RESUMEN
Introduction: Propofol has been suggested as a useful adjunct to cardiopulmonary bypass (CPB) because of its potential protective effect on the heart mediated by a decrease in ischemia-reperfusion injury and inflammation at clinically relevant concentrations. In view of these potentially protective properties, which modulate many of the deleterious mechanism of inflammation attributable to reperfusion injury and CPB, we sought to determine whether starting a low dose of propofol infusion at the beginning of CPB would decrease inflammation as measured by pro-inflammatory markers. Materials and Methods: We enrolled 24 patients undergoing elective coronary artery bypass graft (CABG). The study group received propofol at rate of 120 mcg/kg/min immediately after starting CPB and was maintained throughout the surgery and for the following 6 hours in the intensive care unit (ICU). The control group received propofol dose of 30-50 mcg/kg/min which was started at the time of chest closure with wires and continued for the next 6 hours in the ICU. Interleukins (IL) -6, -8 and -10 and tumor necrosis factor alpha (TNFalpha) were assayed. Result: The most significant difference was in the level of IL-6 which had a P value of less than 0.06. Starting a low dose propofol early during the CPB was not associated with significant hemodynamic instability in comparison with the control group. Conclusion: Our study shows that propofol may be suitable as an anti-inflammatory adjunct for patients undergoing CABG.
RESUMEN
The 1995 rubella outbreak in Jamaica indicated a need to survey the susceptibility rate in Jamaican antenatal women at risk. In this 1996 study, 389 women in the reproductive age group were investigated for rubella antibodies. In the public sector urban group (A), rubella susceptibility was 20.2, while in a private sector urban clinic (B) practising routine rubella surveillance and recommending postpartum immunization in seronegatives, the susceptibility rate was 13.8. The latter rate was significantly lower than that in the rural group (C) (35.9; p < 0.001). The overall susceptibility rate was 21.3. Rubella susceptibility has improved overall in women of childbearing age compared with levels in the prevaccine year of 1968. A significant thrust in rubella prevention will still be required before the next rubella epidemic in order to reduce the risk of congenital rubella syndrome.
Asunto(s)
Humanos , Femenino , Adolescente , Adulto , Embarazo , Anticuerpos Antivirales/análisis , Rubéola (Sarampión Alemán)/inmunología , Virus de la Rubéola/inmunología , Complicaciones Infecciosas del Embarazo/inmunología , Estudios Seroepidemiológicos , Jamaica/epidemiología , Rubéola (Sarampión Alemán)/epidemiologíaAsunto(s)
Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Angiopatías DiabéticasRESUMEN
En este trabajo se muestra aun cuando se hagan pruebas diagnosticas apropiadas que identifiquen las causas de trastornos cognoscitivos en los ancianos, los sintomas y comportamiento habitualmente continuan, debido a la falta de tratamiento adecuado que podria, reducir o eliminar estas causas. La meta es estimular las investigaciones en esta area para determinar que modalidades de tratamiento son mas efectivas para modificar las conductas inadecuadas que acompanan al disfuncionamiento cognoscitivo. La meta final es modificar el tratamiento clinico de los ancianos afectados por un problema cognoscitivo para elevar al maximo sus niveles funcionales