ABSTRACT
We report a rare case of a patient with esophageal carcinoma diagnosed using transthoracic echocardiography. This examination proved to be useful in the identification of a paracardiac mediastinal mass. Images of the esophageal carcinoma, of the stent in the esophagus, and the bubbles inside the stent generated with the ingestion of a carbonated beverage, have not been previously published. Therefore, we believe our findings may be useful to other echocardiographers.
Subject(s)
Cardiac Tamponade/diagnostic imaging , Cardiac Tamponade/etiology , Deglutition Disorders/etiology , Deglutition Disorders/prevention & control , Echocardiography/methods , Esophageal Neoplasms/complications , Esophageal Neoplasms/diagnostic imaging , Cardiac Tamponade/prevention & control , Deglutition Disorders/diagnosis , Diagnosis, Differential , Esophageal Neoplasms/drug therapy , Humans , Male , Middle AgedSubject(s)
Intestinal Perforation/surgery , Polytetrafluoroethylene , Prostheses and Implants , Aged, 80 and over , Fatal Outcome , Female , Follow-Up Studies , Humans , Intestinal Mucosa/pathology , Intestinal Perforation/etiology , Intestinal Perforation/pathology , Middle Aged , Stomach Ulcer/complications , Treatment OutcomeABSTRACT
BACKGROUND: Procalcitonin (PCT) is widely accepted as an early marker of the severity of sepsis and its prognosis. This study was designed to evaluate the utility of PCT in the early diagnosis of immediate postoperative complications (infectious and non-infectious) following cephalic pancreatoduodenectomy (PD). PATIENTS AND METHOD: Thirty-one patients who underwent elective PD were prospectively analyzed. The patients were divided into two groups according to the presence or absence of postoperative complications. Plasma PCT concentrations were determined by an immunochromatographic method. The correlation between PCT concentrations and the presence of complications, as well as the existence of statistically significant differences in PCT concentrations between the 2 groups of patients, were analyzed. The value of plasma PCT concentrations in predicting complications compared with that of other biochemical variables (C-reactive protein, lactic acid, base excess) and clinical parameters (systemic inflammatory response syndrome) was analyzed. RESULTS: Significant differences in PCT concentrations were found between the two groups. An inverse correlation between marker levels and patient outcome was observed. The variables that best predicted the development of complications were PCT concentrations and axillary temperature. CONCLUSIONS: Plasma PCT should be taken into account as a useful marker for postoperative clinical course in the follow-up of PD and for the early detection of non-infectious complications.
Subject(s)
Calcitonin/blood , Pancreaticoduodenectomy/methods , Postoperative Care , Postoperative Complications , Protein Precursors/blood , Sepsis/blood , Sepsis/etiology , Adult , Aged , Calcitonin Gene-Related Peptide , Female , Follow-Up Studies , Humans , Male , Middle Aged , Predictive Value of Tests , Preoperative Care , Prospective StudiesABSTRACT
Introducción. La utilidad de la procalcitonina (PCT) es aceptada como marcador de gravedad de la sepsis y su evolución. El propósito del presente trabajo es demostrar su utilidad en el diagnóstico temprano de complicaciones infecciosas y no infecciosas en el postoperatorio inmediato de la duodenopancreatectomía cefálica (DPC). Pacientes y método. Se analizó prospectivamente a 31 pacientes sometidos a una DPC programada. La población se dividió en dos grupos, con y sin complicaciones postoperatorias. La concentración plasmática de PCT se determinó mediante una prueba inmunocromatográfica. Se examinó: la correlación entre las concentraciones del marcador y la presencia de complicaciones; la existencia de diferencias estadísticamente significativas en las concentraciones de PCT entre los dos grupos de pacientes; el valor predictivo de las concentraciones plasmáticas de PCT en la aparición de complicaciones comparadas con otras variables bioquímicas (proteína C reactiva, ácido láctico, exceso de base) y clínicas (criterios del síndrome de respuesta inflamatoria sistémica). Resultados. Las concentraciones de PCT resultaron significativamente diferentes entre los grupos estudiados. Se observó una correlación inversa entre los valores del marcador y la evolución de los pacientes. Las concentraciones de PCT y la temperatura axilar fueron las variables que mejor predijeron la aparición de complicaciones. Conclusiones. La PCT plasmática debería tenerse en cuenta como marcador evolutivo del postoperatorio en el seguimiento de la DPC como también para complicaciones no infecciosas (AU)
Background. Procalcitonin (PCT) is widely accepted as an early marker of the severity of sepsis and its prognosis. This study was designed to evaluate the utility of PCT in the early diagnosis of immediate postoperative complications (infectious and non-infectious) following cephalic pancreatoduodenectomy (PD). Patients and method. Thirty-one patients who underwent elective PD were prospectively analyzed. The patients were divided into two groups according to the presence or absence of postoperative complications. Plasma PCT concentrations were determined by an immunochromatographic method. The correlation between PCT concentrations and the presence of complications, as well as the existence of statistically significant differences in PCT concentrations between the 2 groups of patients, were analyzed. The value of plasma PCT concentrations in predicting complications compared with that of other biochemical variables (C-reactive protein, lactic acid, base excess) and clinical parameters (systemic inflammatory response syndrome) was analyzed. Results. Significant differences in PCT concentrations were found between the two groups. An inverse correlation between marker levels and patient outcome was observed. The variables that best predicted the development of complications were PCT concentrations and axillary temperature. Conclusions. Plasma PCT should be taken into account as a useful marker for postoperative clinical course in the follow-up of PD and for the early detection of non-infectious complications (AU)
Subject(s)
Male , Female , Adult , Middle Aged , Humans , Calcitonin/therapeutic use , Postoperative Care/methods , Pancreatectomy/methods , Pancreaticoduodenectomy/methods , Postoperative Complications/diagnosis , Bacterial Infections/diagnosis , Protein Precursors , Logistic Models , Digestive System Surgical Procedures/methods , Predictive Value of Tests , Prospective Studies , Biomarkers , Regression Analysis , Diagnostic Techniques, Digestive SystemABSTRACT
OBJECTIVE: To determine the utility of biochemical parameters such as lactic acid (LA), C-reactive protein (CRP), microalbuminuria (MAU), and base deficit (BD) as early markers of complications in the immediate postoperative evolution of elective open gastrointestinal surgeries. DESIGN AND METHODS: Sixty-two patients subject to elective open gastrointestinal surgery were evaluated during a period of 22 months. RESULTS: From the initial 62 patients, 2 were excluded, 29 (48.3%) evolved without complications, and 31 (51.6%) with complications. It was observed that the most significant areas under the ROC curve corresponded to BD in the preoperative period, LA on the first day, and CRP from the second to the seventh day after surgery. MAU was not a discriminating parameter since it did not reach a significant area under the curve (AUC) at any time. CONCLUSIONS: The biochemical markers that best relate to the presence of complications are BD in the preoperative period, LA on the first day, and CRP from the second to the seventh day after surgery.
Subject(s)
Digestive System Surgical Procedures , Postoperative Complications , Systemic Inflammatory Response Syndrome/blood , Acid-Base Imbalance/blood , Adult , Aged , Albuminuria/blood , Argentina , Biomarkers/blood , C-Reactive Protein/analysis , Creatinine/urine , Female , Humans , Lactic Acid/blood , Male , Middle Aged , Postoperative Complications/blood , Postoperative Period , Predictive Value of Tests , Prospective Studies , Systemic Inflammatory Response Syndrome/etiologyABSTRACT
Las enzimas citrocromo-c-oxidasa y P-450 fueron mediadas en cortezas adrenales de ratas macho adultas en cuatro condiciones experimentales: G1, controles; G2, castrados; G3, castrados y tratados con testosterona y G4, castrados y tratados con testosterona y dexametasona. Con la citocromo-c-oxidasa no se observaron diferencias significativas entre G1, G2 y G4. La máxima actividad se encontró en el grupo G3, el cual difiere significativamente del resto de los grupos. Con citocromo P-450 no se encontraron diferencias entre G1 y G3. Sin embargo, se encontraron diferencias significativas entre G1 y G4. Estos estudios proveen nuevas evidencias con referencia a la interacción de la corteza adrenal y las gónadas en relación con la actividad esteroidogénica y respiratoria
Subject(s)
Rats , Animals , Male , Adrenal Cortex/metabolism , Castration , Cytochrome P-450 Enzyme System/metabolism , Dexamethasone/pharmacology , Electron Transport Complex IV/metabolism , Testosterone/pharmacology , Adrenal Cortex/enzymology , Rats, WistarABSTRACT
Las enzimas citrocromo-c-oxidasa y P-450 fueron mediadas en cortezas adrenales de ratas macho adultas en cuatro condiciones experimentales: G1, controles; G2, castrados; G3, castrados y tratados con testosterona y G4, castrados y tratados con testosterona y dexametasona. Con la citocromo-c-oxidasa no se observaron diferencias significativas entre G1, G2 y G4. La máxima actividad se encontró en el grupo G3, el cual difiere significativamente del resto de los grupos. Con citocromo P-450 no se encontraron diferencias entre G1 y G3. Sin embargo, se encontraron diferencias significativas entre G1 y G4. Estos estudios proveen nuevas evidencias con referencia a la interacción de la corteza adrenal y las gónadas en relación con la actividad esteroidogénica y respiratoria (AU)
