ABSTRACT
No disponible
No disponible
Subject(s)
Male , Female , Middle Aged , Humans , Anesthesiology/legislation & jurisprudence , Intubation, Intratracheal/adverse effects , Lacerations/etiology , Malpractice , Trachea/injuries , Equipment Failure , Internship and Residency , Intubation, Intratracheal/instrumentation , Professional-Family Relations , Risk Factors , Rupture/etiology , Truth Disclosure , Vocal Cord Paralysis/etiologyABSTRACT
El flurbiprofeno es un analgésico antiinflamatorio no esteroideo del grupo de los aril-propiónicos. Posee una actividad antiagregante plaquetaria importante que ejerce de forma reversible y cuyo efecto desaparece en 24 h. Esta cualidad es uno de los motivos de su resurgimiento actual en el arsenal terapéutico. En anestesia se está indicando para la sustitución de la profilaxis secundaria de clopidogrel o ticlopidina, con un nivel de evidencia II. Sólo son necesarias dosis de 50 a 100 mg/día para ejercer este efecto de forma similar al AAS, ya que es muy potente y raramente a esta dosis prolonga el tiempo de hemorragia. Se revisan distintos aspectos farmacocinéticos, su perfil clínico de seguridad, estudios sobre su eficacia antiagregante y sus potenciales efectos adversos
Flurbiprofen is a non steroidal anti-inflammatory drug of the aryl-propionic acid class. It possesses an important platelet antiaggregant activity, that is reversible, and its effects disappear in 24 h. This characteristic is one of the causes for its renewed importance in the therapeutic arsenal. Now, in neuraxial anesthesia, flurbiprofen is indicated for the substitution of secondary prophylaxis when the patients are treated with clopidogrel or ticlopidine, with a II level of evidence. Only 50-100 mg/day are necessary to get the same effect as aspirin, because flurbiprofen is very powerful and rarely prolongs the hemorrhagic time. We review several pharmacokinetic aspects, clinical safety profile, antiaggregant efficacy studies and its potencial adverse effects
Subject(s)
Humans , Flurbiprofen/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Platelet Aggregation Inhibitors/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/pharmacokinetics , Platelet Aggregation Inhibitors/adverse effects , Platelet Aggregation Inhibitors/pharmacokinetics , Flurbiprofen/pharmacokinetics , Flurbiprofen/adverse effectsABSTRACT
We report the case of a man diagnosed with cervical spinal stenosis who underwent a C3-C6 bilateral laminectomy. In the immediate postoperative period he developed subcutaneous emphysema and pneumomediastinum caused by tracheal laceration. Continuous airflow (1 L x min(-1)) through the outer cuff was applied during the operation to compensate for air leak when loss of balloon cuff pressure was detected.
Subject(s)
Intubation, Intratracheal/adverse effects , Pulmonary Ventilation , Trachea/injuries , Aged , Humans , Intubation, Intratracheal/instrumentation , MaleABSTRACT
Exponemos el caso de un paciente diagnosticado deestenosis del canal medular cervical y sometido a laminectomíabilateral C3-C6, que en el postoperatorioinmediato desarrolló un enfisema subcutáneo y neumomediastinoocasionado por una laceración traqueal.Durante la intervención, al detectar pérdida de presiónen el balón de neumotaponamiento, aplicamos un flujocontinuo de aire (1 L min-1) a través del manguito externopara evitar la fuga aérea
We report the case of a man diagnosed with cervicalspinal stenosis who underwent a C3-C6 bilateral laminectomy.In the immediate postoperative period he developedsubcutaneous emphysema and pneumomediastinumcaused by tracheal laceration. Continuous airflow (1L·min-1) through the outer cuff was applied during theoperation to compensate for air leak when loss of ballooncuff pressure was detected
Subject(s)
Male , Aged , Humans , Intubation, Intratracheal/adverse effects , Pulmonary Ventilation , Trachea/injuries , Intubation, Intratracheal/instrumentationSubject(s)
Carotid Artery Diseases/therapy , Embolization, Therapeutic/methods , Intracranial Aneurysm/therapy , Adult , Anesthesia, General , Carotid Artery Diseases/complications , Conscious Sedation , Electroencephalography , Humans , Hypopituitarism/complications , Incidental Findings , Intracranial Aneurysm/complications , Male , Monitoring, Physiologic , PremedicationABSTRACT
No disponible
Subject(s)
Middle Aged , Female , Humans , Spinal Fusion , Pulmonary Embolism , Bone CementsSubject(s)
Bone Cements/adverse effects , Pulmonary Embolism/etiology , Spinal Fusion , Female , Humans , Middle AgedABSTRACT
La segunda epidemia del dengue clásico se inició en Paraguay a partir de febrero de 1999. En marzo de 2000 se establece un plan de emergencia interinstitucional por decreto del poder ejecutivo. Objetivo: determinar los conocimientos, actitudes y prácticas que poseen los pobladores del barrio San Pablo de la ciudad de Asunción acerca del control de los mosquitos y del dengue. Material y Método: estudio observacional, descriptivo, aplicado a residentes adultos del barrio San Pablo, a través de una encuesta durante los meses de marzo y abril/2000. El muestreo fue por conglomerados en una sola etapa. La selección de las manzanas se realizó en forma aleatoria para un n=187 viviendas, y una prevalencia esperada del 50 porcientos, con un nivel de confianza del 95 porcientos. Resultados: la prevalencia de la enfermedad fue del 41.2 porcientos. De este grupo el 66.2 porcientos el diagnóstico fue médico y el 33.8 porcientos fue empírico. El 96.8 porcientos conocía la presencia actual de una epidemia de dengue y que los mosquitos podían transmitir enfermedades. El 89 porcientos no estaba organizada en su comunidad para luchar contra el dengue; el 61,8 cumplió con las medidas higiénicas de prevención en el hogar. Acerca del conocimientos para eliminar los criaderos de mosquitos el 88.2 porcientos respondió adecuadamente y el 11.2 porcientos tuvo conocimiento incopleto sobre estas medidas higiénicas. Al ser indagados dónde depositaban sus huevos los mosquitos el 70.1 respondió en cualqueir lugar donde esté un deposito de agua limpia y estancada y el 18.7 porcientos en los lugares donde se arrojan los desechos. El 24.6 porcientos de la población entrevistada supo que los mosquitos podían trasmitir tres enfermedades, el 85.1 porcientos incluyó al dengue en sus respuestas y el 14.4 porcientos desconoció las enfermedades trasmitidas por los mosquitos. Conclusión: la población estudiada posee conocimientos adecuados con respecto a las características del dengue y el control de los mosquitos. Existe escasa participación en actividades comunitarias. Los conocimientos (información) adecuados no necesariamente derivan en prácticas preventivas
Subject(s)
Paraguay , Health Knowledge, Attitudes, Practice , DengueABSTRACT
(-)-Podorhizol (1) was stereoselectively synthesized by erythro preferential aldol condensation of 3,4,5-trimethoxy- benzaldehyde with potassium enolate from (+)-(R)-3- (3,4-methylenedioxybenzyl)-4-butanolide (2) (erythro:threo=85:15). Erythro selectivity was observed in the aldol condensation of many alkoxybenzaldehydes with potassium enolate from (+)-γ-butyrolactone 2. However, benzaldehydes having methoxy groups at both the 2 and 6 positions gave threo selectivity in the aldol condensation with potassium enolate from (+)-γ-butyrolactone 2.
ABSTRACT
BACKGROUND: Men with benign prostatic hyperplasia can be treated with alpha 1-adrenergic-antagonist drugs that relax prostatic smooth muscle or with drugs that inhibit 5 alpha-reductase and therefore reduce tissue androgen concentrations. However, the effects of the two types of drugs have not been compared. METHODS: We compared the safety and efficacy of placebo, terazosin (10 mg daily), finasteride (5 mg daily), and the combination of both drugs in 1229 men with benign prostatic hyperplasia. American Urological Association symptom scores and peak urinary-flow rates were determined at base line and periodically for one year. RESULTS: The mean changes from base line in the symptom scores in the placebo, finasteride, terazosin, and combination-therapy groups at one year were decreases of 2.6, 3.2, 6.1, and 6.2 points, respectively (P<0.001 for the comparisons of both terazosin and combination therapy with finasteride and with placebo). The mean changes at one year in the peak urinary-flow rates were increases of 1.4, 1.6, 2.7, and 3.2 ml per second, respectively (P<0.001 for the comparisons of both terazosin and combination therapy with finasteride and with placebo). Finasteride had no more effect on either measure than placebo. In the placebo group, 1.6 percent of the men discontinued the study because of adverse effects, as did 4.8 to 7.8 percent of the men in the other three groups. CONCLUSIONS: In men with benign prostatic hyperplasia, terazosin was effective therapy, whereas finasteride was not, and the combination of terazosin and finasteride was no more effective than terazosin alone.
Subject(s)
Adrenergic alpha-Antagonists/therapeutic use , Enzyme Inhibitors/therapeutic use , Finasteride/therapeutic use , Oxidoreductases/antagonists & inhibitors , Prazosin/analogs & derivatives , Prostatic Hyperplasia/drug therapy , Adrenergic alpha-Antagonists/adverse effects , Aged , Aged, 80 and over , Double-Blind Method , Drug Therapy, Combination , Enzyme Inhibitors/adverse effects , Finasteride/adverse effects , Humans , Male , Middle Aged , Prazosin/adverse effects , Prazosin/therapeutic use , Treatment Outcome , Urodynamics/drug effectsSubject(s)
Cranial Nerve Diseases/etiology , Herpesviridae Infections/complications , Herpesvirus 4, Human/isolation & purification , Leukemia, Lymphoid/complications , Paraneoplastic Syndromes/etiology , Tumor Virus Infections/complications , Adult , CD3 Complex/analysis , Clone Cells/pathology , Clone Cells/virology , Diagnosis, Differential , Fatal Outcome , Herpesviridae Infections/virology , Humans , Killer Cells, Natural/pathology , Killer Cells, Natural/virology , Leukemia, Lymphoid/diagnosis , Leukemia, Lymphoid/pathology , Leukemia, Lymphoid/virology , Leukemic Infiltration/complications , Leukemoid Reaction/diagnosis , Male , Meninges/pathology , Neoplastic Stem Cells/pathology , Neoplastic Stem Cells/virology , Tumor Virus Infections/virologyABSTRACT
PURPOSE: We assessed the relationship between changes in scores for the American Urological Association (AUA) symptom index and benign prostatic hyperplasia (BPH) impact index with patient global ratings of improvement in a large Veterans Affairs trial comparing different pharmacological therapies for BPH. MATERIALS AND METHODS: The primary analyses compared absolute score changes from baseline with global ratings of improvement at 13 weeks for 1,218 men. RESULTS: Subjects who rated themselves as being slightly improved had a mean decrease in AUA symptom index and BPH impact index scores of 3.1 and 0.4 points, respectively. However, the baseline scores strongly influenced this relationship. CONCLUSIONS: These data provide guidance for investigators using the AUA symptom index and BPH impact index as outcome measures.
Subject(s)
Health Status , Prostatic Hyperplasia/diagnosis , Humans , Male , Patient Satisfaction , Prostatic Hyperplasia/drug therapy , Research , Sensitivity and Specificity , Societies, Medical , Surveys and Questionnaires , UrologyABSTRACT
We retrospectively examined the postoperative clinical course of 50 consecutive patients with myasthenia gravis who underwent a transsternal extended thymectomy. Twenty-six patients (52%) showed a steady improving postoperative course without any additional immunotherapy (group A). The remaining 24 patients (48%) had an intractable postoperative course, and most of them needed additional immunotherapy (group B). A significant increases in CD3+ cells, HLA-DR+ cells and B-cells and significant decreases in CD1+ cells and CD8+ cells were observed in the thymuses from patients in group B, compared with the findings in group A. In the peripheral blood, the ratio of CD4+ cells to CD8+ cells was significantly increased in group B. Patients who were either under 40 years of age, females, or without thymoma had good clinical courses after the thymectomy alone.
Subject(s)
Immunotherapy , Myasthenia Gravis/immunology , Myasthenia Gravis/surgery , T-Lymphocyte Subsets/immunology , Thymectomy , Thymus Gland/immunology , Adult , Antigens, CD/analysis , Antigens, CD1 , Antigens, Differentiation, T-Lymphocyte/analysis , CD3 Complex , CD4-CD8 Ratio , CD8 Antigens/analysis , Female , HLA-DR Antigens/analysis , Humans , Male , Prognosis , Receptors, Antigen, T-Cell/analysis , Treatment OutcomeABSTRACT
Two siblings with congenital myopathy showing myasthenic manifestations together with congenital cataract are reported. Their muscle weakness fluctuated and was alleviated by edrophonium chloride. Their serum creatine kinase activity was elevated, and the waning phenomenon was observed on repetitive nerve stimulation. Biopsied muscle showed degenerative changes with type 1 fibre predominance and abnormal morphology of neuromuscular junctions.
Subject(s)
Cataract/congenital , Muscular Diseases/congenital , Adult , Cataract/complications , Female , Humans , Male , Middle Aged , Muscular Diseases/complications , Muscular Diseases/pathology , Myasthenia Gravis/pathologyABSTRACT
We investigated surface phenotypes of peripheral blood lymphocytes and thymic lymphoid cells from patients with myasthenia gravis (MG) by fluorocytometry, using monoclonal antibodies to human lymphoid cells. There were no significant differences in peripheral blood lymphocyte subsets in myasthenic patients, with or without a thymus. In the MG hyperplastic thymuses, the percentage of OKIa1+ cells or CCB1+ cells was significantly increased compared with controls. Although there were no significant differences in the percentage of T-cell lineage (CD3+, CD4+, CD8+, or CD1+ cells) between MG hyperplastic thymuses and the controls, the surface densities of T-cell lineage antigens (CD3, CD4, and CD8) were significantly increased on lymphoid cells in MG hyperplastic thymuses, compared with those in control thymuses. There were no significant differences in the percentage or fluorocytograph of lymphoid cells between the MG thymomas and the controls.
