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1.
J Surg Res ; 202(1): 66-70, 2016 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-27083949

RESUMEN

BACKGROUND: Infective endocarditis, a disease with high mortality and morbidity, is most commonly caused by Staphylococcus aureus; mortality and morbidity further increase in the presence of methicillin-resistant strains of S. aureus. Linezolid is the first of the oxazolidinones, a new antibiotic group that has been approved for the treatment of infections caused by gram-positive cocci. Linezolid reduces the quantity of microorganisms in vegetation to some extent; in addition, the use of hyperbaric oxygen (HBO) and ozone (O3) therapies is likely to improve targeted antibacterial effect. MATERIALS AND METHODS: Fifty-six adult male Wistar rats weighing 300-350 g were used. The subjects were divided into groups as follows: Group 1 (n = 8): control group that was not inoculated with microorganisms and was untreated; Group 2 (n = 8): control group that was inoculated with microorganisms but was untreated; Group 3 (n = 8): linezolid treatment group; Group 4 (n = 8): O3 therapy group; Group 5 (n = 8): HBO therapy group; Group 6 (n = 8): linezolid + O3 therapy group; Group 7 (n = 8): linezolid + HBO therapy group. RESULTS: In terms of reducing the number of colonies in the aortic valve, linezolid + HBO therapy was found to be the most effective treatment. Then, respectively linezolid + O3, linezolid, HBO, and O3 were found to be effective. CONCLUSIONS: We found that linezolid significantly reduced the number of bacteria in the vegetation in the experimental endocarditis model, and HBO therapy increases the effectiveness of linezolid and makes this better than O3.


Asunto(s)
Antibacterianos/uso terapéutico , Endocarditis Bacteriana/terapia , Oxigenoterapia Hiperbárica , Linezolid/uso terapéutico , Oxidantes Fotoquímicos/uso terapéutico , Ozono/uso terapéutico , Infecciones Estafilocócicas/terapia , Animales , Terapia Combinada , Masculino , Ratas , Ratas Wistar , Resultado del Tratamiento
2.
J Pediatr Hematol Oncol ; 38(7): e254-6, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27379531

RESUMEN

Wolfram syndrome-1 is a rare and severe autosomal recessive neurodegenerative disease characterized by diabetes mellitus (DM), optic atrophy, diabetes insipidus, and deafness. Poorly controlled type 1 DM increases the risk for thrombosis. However, coexistence of DM and hereditary thrombosis factors is rarely observed. Here we present the case of a 13.5-year-old, nonfollowed girl newly diagnosed with poorly controlled Wolfram syndrome on the basis of the results of clinical and laboratory examinations. On the eighth day after diabetic ketoacidosis treatment, pulmonary embolism developed in the subject. Thrombus identified in the right atrium using echocardiography was treated by emergency thrombectomy. Homozygous mutation in the methylenetetrahydrofolate reductase gene C677T, heterozygous factor-V Leiden mutation, and active protein C resistance were identified in the patient. The patient was lost because of a recurring episode of pulmonary embolism on the 86th day of hospitalization. We present this case to highlight the need for investigating hereditary thrombosis risk factors in diabetic patients in whom thromboembolism develops.


Asunto(s)
Embolia Pulmonar/etiología , Trombofilia/complicaciones , Síndrome de Wolfram/complicaciones , Resistencia a la Proteína C Activada/etiología , Adolescente , Diabetes Mellitus Tipo 1/complicaciones , Factor V/genética , Resultado Fatal , Femenino , Humanos , Metilenotetrahidrofolato Reductasa (NADPH2)/genética
3.
J Surg Res ; 178(1): 92-5, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22483809

RESUMEN

BACKGROUND: Subclinical atrial stunning (AS) (left atrial dysfunction) may increase vulnerability to oxidative and inflammatory stressors, thus increasing the likelihood of postoperative supraventricular arrhythmias, especially atrial fibrillation (AF). Evaluation of mitral annular velocities by tissue Doppler imaging (TDI) may be useful in seeking subclinical AS. This prospective study aimed to evaluate the relationship between atrial fibrillation after bypass surgery and presurgical determination of subclinical AS by assessing mitral annular velocities by TDI. METHODS: We enrolled patients who underwent coronary artery bypass graft (CABG) surgery into this prospective study. Inclusion criteria were sinus rhythm and a negative history of atrial tachycardia during the previous 3 mo. An experienced cardiologist performed transthoracic echocardiography in all patients. We recorded standard two-dimensional, mitral inflow conventional Doppler interrogation and TDI pulsed wave data from the lateral and septal annulus. All patients underwent CABG surgery at our Cardiovascular Surgery Unit. Patients were divided into two groups based on their postoperative AF status: group 1 patients had postoperative AF and group 2 patients did not. RESULTS: This study included 44 patients. Age and the presence of chronic obstructive pulmonary disease were the only two significantly different parameters among clinical characteristics between groups. Echocardiographic findings that were statistically significantly different between groups were as follows: lateral A diastolic mitral annular velocity, group 1: 0.11 ± 0.19 ms(-1)versus group 2: 0.08 ± 0.19 ms(-1) (P = 0.001); lateral E diastolic mitral annular velocity, group 1: 0.69 ± 0.24 ms(-1)versus group 2: 0.62 ± 0.31 ms(-1) (P = 0.016); Septal E diastolic mitral annular velocity, group 1: 0.05 ± 0.01 ms(-1)versus group 2: 0.04 ± 0.01 ms(-1) (P = 0.033); septal A diastolic mitral annular velocity, group 1: 0.08 ± 0.02 ms(-1)versus group 2: 0.05 ± 0.02 ms(-1) (P = 0.005). CONCLUSIONS: There is no relationship between AF after CABG surgery and preexisting subclinical AS determined with mitral annular velocities by TDI. Preoperative appropriate prophylactic treatment should be administered to all patients.


Asunto(s)
Fibrilación Atrial/fisiopatología , Puente de Arteria Coronaria/efectos adversos , Válvula Mitral/fisiología , Complicaciones Posoperatorias/fisiopatología , Anciano , Fibrilación Atrial/etiología , Ecocardiografía Doppler , Femenino , Atrios Cardíacos/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Válvula Mitral/diagnóstico por imagen , Aturdimiento Miocárdico/complicaciones , Aturdimiento Miocárdico/fisiopatología , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Estudios Prospectivos
4.
J Surg Res ; 155(1): 111-5, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19181335

RESUMEN

BACKGROUND: Mediastinitis is a dreaded complication of cardiac surgical procedures. The purpose of our study was to research the role of hyperbaric oxygen therapy (HBO) in the treatment of experimental mediastinitis and to investigate whether it potentiates the antibiotic effects of linezolid, teicoplanin, and vancomycin. METHODS: The study included nine groups; an uncontaminated and a contaminated untreated control groups, and seven contaminated groups that received HBO or systemic antibiotics with linezolid, vancomycin, or teicoplanin, or a combination therapy consisting of one of these antibiotics and HBO. There were six adult male Wistar rats in each group. Contaminated groups were inoculated with 0.5 mL 10(8) CFU/mL methicillin resistant Staphylococcus aureus in the mediastinal and in the sternal layers. The antibiotic treatment continued 7 d. Twelve hours later at the end of the treatment, the rats were sacrificed, a sternotomy was performed for each rat and tissue samples from the upper ends of the sternum were aseptically obtained and evaluated microbiologically. RESULTS: There was no difference between the therapeutic efficacy of linezolid, teicoplanin, or vancomycin (P>0.05). When the groups were analyzed separately, treatment with a combination of HBO and antibiotic therapy reduced the bacterial count in comparison with HBO or antibiotic treatment alone (P<0.05). The combination of teicoplanin or vancomycin and HBO, respectively, was not more effective in reducing the bacterial count in comparison with the combination of linezolid and HBO (P>0.05). CONCLUSIONS: Linezolid and teicoplanin therapy was found as effective as standard vancomycin therapy for methicillin resistant Staphylococcus aureus (MRSA) mediastinitis. Adjunctive HBO offered additional benefit to the antibiotic treatment of mediastinitis.


Asunto(s)
Antiinfecciosos/uso terapéutico , Oxigenoterapia Hiperbárica , Mediastinitis/terapia , Infecciones Estafilocócicas/terapia , Acetamidas/uso terapéutico , Animales , Terapia Combinada , Linezolid , Masculino , Mediastinitis/microbiología , Staphylococcus aureus Resistente a Meticilina , Oxazolidinonas/uso terapéutico , Ratas , Ratas Wistar , Teicoplanina/uso terapéutico , Vancomicina/uso terapéutico
5.
J Surg Res ; 152(1): 89-95, 2009 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-18952240

RESUMEN

BACKGROUND: We aimed to investigate the therapeutic efficacy of linezolid in an experimental mediastinitis model and to compare it with vancomycin, which is commonly used. The objective of this study was also to evaluate the role of the immune system in mediastinitis. MATERIALS AND METHODS: Fifty adult Wistar rats were randomly divided into five groups: an uncontaminated and contaminated untreated control groups; a group that received sefazolin prophylaxis; and two groups treated with vancomycin or linezolid. Median sternotomy without access to pleural spaces was performed on all rats. All groups, except the uncontaminated one, were inoculated with 0.5 mL 10(8) colony-forming units/mL methicillin-resistant Staphylococcus aureus in the mediastinal and sternal layers. Postoperatively, vancomycin and linezolid groups were given antibiotic treatment for 7 d, starting 24 h after the end of the procedure. After 7-d treatment tissue samples from the upper ends of the sternotomy line and mediastinum were obtained and evaluated microbiologically. Additionally, serum, heart, lung, liver, kidney, and mediastinal tissues samples were obtained to determine malondialdehyde (MDA) and myeloperoxidase (MPO). RESULTS: The study showed that either vancomycin or linezolid successfully reduced bacterial counts in mediastinum and sternotomy line. MDA and MPO levels were found to be decreased in the treated groups. There was a positive correlation between serum and tissues MDA and MPO in all of the groups. CONCLUSIONS: Our study showed that linezolid appears to be a promising option for treating mediastinitis due to methicillin-resistant S. aureus. Additionally, it was demonstrated that a wide inflammatory process occurred after mediastinitis.


Asunto(s)
Acetamidas/uso terapéutico , Antibacterianos/uso terapéutico , Mediastinitis/tratamiento farmacológico , Oxazolidinonas/uso terapéutico , Vancomicina/uso terapéutico , Animales , Modelos Animales de Enfermedad , Linezolid , Masculino , Malondialdehído/metabolismo , Mediastinitis/etiología , Mediastinitis/inmunología , Mediastinitis/metabolismo , Staphylococcus aureus Resistente a Meticilina , Peroxidasa/metabolismo , Ratas , Ratas Wistar
6.
J Surg Res ; 149(2): 219-30, 2008 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-18533185

RESUMEN

BACKGROUND: Activated protein C (APC) is a serine protease with anticoagulant and ant-inflammatory activities. APC has been shown to attenuate deleterious effects of ischemia/reperfusion (I/R) injury in many organs. In this study, we aimed to investigate the effects of APC on intestinal mucosal injury induced by superior mesenteric occlusion. MATERIALS AND METHODS: Male Wistar-albino rats were allocated into four groups: (1) sham-operated group, laparotomy without I/R injury (n = 12); (2) sham + APC group, identical to Group 1 except for APC treatment (n = 12); (3) I/R group, 60 min of ischemia followed by 3-h of reperfusion (n = 12); and (4) I/R + APC-treated group, 100 mug/kg injection of APC intravenously, 15 min before reperfusion (n = 12). We evaluated the degree of intestinal mucosal injury on a grading scale from 0 to 5, histopathologically, and by measuring activities of oxidative and antioxidative enzymes as well as nitrate/nitrite levels, biochemically. Intestinal edema was estimated by using wet/dry weight ratios. The plasma levels of proinflammatory cytokines and D-dimer were measured. Animal survival was observed up to 1 wk. RESULTS: Intestinal mucosal injury scores were significantly decreased with APC administration (P < 0.05). APC treatment significantly reduced activities of oxidative enzymes and nitrate/nitrite levels in the intestinal tissues, and plasma levels of proinflammatory cytokines and D-dimer, and also significantly increased activities of antioxidative enzymes in the intestinal tissues (P < 0.05). Intestinal edema was significantly alleviated with APC treatment (P < 0.05). The survival rate of rats in the APC-treated group were significantly higher than that of the I/R-treated group (P < 0.05). CONCLUSIONS: This study clearly showed that APC treatment significantly attenuated intestinal mucosal injury caused by superior mesenteric ischemia/reperfusion. Further clinical studies are required to clarify whether APC has a useful role in reperfusion injury during particular surgeries in which I/R-induced organ injury occurs.


Asunto(s)
Anticoagulantes/uso terapéutico , Mucosa Intestinal/lesiones , Oclusión Vascular Mesentérica/tratamiento farmacológico , Proteína C/uso terapéutico , Daño por Reperfusión/tratamiento farmacológico , Animales , Edema/prevención & control , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Glutatión/metabolismo , Glutatión Reductasa/metabolismo , Interleucina-6/sangre , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patología , Masculino , Malondialdehído/metabolismo , Arteria Mesentérica Superior , Nitratos/metabolismo , Nitritos/metabolismo , Peroxidasas/metabolismo , Ratas , Ratas Wistar , Daño por Reperfusión/metabolismo , Daño por Reperfusión/patología , Factor de Necrosis Tumoral alfa/sangre , Isquemia Tibia , Xantina Oxidasa/metabolismo
7.
Int J Infect Dis ; 12(4): 396-401, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-18162429

RESUMEN

INTRODUCTION: The treatment of postoperative mediastinitis is very important because of its high morbidity, mortality, and increased hospital stay and hospital costs. The aims of our research were to investigate whether linezolid alone can be an effective treatment agent for methicillin-resistant Staphylococcus aureus (MRSA) mediastinitis, and to determine whether linezolid can provide synergistic activity when given in combination with rifampin. METHODS: A partial upper median sternotomy was performed on 70 rats. The animals were divided into seven groups: an uncontaminated control group; an untreated contaminated group; three contaminated groups that received antibiotic therapy with either 25 or 50 mg/kg linezolid twice a day, or rifampin 5 mg/kg twice a day; and two contaminated groups that received a combination therapy consisting of 25 or 50 mg/kg linezolid and rifampin 5 mg/kg twice a day. The antibiotic treatment lasted 7 days. Tissue samples from the upper ends of the sternum and swab specimens of the upper mediastinum were obtained and evaluated microbiologically. RESULTS: The 25-mg/kg dose of linezolid, either alone or combined with rifampin, was not effective in reducing the bacterial counts in mediastinum and sternum. Quantitative bacterial cultures of mediastinum and sternum were significantly lower in the groups receiving 50 mg/kg linezolid alone or in combination with rifampin compared with the control. Adding of rifampin to linezolid therapy did not result in a significant change in bacterial counts versus linezolid alone. CONCLUSION: A high dose of linezolid should be considered as a possible therapeutic agent for the treatment of post-sternotomy infection caused by MRSA.


Asunto(s)
Acetamidas/administración & dosificación , Antibacterianos/administración & dosificación , Mediastinitis/tratamiento farmacológico , Resistencia a la Meticilina/efectos de los fármacos , Oxazolidinonas/administración & dosificación , Staphylococcus aureus/efectos de los fármacos , Infección de la Herida Quirúrgica/tratamiento farmacológico , Animales , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Linezolid , Masculino , Ratas , Rifampin/uso terapéutico , Infecciones Estafilocócicas/tratamiento farmacológico
8.
Ulus Travma Acil Cerrahi Derg ; 14(3): 182-7, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-18781412

RESUMEN

BACKGROUND: We investigated the effects of iloprost and pentoxifylline on skeletal muscle ischemia-reperfusion injury in a rabbit model. METHODS: Forty New Zealand white rabbits were grouped into four. In Group 1, iloprost was continuously infused starting half an hour before the reperfusion following a 2-hour ischemia formed by abdominal aortic occlusion, and it was continued during the 4-hour reperfusion period. Group 2 was treated with pentoxifylline, and Group 3 received saline solution. Group 4 was the sham group. Malondialdehyde levels and edema scores in gastrocnemius muscle were evaluated. RESULTS: Edema score was significantly lower in Group 1 when compared with the control group (Group 1 vs Group 3, p=0.040; Group 2 vs Group 3, p=0.145; Group 1 vs Group 2, p=0.580). Malondialdehyde levels of the medicated groups were significantly lower when compared with the control group (Group 1: 60+/-11 nmol/g tissue, Group 2: 74+/-11 nmol/g tissue, Group 3: 95+/-10 nmol/g tissue; Group 1 vs Group 2, p=0.010; Group 1 vs Group 3, p<0.001; Group 2 vs Group 3, p<0.001; Group 1 vs Group 4, p<0.001; Group 2 vs Group 4, p<0.001; Group 3 vs Group 4: p<0.001). CONCLUSION: Acute skeletal muscle ischemia is a common problem. We are of the opinion that in the early phase of skeletal muscle ischemia, iloprost and pentoxifylline medication may reduce ischemia-reperfusion injury.


Asunto(s)
Iloprost/uso terapéutico , Músculo Esquelético/irrigación sanguínea , Pentoxifilina/uso terapéutico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Daño por Reperfusión/prevención & control , Vasodilatadores/uso terapéutico , Animales , Modelos Animales de Enfermedad , Quimioterapia Combinada , Edema/patología , Femenino , Humanos , Masculino , Malondialdehído/análisis , Malondialdehído/metabolismo , Músculo Esquelético/patología , Conejos , Distribución Aleatoria , Resultado del Tratamiento
9.
Curr Ther Res Clin Exp ; 68(1): 23-31, 2007 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24678116

RESUMEN

BACKGROUND: Graft infections are severe complications of vascular surgery that may result in amputation or mortality. Staphylococci are the most frequent cause of vascular graft infections. OBJECTIVE: In this study we assessed the prophylactic efficacy of linezolid in comparison with vancomycin in preventing prosthetic vascular graft infection due to methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-resistant Staphylococcus epidermidis (MRSE). METHODS: This randomized, controlled, experimental study using healthy adult (aged >5 months) male Wistar rats was conducted in the research laboratory of the Pamukkale University, Denizli, Turkey. The study consisted of an uncontaminated control group and 3 groups for both staphylococcal strains: a contaminated group that did not receive any antibiotic prophylaxis; a contaminated group that received preoperative intraperitoneal (IP) prophylaxis with vancomycin; and a contaminated group that received preoperative IP prophylaxis with linezolid. All rats received a vascular Dacron graft placed inside a subcutaneous pocket created on the right side of the median line. Sterile saline solution (1 mL), to which MRSA or MRSE at a concentration of 2 × 10(7) colony-forming units per milliliter had been added, was inoculated onto the graft surface using a tuberculin syringe to fill the pocket. The grafts were explanted 7 days after implantation and assessed by quantitative culture. RESULTS: Seventy rats (mean [SD]weight, 323.7 [17.9]g; mean [SD]age, 5.98 [0.64] months) were evenly divided between the 7 groups. Statistical analysis of the quantitative graft culture suggested that both vancomycin and linezolid were effective in significantly inhibiting bacterial growth when compared with the untreated contaminated groups (all, P < 0.001). However, a statistically significant difference was not observed between the bacteria count in the vancomycin and linezolid prophylaxis groups. When a comparison was made between the bacterial growth in the contaminated control groups, MRSA had significantly greater affinity to the Dacron prostheses than MRSE (all, P < 0.001). CONCLUSION: Our study found that linezolid was as effective as vancomycin in suppressing colony counts in MRSA- or MRSE-infected vascular Dacron grafts in rats.

10.
Am J Infect Control ; 34(9): 606-9, 2006 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17097459

RESUMEN

BACKGROUND: Hospital-acquired infection often occurs because of lapses in accepted standards of practice on the part of health care personnel. The aim of this study is to attract attention on poor hospital infection control practice in venepuncture and use of tourniquets and emphasize the importance of hand hygiene. METHODS: Overall compliance with hygiene during usage of tourniquets and routine patient care before and after implementation of a hospital infection control measures was evaluated. RESULTS: According to the questionnaire, only 26.9% of respondents always washed their hands both before and after venepuncture. In the second step of the study, based on direct observation, hands were washed both before and after venepuncture on only 41 (45.1%) occasions. Failure to remove gloves after patient contact was observed on 23.1% occasions. CONCLUSION: Our survey reveals poor infection control practice in hand hygiene, glove utilization, and usage of tourniquets and the implementation of infection control measures produced a moderate improvement in compliance with them.


Asunto(s)
Infección Hospitalaria/prevención & control , Fómites/microbiología , Adhesión a Directriz , Desinfección de las Manos/normas , Control de Infecciones/métodos , Torniquetes/microbiología , Guantes Protectores/normas , Guantes Protectores/estadística & datos numéricos , Encuestas de Atención de la Salud , Humanos , Resistencia a la Meticilina , Flebotomía/efectos adversos , Staphylococcus aureus/aislamiento & purificación , Turquía
11.
Acta Cardiol ; 61(1): 89-94, 2006 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-16485738

RESUMEN

OBJECTIVE: The purpose of this study was to evaluate the influence of preserved integrity of pleura on postoperative bleeding and respiratory function in patients undergoing coronary artery bypass grafting (CABG). METHODS AND RESULTS: Seventy-two CABG patients who received pedunculated IMA graft without opening the pleura (group of intact pleura, group IP) between July 2002 and September 2004 were matched to 72 CABG patients who received pedunculated IMA graft with opened pleura (group of opened pleura, group OP). To match the patients with IP and unique patients with OP, logistic regression was used to develop a propensity score. The C statistic for this model was 0.79. Patients with IP were matched to unique patients with OP with an identical 5-digit propensity score. If this could not be done, we proceeded to a 4-, 3-, 2-, or 1-digit match. Patients characteristics were well matched. There were no differences in preoperative and peroperative variables between the groups. The incidence of postoperative pleural effusion and thoracentesis were significantly lower in group IP than group OP (pleural effusion in 15.2 versus 30.5%; p = 0.029, thoracentesis in 5.5 versus 18.5%; p = 0.036). Other pulmonary complications such as prolonged ventilation, reintubation, pneumothorax, atelectasis, diaphragmatic paralysis were similar in both groups. Patients with IP had significantly lower blood loss (520 versus 870 ml; p < 0.001) and whole blood unit transfusion (26.3 versus 41.6%, p = 0.036). Also, intensive care unit and hospital stay were similar in both groups. CONCLUSIONS: Meticulous internal mammary artery harvesting and preservation of the pleural integrity significantly reduces postoperative bleeding and pleural effusion.


Asunto(s)
Puente de Arteria Coronaria , Hemorragia/etiología , Enfermedades Pulmonares/etiología , Pleura/cirugía , Derrame Pleural/etiología , Complicaciones Posoperatorias/etiología , Distribución de Chi-Cuadrado , Femenino , Hemorragia/epidemiología , Mortalidad Hospitalaria , Humanos , Incidencia , Anastomosis Interna Mamario-Coronaria , Modelos Logísticos , Enfermedades Pulmonares/epidemiología , Masculino , Derrame Pleural/epidemiología , Complicaciones Posoperatorias/epidemiología , Estudios Prospectivos , Pruebas de Función Respiratoria , Estadísticas no Paramétricas
12.
Adv Ther ; 23(2): 256-62, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16751158

RESUMEN

Vascular prosthetic graft infection is a major complication of vascular surgery that starts with adhesion of the microorganism to the graft. Because slime-forming microorganisms are the major causative agents in graft infection, the goals of investigators in this study were (1) to investigate the bacterial adherence of slime-forming and non-slime-forming coagulase-negative staphylococci (CNS), and (2) to determine the role of neuraminidase (NANase) in bacterial adherence to the biosynthetic ovine collagen graft. Human plasma was instilled and incubated at 37 degrees C in preparation for fibrin deposition of grafts. After 48 hours, incubation grafts were drained and inoculated with slime-forming and non-slime-forming CNS in tryptic soy broth in the presence and in the absence of neuraminidase. After 24 hours of incubation at 36 degrees C, grafts were vortexed and cultured for colony count. Bacterial counts were expressed as total colony-forming units per longitudinal centimeter of the graft. Slime-forming CNS had greater affinity to the collagen graft compared with non-slime-forming CNS (P<.05). Adherence of slime-forming CNS was impaired by NANase treatment (P<.001). NANase treatment of patients with non-slime-forming CNS did not change adherence to the graft (P>.05). Results show that slime plays an important role in the pathogenesis of vascular graft infection. Adherence of slime-forming CNS can be decreased through the administration of NANase. This may have implications for the development of neuraminidase-embedded vascular grafts designed to reduce the occurrence of biomaterial-related infection.


Asunto(s)
Prótesis Vascular , Neuraminidasa/farmacología , Infecciones Estafilocócicas/prevención & control , Staphylococcus/efectos de los fármacos , Infección de la Herida Quirúrgica/prevención & control , Animales , Adhesión Bacteriana/efectos de los fármacos , Adhesión Bacteriana/fisiología , Coagulasa/biosíntesis , Humanos , Neuraminidasa/administración & dosificación , Ovinos , Staphylococcus/metabolismo , Staphylococcus/fisiología
13.
Adv Ther ; 23(6): 869-77, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-17276955

RESUMEN

Antegrade cardioplegic delivery via the aorta ensures distribution of cardioplegic solution through open arteries, but distribution may not be adequate beyond a stenotic coronary artery. This potential problem can be overcome by direct delivery of cardioplegia via a vein graft. The purpose of this study was to compare simultaneous antegrade/vein graft cardioplegia with antegrade cardioplegia during coronary artery bypass surgery. Twenty patients were divided into 2 groups. In group 1, intermittent antegrade cardioplegia was provided (n=10). In group 2, intermittent antegrade cardioplegia was supplemented by antegrade perfusion of vein grafts after distal anastomoses were completed (n=10). Data on enzyme release and hemodynamics were obtained preoperatively, before the induction of anesthesia, just before cross-clamping, immediately after aortic unclamping, and at 1, 6, 12, 24, and 48 h after unclamping. Enzyme release (creatinine phosphokinase-isoenzyme MB, cardiac troponin I, myoglobin) was similar in both groups (P>.05). Furthermore, no significant difference was noted in the incidence of postoperative low cardiac output syndrome, perioperative myocardial infarction, or ventricular arrhythmia (P>.05). In conclusion, both techniques permitted rapid postoperative recovery of myocardial function. Supplementation of antegrade perfusion of vein grafts with antegrade cold blood cardioplegia offered no advantage to study patients.However, hemostasis of a distal anastomosis may be controlled by this technique.


Asunto(s)
Bloqueo de Rama/prevención & control , Soluciones Cardiopléjicas/administración & dosificación , Puente de Arteria Coronaria/métodos , Paro Cardíaco Inducido/métodos , Isquemia Miocárdica/prevención & control , Biomarcadores , Comorbilidad , Puente de Arteria Coronaria/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
14.
Tex Heart Inst J ; 33(4): 526-8, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-17215988

RESUMEN

Cardiac herniation and torsion is a rare condition associated with a high mortality rate. We present an unusual case of sudden cardiogenic shock that was caused by torsion and herniation of the heart after an operation for a penetrating cardiac injury. The patient was successfully treated by urgent surgical intervention.


Asunto(s)
Cardiopatías/etiología , Lesiones Cardíacas/complicaciones , Hernia/etiología , Enfermedad Iatrogénica , Heridas Punzantes/complicaciones , Adolescente , Cardiopatías/diagnóstico , Cardiopatías/patología , Cardiopatías/cirugía , Lesiones Cardíacas/cirugía , Hernia/diagnóstico , Hernia/patología , Herniorrafia , Humanos , Masculino , Marcapaso Artificial , Anomalía Torsional/diagnóstico , Anomalía Torsional/etiología , Anomalía Torsional/patología , Anomalía Torsional/cirugía , Heridas Penetrantes , Heridas Punzantes/cirugía
15.
Perspect Vasc Surg Endovasc Ther ; 18(3): 217-20, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-17172535

RESUMEN

A case is reported of an inferior mesenteric artery aneurysm that starts approximately 1 cm from its origin and ends at the proximal portion of the bifurcation of the sigmoidal and left colic arteries accompanied with complete absence of the celiac axis and superior mesenteric arteries. Additionally, left renal artery stenosis existed. The diagnosis was made by digital subtraction arteriography and confirmed by magnetic resonance arteriogram. Disease involving the inferior mesenteric artery is extremely uncommon. This may be the first reported case of neurofibromatosis in combination with renal artery stenosis and inferior mesenteric artery aneurysm associated with celiac and superior mesenteric artery occlusion and treated surgically.


Asunto(s)
Aneurisma/complicaciones , Arteria Mesentérica Inferior , Neurofibromatosis 1/complicaciones , Obstrucción de la Arteria Renal/complicaciones , Adulto , Aneurisma/cirugía , Humanos , Masculino
16.
Anatol J Cardiol ; 16(11): 875-880, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27163534

RESUMEN

OBJECTIVE: Pulsatile flow, generated by a pump during cardiopulmonary bypass, has been accepted as more physiological in coronary artery bypass grafting surgery (CABG). Therefore, we aimed to investigate the effects of pulsatile and nonpulsatile flow on postoperative cognitive function and to review relationship with the biomarkers S100ß and neuron-specific enolase (NSE). METHODS: Patients who underwent isolated CABG were included this prospective, randomized, double-blind study, which was performed between March 2010 and December 2010. Patients were divided into two groups: pulsatile (Group I, n=20) and nonpulsatile (Group II, n=20) flow. Blood samples were collected 1 day before surgery and in the sixth postoperative hour for the analysis of S100ß and NSE. In addition, Mini-Mental State Examination (MMSE) was performed during preoperative period and on third postoperative day. Outcomes were determination of effects of pump flow type on cognitive function and relationships with concentrations of S100ß and NSE. RESULTS: Forty patients were included. No differences were observed between the groups with respect to complications, mortality, S100ß (Group I: 1.9±0.2 µ/L; Group II: 2.0±0.2 µ/L), NSE (Group I: 12.5±0.8 µ/L; Group II: 12.4±0.7 µ/L), MMSE scores [Group I: 25 (23-27); Group II: 25 (23-27)], and postoperative cognitive dysfunction (POCD) (p>0.05). No correlation was observed between MMSE scores and concentrations of S100ß (r=-0.032) and NSE (r=-0.423) (p>0.05). CONCLUSION: There was no difference between types of pump flow for POCD and no relationship between cognitive dysfunction and S100ß and NSE concentrations. Pump flow type does not affect NSE concentrations.


Asunto(s)
Puente Cardiopulmonar/métodos , Disfunción Cognitiva/etiología , Puente de Arteria Coronaria , Complicaciones Posoperatorias , Cognición , Vasos Coronarios , Método Doble Ciego , Humanos , Estudios Prospectivos
17.
BMC Infect Dis ; 5: 91, 2005 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-16242027

RESUMEN

BACKGROUND: The aim of the study was to investigate the in vivo efficacy of local and systemic antibiotic prophylaxis in the prevention of Staphylococcus (S.) epidermidis graft infection in a rat model and to evaluate the bacterial adherence to frequently used prosthetic graft materials. METHODS: Graft infections were established in the subcutaneous tissue of 120 male Wistar rats by implantation of Dacron/ePTFE grafts followed by topical inoculation with 2 x 10(7) CFUs of clinical isolate of methicillin-resistant S. epidermidis. Each of the graft series included a control group, one contaminated group that did not receive any antibiotic prophylaxis, two contaminated groups that received systemic prophylaxis with teicoplanin or levofloxacin and two contaminated groups that received teicoplanin-soaked or levofloxacin-soaked grafts. The grafts were removed 7 days after implantation and evaluated by quantitative culture. RESULTS: There was significant bacterial growth inhibition in the groups given systemic or local prophylaxis (P < 0.05). Methicillin-resistant S. epidermidis had greater affinity to Dacron graft when compared with ePTFE graft in the untreated contaminated groups (P < 0.05). CONCLUSION: The study demonstrated that the usage of systemic or local prophylaxis and preference of ePTFE graft can be useful in reducing the risk of vascular graft infections caused by staphylococcal strains with high levels of resistance.


Asunto(s)
Antibacterianos/administración & dosificación , Antibacterianos/farmacología , Profilaxis Antibiótica , Prótesis Vascular/microbiología , Infecciones Relacionadas con Prótesis/prevención & control , Infecciones Estafilocócicas/prevención & control , Staphylococcus epidermidis/efectos de los fármacos , Animales , Implantación de Prótesis Vascular , Levofloxacino , Masculino , Resistencia a la Meticilina , Ofloxacino/administración & dosificación , Ofloxacino/farmacología , Tereftalatos Polietilenos , Politetrafluoroetileno , Ratas , Ratas Wistar , Teicoplanina/administración & dosificación , Teicoplanina/farmacología
18.
J Investig Med ; 53(5): 267-70, 2005 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16042961

RESUMEN

BACKGROUND AND OBJECTIVE: Pleurodesis is a frequently preferred procedure in thoracic surgery, and many factors may affect the process. We aimed to determine whether the administration of systemic diclofenac sodium diminishes the effectiveness of the pleurodesis induced by intrapleural tetracycline in rabbits. METHODS: Twelve male New Zealand rabbits that received tetracycline 35 mg/kg intrapleurally were allocated into two groups. The first group (diclofenac group, n = 6) received 2 mg/kg diclofenac sodium intramuscularly for 10 days, and the second group (control group, n = 6) received acetaminophen 30 mg/kg orally for 10 days after the pleurodesis procedure. The rabbits were sacrificed after 28 days, and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of fibrosis, inflammation, and collagenization. RESULTS: The mean macroscopic pleurodesis score of the diclofenac group was 2.16 +/- 0.40 compared with 2.83 +/- 0.40 in the control group (p = .027). The mean microscopic pleurodesis score of the diclofenac group was 2. 3 +/- 1.03, whereas it was 3.5 +/- 0.54 in the control group (p = .045). CONCLUSION: The administration of diclofenac sodium for 10 days following tetracycline pleurodesis reduces the effectiveness of pleurodesis in rabbits.


Asunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Diclofenaco/efectos adversos , Pleura/efectos de los fármacos , Pleurodesia , Soluciones Esclerosantes/farmacología , Tetraciclina/farmacología , Animales , Modelos Animales de Enfermedad , Fibrosis , Masculino , Pleurodesia/métodos , Conejos
19.
Braz J Cardiovasc Surg ; 30(5): 538-43, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26735600

RESUMEN

OBJECTIVE: In the post-sternotomy mediastinitis patients, Staphylococcus aureus is the pathogenic microorganism encountered most often. In our study, we aimed to determine the efficacy of antibiotic treatment with vancomycin and tigecycline, alone or in combination with hyperbaric oxygen treatment, on bacterial elimination in experimental S. aureus mediastinitis. METHODS: Forty-nine adult female Wistar rats were used. They were randomly divided into seven groups, as follows: non-contaminated, contaminated control, vancomycin, tigecycline, hyperbaric oxygen, hyperbaric oxygen + vancomycin and hyperbaric oxygen + tigecycline. The vancomycin rat group received 10 mg/kg/day of vancomycin twice a day through intramuscular injection. The tigecycline group rats received 7 mg/kg/day of tigecycline twice a day through intraperitoneal injection. The hyperbaric oxygen group underwent 90 min sessions of 100% oxygen at 2.5 atm pressure. Treatment continued for 7 days. Twelve hours after the end of treatment, tissue samples were obtained from the upper part of the sternum for bacterial count assessment. RESULTS: When the quantitative bacterial counts of the untreated contaminated group were compared with those of the treated groups, a significant decrease was observed. However, comparing the antibiotic groups with the same antibiotic combined with hyperbaric oxygen, there was a significant reduction in microorganisms identified (P<0.05). Comparing hyperbaric oxygen used alone with the vancomycin and tigecycline groups, it was seen that the effect was not significant (P<0.05). CONCLUSION: We believe that the combination of hyperbaric oxygen with antibiotics had a significant effect on mediastinitis resulting from methicillin-resistant Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus mediastinitis can be treated without requiring a multidrug combination, thereby reducing the medication dose and concomitantly decreasing the side effects.


Asunto(s)
Terapia Combinada/métodos , Oxigenoterapia Hiperbárica/métodos , Mediastinitis/terapia , Staphylococcus aureus Resistente a Meticilina/crecimiento & desarrollo , Animales , Antibacterianos/uso terapéutico , Terapia Combinada/normas , Femenino , Mediastinitis/complicaciones , Mediastinitis/microbiología , Minociclina/análogos & derivados , Minociclina/uso terapéutico , Modelos Animales , Distribución Aleatoria , Ratas Wistar , Infecciones Estafilocócicas/complicaciones , Infecciones Estafilocócicas/terapia , Esternón/microbiología , Tigeciclina , Vancomicina/administración & dosificación
20.
Wien Klin Wochenschr ; 127(13-14): 529-34, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25777147

RESUMEN

BACKGROUND: It takes years for atherosclerosis to manifest symptoms. However, it needs to be identified earlier because of the premature cardiovascular risk factors in patients with rheumatoid arthritis (RA). In this study, we aimed to investigate the effect of atherosclerosis on the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) in patients with RA. METHODS: RA patients attending the rheumatology clinic were examined retrospectively; then we called them for the measurements of ABPI and CIMT prospectively. Subjects were divided into four groups, as follows (Table 1): group 1 comprised RA patients with an ABPI less than 0.9; group 2 included RA patients with an ABPI between 0.9 and 1.2; group 3 was made up of RA patients with an ABPI greater than 1.2; and group 4 included patients without RA with an ABPI between 0.9 and 1.2 as a control group. Patients' demographic data were recorded. Hypertension (HT), diabetes mellitus, ABPI and CIMT measurements were taken by specialists. Duration of RA and disease scores (disease activity score-28, health assessment questionnaire score and visual assessment score) were recorded. RESULTS: The prevalence of peripheral vascular disease in patients with RA was twice as high as that in the normal population of equivalent age. Patients in group 2, with RA and normal ABPI, exhibited a significant higher mean in CIMT (mm) compared with the control group (p < 0.01), despite having normal ABPI. This confirms that these patients have a higher risk of stroke compared with the control group. Group 1's newly diagnosed HT (p < 0.01) and systolic blood pressure (SBP) values (p < 0.01) were higher and statistically significant when compared with the group 4 (control group); in addition, significant plaque levels were observed in the carotid arteries (p < 0.01). Group 3 patients had a similar history of HT and increased SBP compared with patients in group 4 (p < 0.01), and had similar characteristics to with group 1. No statistically significant differences were found between the groups in terms of inflammatory markers such as C-reactive protein and rheumatoid factor, anti-cyclic citrullinated peptide and white blood cell counts. CONCLUSION: Based on the present findings, patients with RA need to be evaluated in the early stage of the disease for subclinical peripheral artery disease using the ABPI, as well as CIMT, which is also a non-invasive technique, in terms of cerebrovascular events. Inflammatory markers exhibited no statistically significant difference. We think that the atherosclerotic process stems not only from the inflammatory effects of RA, but also perhaps from its immunological nature.


Asunto(s)
Índice Tobillo Braquial/estadística & datos numéricos , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/epidemiología , Aterosclerosis/diagnóstico , Aterosclerosis/epidemiología , Grosor Intima-Media Carotídeo/estadística & datos numéricos , Enfermedades Asintomáticas , Causalidad , Comorbilidad , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Factores de Riesgo , Sensibilidad y Especificidad , Turquía/epidemiología
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