ABSTRACT
No disponible
Subject(s)
Female , Adult , Humans , Kidney Diseases/complications , Nephrectomy/adverse effects , Pneumothorax/etiology , Respiratory Tract Fistula/complications , Urinary Fistula/complications , Lung Diseases/complicationsABSTRACT
OBJECTIVES: To assess the clinical performance of a new anesthetic system developed to provide novel advantages in ventilating the anesthetized patient. PATIENTS AND METHOD: The clinical performance of the Temel Supra was evaluated in 100 adult patients who were anesthetized and ventilated using the device. RESULTS: The patients were adequately oxygenated and ventilated; no adverse events were observed. An open circuit, low flow, or closed circuit could be chosen freely. Ventilation was fully monitored: among the variables measured were rebreathed volume; leaks while the patient was connected; consumption of oxygen, nitrous oxide and anesthetic agents; and cardiac output (noninvasively). CONCLUSIONS: Ventilation and gas exchange were satisfactory in all cases even though some patients developed considerable respiratory impedance. The monitoring of oxygen and other gases consumed and of carbon dioxide produced provided very valuable information about metabolism and pharmacokinetics. The noninvasive monitoring of cardiac output seems to us to be a useful feature for aiding hemodynamic control. The independence of the open and closed circuits means that expired gases do not pass through the canister when the open circuit is used, resulting in savings on soda lime for drying. During pressure-control ventilation, the system maintains a plateau to guarantee better distribution of inspired gases. Other important features are warnings, constant monitoring of leaks, the 100% efficacy of the circuit, and the low internal volume.
Subject(s)
Anesthesiology/instrumentation , Adult , Hemodynamics , Humans , Respiration, ArtificialSubject(s)
Intraoperative Complications/etiology , Intubation, Intratracheal/adverse effects , Nasal Cavity , Skull Fractures/etiology , Turbinates/injuries , Adolescent , Epistaxis/etiology , Humans , Intubation, Intratracheal/instrumentation , Male , Mandibular Neoplasms/surgery , Neoplasm Recurrence, Local/surgeryABSTRACT
No disponible
Subject(s)
Humans , Male , Adolescent , Nasal Cavity , Nasal Cavity , Epistaxis , Intraoperative Complications , Intubation, Intratracheal , Skull Fractures , Turbinates , Epistaxis , Mandibular Neoplasms , Neoplasm Recurrence, LocalSubject(s)
Amyloidosis/diagnosis , Syncope/etiology , Aged , Amyloidosis/complications , Humans , MaleABSTRACT
INTRODUCTION: The macro-creatine kinase type 1 is a complex of IgG linked to the BB fraction of the creatine kinase enzyme. Its presence in serum interferes with the immunoinhibition methods normally used in emergency room laboratories that produce false elevations of the creatine kinase MB isoenzyme, and which may cause a misunderstanding in the evaluation of patients who are suspected of having ischemic cardiopathy. PATIENTS AND METHOD: We have studied seven patients using an immunoinhibition method. They showed high levels of creatine kinase MB isoenzyme with normal values of creatine kinase enzyme. Electrophoresis was performed on all patients to determine the presence of creatine kinase enzyme. RESULTS: The electrophoresis showed in all the cases the presence of a macro-creatine kinase type 1 responsible for this interference. The clinical and analytical evaluation, as well as the radiological and electrocardiographical evaluation of this patients did not show any acute coronary disease. CONCLUSIONS: The macro-creatine kinase type 1 has been related to the existence of underlying cardiovascular pathology; a fact that was confirmed in three patients. With the immunoinhibition methods, the macro-creatine kinases usually, occurs with high values of creatine kinase MB isoenzyme (normally above 50% of the total activity of the creatine kinase) with normal creatine kinase levels. This fact, although strongly suggesting its presence, creates the necessity of using more sensitive methods to prevent these interferences. Likewise, we recommend using the electrophoresis of the creatine kinase enzyme to determine the nature of these interferences.
Subject(s)
Cardiovascular Diseases/diagnosis , Clinical Enzyme Tests , Creatine Kinase/blood , Aged , Aged, 80 and over , Cardiovascular Diseases/enzymology , Diagnosis, Differential , Electrophoresis , Female , Humans , Immunoenzyme Techniques , Isoenzymes , Male , Middle AgedSubject(s)
Creatine Kinase/blood , Biomarkers/blood , Clinical Enzyme Tests , Humans , Isoenzymes , Macromolecular Substances , Molecular WeightABSTRACT
The aim of this study was to determine the frequency and aetiology of fever of unknown origin (FUO) in patients infected with the human immunodeficiency virus (HIV), to assess the value of the tests used in its diagnosis, and to evaluate possible models of diagnosis for the causes found most frequently. One hundred twenty-eight (3.5%) of 3603 hospitalised HIV-positive patients evaluated from October 1992 to December 1993 had FUO, defined by established criteria. Eighty-six percent of patients with FUO had previously progressed to AIDS. The median CD4+ cell count was 46/mm3. A definite diagnosis was made in 96 (75%) of the 128 patients and a possible diagnosis in 24 (18.7%). whilst no diagnosis was made in eight cases (6.2%). Tuberculosis (48.3%), visceral leishmaniasis (16%), and infection by Mycobacterium avium complex (6.9%) were the diseases found most frequently. The most useful diagnostic tests were liver biopsy (68.9%) and bone marrow aspirate/biopsy (39.7%). It is not possible to predict clinically the cases of FUO due to tuberculosis, whilst thrombocytopaenia < 100,000 cells/mm3 alone is useful for differentiating the cases of visceral leishmaniasis, with a negative predictive value of 95.2%.
