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1.
Cell Mol Biol (Noisy-le-grand) ; 68(2): 197-202, 2022 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-35869733

RESUMEN

Ventilator-associated pneumonia (VAP) is a common nosocomial infection in patients admitted to intensive care units (ICU), leading to prolonged stay in the ICU, increased hospital costs, and mortality. This study aimed to compare the effect of using normal saline with eucalyptus in endotracheal suctioning on the rate of ventilator-dependent pneumonia. For this purpose, a randomized clinical trial study was performed on 120 patients under a ventilator in the hospital ICU. Patients were randomly divided into control and intervention groups. The control group consisted of 60 patients who used 0.9% normal saline to dilute endotracheal secretions. The intervention group also included 60 patients treated with 0.9% normal saline with 5% eucalyptus to dilute endotracheal secretions. The sensitivity of isolated microbes was determined by the diffusion susceptibility test Kirby-Bauer disk protocol. The CDC protocol was used to diagnose VAP. 100 CFU/ml of endotracheal aspiration was considered the differentiation number between the microbe responsible for VAP and colonization. Whenever a VAP guess was made, a blood culture was done. Finally, the incidence of ventilator-associated pneumonia in the two groups was compared. The results showed that the incidence of VAP during using normal saline and normal saline with eucalyptus as a diluent for pulmonary secretions was different between the two groups (P = 0.042). Also, among infected patients with VAP, there was a difference between the types of microorganisms in the two groups (P = 0.019). Seven cases of Klebsiella pneumonia were observed in the control group, while no case of this bacterium was observed in the intervention group. In terms of the prevalence of Pseudomonas (two cases), both groups had a similar situation. These findings can reassure nurses and the treatment team that they can use normal saline solution with 5% eucalyptus during suction to dilute pulmonary secretions.


Asunto(s)
Neumonía Asociada al Ventilador , Humanos , Incidencia , Neumonía/epidemiología , Neumonía Asociada al Ventilador/epidemiología , Neumonía Asociada al Ventilador/etiología , Neumonía Asociada al Ventilador/prevención & control , Solución Salina , Succión , Ventiladores Mecánicos/efectos adversos
2.
Surg Endosc ; 35(11): 6291-6299, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-33146811

RESUMEN

BACKGROUND: Endoscopic retrograde appendicitis therapy (ERAT) is an emerging endoscopic treatment modality for acute uncomplicated appendicitis (AUA) supported by several case series. However, to date, systematic studies have not been conducted in children and the prospective comparative data are lacking. Moreover, due to a concern for future malignancy risk in children from ionizing radiation, we used contrast-enhanced ultrasound (CEUS) instead of endoscopic retrograde appendiceal radiography (ERAR). Therefore, we conducted a prospective, randomized control clinical trial to compare the modified ERAT (mERAT) to antibiotic therapy in children with AUA. The aim of this study was to evaluate the safety and feasibility and of mERAT in the treatment of hospitalized children with AUA. METHODS: Children with AUA, confirmed by ultrasonography and or abdominal computed tomography, were consecutively enrolled from October 2018 to February, 2020. They were randomly assigned to receive mERAT or routine antibiotic treatment. Patients were followed until May, 2020. Th primary outcome variable was the duration of relief of the abdominal pain after treatment. We collected patient's demographics, ultrasonic imaging findings, colonoscopy findings, and treatment outcomes of the mERAT and adverse even associated with mERAT. RESULTS: A total of 83 children were enrolled. 36 were randomized to mERAT and 47 to antibiotics treatment. All children in the mERAT group had endoscopic confirmed acute uncomplicated appendicitis, and there were no significant complications. However, 9 of patients in antibiotic group were poor responsive to treatment and switched to mERAT. The overall success rate of treatment with mERAT (100%) was significantly higher than that of antibiotics (80.9%) (P = 0.004). The median time to discharge was significantly shorter in mERAT group than in antibiotics treatment group [6.0 ± 1.76 days] (P = 0.004). CONCLUSIONS: mERAT provide a new alternative therapeutic option for childhood with AUA, especially for families who are reluctant to undergo an appendectomy.


Asunto(s)
Apendicitis , Apéndice , Enfermedad Aguda , Antibacterianos/uso terapéutico , Apendicectomía , Apendicitis/diagnóstico por imagen , Apendicitis/tratamiento farmacológico , Apendicitis/cirugía , Niño , Humanos , Estudios Prospectivos , Resultado del Tratamiento
3.
Neural Plast ; 2015: 752782, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26609438

RESUMEN

Evidence has accumulated that reactive oxygen species and inflammation play crucial roles in the development of chronic pain, including radicular low back pain. Nonsteroid anti-inflammatory drugs (NSAIDs), for example, salicylic acid, aspirin, provided analgesic effects in various types of pain. However, long-term use of these drugs causes unwanted side effects, which limits their implication. Stable nitronyl (NIT) nitroxide radicals have been extensively studied as a unique and interesting class of new antioxidants for protection against oxidative damage. The present study synthesized a novel NIT nitroxide radical with salicylic acid framework (SANR) to provide synergistic effect of both antioxidation and antiinflammation. We demonstrated for the first time that both acute and repeated SANR treatment exerted dramatic analgesic effect in radicular low back pain mimicked by chronic compression of dorsal root ganglion in rats. This analgesic potency was more potent than that produced by classical NSAIDs aspirin and traditional nitroxide radical Tempol alone. Furthermore, SANR-induced behavioral analgesia is found to be mediated, at least in partial, by a reduction of ectopic spontaneous discharges in injured DRG neurons. Therefore, the synthesized NIT nitroxide radical coupling with salicylic acid framework may represent a novel potential therapeutic candidate for treatment of chronic pain, including radicular low back pain.


Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Óxidos N-Cíclicos/uso terapéutico , Hiperalgesia/tratamiento farmacológico , Imidazoles/uso terapéutico , Dolor de la Región Lumbar/tratamiento farmacológico , Neuronas/efectos de los fármacos , Radiculopatía/tratamiento farmacológico , Ácido Salicílico/química , Animales , Antiinflamatorios no Esteroideos/química , Antiinflamatorios no Esteroideos/farmacología , Antioxidantes/farmacología , Aspirina/farmacología , Conducta Animal/efectos de los fármacos , Óxidos N-Cíclicos/química , Óxidos N-Cíclicos/farmacología , Sinergismo Farmacológico , Ganglios Espinales/patología , Hiperalgesia/etiología , Imidazoles/química , Dolor de la Región Lumbar/patología , Dolor de la Región Lumbar/psicología , Masculino , Radiculopatía/patología , Radiculopatía/psicología , Ratas , Ratas Sprague-Dawley , Marcadores de Spin , Compresión de la Médula Espinal/tratamiento farmacológico , Compresión de la Médula Espinal/patología
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