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1.
Polymers (Basel) ; 16(16)2024 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-39204540

RESUMEN

The mechanical testing of additively manufactured parts has largely relied on the existing standards developed for traditional manufacturing. While this approach leverages the investment made in current standards development, it inaccurately assumes that the mechanical response of additive manufacturing (AM) parts is identical to that of parts manufactured through traditional processes. When considering thermoplastic, material extrusion AM, the differences in response can be attributed to an AM part's inherent inhomogeneity caused by porosity, interlayer zones, and surface texture. Additionally, the interlayer bonding of parts printed with large-scale AM is difficult to adequately assess, as much testing is performed such that stress is distributed across many layer interfaces; therefore, the lack of AM-specific standards to assess interlayer bonding is a significant research gap. To quantify interlayer bonding via fracture toughness, double cantilever beam (DCB) testing has been used for some AM materials, and DCB has been generally used for a variety of materials including metal, wood, and laminates. Mode I DCB testing was performed on thermoplastic matrix composites printed with Big Area Additive Manufacturing (BAAM). Of particular interest was the notch shape and deflection speed during testing. The results examine the differences when using two notch types and three deflection speeds. The testing method introduced by the following paper differentiates itself from the ones described in the standards used by modernizing the methodology. This was conducted with the introduction of Digital Image Correlation (DIC) to gather displacement and load data simultaneously without human intervention.

3.
Mater Today Bio ; 9: 100094, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33665603

RESUMEN

Bioengineering of the human auricle remains a significant challenge, where the complex and unique shape, the generation of high-quality neocartilage, and shape preservation are key factors. Future regenerative medicine-based approaches for auricular cartilage reconstruction will benefit from a smart combination of various strategies. Our approach to fabrication of an ear-shaped construct uses hybrid bioprinting techniques, a recently identified progenitor cell population, previously validated biomaterials, and a smart scaffold design. Specifically, we generated a 3D-printed polycaprolactone (PCL) scaffold via fused deposition modeling, photocrosslinked a human auricular cartilage progenitor cell-laden gelatin methacryloyl (gelMA) hydrogel within the scaffold, and cultured the bioengineered structure in vitro in chondrogenic media for 30 days. Our results show that the fabrication process maintains the viability and chondrogenic phenotype of the cells, that the compressive properties of the combined PCL and gelMA hybrid auricular constructs are similar to native auricular cartilage, and that biofabricated hybrid auricular structures exhibit excellent shape fidelity compared with the 3D digital model along with deposition of cartilage-like matrix in both peripheral and central areas of the auricular structure. Our strategy affords an anatomically enhanced auricular structure with appropriate mechanical properties, ensures adequate preservation of the auricular shape during a dynamic in vitro culture period, and enables chondrogenically potent progenitor cells to produce abundant cartilage-like matrix throughout the auricular construct. The combination of smart scaffold design with 3D bioprinting and cartilage progenitor cells holds promise for the development of clinically translatable regenerative medicine strategies for auricular reconstruction.

4.
J Vet Pharmacol Ther ; 41(3): 476-484, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29465161

RESUMEN

Parasitic diseases have a significant impact on livestock production. Nematodicidal drugs, such as fenbendazole (FBZ) or its oxidized metabolite oxfendazole (OFZ), can be used along with the trematodicidal triclabendazole (TCBZ), to broaden the spectrum of anthelmintic activity. However, co-exposure to these compounds could lead to drug-drug (D-D) interactions and eventually alter the clinical profile of each active principle. The aim of this study was to assess the presence of such interactions by means of two in vitro models, namely bovine liver microsomal fractions and bovine precision-cut liver slices (PCLSs). To this end, an in vitro assessment involving incubation of FBZ and TCBZ or a combination of FBZ and TCBZ was carried out. Results with microsomal fractions showed a 78.4% reduction (p = .002) in the rate of OFZ production upon co-incubation, whereas the sulfoxide metabolite of TCBZ (TCBZSO) exhibited a decreasing tendency. With PCLS, OFZ accumulation in the incubation medium increased 1.8-fold upon co-incubation, whereas TCBZSO accumulation decreased by 28%. The accumulation of FBZ and OFZ in the liver tissue increased upon 2-hr co-incubation, from 2.1 ± 1.5 to 18.2 ± 6.1 (p = .0009) and from 0.4 ± 0.1 to 1.3 ± 0.3 nmol (p = .0005), respectively. These results confirm the presence of D-D interactions between FBZ and TCBZ. Further studies are needed to determine the extent of involvement of drug-metabolizing enzymes and membrane transporters in interactions between compounds largely used in livestock production systems.


Asunto(s)
Bencimidazoles/farmacocinética , Bovinos , Fenbendazol/farmacocinética , Hígado/metabolismo , Microsomas Hepáticos/metabolismo , Albendazol/farmacocinética , Animales , Antihelmínticos/farmacocinética , Interacciones Farmacológicas , Manejo de Especímenes , Triclabendazol
5.
Phys Rev Lett ; 118(15): 152502, 2017 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-28452556

RESUMEN

Angular distributions of the elastic, inelastic, and breakup cross sections of the halo nucleus ^{11}Be on ^{197}Au were measured at energies below (E_{lab}=31.9 MeV) and around (39.6 MeV) the Coulomb barrier. These three channels were unambiguously separated for the first time for reactions of ^{11}Be on a high-Z target at low energies. The experiment was performed at TRIUMF (Vancouver, Canada). The differential cross sections were compared with three different calculations: semiclassical, inert-core continuum-coupled-channels and continuum-coupled-channels ones with including core deformation. These results show conclusively that the elastic and inelastic differential cross sections can only be accounted for if core-excited admixtures are taken into account. The cross sections for these channels strongly depend on the B(E1) distribution in ^{11}Be, and the reaction mechanism is sensitive to the entanglement of core and halo degrees of freedom in ^{11}Be.

6.
Acta Ortop Mex ; 29(1): 40-5, 2015.
Artículo en Español | MEDLINE | ID: mdl-26999925

RESUMEN

BACKGROUND: In Mexico low back pain is a very frequent symptom in the orthopedic practice. It is an important cause of work absenteeism, it is difficult to diagnose due to its various etiologies, and its treatment should be carefully chosen as, according to the World Health Organization, only 4% of patients require surgery. OBJECTIVE: To determine the frequency of low back pain at Hospital Angeles Mocel during a two-year period, and analyze the various etiologies and the treatment provided to patients. MATERIAL AND METHODS: The data base of the Orthopedics and Traumatology Service at Hospital Angeles Mocel was analyzed. It consisted of 246 patients over'18 years of age admitted with a diagnosis of low back pain. Frequency, sex, age, etiology and treatment were analyzed. RESULTS: At this hospital low back pain ranks second among the causes for hospital admission at the Orthopedics and Traumatology Service. Frequency is 13.5%; the most frequent age group affected is 31-45 years (36.9%); females were predominant (53.6%). Most cases admitted for low back pain were acute and had a posttraumatic etiology (90% of cases). CONCLUSION: Low back pain is a frequent reason for visiting the doctor worldwide. Epidemiologic studies about the frequency, etiology and treatment of low back pain are scarce in Mexico, even though it is one of the major causes for hospital admission at a private hospital.


Asunto(s)
Hospitalización/estadística & datos numéricos , Dolor de la Región Lumbar/epidemiología , Heridas y Lesiones/complicaciones , Adolescente , Adulto , Anciano , Femenino , Hospitales Privados , Humanos , Dolor de la Región Lumbar/etiología , Dolor de la Región Lumbar/terapia , Masculino , México/epidemiología , Persona de Mediana Edad , Heridas y Lesiones/epidemiología , Adulto Joven
7.
Vet Pathol ; 52(3): 465-75, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-24964921

RESUMEN

Clostridium perfringens type D causes enterotoxemia in sheep and goats. The disease is mediated by epsilon toxin (ETX), which affects the cerebrovascular endothelium, increasing vascular permeability and leading to cerebral edema. In the present study, we compared the distribution and severity of the cerebrovascular changes induced in lambs by C. perfringens type D strain CN1020, its isogenic etx null mutant, and the ETX-producing complemented mutant. We also applied histochemical and immunohistochemical markers to further characterize the brain lesions induced by ETX. Both ETX-producing strains induced extensive cerebrovascular damage that did not differ significantly between each other in nature, neuroanatomic distribution, or severity. By contrast, lambs inoculated with the etx mutant or sterile, nontoxic culture medium did not develop detectable brain lesions, confirming that the neuropathologic effects observed in these infections are dependent on ETX production. Lambs treated with the wild-type and complemented strains showed perivascular and mural vascular edema, as well as serum albumin extravasation, particularly severe in the cerebral white matter, midbrain, medulla oblongata, and cerebellum. Brains of animals inoculated with the ETX-producing strains showed decreased expression of glial fibrillary acidic protein and increased expression of aquaporin-4 in the end-feet processes of the astrocytes around blood vessels. Early axonal injury was demonstrated with anti-amyloid precursor protein immunohistochemistry. Perivascular accumulation of macrophages/microglia with intracytoplasmic albumin globules was also observed in these animals. This study demonstrates that ETX is responsible for the major cerebrovascular changes in C. perfringens type D-induced disease.


Asunto(s)
Encéfalo/patología , Clostridium perfringens/patogenicidad , Enterotoxemia/patología , Enfermedades de las Ovejas/patología , Animales , Acuaporina 4/análisis , Encéfalo/irrigación sanguínea , Química Encefálica , Clostridium perfringens/genética , Enterotoxemia/microbiología , Proteína Ácida Fibrilar de la Glía/análisis , Ovinos , Enfermedades de las Ovejas/microbiología
8.
Toxicon ; 88: 93-8, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24950050

RESUMEN

Epsilon toxin (ETX), produced by Clostridium perfringens types B and D, is among the most lethal toxins known. ETX is a potential bioterrorism threat that was listed as a Category B agent by the U.S. Centers for Disease Control until 2012 and it still remains a toxin of interest for several government agencies. We produced a monoclonal antibody (MAb) against ETX (ETX MAb c4D7) in Nicotiana benthamiana and characterized its preventive and therapeutic efficacy in mice. The ETX preparation used was highly lethal for mice (LD50 = 1.6 µg/kg) and resulted in a mean time from inoculation to death of 18 and 180 min when administered intravenously or intraperitoneally, respectively. High lethal challenge resulted in dramatic increases of a variety of pro-inflammatory cytokines in serum, while lower, but still lethal doses, did not elicit such responses. ETX MAb c4D7 was highly effective prophylactically (ED50 = 0.3 mg/kg; ED100 = 0.8 mg/kg) and also provided protection when delivered 15-30 min post-ETX intoxication. These data suggest that ETX MAb c4D7 may have use as a pre- and post-exposure treatment for ETX intoxication.


Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Neutralizantes/uso terapéutico , Toxinas Bacterianas/envenenamiento , Nicotiana/genética , Animales , Toxinas Bacterianas/inmunología , Citocinas/sangre , Femenino , Dosificación Letal Mediana , Masculino , Ratones , Ratones Endogámicos BALB C
9.
Colloids Surf B Biointerfaces ; 118: 90-100, 2014 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-24736044

RESUMEN

A multifaceted study on the interaction of calf-thymus DNA with two different cationic gemini surfactants alkanediyl-α-ω-bis(dodecyldimethyl-amonium)bromide, 12-s-12,2Br(-) (with s=2, G2, and 10, G10) was carried out. The measurements were done at different molar ratios X=[surfactant]/[DNA]. Results show two different conformational changes in DNA: a first compaction of the polynucleotide corresponding to a partial conformational (not total) change of DNA from an extended coil state to a globular state that happens at the lower molar ratio X. A second change corresponds to a breaking of the partial condensation, that is, the transition from the compacted state to a new more extended conformation (for the higher X values) different to the initial extension. According to circular dichroism spectra and dynamic light scattering measurements, this new state of DNA seems to be similar to a ψ-phase. Measurements confirm that interactions involved in the compaction are different to those previously obtained for the analog surfactant CTAB. X values at which the conformational changes happen depend on the length of the spacer in the surfactant along with the charge of the polar heads.


Asunto(s)
ADN/química , Conformación de Ácido Nucleico , Polinucleótidos/química , Compuestos de Amonio Cuaternario/química , Tensoactivos/química , Animales , Bovinos , Dicroismo Circular , Cinética , Luz , Microscopía de Fuerza Atómica , Peso Molecular , Desnaturalización de Ácido Nucleico , Dispersión de Radiación , Espectrometría de Fluorescencia , Electricidad Estática , Viscosidad
11.
Vet Pathol ; 51(3): 624-7, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-23978840

RESUMEN

Within a 24-hour period, 7 out of 200 three- to four-week-old pastured Katahdin lambs died after showing clinical signs of hemoglobinuria, red-tinged feces, weakness, and recumbency. One of the lambs that was examined clinically before natural death also had abdominal pain, trembling, tachycardia, and severe anemia with a packed cell volume of 4%. Pathologic findings included icterus, hemoglobinuric nephrosis, dark red urine, pulmonary edema, hydrothorax, splenomegaly, and acute centrilobular to midzonal hepatocellular degeneration and necrosis with cholestasis. The differential diagnoses and diagnostic workup to achieve the diagnosis are briefly discussed.


Asunto(s)
Clostridium perfringens , Muerte Súbita/veterinaria , Enterotoxemia/diagnóstico , Hemólisis/fisiología , Enfermedades de las Ovejas/diagnóstico , Enfermedades de las Ovejas/microbiología , Enfermedades de las Ovejas/patología , Animales , Muerte Súbita/etiología , Muerte Súbita/patología , Diagnóstico Diferencial , Enterotoxemia/patología , Resultado Fatal , Contenido Digestivo , Hemoglobinuria/veterinaria , Técnicas Histológicas/veterinaria , Hidrotórax/patología , Hidrotórax/veterinaria , Inmunohistoquímica/veterinaria , Ictericia/patología , Ictericia/veterinaria , Hígado/microbiología , Pulmón/microbiología , Nefrosis/patología , Nefrosis/veterinaria , Edema Pulmonar/patología , Edema Pulmonar/veterinaria , Ovinos , Esplenomegalia/patología , Esplenomegalia/veterinaria
13.
Am J Transplant ; 13(10): 2743-9, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23915309

RESUMEN

Procurement of a facial vascularized composite allograft (VCA) should allow concurrent procurement of all solid organs and ensure their integrity. Because full facial procurement is time-intensive, "simultaneous-start" procurement could entail VCA ischemia over 12 h. We procured a total face osteomyocutaneous VCA from a brain-dead donor. Bedside tracheostomy and facial mask impression were performed preoperative day 1. Solid organ recovery included heart, lungs, liver, kidneys, and pancreas. Facial dissection time was 12 h over 15 h to diminish ischemia while awaiting recipient preparation. Solid organ recovery began at 13.5 h, during midfacial osteotomies, and concluded immediately after facial explantation. Facial thoracic and abdominal teams worked concurrently. Estimated blood loss was 1300 mL, requiring five units of pRBC and two units FFP. Urine output, MAP, pH and PaO2 remained normal. All organs had good postoperative function. We propose an algorithm that allows "face first, concurrent completion" recovery of a complex facial VCA by planning multiple pathways to expedient recovery of vital organs in the event of clinical instability. Beginning the recipient operation earlier may reduce waiting time due to extensive recipient scarring causing difficult dissection.


Asunto(s)
Algoritmos , Muerte Encefálica , Cara/cirugía , Trasplante Facial/métodos , Donantes de Tejidos/provisión & distribución , Obtención de Tejidos y Órganos/métodos , Adulto , Puntos Anatómicos de Referencia , Cara/irrigación sanguínea , Humanos , Masculino , Adulto Joven
14.
Infect Immun ; 81(7): 2405-14, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23630957

RESUMEN

Clostridium perfringens type D causes disease in sheep, goats, and other ruminants. Type D isolates produce, at minimum, alpha and epsilon (ETX) toxins, but some express up to five different toxins, raising questions about which toxins are necessary for the virulence of these bacteria. We evaluated the contribution of ETX to C. perfringens type D pathogenicity in an intraduodenal challenge model in sheep, goats, and mice using a virulent C. perfringens type D wild-type strain (WT), an isogenic ETX null mutant (etx mutant), and a strain where the etx mutation has been reversed (etx complemented). All sheep and goats, and most mice, challenged with the WT isolate developed acute clinical disease followed by death in most cases. Sheep developed various gross and/or histological changes that included edema of brain, lungs, and heart as well as hydropericardium. Goats developed various effects, including necrotizing colitis, pulmonary edema, and hydropericardium. No significant gross or histological abnormalities were observed in any mice infected with the WT strain. All sheep, goats, and mice challenged with the isogenic etx mutant remained clinically healthy for ≥24 h, and no gross or histological abnormalities were observed in those animals. Complementation of etx knockout restored virulence; most goats, sheep, and mice receiving this complemented mutant developed clinical and pathological changes similar to those observed in WT-infected animals. These results indicate that ETX is necessary for type D isolates to induce disease, supporting a key role for this toxin in type D disease pathogenesis.


Asunto(s)
Toxinas Bacterianas/metabolismo , Infecciones por Clostridium/patología , Clostridium perfringens/patogenicidad , Cabras/microbiología , Ovinos/microbiología , Animales , Toxinas Bacterianas/genética , Clostridium perfringens/genética , Clostridium perfringens/metabolismo , Femenino , Técnicas de Inactivación de Genes , Genes Bacterianos , Prueba de Complementación Genética , Intestinos/microbiología , Estimación de Kaplan-Meier , Masculino , Ratones , Viabilidad Microbiana , Mutación , Plásmidos/genética , Plásmidos/metabolismo , Virulencia
15.
Phys Rev Lett ; 110(14): 142701, 2013 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-25166983

RESUMEN

The inclusive breakup for the (11)Li + (208)Pb reaction at energies around the Coulomb barrier has been measured for the first time. A sizable yield of (9)Li following the (11)Li dissociation has been observed, even at energies well below the Coulomb barrier. Using the first-order semiclassical perturbation theory of Coulomb excitation it is shown that the breakup probability data measured at small angles can be used to extract effective breakup energy as well as the slope of B(E1) distribution close to the threshold. Four-body continuum-discretized coupled-channels calculations, including both nuclear and Coulomb couplings between the target and projectile to all orders, reproduce the measured inclusive breakup cross sections and support the presence of a dipole resonance in the (11)Li continuum at low excitation energy.

16.
Vet Microbiol ; 157(3-4): 412-9, 2012 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-22296994

RESUMEN

Clostridium perfringens type C is an important cause of enteritis and/or enterocolitis in several animal species, including pigs, sheep, goats, horses and humans. The disease is a classic enterotoxemia and the enteric lesions and associated systemic effects are thought to be caused primarily by beta toxin (CPB), one of two typing toxins produced by C. perfringens type C. This has been demonstrated recently by fulfilling molecular Koch's postulates in rabbits and mice. We present here an experimental study to fulfill these postulates in goats, a natural host of C. perfringens type C disease. Nine healthy male or female Anglo Nubian goat kids were inoculated with the virulent C. perfringens type C wild-type strain CN3685, an isogenic CPB null mutant or a strain where the cpb null mutation had been reversed. Three goats inoculated with the wild-type strain presented abdominal pain, hemorrhagic diarrhea, necrotizing enterocolitis, pulmonary edema, hydropericardium and death within 24h of inoculation. Two goats inoculated with the CPB null mutant and two goats inoculated with sterile culture media (negative controls) remained clinically healthy during 24h after inoculation and no gross or histological abnormalities were observed in the tissues of any of them. Reversal of the null mutation to partially restore CPB production also increased virulence; 2 goats inoculated with this reversed mutant presented clinical and pathological changes similar to those observed in goats inoculated with the wild-type strain, except that spontaneous death was not observed. These results indicate that CPB is required for C. perfringens type C to induce disease in goats, supporting a key role for this toxin in natural C. perfringens type C disease pathogenesis.


Asunto(s)
Toxinas Bacterianas/genética , Clostridium perfringens/patogenicidad , Enterocolitis Necrotizante/veterinaria , Enterotoxemia/microbiología , Cabras/microbiología , Animales , Clostridium perfringens/genética , Enterocolitis Necrotizante/microbiología , Enterocolitis Necrotizante/patología , Enterotoxemia/patología , Femenino , Intestino Delgado/microbiología , Intestino Delgado/patología , Masculino , Mutación , Virulencia
17.
Vet Microbiol ; 156(3-4): 395-402, 2012 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-22177970

RESUMEN

Clostridium perfringens type C is one of the most important agents of enteric disease in newborn foals. Clostridium difficile is now recognized as an important cause of enterocolitis in horses of all ages. While infections by C. perfringens type C or C. difficile are frequently seen, we are not aware of any report describing combined infection by these two microorganisms in foals. We present here five cases of foal enterocolitis associated with C. difficile and C. perfringens type C infection. Five foals between one and seven days of age were submitted for necropsy examination to the California Animal Health and Food Safety Laboratory. The five animals had a clinical history of acute hemorrhagic diarrhea followed by death and none had received antimicrobials or been hospitalized. Postmortem examination revealed hemorrhagic and necrotizing entero-typhlo-colitis. Histologically, the mucosa of the small intestine and colon presented diffuse necrosis and hemorrhage and it was often covered by a pseudomembrane. Thrombosis was observed in submucosal and/or mucosal vessels. Immunohistochemistry of intestinal sections of all foals showed that many large bacilli in the sections were C. perfringens. C. perfringens beta toxin was detected by ELISA in intestinal content of all animals and C. difficile toxin A/B was detected in intestinal content of three animals. C. perfringens (identified as type C by PCR) was isolated from the intestinal content of three foals. C. difficile (typed as A(+)/B(+) by PCR) was isolated from the intestinal content in 3 out of the 5 cases. This report suggests a possible synergism of C. perfringens type C and C. difficile in foal enterocolitis. Because none of the foals had received antibiotic therapy, the predisposing factor, if any, for the C. difficile infection remains undetermined; it is possible that the C. perfringens infection acted as a predisposing factor for C. difficile and/or vice versa. This report also stresses the need to perform a complete diagnostic workup in all cases of foal digestive disease.


Asunto(s)
Clostridioides difficile/aislamiento & purificación , Infecciones por Clostridium/veterinaria , Clostridium perfringens/aislamiento & purificación , Coinfección , Enfermedades de los Caballos/diagnóstico , Caballos/microbiología , Animales , California , Infecciones por Clostridium/diagnóstico , Infecciones por Clostridium/microbiología , Infecciones por Clostridium/patología , Diarrea/microbiología , Diarrea/veterinaria , Enterocolitis/diagnóstico , Enterocolitis/microbiología , Enterocolitis/patología , Enterocolitis/veterinaria , Femenino , Enfermedades de los Caballos/microbiología , Enfermedades de los Caballos/patología , Intestino Delgado/patología , Masculino
18.
Phys Rev Lett ; 109(26): 262701, 2012 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-23368554

RESUMEN

The first measurement of the elastic scattering of the halo nucleus 11Li and its core 9Li on 208Pb at energies near the Coulomb barrier is presented. The 11Li+208Pb elastic scattering shows a strong reduction with respect to the Rutherford cross section, even at energies well below the barrier and down to very small scattering angles. This drastic change of the elastic differential cross section observed in 11Li+208Pb is the consequence of the halo structure of 11Li, as it is not observed in the elastic scattering of its core 9Li at the same energies. Four-body continuum-discretized coupled-channels calculations, based on a three-body model of the 11Li projectile, are found to explain the measured angular distributions and confirm that the observed reduction is mainly due to the strong Coulomb coupling to the dipole states in the low-lying continuum of 11Li. These calculations suggest the presence of a low-lying dipole resonance in 11Li close to the breakup threshold.

20.
Rev Esp Anestesiol Reanim ; 56(1): 27-30, 2009 Jan.
Artículo en Español | MEDLINE | ID: mdl-19284125

RESUMEN

OBJECTIVE: To evaluate the effect of prehydration with hydroxyethyl starch 130/0.4 (Voluven) compared to lactated Ringer solution in laparoscopic cholecystectomy. PATIENTS AND METHODS: We performed a randomized single-blind clinical trial on patients classified as ASA 1 and 2. The exclusion criteria were hypertension, kidney failure, treatment with diuretics or other antihypertensive drugs, diabetes, and use of nonsteroidal anti-inflammatory drugs. Balanced general anesthesia with remifentanil and sevoflurane was used. The total volume of administered fluids (including prehydration) was 2 mL x kg(-1) x h(-1) fasting plus 5 mL x kg(-1) x h(-1) during surgery. Group 1 was prehydrated 30 minutes before surgery with 500 mL of lactated Ringer solution in group 1; in group 2 the same quantity of Voluven was used. Ringer solution was used in both groups to provide additional fluids. Blood pressure was kept within 20% above or below baseline values. Standard anesthetic monitoring was performed. Intraoperative diuresis and creatinine clearance were recorded. The groups were compared using the t test; a P value of 05 or less was considered significant. RESULTS: Twenty-nine patients were enrolled in the study. Diuresis and creatinine clearance were significantly higher in the group that received prehydration with Voluven. The mean (SD) creatinine clearance rate was 176.44 (1433) mL x min(-1) in group 1 and 61.90 (6.6) mL x min(-1) in group 2 (P = .036). The mean volume of urine excreted was 1.71 (0.06) mL x kg(-1) x h(-1) in group 1 and 0.47 (0.02) mL x kg(-1) x h(-1) in group 2 (P = .017). CONCLUSION: Prehydration with Voluven can be an effective measure for protecting renal function against the adverse effects of pneumoperitoneum in laparoscopic surgery.


Asunto(s)
Colecistectomía Laparoscópica , Diuresis/efectos de los fármacos , Fluidoterapia , Derivados de Hidroxietil Almidón/uso terapéutico , Tasa de Depuración Metabólica/efectos de los fármacos , Neumoperitoneo Artificial/efectos adversos , Premedicación , Circulación Renal/efectos de los fármacos , Adulto , Creatinina/sangre , Femenino , Humanos , Derivados de Hidroxietil Almidón/administración & dosificación , Derivados de Hidroxietil Almidón/farmacología , Soluciones Isotónicas/administración & dosificación , Soluciones Isotónicas/farmacología , Soluciones Isotónicas/uso terapéutico , Masculino , Persona de Mediana Edad , Monitoreo Intraoperatorio , Lactato de Ringer
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