ABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Emphysema/complications , Cholangiopancreatography, Endoscopic Retrograde/adverse effects , Cholangiopancreatography, Endoscopic Retrograde/methods , Deep Sedation/instrumentation , Propofol/therapeutic use , Fentanyl/therapeutic use , Anesthesia, General/methods , Choledocholithiasis/complications , Choledocholithiasis/surgery , Tomography, Emission-Computed/instrumentation , Tomography, Emission-Computed/methodsABSTRACT
Introducción. Los autores comparan de forma aleatorizada el número de intentos durante la intubación endotraqueal convencional de un maniquí utilizando 2 tubos de polivinilo (PVC) aparentemente similares pero de distinto fabricante: Intersurgical (IS; Intersurgical S.L., Madrid, España) y Mallinckrodt (ML; Mallinkrodt Medical S.A., Madrid, España). Método. Veintiséis anestesiólogos experimentados intubaron 2 veces un maniquí utilizando un tubo diferente en cada ocasión y cuyo orden fue establecido de forma aleatoria (secuencia aleatoria generada por Epidat 3.1.). El tubo fue pintado para enmascararlo y no ser reconocido por el participante. El objetivo principal del estudio era comparar el número de intentos necesarios para completar la maniobra con cada tubo. El tiempo de intubación y las intubaciones fallidas también fueron recogidos. Resultados. El número de intentos con el tubo de ML fue significativamente menor que con el tubo de IS. Con el de ML se completó la intubación al primer intento en el 93,3% de los casos, mientras que con el de IS el porcentaje se redujo al 30,8% (test exacto de Fisher, p < 0,001). El tiempo necesario para completar la maniobra fue mayor con el tubo de IS (mediana 10,8 s, rango intercuartílico 6-22) que con el tubo de ML (mediana 4,4 s, rango intercuartílico 3,5-6,3). Conclusiones. El tubo de PVC de la casa ML se mostró superior al compararlo con el de IS, asociándose este último a la necesidad de un mayor número de intentos para completar la intubación de un maniquí. Los autores han atribuido estos resultados a un defecto en la curvatura de la punta del tubo de IS (AU)
Background. A randomised study was conducted on the number of attempts made during the conventional endotracheal intubation of a mannequin using two polyvinyl (PVC) tracheal tubes, apparently similar but from different manufactures: INTERSURGICAL (IS; Intersurgical S.L., Madrid, Spain) and Mallinckrodt (ML; Mallinkrodt Medical S.A., Madrid, Spain). Methods. A total of 26 anaesthesiologists, in randomly established order (generated by Epidat 3.1) intubated a mannequin twice using a different tube each time. The tubes were masked by painting them to prevent recognition. The main outcome of the study was to compare the number of attempts needed to complete the manoeuvre for each tube. Data on intubation time and failed intubations were also collected. Results. The number of attempts with the ML tube was significantly lower than with the IS tube. Intubation was completed on the first attempt with the ML tube in 93.3% of cases, while using the IS tube the percentage fell to 30.8% (Fisher exact test, P < .001). The time required to complete the manoeuvre was greater with the IS tube (median 10.8 seconds, interquartile range 6-22) than with the ML tube (median 4.4 seconds, interquartile range 3.5 to 6.3). Conclusions. The PVC tube from the ML manufacturer was superior when compared with the IS, the latter was also associated with a larger number of attempts to complete intubation using a conventional Macintosh blade (AU)
Subject(s)
Intubation, Intratracheal/classification , Intubation, Intratracheal/methods , Intubation, Intratracheal , Anesthesia, Endotracheal/methods , Intubation, Intratracheal/instrumentation , Intubation, Intratracheal/standards , Prospective Studies , Cross-Over Studies , Intubation/classification , Intubation/instrumentation , Intubation/methodsSubject(s)
Airway Obstruction , Emphysema , Humans , Pancreas/diagnostic imaging , Pressure , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: A randomised study was conducted on the number of attempts made during the conventional endotracheal intubation of a mannequin using two polyvinyl (PVC) tracheal tubes, apparently similar but from different manufactures: INTERSURGICAL (IS; Intersurgical S.L., Madrid, Spain) and Mallinckrodt (ML; Mallinkrodt Medical S.A., Madrid, Spain). METHODS: A total of 26 anaesthesiologists, in randomly established order (generated by Epidat 3.1) intubated a mannequin twice using a different tube each time. The tubes were masked by painting them to prevent recognition. The main outcome of the study was to compare the number of attempts needed to complete the manoeuvre for each tube. Data on intubation time and failed intubations were also collected. RESULTS: The number of attempts with the ML tube was significantly lower than with the IS tube. Intubation was completed on the first attempt with the ML tube in 93.3% of cases, while using the IS tube the percentage fell to 30.8% (Fisher exact test, P<.001). The time required to complete the manoeuvre was greater with the IS tube (median 10.8seconds, interquartile range 6-22) than with the ML tube (median 4.4seconds, interquartile range 3.5 to 6.3). CONCLUSIONS: The PVC tube from the ML manufacturer was superior when compared with the IS, the latter was also associated with a larger number of attempts to complete intubation using a conventional Macintosh blade.
Subject(s)
Intubation, Intratracheal , Humans , Laryngoscopes , Polyvinyl Chloride , Prospective Studies , SpainABSTRACT
No disponible
Subject(s)
Humans , Male , Young Adult , Foreign Bodies/surgery , Endoscopy/methods , Multiple Trauma/complications , Foreign-Body Migration/diagnosis , Tomography, X-Ray Computed , Emergency Treatment/methodsSubject(s)
Bronchi , Foreign Bodies/surgery , One-Lung Ventilation/instrumentation , Accidents, Traffic , Balloon Occlusion/instrumentation , Bronchoscopes , Foreign Bodies/diagnostic imaging , Humans , Imaging, Three-Dimensional , Laryngeal Masks , Male , Multiple Trauma/complications , Tomography, X-Ray Computed , Tooth , Young AdultSubject(s)
Intubation, Intratracheal/instrumentation , Multiple Trauma/therapy , Accidents, Traffic , Adult , Drainage , Emergencies , Equipment Design , Fractures, Multiple/therapy , Humans , Male , Mediastinal Emphysema/etiology , Mediastinal Emphysema/therapy , Pneumopericardium/etiology , Pneumopericardium/therapySubject(s)
Hernias, Diaphragmatic, Congenital , Mucocele , Hernia, Diaphragmatic , Humans , Intestinal DiseasesABSTRACT
Recently we have proved that Span 20 has the same enhancer effect as Azone on in vitro percutaneous penetration of lipophilic compounds (logP(oct) from 1.34 to 2.33). The purpose of this work is to study the interactions of Span 20 with stratum corneum lipids monolayers and to compare them with Azone. The surface pressure-area characteristics of Span 20 in mixed monolayers with different model lipids (ceramides, cholesterol, free fatty acids and two mixtures of ceramides+cholesterol, and ceramides+cholesterol+free fatty acids) in similar proportions to that which exists in human stratum corneum lipids were recorded as compression isotherms at 25 degrees C. Azone was also investigated on monomolecular films of some of these lipids. The results indicate that the effect exerted upon lipid packing by the Span 20 correspond, as in the case of Azone, to increased fluidity within monolayers. To quantify and compare the effect of Span 20 and Azone, the compressibility of enhancer-lipid model mixed monolayers was calculated, and expressed as a function of mole fraction of enhancer present on the films. Statistical comparison of the results obtained from both enhancers shows that they are equally potent in their interaction with the lipid models assayed. These models, if restricted, seem to be good for predict the activity and potency of percutaneous enhancers on the fluididity of the lipidic structure of the stratum corneum.
Subject(s)
Azepines/pharmacology , Epidermis/drug effects , Hexoses/pharmacology , Lipids/analysis , Skin Absorption/drug effects , Animals , Cattle , Ceramides/analysis , Cholesterol/analysis , Epidermis/chemistry , HumansABSTRACT
Sarcoidosis is a multisystemic granulomatous disease of unknown origin that often affects the lungs, eyes, and lymphatic system. Neurological manifestations are rare (5-6%). A case is reported of neurosarcoidosis that presented with anterior uveitis, lymph node enlargement, lymphocytic meningitis, cochleovestibular disease, and right peripheral facial nerve paralysis. Current diagnostic and therapeutic methods in this hard-to-diagnose entity are discussed.
Subject(s)
Hearing Loss, Sensorineural/etiology , Sarcoidosis/complications , Adult , Audiometry, Pure-Tone , Female , Hearing Loss, Sensorineural/diagnosis , HumansABSTRACT
We present a 43-year-old patient with a history of immunodepression secondary to a renal transplant, chronic herpetic hepatitis and steroid diabetes, who showed sudden symptomatology suggestive of rhinocerebral mucormycosis, which was confirmed through cultures of the material obtained after a Caldwell-Luc operation of the affected sinus. Once the diagnosis was confirmed, a radical left superior maxillectomy was performed and medical treatment with progressive doses of amphotericin B was given. The patient improved markedly and left the hospital four months later.
