Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 33
Filtrar
1.
Infect Immun ; 88(3)2020 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-31871101

RESUMO

Severe malaria is mostly caused by Plasmodium falciparum, resulting in considerable, systemic inflammation and pronounced endothelial activation. The endothelium forms an interface between blood and tissue, and vasculopathy has previously been linked with malaria severity. We studied the extent to which the endothelial glycocalyx that normally maintains endothelial function is involved in falciparum malaria pathogenesis by using incident dark-field imaging in the buccal mucosa. This enabled calculation of the perfused boundary region, which indicates to what extent erythrocytes can permeate the endothelial glycocalyx. The perfused boundary region was significantly increased in severe malaria patients and mirrored by an increase of soluble glycocalyx components in plasma. This is suggestive of a substantial endothelial glycocalyx loss. Patients with severe malaria had significantly higher plasma levels of sulfated glycosaminoglycans than patients with uncomplicated malaria, whereas other measured glycocalyx markers were raised to a comparable extent in both groups. In severe malaria, the plasma level of the glycosaminoglycan hyaluronic acid was positively correlated with the perfused boundary region in the buccal cavity. Plasma hyaluronic acid and heparan sulfate were particularly high in severe malaria patients with a low Blantyre coma score, suggesting involvement in its pathogenesis. In vivo imaging also detected perivascular hemorrhages and sequestering late-stage parasites. In line with this, plasma angiopoietin-1 was decreased while angiopoietin-2 was increased, suggesting vascular instability. The density of hemorrhages correlated negatively with plasma levels of angiopoietin-1. Our findings indicate that as with experimental malaria, the loss of endothelial glycocalyx is associated with vascular dysfunction in human malaria and is related to severity.


Assuntos
Endotélio Vascular/patologia , Glicocálix/patologia , Malária Falciparum/patologia , Mucosa Bucal/patologia , Hemorragia Bucal/patologia , Angiopoietina-1/sangue , Angiopoietina-2/sangue , Biomarcadores/sangue , Criança , Pré-Escolar , Endotélio Vascular/fisiopatologia , Feminino , Glicosaminoglicanos/sangue , Humanos , Lactente , Malária Falciparum/sangue , Malária Falciparum/diagnóstico por imagem , Malária Falciparum/fisiopatologia , Masculino , Mucosa Bucal/irrigação sanguínea , Mucosa Bucal/diagnóstico por imagem , Mucosa Bucal/fisiopatologia , Hemorragia Bucal/sangue , Hemorragia Bucal/diagnóstico por imagem , Hemorragia Bucal/fisiopatologia
2.
Emerg Med J ; 37(1): 14-18, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31767676

RESUMO

OBJECTIVE: The aim of this study was to compare the incidence of airway haemorrhage between participants who received manual cardiopulmonary resuscitation (CPR) and those who had received mechanical CPR using the LUCAS device. METHODS: A retrospective cohort study was conducted by means of a medical chart review. All non-traumatic cardiac arrest patients that presented to the ED, from May 2014 to February 2018, were recruited. The groups were stratified according to those who had the majority of CPR performed using the LUCAS and those who had the majority of CPR performed manually. The primary outcome was the proportion of participants with airway haemorrhage, defined as blood observed in the endotracheal tube, pharynx, trachea or mouth, and documented in the doctor or nursing notes. Logistic regression analysis was performed to adjust for confounders. RESULTS: 12 of 54 (22%) participants in the majority LUCAS CPR group had airway haemorrhage, compared with 20 of 215 (9%) participants in the majority manual CPR group, a difference of 13% (95% CI 3% to 26%, p=0.02). The unadjusted odds for developing airway haemorrhage in the majority LUCAS CPR group was 2.8 (95% CI 1.3 to 6.1). After adjusting for confounders, the odds for developing airway haemorrhage in the majority LUCAS CPR group was 2.5 (95% CI 1.1 to 5.7). CONCLUSIONS: The LUCAS mechanical CPR device is associated with a higher incidence of airway haemorrhage compared with manual CPR. Limitations in the study design mean this conclusion is not robust.


Assuntos
Obstrução das Vias Respiratórias/etiologia , Reanimação Cardiopulmonar/instrumentação , Hemorragia Bucal/etiologia , Parada Cardíaca Extra-Hospitalar/terapia , Obstrução das Vias Respiratórias/mortalidade , Obstrução das Vias Respiratórias/fisiopatologia , Austrália , Reanimação Cardiopulmonar/efeitos adversos , Reanimação Cardiopulmonar/métodos , Serviços Médicos de Emergência , Desenho de Equipamento , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Hemorragia Bucal/mortalidade , Hemorragia Bucal/fisiopatologia , Parada Cardíaca Extra-Hospitalar/mortalidade , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
4.
Anesth Prog ; 53(1): 8-12, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16722278

RESUMO

The aim of this study is to assess the difference in duration of action after infiltration anesthesia when elevation of a periosteal flap (EPF) was accomplished with water or saline irrigation versus nonelevation of a periosteal flap (NEPF). The 57 patients in this study were under conscious sedation. A long treatment time of more than 1 hour was used. Instances where peripheral nerve block or opioids were administered and infiltration anesthesia over 2 fields were excluded before the study. Patients were included in either an EPF group (n = 29) or an NEPF group (n = 28). Statistically significant differences were detected in the initial dose of anesthetic (EPF: 4.3 +/- 1.4 mL, NEPF: 1.8 +/- 0.9 mL), the time until initial supplemental anesthesia (EPF: 38 +/- 26 minutes, NEPF: 65 +/- 27 minutes), and the frequency of anesthesia administration (EPF: 2.5 +/- 1.2 times, NEPF: 1.3 +/- 0.7 times). These results suggest that the duration of anesthesia action in EPF decreases to half compared with NEPF, even if the anesthetic was infiltrated in double the amount. Although supplemental anesthesia is required frequently in EPF, it is not efficacious. We speculated that the residual anesthetics in tissue were washed out by irrigation and hemorrhage and that supplemental anesthesia became ineffective because of leakage from the opened flap. Elevation of a periosteal flap reduces the effect of infiltration anesthetics.


Assuntos
Anestesia Dentária , Anestesia Local , Procedimentos Cirúrgicos Bucais , Periósteo/cirurgia , Retalhos Cirúrgicos , Irrigação Terapêutica , Adulto , Anestésicos Locais/administração & dosagem , Sedação Consciente , Feminino , Humanos , Injeções , Lidocaína/administração & dosagem , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Menores , Hemorragia Bucal/fisiopatologia , Estudos Retrospectivos , Cloreto de Sódio , Fatores de Tempo , Água
5.
Artigo em Inglês | MEDLINE | ID: mdl-12374928

RESUMO

OBJECTIVE: The purpose of this study was to summarize the clinical manifestation, plain-film radiography, and computed tomographic (CT) scan features of arteriovenous malformations (AVMs) of the jaws on the basis of a series of 12 patients. STUDY DESIGN: This study group comprised twelve patients with AVM of the jaws from February 1996 to February 2001. Seven cases were located in the mandible, and 5 in the maxilla. Both plain-film radiography and CT scan were available for all cases. For the patients with lesions in the mandible, panoramic, posterioanterior, and lateral mandibular views were applied. Waters' position view and panoramic radiography were indicated for AVMs of the maxilla. RESULTS: Each patient with AVM of the maxillary bone had involvement of adjacent soft tissues. Various radiographic signs were noted, including erosion, coarse trabeculae, and apparent lack of any radiographic change, and CT scans featured cystic expansion of alveolar process with broken cortex. The radiographic signs and CT scan features of AVMs in the mandible were related to involvement of surrounding soft tissues. If involvement of the adjacent soft tissues was found, "soap bubble" radiolucency was shown radiographically and osteolytic expansion with perforation of cortex was present on CT scan. In cases without surrounding soft tissue involvement, the various radiographic signs included multilocular or unilocular radiolucency or coarse trabeculae; osteolytic expansions with intact cortex were found on CT scan. CONCLUSION: AVMs of the jaws showed intraosseous osteolytic expansion on CT scan but had variable appearance on plain-film radiographs.


Assuntos
Malformações Arteriovenosas/diagnóstico por imagem , Mandíbula/irrigação sanguínea , Maxila/irrigação sanguínea , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Processo Alveolar/irrigação sanguínea , Processo Alveolar/diagnóstico por imagem , Malformações Arteriovenosas/fisiopatologia , Criança , Meios de Contraste , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Pessoa de Meia-Idade , Hemorragia Bucal/fisiopatologia , Osteólise/diagnóstico por imagem , Fluxo Pulsátil/fisiologia , Intensificação de Imagem Radiográfica , Radiografia Panorâmica
6.
Med Oral ; 6(3): 205-17, 2001.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-11500638

RESUMO

OBJECTIVE: An analysis is made of the etiologic factors underlying actinic cheilitis and of the results obtained following surgical treatment of the disease in a series of 54 patients (32 males and 22 females). STUDY DESIGN: The case history was evaluated, along with the triggering factors, histopathological pattern and recurrence of lesions. A cold scalpel vermilionectomy was performed in 41 patients, followed by primary closure of the defect using an oral mucosal flap. The remaining 13 patients were subjected to carbon dioxide laser vermilion ablation. RESULTS: The history of the patients revealed liver disease associated to alcohol consumption in 35.2% of cases and tobacco smoking in 77.8%. As regards solar exposure, 53.1% of the men referred open-air professional activities, while 100% of the women presented important solar exposure. The most frequent clinical manifestations were bleeding and the presence of leukoplakia patches; pain was reported in only 16% of cases. Over 40% of the patients were asymptomatic. Following treatment, and after a follow-up period of at least 6 months, 90.7% of the subjects showed complete healing. Of the 5 patients reoperated upon, four healed and one evolved towards squamous cell carcinoma. CONCLUSION: Vermilionectomy is the recommended treatment for actinic cheilitis, using either a cold scalpel or carbon dioxide laser. A histological study of the lesion is indicated in all cases to secure early detection of possible malignization. The control of the possible etiologic factors is also essential.


Assuntos
Queilite/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Dióxido de Carbono , Carcinoma de Células Escamosas/patologia , Transformação Celular Neoplásica/patologia , Queilite/etiologia , Queilite/fisiopatologia , Feminino , Seguimentos , Humanos , Terapia a Laser , Leucoplasia Oral/fisiopatologia , Leucoplasia Oral/cirurgia , Lábio/cirurgia , Neoplasias Labiais/patologia , Hepatopatias Alcoólicas/complicações , Masculino , Pessoa de Meia-Idade , Hemorragia Bucal/fisiopatologia , Hemorragia Bucal/cirurgia , Satisfação do Paciente , Recidiva , Reoperação , Estudos Retrospectivos , Fumar/efeitos adversos , Luz Solar/efeitos adversos , Retalhos Cirúrgicos , Resultado do Tratamento , Cicatrização
7.
Ann Fr Anesth Reanim ; 20(6): 549-51, 2001 Jun.
Artigo em Francês | MEDLINE | ID: mdl-11471502

RESUMO

Two patients have presented postoperative otorrhagia following gynaecologic laparoscopic procedures. This occurred after uneventful anaesthesia and recovery for surgery performed in forced Trendelenburg position (35 degrees with horizontal position). Different responsible mechanisms are discussed including haemodynamic changes induced by both the Trendelenburg position and the pneumoperitoneum. Particularities of external ear blood supply directly submitted to arterial and venous pressure changes, may also have contributed to the appearance of otorrhagia.


Assuntos
Decúbito Inclinado com Rebaixamento da Cabeça/efeitos adversos , Laparoscopia , Hemorragia Bucal/etiologia , Complicações Pós-Operatórias/etiologia , Adulto , Idoso , Decúbito Inclinado com Rebaixamento da Cabeça/fisiologia , Humanos , Masculino , Hemorragia Bucal/fisiopatologia , Complicações Pós-Operatórias/fisiopatologia
8.
Eur J Anaesthesiol ; 17(1): 33-7, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10758441

RESUMO

A survey was constructed to ascertain the views of The Royal College of Anaesthetists tutors regarding the acceptability of inhalational induction with sevoflurane for emergency anaesthesia. A questionnaire was sent to all tutors asking them to indicate their preferred choice of anaesthetic technique, and whether they believed inhalation induction with sevoflurane to be acceptable, in each of four scenarios: acute epiglottis; bleeding after tonsillectomy; appendicitis; and laparotomy in the shocked patient. Two hundred and sixty-two (89%) completed questionnaires were received from 294 college tutors. We have shown that the majority of The Royal College of Anaesthetists tutors would use sevoflurane for patients with an acutely compromised airway. One in four college tutors would accept the use of sevoflurane for a shocked patient for laparotomy. Anaesthetists who manage critically ill patients with an inhalational induction should be reassured by the fact, that a significant proportion of their colleagues would find this technique acceptable.


Assuntos
Anestesia por Inalação , Anestesia Intravenosa , Anestésicos Inalatórios/administração & dosagem , Éteres Metílicos/administração & dosagem , Padrões de Prática Médica , Doença Aguda , Adolescente , Idoso , Apendicite/cirurgia , Criança , Pré-Escolar , Estado Terminal , Emergências , Epiglotite/fisiopatologia , Feminino , Humanos , Laparotomia , Masculino , Hemorragia Bucal/fisiopatologia , Peritonite/fisiopatologia , Hemorragia Pós-Operatória/fisiopatologia , Sevoflurano , Choque/fisiopatologia , Inquéritos e Questionários , Tonsilectomia/efeitos adversos , Reino Unido
9.
In. Silveira, Jorge Omar Lopes da; Belträo, Gilson Correia. Exodontia. Porto Alegre, Médica Missau, 1998. p.361-9. (BR).
Monografia em Português | LILACS, BBO - Odontologia | ID: lil-211155
10.
J Clin Periodontol ; 17(1): 55-60, 1990 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-2295709

RESUMO

In the present study, the relationship between bleeding/plaque ratio, family history of diabetes mellitus and oral glucose tolerance pattern were investigated in 85 non-diabetic individuals without periodontal breakdown. In this group, no relationship between bleeding/plaque ratio, family history of diabetes mellitus and impaired glucose tolerance was found. The results of the present study suggest that the observed variation in bleeding/plaque ratio cannot be explained by impaired glucose tolerance or family history of diabetes mellitus. It is hypothesized that in subjects with impaired glucose tolerance, the periods of elevated blood glucose values may be too short to introduce tissue changes.


Assuntos
Placa Dentária/fisiopatologia , Diabetes Mellitus/genética , Hemorragia Gengival/fisiopatologia , Hemorragia Bucal/fisiopatologia , Estado Pré-Diabético/fisiopatologia , Adulto , Glicemia/análise , Índice de Placa Dentária , Diabetes Mellitus/sangue , Feminino , Humanos , Masculino , Índice Periodontal , Estado Pré-Diabético/sangue
11.
Stomatologiia (Mosk) ; 69(1): 78-80, 1990.
Artigo em Russo | MEDLINE | ID: mdl-2326822

RESUMO

The authors compare the intensities of nociceptive stimulation and blood loss volumes in children subjected to radical uranostaphyloplasty involving the use of all the elements of the technique and to its sparing modifications. The level of pain aggression, blood loss volume, and mean length of the operation were lower with the sparing methods than with the traditional one, this leading to a conclusion on the lower traumatism of the sparing uranostaphyloplasty technique for the body.


Assuntos
Complicações Intraoperatórias/etiologia , Palato/cirurgia , Complicações Pós-Operatórias/etiologia , Adolescente , Criança , Pré-Escolar , Fissura Palatina/fisiopatologia , Fissura Palatina/cirurgia , Hemodinâmica/fisiologia , Humanos , Complicações Intraoperatórias/fisiopatologia , Métodos , Hemorragia Bucal/etiologia , Hemorragia Bucal/fisiopatologia , Osteotomia/efeitos adversos , Osteotomia/métodos , Complicações Pós-Operatórias/fisiopatologia
13.
J Clin Periodontol ; 13(7): 654-7, 1986 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-3531244

RESUMO

Periodontal sites of shallow initial probing depth often seem to lose probing attachment following various types of periodontal therapy, including nonsurgical therapy. The susceptibility to this treatment-associated probing attachment loss may conceivably be related to gingival architecture as well as to the inflammatory status of the tissues. This study was designed to study the relationship of buccolingual gingival thickness and bleeding on probing in shallow buccal sites (less than or equal to 3.5 mm probing depth) to loss of probing attachment following nonsurgical therapy. 3 months following treatment consisting of oral hygiene instruction and supra- and subgingival debridement, thin (less than or equal to 1.5 mm), initially non-bleeding sites displayed a mean loss of probing attachment of 0.3 mm. Thick (greater than or equal to 2.0 mm), non-bleeding sites displayed a less noticeable mean loss of probing attachment, whereas bleeding sites of both categories of gingival thickness showed a tendency towards gains in probing attachment levels. It may be concluded that the mean loss in probing attachment levels, commonly seen for shallow sites post-therapy, may be primarily due to the changes in shallow, thin healthy areas.


Assuntos
Inserção Epitelial/patologia , Gengiva/anatomia & histologia , Hemorragia Gengival/fisiopatologia , Bolsa Gengival/terapia , Gengivite/terapia , Hemorragia Bucal/fisiopatologia , Periodonto/patologia , Adulto , Placa Dentária/patologia , Raspagem Dentária , Bolsa Gengival/patologia , Retração Gengival/patologia , Humanos
15.
J Oral Maxillofac Surg ; 44(1): 16-20, 1986 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-3484524

RESUMO

Etidocaine hydrochloride, an amide-type of local anesthetic with prolonged duration of action, was evaluated and compared with the standard local anesthetic lidocaine to determine its efficacy of action and its effect on bleeding during and following the removal of impacted mandibular third molar teeth. The findings indicate that 1.5% etidocaine hydrochloride with 1:200,000 epinephrine, in comparison with 2% lidocaine with 1:100,000 epinephrine, produces anesthesia comparable to that obtained with lidocaine but results in greater measured intraoperative blood loss.


Assuntos
Acetanilidas/farmacologia , Etidocaína/farmacologia , Lidocaína/farmacologia , Hemorragia Bucal/fisiopatologia , Adolescente , Adulto , Anestesia Dentária , Epinefrina/farmacologia , Feminino , Humanos , Complicações Intraoperatórias , Masculino , Dente Molar/cirurgia , Hemorragia Bucal/prevenção & controle , Parestesia/fisiopatologia , Complicações Pós-Operatórias , Fatores de Tempo , Extração Dentária/efeitos adversos , Dente Impactado/cirurgia
17.
Int J Oral Surg ; 14(4): 339-45, 1985 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-3928509

RESUMO

A total of 185 permanent teeth were extracted in 43 hemophiliacs. The patient material is divided into 3 groups with respect to antifibrinolytic therapy. Patients in group 1 were given antifibrinolytics systemically. In group 2, antifibrinolytics were applied locally, and in group 3 they were used both locally and systemically. The results of the treatment were evaluated using the number of units per kilogram of F VIII administered per patient and the Coagulum Index (CoI). It is shown that local use of antifibrinolytics can reduce the amount of F VIII required for the control of bleeding, but regarding the high values of the CoI, the therapeutic effects are unsatisfactory. Approximately 20 U/kg of F VIII per patient, given in single infusion prior to intervention, were required in group 1 as well as in group 3. However, with respect to the CoI, a statistically significant difference is found between groups 3 and 1. On this basis, it is concluded that antifibrinolytics, used both locally and systemically, appear to show distinct advantages in the treatment of hemophiliacs undergoing dental extractions and also receiving F VIII therapy.


Assuntos
Antifibrinolíticos/administração & dosagem , Hemofilia A/tratamento farmacológico , Extração Dentária/efeitos adversos , Administração Oral , Administração Tópica , Adolescente , Adulto , Antifibrinolíticos/uso terapêutico , Coagulação Sanguínea/efeitos dos fármacos , Criança , Hemofilia A/fisiopatologia , Humanos , Hemorragia Bucal/fisiopatologia , Hemorragia Bucal/prevenção & controle
18.
J Clin Periodontol ; 12(6): 432-40, 1985 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-3874887

RESUMO

Incisors, cuspids and premolars in 49 patients with advanced chronic periodontitis were treated with initial, nonsurgical periodontal therapy. The results were monitored by probing attachment level measurements for 6 sites of each tooth every 3rd month during a period of 24 months. Amongst sites with initial probing depth greater than or equal to 4.0 mm, sites with probing attachment loss were identified using regression analysis. Scores for plaque, bleeding, suppuration on probing and probing depth, obtained for these sites during the 24-month study, were analyzed to determine whether any of the scores could be used diagnostically as an indicator of probing attachment loss. Diagnostic sensitivity and predictability were calculated for different levels of each of the scores. The results showed that sites with probing attachment loss were more frequent for sites with high scores for plaque, bleeding, residual probing depth and suppuration than in sites with low scores. However, the diagnostic sensitivity and predictability of these clinical indicators was generally low. Thus, records of plaque, bleeding, suppuration and probing depth do not obviate the need for probing attachment level measurements for identification of sites with probing attachment loss following initial, nonsurgical periodontal therapy.


Assuntos
Hemorragia Gengival/fisiopatologia , Hemorragia Bucal/fisiopatologia , Bolsa Periodontal/fisiopatologia , Periodontite/fisiopatologia , Periodontite/terapia , Adulto , Doença Crônica , Índice de Placa Dentária , Inserção Epitelial/fisiopatologia , Feminino , Seguimentos , Hemorragia Gengival/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Bolsa Periodontal/diagnóstico , Periodontia/instrumentação , Periodontite/diagnóstico , Supuração/fisiopatologia
20.
Oral Surg Oral Med Oral Pathol ; 57(3): 254-7, 1984 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-6608711

RESUMO

A case of a 13-year-old boy with prolonged bleeding after tooth extraction is reported. This was the first manifestation of systemic lupus erythematosus found to be associated with circulating anticoagulants, including the "lupus anticoagulant," and possible hypoprothrombinemia.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Hemorragia Bucal/etiologia , Extração Dentária/efeitos adversos , Adolescente , Testes de Coagulação Sanguínea , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/fisiopatologia , Masculino , Hemorragia Bucal/diagnóstico , Hemorragia Bucal/fisiopatologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...