolución de las ideas filosóficas desde fines de la edad Media hasta la actualidad. este fenómeno no hace más que poner de relieve cierta inseguridad connatural al hombre, que genera la opción por soluciones simplistas, y “puras”, lo que culmina en muchos casos en una aproximación reduccionista a la realidad. El problema científico que plantea el reduccionismo epistemológico es que éste, al desentenderse de la realidad existencial del hombre, es incapaz de darle respuestas satisfactorias para resolver conflictos. Este inconveniente lo sufre el positivismo jurídico –así como también lo ha padecido el iusnaturalismo ingenuo–, por su imposibilidad de resolver conflictos jurídicos reales; y esto, a causa de su pretendida aproximación avalorativa que da lugar a dos especies de reduccionismos: el que desconoce tajantemente las valoraciones, y aquél que, reconociéndolas, escoge de manera arbitraria los valores objeto de su conocimiento.

Sea urchin granuloma Granulomas por ouriços-do-mar

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André Luiz Rossetto

2006-10-01

Full Text Available Injuries caused by venomous and poisonous aquatic animals may provoke important morbidity in humans. The phylum Echinoderma include more than 6000 species of starfish, sea urchins, sand dollars, and sea cucumbers some of which have been found responsible for injuries to humans. Initial injuries by sea urchins are associated with trauma and envenomation, but later effects can be observed. Sea urchin granuloma is a chronic granulomatous skin disease caused by frequent and successive penetration of sea urchin spines which have not been removed from wounds. The authors report a typical case of sea urchin granuloma in a fisherman and its therapeutic implications.Os acidentes por animais aquáticos traumatizantes e venenosos podem provocar morbidez importante em humanos. Equinodermos marinhos incluem mais de 6000 espécies de estrelas-do-mar, ouriços-do-mar, "bolachas-de-praia" e pepinos-do-mar. Vários equinodermos têm sido responsabilizados por acidentes em humanos. Granulomas por ouriço-do-mar são lesões de caráter granulomatoso, crônicas, causada por acidentes com espículas de ouriço-do-mar. Os autores relatam um caso típico de granulomas por ouriço-do-mar ocorrido em um pescador e enfatizam as implicações terapêuticas aplicadas.

Indultos concedidos por la Cámara de Castilla en tiempos de los Austrias

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José Luis de las HERAS SANTOS

2009-12-01

Full Text Available Maquiavelo aconsejaba a los príncipes que se reservaran para sí la disposición de las materias de gracia. Este principio nunca fue olvidado por los reyes castellanos que consideraron el derecho de perdonar como una regalía. A lo largo del Antiguo Régimen se concedieron perdones reales por motivos diversos: políticos, religiosos, acontecimientos cortesanos, triunfos militares de la monarquía, o merced especial que el soberano deseó hacer a algún subdito. Por el número de afectados pueden clasificarse en generales, si absuelven a un colectivo de reos, o particulares, cuando el agraciado es uno solo. Los generales se regulaban por cédula específica que el rey despachaba al efecto. Su cumplimiento era vigilado por comisiones formadas por miembros de la Cámara, y los aspirantes a sus beneficios no necesitaban presentar solicitud personal ante ningún consejo regio, sino que siendo el caso de los incluidos en la cédula, las justicias de la causa se encargaban de su ejecución. Por está razón este tipo de indultos no han dejado huella en los archivos centrales, salvo las cédulas de concesión. Por el contrario, los individuales eran despachados por la Cámara en nombre del rey después de estudiar los autos procesales y han dejado en los archivos de la corona miles de testimonios. Estos van a ser el objeto de nuestro estudio.

Liver resection in metastatic colorectal cancer: a multidisciplinary approach Resección hepática por metástasis de cáncer colorrectal: una visión multidisciplinar

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J. F. Noguera Aguilar

2005-11-01

combinada a otras técnicas. Resultados: la mortalidad postoperatoria a los 30 días fue del 4%. Presentaron complicaciones el 28%, siendo la complicación más frecuente la infección de la herida quirúrgica (20%. Se transfundieron el 16,6% de los pacientes, con una necesidad transfusional media de 1000 cc. Dos casos precisaron reintervención (8%, en un caso precoz por absceso intraabdominal, y en otro caso tardía, por estenosis de la vía biliar principal. El porcentaje de recaídas global es del 36%, siendo más frecuente la extrahepática (26%. La supervivencia actuarial al año de seguimiento es del 90 y del 82% a los dos años. Se hallaban libres de enfermedad a los dos años el 64% de los pacientes. Conclusiones: los programas de resección hepática de metástasis de cáncer colorrectal pueden ser implantados por equipos multidisciplinares de reciente creación, si bien existe la necesidad de auditarse y situarse dentro de los parámetros de calidad.

Aumento de consultas en atención primaria por infección respiratoria de vías altas y por fiebre coincidiendo con la gripe (H1N1 2009

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Pablo Aldaz

2011-01-01

Full Text Available Fundamento: En verano de 2009 se registró en Navarra una onda de gripe A (H1N1 2009. Evaluar su repercusión en consultas de atención primaria con diagnóstico diferente al de gripe. Métodos: Estudiamos las consultas en atención primaria del Servicio Navarro de Salud desde el 21 de junio y al 21 de septiembre de 2009 con diagnósticos de gripe (Clasificación Internacional de Atención Primaria, código R80, síndrome febril (código A03, infección respiratoria aguda de vías altas (código R74 y bronquitis aguda (código R78, y las comparamos con las registradas en el mismo periodo en los tres años previos. Resultados: En verano de 2009 se notificaron 3417 casos de síndrome gripal (5,5 por 1.000 habitantes. Entre las semanas 27 y 31 se produjo un brote de gripe, con más de la mitad (87/160 de los frotis de pacientes con síndrome gripal positivos para el virus (H1N1 2009 sin detectarse otros tipos de virus gripal. Coincidiendo con la onda de síndromes gripales observamos aumentos de consultas por síndrome febril e infección respiratoria de vías altas. En comparación con la media de los tres años anteriores, en el verano del 2009 se produjo un incremento del 44! en consultas por síndrome febril (de 3,6 a 5,3 por 1000: p<0,001, del 6! en consultas por infección de vías altas (de 13,2 a 14,1 por 1000; p<0,001 y del 8! en consultas por bronquitis aguda (de 6,3 a 6,9 por 1000; p=0,003. Estos diagnósticos supusieron 3,2 consultas adicionales por 1.000 habitantes atribuibles a la gripe, es decir, un 58! de consultas adicionales. Conclusiones: La gripe se acompaña de aumento en el número de consultas por síndrome febril y por infección respiratoria de vías altas.

Examenes pulmonares por el método de Abreu: sus resultados

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Alfonso Reyes

1950-02-01

definitiva en 1936. Posteriormente el doctor Hanker aplica la Abrengrafía al examen en serio de colectividades. Entre nosotros, fue el doctor Omar Benavides en 1940 quien presentó su trabajo de tesis sobre las primeras abreugrafías tomadas en un aparato ideado por él. En Bogotá, se inició la campaña por este sistema en enero de 1947 con la fundación del Centro Epidemiológico No 1, dirigido por el doctor Antonio Acosta Pinzón.

Micetoma pulmonar por Scedosporium sp, reporte de dos casos

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José G. Somocurcio

2009-07-01

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

GRAVIDADE DE INTOXICAÇÕES POR SANEANTES CLANDESTINOS

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Jessica Adrielle Teixeira Santos

2011-01-01

Full Text Available El presente estudio tuvo como objetivo analizar las intoxicaciones por saneantes comercializados clandestinamente, reportadas en el Centro de Control de Intoxicaciones del Hospital Universitario Regional de Maringá. Es un estudio cuantitativo, con análisis retrospectivo de registros epidemiológicos de personas intoxicadas por estos agentes, en el período de enero de 2005 a diciembre de 2009. De los 118 casos reportados, la mayoría (74-62,7% se produjeron en varones, 105 (88,9% necesitaron de asistencia en unidades de atención de emergencia y hospitalización de alta complejidad, en 14 casos (11,8% requirieron de Cuidados Intensivos, y se reportaron cinco óbitos, todos por intoxicación intencional. Los resultados demuestran la gravedad y la letalidad de este tipo de intoxicación, sugieren la necesidad de medidas urgentes de fiscalización y control de la Vigilancia Sanitaria, así como de medidas para la educación de los consumidores, haciendo hincapié en el papel educativo de la Enfermería

Por uma estrada do M' Boi Mirim sustentável

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Carlos Henrique Santos de Oliveira

2015-10-01

Full Text Available Este artigo trata de avaliar importante via de transporte situada na zona sul da cidade de São Paulo, analisando quais fatores dificultam a circulação de bens e pessoas no espaço urbano, bem como a dificuldade de promover a mobilidade urbana de acordo com os princípios de sustentabilidade, por meio de uma pesquisa qualitativa, exploratória e bibliográfica, com base em um estudo de caso realizado na Estrada do M’ Boi Mirim. Os instrumentos de coleta de dados utilizados foram a observação pessoal, bem como pesquisas em artigos científicos, dissertações e teses relacionadas ao tema. Apesar de essa questão estar sendo amplamente discutida por diversos setores da sociedade, notam-se poucas soluções práticas, haja vista, o crescente uso de transportes individuais motorizados, muitos acidentes nas vias e por muitas vezes, pouca infraestrutura, bem como a falta integração das regiões por meio das vias existentes, principalmente em áreas distantes do centro das cidades.

Algunos aspectos relacionados con las enfermedades tropicales transmitidas por moluscos

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A. Mijail Pérez

1999-12-01

Full Text Available Muchas especies de moluscos son hospedantes de diversos parásitos que provocan infecciones muy serias e incluso mortales en seres humanos y ganado. La esquistosomiasis extendida por 74 países, infecta a unos 200 millones de personas y está en segundo lugar, después de la malaria, como causa de la mortalidad humana originada por parásitos. La infección es causada por un platelminto que se desarrolla en caracoles de agua dulce y que desde el agua puede penetrar en la piel de un ser humano y desarrollarse dentro de sus órganos, produciendo distintos grados de infección, hasta provocar la muerte. Distintas especies de esos caracoles están extendidas por Centro América. El cólera, otra enfermedad que también es mortal, se ha encontrado en moluscos bivalvos comestibles colectados en el Golfo de Nicoya, que bordea Nicaragua y Costa Rica Estas epidemias se pueden combatir con diversos métodos de control de los caracoles hospedantes de parásitos.

Fístula vesicovaginal por litíase: relato de caso

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Chambô Filho Antônio

2003-01-01

Full Text Available As fístulas de etiologia traumática são raras, sobretudo as intrínsecas por litíase vesical. O manejo dessas fístulas tem controvérsias no que diz respeito à técnica cirúrgica ideal. Uma variedade de tratamentos tem sido descrita, incluindo reparação cirúrgica por vias transvaginal e transabdominal. Os autores relatam o caso de uma paciente com queixa de perda urinária contínua com evolução de seis meses, sendo identificado ao exame especular orifício fistuloso no terço médio da parede anterior da vagina, por onde se exteriorizava urina. Nesta topografia, identificava-se, durante o toque bimanual, estrutura de consistência pétrea. A suspeita de litíase vesical foi confirmada pela radiografia de pelve. O tratamento cirúrgico se deu em dois tempos, com exérese do cálculo vesical e posterior correção da fístula por via vaginal.

Agente topológico de aprendizado por reforço

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Arthur Plínio de Souza Braga

2004-01-01

Os métodos de Aprendizagem por Reforço (AR) se mostram adequados para problemas de tomadas de decisões em diversos domínios por sua estrutura flexível e adaptável. Apesar de promissores, os métodos AR frequentemente tem seu campo de atuação prático restrito a problemas com espaço de estados de pequeno ou médio porte devido em muito à forma com que realizam a estimativa da função de avaliação. Nesta tese, uma nova abordagem de AR, denominada de Agente Topológico de Aprendizagem por Reforço (AT...

Detección de anticuerpos antiplasmodium por ELISA en donantes de sangre

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Patricia Olaya de Morales

1982-06-01

Full Text Available La malaria, una enfermedad transmitida por mosquitos del genero anopheles, puede ser inducida a través de transfusiones de sangre infectada con alguna de las especies de Plasmodium que afectan al hombre. Con el objeto de determinar el riesgo potencial de infección inducida por transfusiones, se analizaron durante 9 meses y mediante la técnica de E.L.I.S.A., las muestras de suero tomadas a los donantes de sangre del Hospital Militar Central de Bogotá. El 8.6 por mil de las 3114 muestras analizadas, resultaron positivas para anticuerpos antimaláricos y durante el tiempo del estudio fueron detectados 3 casos de malaria inducida por transfusiones.

Dano cavitacional em revestimentos depositados por aspersão termica a chama

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Paulo Villani Marques

1996-01-01

Resumo: Quantias elevadas são gastas anualmente na manutenção de turbinas hidráulicas usadas na geração de energia elétrica por causa do ataque cavitacional. Avaliou-se a aplicabilidade de revestimentos metálicos e cerâmicos depositados sobre aço carbono por aspersão térmica a chama na manutenção destes equipamentos em função de sua resistência à erosão por cavitação. Foram realizados ensaios de dureza, rugosidade, ensaio acelerado de cavitação induzida por vibração ultra-sônica, adesão (traç...

Nodulose por Metotrexato Methotrexate Induced Nodulosis

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Fernanda Guidolin

2005-08-01

Full Text Available A nodulose por metotrexato (MTX é um dos efeitos colaterais pouco conhecidos do uso desse medicamento em doses baixas. Embora classicamente descrita em casos de artrite reumatóide, tem aparecido, também, em outras doenças reumáticas. Descreve-se aqui um caso de nodulose por MTX em uma paciente com artrite reumatóide soropositiva, que utilizava esse medicamento há um ano, com bom controle do processo articular. Segue-se uma breve revisão sobre o assunto.Methotrexate-induced nodulosis is a rare side effect of this drug when it is used in low doses. Although classically described in rheumatoid arthritis patients, it may also appear in other rheumatic disorders. We describe a seropositive rheumatoid arthritis patient who developed methotrexate-induced nodulosis after using this drug for a year, with good control of articular symptoms. This case presentation is followed by a brief revision on the subject.

Reacciones adversas por antiinflamatorios no esteroideos

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Luisa Ivet Sánchez Ricardo

2011-03-01

Full Text Available Se realizó un estudio descriptivo y transversal en el Consultorio Médico de la Familia No. 28 perteneciente al Policlínico Universitario y Docente "Dr. Mario Muñoz Monroy" desde el 1ro. de junio al 31 de diciembre de 2008, con el objetivo de detectar las reacciones adversas más frecuentes provocadas por el consumo de antiinflamatorios no esteroideos. El universo estuvo constituido por 105 pacientes que asistieron a consulta en el tiempo de estudio y de estos se seleccionó una muestra de 60 pacientes, a quienes se les aplicó un cuestionario de preguntas donde se recogieron las variables de análisis. .Las mujeres resultaron las que más antiinflamatorios consumieron y en el rango de edades de 31-59 años. Las reacciones adversas que más se reportaron fueron la epigastralgia y la hipertensión arterial, así mismo se comprobó la automedicación en algunos pacientes.

Engorde de bagres (Rhamdia quelen) en sistema de cultivo intensivo por sexos separados

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Comolli, J; Roux, J.P; Sánchez, S; Hernández, D

2013-01-01

El bagre sudamericano (ramdiá o jundiá) se caracteriza por rápido crecimiento en los primeros meses de vida e importante diferencia de desarrollo entre ambos sexos. La madurez sexual del macho es precoz, por lo cual la hembra alcanza un peso vivo 30% mayor que el del macho. El presente trabajo tuvo por objetivo analizar el engorde de especimenes de Rhamdia quelen separados por sexos en un sistema intensivo. Se llevaron a cabo tres tratamientos: TA- hembra, TB- mixto y TC- macho. El engorde se...

Coeficiente de fricción por curvatura no intencional en concreto postensado

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Diego Ernesto Dueñas Puentes

2007-09-01

Full Text Available En el presente artículo se establece un coeficiente de fricción por curvatura no intencional (K para puentes de placa y vigas y puentes por voladizos sucesivos a partir de los registros de tensionamiento de algunos puentes postensados construidos en Colombia, el cual es inferior al empleado habitualmente en el diseño de puentes pos-tensados en el país y establecido por el Código Colombiano de Diseño Sísmico de Puentes (CCDSP publicado por el Instituto Nacional de Vías en 1995. Este estudio parte del hecho de que en algunas importantes obras se obtienen alargamientos de torones mayores a los estimados teóricamente, puentes de los cuales se dispone de registros de tensionamiento y de los que se deducen valores de coeficientes más cercanos a los indicados por las últimas ediciones de la Standard Specifications for Highway Bridges, publicada por American Association of State Highway and Transportation Officials “AASHTO”. En Colombia, el CCDSP, considera un coeficiente de fricción por curvatura no intencional (K para cables, con valores entre 0.0050 y 0.00066 m-1, dependiendo del material del que esté fabricado el ducto (acero galvanizado, sin galvanizar, metal brillante, valor superior al encontrado en este trabajo. En este artículo, en primer lugar, se realiza una breve descripción del efecto de fricción a lo largo de los cables, presentando los diferentes valores de coeficientes de fricción indicados en el CCDSP y en “AASHTO.”, en el diseño de puentes preesforzados. Se hace una corta descripción de cada uno de los puentes de los cuales se tienen registros de tensionamiento con el fin de identificar otras variables que intervienen en el proceso de ten-sionamiento como materiales, equipos y mano de obra, y posteriormente, a partir de la validación y tabulación de datos registrados en obra (registros en los cuales se controla la fuerza aplicada y el alargamiento de los torones, se efectuó la evaluación del coeficiente

Bloqueios nervosos guiados por ultra-som Bloqueos nerviosos guiados por ultrasonido Ultrasound-guided nerve blocks

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Pablo Escovedo Helayel

2007-02-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: As técnicas de bloqueios nervosos guiados por ultra-som são baseadas na visualização direta das estruturas nervosas, da agulha de bloqueio e das estruturas anatômicas adjacentes. Desta maneira, é possível depositar a solução de anestésico local precisamente em torno dos nervos e acompanhar a sua dispersão em tempo real, obtendo-se, assim, um bloqueio mais eficaz, de menor latência, menor dependência de referências anatômicas, menor volume de solução anestésica e maior segurança. CONTEÚDO: O artigo revisa os aspectos relativos aos mecanismos físicos para formação de imagens, a anatomia ultra-sonográfica do neuroeixo e dos plexos braquial e lombossacral, os equipamentos e materiais empregados nos bloqueios, os ajustes do aparelho de ultra-som para melhorar as imagens, os planos de visualização das agulhas de bloqueio e as técnicas e o treinamento em bloqueios guiados por ultra-som. CONCLUSÕES: Os passos para se obter sucesso em anestesia regional incluem a identificação exata da posição dos nervos, a localização precisa da agulha, sem lesões nas estruturas adjacentes e, finalmente, a injeção cuidadosa de anestésico local junto aos nervos. Embora a neuroestimulação forneça grande auxílio na identificação dos nervos, esta não consegue, isoladamente, preencher todas essas exigências. Por isso, acredita-se que os bloqueios guiados por ultra-som serão a técnica de eleição para anestesia regional num futuro não muito distante.JUSTIFICATIVA Y OBJETIVOS: Las técnicas de bloqueos nerviosos guiados por ultrasonido se basan en la visualización directa de las estructuras nerviosas, de la aguja de bloqueo y de las estructuras anatómicas adyacentes. De esa manera, se puede depositar la solución de anestésico local precisamente en torno de los nervios y acompañar su dispersión en tiempo real, obteniéndose así, un bloqueo más eficaz, de menor latencia, menor dependencia de

Sinterização ultrarrápida por micro-ondas de compósitos particulados PZT/FCO preparados por mistura em ultrassom

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C. P. Fernandez

Full Text Available Resumo Pós de Pb(Zr0,53Ti0,47O3 (PZT e Fe2CoO4 (FCO, foram sintetizados separadamente pelo método Pechini e misturados em ultrassom, nas proporções molares 80/20 e 50/50 (PZT/FCO. Os compósitos preparados foram prensados e submetidos à sinterização em forno convencional e sinterização ultrarrápida assistida por micro-ondas. A caracterização estrutural e microestrutural das amostras foram realizadas por difração de raios X e microscopia eletrônica de varredura, respectivamente. Medidas de constante dielétrica em função da temperatura, resistividade elétrica e coeficiente de acoplamento magnetoelétrico foram também realizadas. Os resultados evidenciaram que o método de mistura do PZT com a FCO por ultrassom foi rápido e eficiente, gerando, após sinterização, compósitos particulados com conectividade global (0-3 e distribuição uniforme de grãos da fase ferromagnética (FCO na matriz ferroelétrica (PZT. Da análise estrutural, verificou-se que a sinterização por micro-ondas propiciou um arranjo diferenciado no esquema de conectividade local na amostra (1-3 e (2-3, relacionada com a intensificação dos processos de difusão que ocorrem nesse tipo de sinterização principalmente em sistemas nanométricos. Pelos altos valores de resistividade obtidos, comprovou-se que a integridade das fases foi conservada nos dois métodos de sinterização, sendo mais eficiente na sinterização por micro-ondas, característica que garantiu o comportamento magnetoelétrico em todos os compósitos estudados neste trabalho. Os valores do campo Hmax foram dependentes da concentração da fase ferrita e da sinterização; para a composição 80/20 de 1,4 e 1,9 kOe, e para 50/50 de 3,5 e 3,0 kOe nas amostras sinterizadas por micro-ondas e convencionalmente, compatíveis com a literatura e que confirmaram a integridade das fases constituintes PZT e FCO.

Variaciones regionales de la mortalidad por homicidios en Jalisco, México

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Vega-López María Guadalupe

2003-01-01

Full Text Available El presente estudio busca describir las variaciones regionales de la mortalidad por homicidios en el estado de Jalisco, México, en 1989-1991, 1994-1996 y 1999-2000, analizando a su vez el comportamiento de la tasa de homicidios según género y estratos de bienestar socioeconómico. A partir de la información sobre mortalidad generada por el Instituto Nacional de Estadística, Geografía y Informática, se calcularon tasas ajustadas por edad y género e índices de sobremortalidad masculina. Además, se calcularon razones de tasa y su intervalo de confianza (95%. Los resultados reflejan que la tasa de homicidios presenta una tendencia decreciente en los años 90; que existe un patrón regional de la mortalidad por homicidios, observándose las tasas más altas en regiones periféricas del estado consideradas entre las más pobres; que los municipios ubicados en el estrato de bienestar más bajo presentan un exceso de mortalidad por homicidios estadísticamente significativo, y que hay una evidente sobremortalidad masculina por esta causa. Aspectos como los antes descritos implican tareas y desafíos para la salud pública y para los organismos encargados de preservar la ley y el orden, entre ellos la necesidad de implementar políticas intersectoriales diferenciadas, que tomen en consideración las particularidades que rodean al homicidio y al crimen violento en Jalisco.

Analisis cualitativo asistido por computadora Computer-assisted qualitative analysis

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César A. Cisneros Puebla

2003-01-01

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

Meningitis por Streptococcus suis

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Geffner Sclarsky, D. E.; Moreno Muñoz, R.; Campillo Alpera, Mª.S.; Pardo Serrano, F.J.; Gómez Gómez, A.; Martínez-Lozano, Mª.D.

2001-01-01

La infección humana por Streptococcus suis (S. suis) es una zoonosis, con un riesgo ocupacional conocido y que suele presentarse como meningitis purulenta, que tiene baja mortalidad y frecuentes secuelas de hipoacusia y ataxia. Se han publicado menos de 150 casos humanos desde el informe original de hace 30 años. Hay una reconocida distribución geográfica viviendo la mayoría de los afectados en el norte de Europa y el sudeste Asiático. En España se han comunicado dos pacientes con enfermedad ...

Apendicitis por Paracoccidioides brasiliensis.

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MUÑOZ URRIBARRI, Ana Beatriz; CHAPARRO DAMMERT, Eduardo; FERRUFINO LLACH, Juan Carlos; VASQUEZ FLORES, Luciola

2012-01-01

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 p...

Análise dos efeitos do ultrassom terapêutico e da eletrolipoforese nas alterações decorrentes do fibroedema geloide

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Machado,Giselle Cunha; Vieira,Rossana Bertolucci; Oliveira,Nuno Miguel Lopes de; Lopes,Célia Regina

2011-01-01

INTRODUÇÃO: A síndrome da desarmonia corporal (SDC) inclui a presença de fibroedema geloide (FEG), adiposidade localizada, aumento de gordura corporal total e flacidez muscular - frequentemente associados - e esses distúrbios estéticos representam uma ameaça à integridade emocional do indivíduo, sendo uma variedade de terapias propostas para o seu tratamento. OBJETIVOS: Avaliar os efeitos do ultrassom terapêutico (UST) e da eletrolipoforese no tratamento das alterações decorrentes do fibroede...

Evaluación docente y aprendizaje por competencia de los estudiantes

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Segovia Suller, Cirilo

2016-01-01

Métodos Estadísticos para la Investigación es una asignatura que genera un grado de dificultad en la enseñanza del docente y el aprendizaje del alumno. En el aula se investigó si existe una relación entre la evaluación docente y el aprendizaje por competencias de los estudiantes. El objetivo era determinar la relación entre la evaluación docente y el aprendizaje por competencias de los estudiantes, para luego formular la hipótesis: la evaluación docente se relaciona con el aprendizaje por com...

Fiebre Tifoidea Diagnóstico por pruebas inmunoenzimáticas: Elisa

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Miguel Guzmán

1981-06-01

Full Text Available Este trabajo describe el desarrollo y normalización de una técnica inmunoenzimática para el diagnóstico indirecto de la Fiebre Tifoidea. El método permite un análisis simple y objetivo de los resultados. La reacción enzimática es proporcional a la concentración de anticuerpos en el suero contra el antígeno somático-0, por tanto, el método es cuantitativo. Por lo demás, la técnica tiene un alto grado de especificidad para Salmonella typhi, ya que los sueros de pacientes con Salmonelosis causada por Salmonella enteritidis serotipos paratyphi A, B y typhimurium dieron resultados negativos, en forma similar a los presentados por el grupo control antes de la vacunación específica. Los resultados obtenidos con esta técnica permitieron definir el nivel de anticuerpos que puede presentar una población control supuestamente sana frente a los niveles inducidos por la enfermedad. Los resultados postvacunales en el grupo control mostraron títulos sorprendentemente bajos; un análisis de este fenómeno se presentó en forma amplia. Igualmente se proponen futuras investigaciones sobre este campo.

HOSPITALIZACIONES EVITABLES POR INSUFICIENCIA CARDÍACA. VARIABLES RELACIONADAS

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Victoria Ruiz-Romero

2016-01-01

Full Text Available Los ingresos hospitalarios evitables por insuficiencia cardiaca (IC son un problema para los sistemas de salud, consumen recursos, generan morbilidades adicionales y alta mortalidad. El objetivo del estudio fue conocer los factores de riesgo de las personas hospitalizadas por insuficiencia cardiaca. Métodos: Se constituyó un grupo con médicos de atención primaria y hospitalaria. Se realizaron auditorías de las historias clínicas de 110 pacien - tes de la poblacion de la comarca del Aljarafe con mayores tasas de ingreso por insuficiencia cardiaca y estudio descriptivo y comparativo con T-Student y U-Mann Whitney para cuantitativas y λ 2 y Fisher para cualitativas. Resultados: Los pacientes que ingresaron por IC tenían 78,1 años (SD: 9,56 de media; 73 (66,4% fueron mujeres; un Índice Barthel de 45,0 de media; un 53,5% con grado III de la NYHA y 17 (15,5% institucionaliza - dos. El 70% presentaban 3-5 comorbilidades, hipertensión (87,3%, dislipe - mia (60,0% diabetes (57,3%, enfermedad renal crónica (56,4%, anemia (53,2% o fibrilación auricular (52,7%. Fallecieron al ingreso 23 (20,9% pacientes. Conclusiones: Los ingresos se dieron en personas mayores con múl - tiples enfermedades (hipertensión, diabetes, EPOC, enfermedad renal y escasa capacidad para actividades básicas de la vida diaria. El fallecimiento hospitalario se asoció a edad avanzada, ser mujer, menor uso de betabloqueantes y la no inclusión del paciente en el proceso asistencial.

161. Necrosis por presión del septo de salida ventricular causado por dos implantes adyacentes

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A. González Calle

2012-04-01

Conclusiones: Esta complicación ilustra que los tejidos entre dos dispositivos duros y con movimiento uno conrespecto al otro pueden desarrollar necrosis por presión y fricción y, consecuentemente, perforación. Probablemente, hubiera sido preferible sustituir el homoinjerto pulmonar con stent en el momento de la sustitución valvular aórtica.

Asociación entre diabetes mellitus tipo 2 y actividad física en personas con antecedentes familiares de diabetes

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Fanny Petermann

2018-05-01

Full Text Available Resumen: Objetivo: Investigar si la asociación entre diabetes mellitus tipo 2 (DMT2 y antecedentes familiares de DMT2 resulta modificada por los niveles de actividad física en población chilena. Método: Se incluyeron en el estudio 5129 participantes de la Encuesta Nacional de Salud de Chile. El tiempo destinado a realizar actividad física se determinó por el cuestionario GPAQ v2, y los antecedentes familiares mediante el autorreporte de cada participante. La asociación entre DMT2, antecedentes familiares de DMT2 y actividad física fue investigada por sexo mediante regresión logística. Resultados: El riesgo de desarrollar DMT2 en personas con antecedentes familiares de esta enfermedad es elevado, independientemente de su nivel de actividad física y de su adiposidad. Tanto las mujeres como los hombres físicamente inactivos y con antecedentes familiares de DMT2 presentan mayor probabilidad de desarrollar DMT2 (odds ratio [OR] mujeres: 5,49; intervalo de confianza del 95% [IC95%]: 3,85-7,84; p <0,0001; y OR hombres: 8,16; IC95%: 4,96-13,4; p <0,0001, comparados con sus pares sin antecedentes familiares y activos físicamente. Conclusión: Dado el alto riesgo de desarrollar DMT2 que presentan los individuos con antecedentes familiares de esta enfermedad, y el efecto de la actividad física en la disminución de dicho riesgo, es esencial incrementar los niveles de actividad física en la población que presenta mayor susceptibilidad a DMT2. Abstract: Objective: To investigate whether the association between type 2 diabetes (T2D and family history of diabetes is modified by the levels of physical activity in the Chilean population. Method: In this study were included 5129 participants from the cross-sectional 2009-2010 National Health Survey. Physical activity level was assessed using the Global Physical Activity Questionnaire and family history of T2D, through self-reporting. The association between diabetes, family history of diabetes and

Impacto da atividade inflamatória e uso de glicocorticóide nas variáveis nutricionais da artrite idiopática juvenil Impact of inflammatory activity and glucocorticoid use in the nutritional variables of juvenile idiopathic arthritis

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Letícia Souza Bisotto

2005-10-01

Full Text Available OBJETIVO: avaliar o estado nutricional na artrite idiopática juvenil (AIJ, a influência da atividade inflamatória e o uso de glicocorticóide. MÉTODOS: foram estudados 116 pacientes com AIJ diagnosticados segundo os critérios da ILAR/1997. Subtipo e atividade da doença foram determinados por reumatologistas pediátricos, e a dose cumulativa de glicocorticóide foi revisada nos prontuários dos pacientes. Foram determinados os percentis do índice de massa corporal (IMC e da prega cutânea tricipital (PCT e o escore Z da estatura, de acordo com a OMS. Considerou-se baixo peso e baixa adiposidade quando o IMC e a PCT apresentavam-se abaixo do percentil 5. Baixa estatura foi definida por escore Z de estatura para idade menor do que -2. O nível sérico de IGF-1 foi medido por meio de radioimunoensaio. RESULTADOS: as prevalências de baixo peso, baixa adiposidade e baixa estatura foram 16,4%, 20,7% e 10,4%, respectivamente. Níveis séricos reduzidos de IGF-1 foram observados em 14 pacientes (12,1%. Os fatores negativamente associados com o escore Z da estatura na análise de regressão multivariável foram: duração da doença (coeficiente parcial de correlação, intervalo de confiança de 95%: -0,370, -0,527 a -0,188: pOBJECTIVE: To assess the nutritional status in juvenile idiopathic arthritis (JIA and the influence of inflammatory activity and glucocorticoid use. METHODS: One hundred and sixteen patients were evaluated. Disease subtype and disease activity were defined by the attending physician, and the cumulative glucocorticoid dose was recorded by chart review. The percentiles of body mass index (BMI and triceps skinfold (TSF and the Z-score for height were determined: low weight and low adiposity were diagnosed when BMI and TSF were below the 5th percentile. Short stature was defined by a Z-score of height for age < -2. The serum level of IGF-I was measured by radioimmunoassay. RESULTS: The prevalences of low weight, low adiposity

Uso de contraceptivos por puérperas adolescentes

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Fernanda Schulz da Rosa

2014-07-01

Full Text Available Objetivo: Indagar el uso de métodos contraceptivos por las puérperas adolescentes a fin de relacionar su (desuso con el embarazo en la adolescencia. Método: Estudio transversal, descriptivo, realizado por medio de un instrumento estructurado con 181 puérperas adolescentes que tuvieron sus partos en el hospital participante de la investigación. Los datos fueron recolectados en el período de diciembre de 2008 a diciembre de 2009. Resultados: El 64,1% de las puérperas usaba algún método contraceptivo antes del embarazo; los métodos más utilizados fueron el anticoncepcional oral (51% y el preservativo masculino (29%. Para el 75% de las adolescentes el embarazo fue planeado y justificado por el deseo y la voluntad propia de experimentar la maternidad. Conclusión: Considerando que casi la mitad de las adolescentes entrevistadas deseaba el embarazo, se deduce que investigar y discutir apenas el uso o no de los métodos contraceptivos no es adecuado. Es necesario profundizar las investigaciones acerca de los significados de ser madre en la adolescencia.