Reacciones adversas de la ozonoterapia en pacientes con retinosis pigmentaria / Adverse reactions of ozone therapy in patients with retinitis pigmentosa

Objetivo: describir las reacciones producidas por la ozonoterapia durante la aplicación de la estrategia cubana para pacientes portadores de retinosis pigmentaria. Métodos: se realizó un estudio descriptivo, longitudinal, retrospectivo en 6 414 pacientes portadores de retinosis pigmentaria, atendidos en el Centro Internacional de Retinosis Pigmentaria Camilo Cienfuegos, a quienes se les aplicó ozonoterapia como parte de la estrategia cubana multiterapéutica de control para pacientes portadores de esta enfermedad. En un grupo de pacientes se aplicaron 10 sesiones de autohemoterapia mayor y en otro grupo se administraron 10 sesiones por insuflación rectal. Para la aplicación de la ozonoterapia se utilizó un equipo Ozomed. Los datos estadísticos se analizaron y compararon usando la prueba t de Student. Se consideró p< 0,05 como significación estadística. Resultados: se observaron reacciones adversas en 28 pacientes; de ellos, 5 recibieron ozono por insuflación rectal y 23 por autohemoterapia mayor. Se observaron 4 pacientes con náuseas, 6 con sensación de estómago repleto, 5 con euforia, 1 con fatiga inusual y 1 con sabor metálico bucal. Esto representa el 0,004 por ciento de la muestra estudiada. Conclusión: la ozonoterapia demuestra ser un tratamiento médico muy seguro e inocuo en pacientes con retinosis pigmentaria(AU)

Objective: to describe adverse reactions of ozone therapy after the Cuban strategy for patients with retinitis pigmentosa. Methods: a retrospective, longitudinal and descriptive study was conducted in 6 414 patients with retinitis pigmentosa seen at Camilo Cienfuegos International Center of Retinitis Pigmentosa. They had been treated with ozone therapy as part of the Cuban multi-therapy strategy for management of these patients. A group of patients received ten applications of major autohemotherapy whereas another group was administered 10 ozone sessions through rectal insufflation. The Ozomed machine was the choice for ozone therapy. Student's test was used to analyze and to compare statistical data. Significant statistical index was p< 0,05. Results: twenty eight patients were found to have adverse reactions, 5 of them under rectal insufflation and 23 in the major autohemotherapy group. There were observed 4 patients with nauseas, 6 with stomach bloating, 5 with euphoria, one with unusual fatigue and one with strange metallic taste. This represented 0,004 percent in this sample. Conclusion: the ozone therapy has been found to be an extremely safe medical therapy in patients with retinitis pigmentosa(AU)

Effect of lung insufflation with oxygen or air during cardiopulmonary bypass on post-bypass pulmonary dysfunction

Cardiopulmonary bypass [CPB] causes various abnormalities in the physical and functional properties of the lungs that initiate increases in pulmonary capillary endothelial permeability, decreases in lung compliance, and impaired gas exchange during the immediate postoperative period. This prospective randomized clinical trial was designed to investigate the effect of insufflating the lungs with 100% oxygen or air versus totally disconnecting the lungs and leaving them to collapse during cardiopulmonary bypass. Fifty-six adult patients undergoing CABG surgery with total CPB and aortic cross-clamping were included. Patients were randomly allocated to 1 of 3 groups that differed only in respiratory management during CPB; Group I [O [2] group, n=19] received 100% oxygen insufflation at 4 L/min. Group II [Air group, n=19] received air [FiO[2] 0.2] at the same flow rate. Group III [Collapse group, n=18] were totally disconnected from the anesthesia machine, and their lungs were left to collapse. PaO[2]/FiO[2] was significantly reduced in O2and Collapse groups in the post-CPB measurement compared to baseline but not in Air group [p<0.05]. In the postoperative period PaO[2]/FiO[2] was significantly higher in Air group compared to O[2] group, measured at 1 hour and 4 hours postoperatively [473 + 60 vs 407 + 90, and 476 +/- 39 vs 416 +/- 73 respectively, p<0.05] denoting a more rapid recovery of the lungs. Static and dynamic lung compliance were significantly reduced in the post-CPB and postoperative measurements in 0[2] and Collapse groups, but not in Air group [p<0.05]. Bronchoalveolar lavage [BAL] cytolines [TNF-alpha and IL-8] were significantly elevated in the post-CPB measurement in 02 group compared to baseline [12.1 [0 -42.1] vs 1 [0 - 17] pg, and 674 [50 - 8767] vs 217 [<10 - 2076] pg respectively, p<0.05], but not in Air or Collapse groups. TNF-alpha and IL-8 were significantly higher in O[2] group in the post-CPB measurement compared to both other groups [p<0.05]. Lung insufflation with air [without the application of mechanical ventilation or CPAP] during CPB has attenuated post-CPB pulmonary dysfunction compared to insufflation with 100% oxygen or disconnecting the lungs and leaving them to collapse. Oxygen on the other hand has caused an inflammatory response as evident by an increase in BAL cytokines