ABSTRACT
Actinorhizal plants have been found in eight genera belonging to three orders (Fagales, Rosales and Cucurbitales). These all bear root nodules inhabited by bacteria identified as the nitrogen-fixing actinobacterium Frankia. These nodules all have a peripheral cortex with enlarged cells filled with Frankia hyphae and vesicles. Isolation in pure culture has been notoriously difficult, due in a large part to the growth of fast-growing contaminants where, it was later found, Frankia was slow-growing. Many of these contaminants, which were later found to be Micromonospora, were obtained from Casuarina and Coriaria. Our study was aimed at determining if Micromonospora were also present in other actinorhizal plants. Nodules from Alnus glutinosa, Alnus viridis, Coriaria myrtifolia, Elaeagnus x ebbingei, Hippophae rhamnoides, Myrica gale and Morella pensylvanica were tested and were all found to contain Micromonospora isolates. These were found to belong to mainly three species: Micromonospora lupini, Micromonospora coriariae and Micromonospora saelicesensis. Micromonospora isolates were found to inhibit some Frankia strains and to be innocuous to other strains.
ABSTRACT
El advenimiento de nuevas drogas es un reto para el anestesiólogo, muchas de éstas resultan ser efectivas, otras quedan sin poder demostrar los beneficios para el paciente. Por esta razón, se hace necesario a través de la investigación clínica darle evidencia a cada una de ellas. La Dexmedetomidina y el Remifentanyl son dos fármacos de reciente introducción en anestesia y sus efectos en el paciente neuroquirúgico no han sido totalmente descritos. Objetivos: evaluar los cambios hemodinámicos durante las tres fases de la anestesia utilizando Fentanyl y Sevoflurane comparado con dexmedetomidina, remifentanyl y sevoflurane a dosis menores de 1 Concentración Alveolar Mínima adicionalmente se evaluaron tiempos de extubación, sedación y analgesia postoperatoria. Adicionalmente se evaluó el costo indirecto de las dos técnicas. Materiales y métodos: se realizo un ensayo clínico no aleatorizado en 50 pacientes, con riesgo anestésico entre I y III entre 18 y 80 años, sometidos a craniectomía. Se evaluó el riesgo relativo de presentar hipo o hipertensión, taquicardia o bradicardia, sedación y analgesia postoperatoria. Resultados: El análisis estadístico no mostro diferencias respecto a las características basales de los pacientes como género, edad, peso o clasificación ASA. Durante la intubación se presentaron cambios hemodinámicos en el 56% de los pacientes de cada grupo, pero sin diferencias entre ellos. Durante el mantenimiento y extubación, el riesgo relativo de presentar taquicardia e hipertensión fue menor y significativo en el grupo intervenido (RR de 0,625 y 0,357 p=0,041 y 0,009). El tiempo a la extubación fue menor en el grupo intervenido (6,8 vs 13,6min. p=0,000), con un nivel Ramsey 3 en el 96% (n=24) versus 12% (n=3) en el grupo control (p=0,000). El dolor postoperatorio se dio en el 54% del grupo control y solo en el 4% del intervenido (p=0,000). Conclusiones: La dexmedetomidina y el Remifentanyl son dos drogas promisorias que nos dan la oportunidad de cumplir mejor los objetivos de la anestesia neuroquirurgica y deben ser evaluadas en futuros estudios clínicos controlados...
The coming of new drugs is a challenge for the anesthesiologist, many of these they turn out to be effective, others are without being able to demonstrate the benefits for the patient. It becomes necessary through the clinical investigation to give him evidences to each one of them. The Dexmedetomidine and the Remifentanyl they are two drugs of recent introduction in anesthesia and their effects in the patient neurosurgical they have not been completely described. Objectives: The major goal of this study was to evaluate the hemodynamic changes during the three phases of the anesthesia using fentanyl and sevoflurane compared with dexmedetomidine, remifentanyl and sevoflurane (DRS) to dose smaller than 1 CAM. A secondary goal was to compare times of extubación, sedation, postoperative analgesia and costs. Patient and Methods: Prospective study not randomized in 50 patients ASA I, II, III between 18 and 80 years, subjected to craniectomía. Patients were divided into one of two groups: Group FS (n=25) and DRS (n=25). The relative risk was evaluated (RR) of presenting hypertension, hypotension, taquicardia, bradicardia, sedation and postoperative analgesia. Results: The statistical analysis did not show differences regarding sex, age or ASA classifi cation between two groups. Group DRS Patients presenting taquicardia and hypertension was smaller and more significant in the intervened group (RR 0.625 and 0.357 p=0.041 and 0.009). The time to the extubación was smaller in the intervened group (6.8 vs 13.6min. p=0.000), with a level Ramsey 3 in 96% (n=24) versus 12% (n=3) in the group control (p=0.000). The postoperative pain was given in 54% of the group control and alone in 4% of the one intervened (p=0.000). Conclusion: The dexmedetomidina and the Remifentanyl are two promissory drugs that give us the opportunity to complete the objectives of the anesthesia neurosurgical better and they should be evaluated in future controlled clinical studies disease and in people older than 60 years, the underlying neoplasm and cases of unknown etiology prevail. The anticoagulant treatment is effective and safe. The prognosis was excellent in the most of the cases...
Subject(s)
Anesthesia , Decompressive Craniectomy , Dexmedetomidine , NeurosurgeryABSTRACT
Estudio analítico descriptivo propuesto por la Secretaría Distrital de Salud a través del desarrollo de términos de referencia, en el que se plantea como objetivo general identificar la capacidad operativa, técnica-administrativa y la calidad de prestación del servicio de radiodiagnóstico de uso médico y odontológico en las instituciones adscritas a la Secretaría Distrital de Salud de Santa Fe de Bogotá, con el fin de generar estrategias que permitan actualizar la infraestructura, dotación y calidad para mejorar las condiciones en la prestación de dicho servicio. El estudio fue desarrollado por la firma Idear Salud Ltda. Se realizó un inventario de las instituciones adscritas a la SDS con servicio de radiodiagnóstico médico; se hizo una descripción de las características de este servicio en su organización, distribución en la ciudad, demanda y acceso de la población, infraestructura para su funcionamiento, recurso humano, tecnológico, evaluación de las radiaciones ionizantes emitidas por los equipos de radiodiagnóstico, efectuando y verificando diseño, alternativas de control e identificación del nivel de conocimiento de los funcionarios encargados del servicio de radiodiagnóstico médico de los hospitales en el manejo de dichos equipos. El universo lo conformaron todas las instituciones adscritas a la Secretaría Distrital de Salud.
Descriptive analytical study proposed by the District Health Secretariat through the development of terms of reference, in which the general objective is to identify the operational, technical-administrative capacity and the quality of the radiodiagnosis service for medical and dental use in the institutions attached to the District Health Secretariat of Santa Fe de Bogotá, in order to generate strategies to update the infrastructure, equipment and quality to improve the conditions in the provision of such service. The study was developed by the firm Idear Salud Ltda. An inventory was made of the institutions attached to the SDS with medical radiodiagnosis service; a description was made of the characteristics of this service in its organization, distribution in the city, demand and access of the population, infrastructure for its operation, human and technological resources, evaluation of the ionizing radiation emitted by the radiodiagnosis equipment, making and verifying design, control alternatives and identification of the level of knowledge of the officials in charge of the medical radiodiagnosis service of the hospitals in the handling of such equipment. The universe was made up of all the institutions attached to the District Health Secretariat.