RESUMO
Selenium has important functions for oxidative defense and thyroid hormone metabolism. Selenium-dependent enzymes include 5'-iodothyronine deiodinase and glutathione peroxidase (GPX). The objective of this study was to investigate the relationship between plasma selenium, GPX activity, and thyroid hormone status in pediatric cardiac surgical patients. Plasma concentrations of selenium, free triiodothyronine (fT3), free thyroxin (fT4), and c-reactive protein as well as plasma activity of GPX were prospectively evaluated at anesthetic induction and 48 hours postoperatively in 59 children requiring cardiopulmonary bypass (CPB). GPX was measured at additional time points at 6, 12, and 24 hours postoperatively. There was a significant reduction in the plasma selenium concentration after cardiopulmonary bypass with obtained median measurements of 0.61 micromol/L (induction) and 0.51 micromol/L (48 hours postoperatively). The fT3/fT4 ratio decreased significantly from 0.28 at anesthetic induction to 0.22 at 48 hours postoperatively. There were no significant changes of GPX activity. 48 hours fT3 concentration, fT3/fT4 ratio, and selenium concentration were significantly negatively correlated with the time spent in intensive care. The concentration of plasma selenium in children undergoing cardiopulmonary bypass significantly decreases, resulting in diminished deiodinase activity, and a subsequent reduction in the conversion of T4 to T3.
Assuntos
Ponte Cardiopulmonar , Selênio/sangue , Adolescente , Proteína C-Reativa/análise , Criança , Pré-Escolar , Feminino , Glutationa Peroxidase/sangue , Cardiopatias Congênitas/sangue , Cardiopatias Congênitas/cirurgia , Humanos , Lactente , Recém-Nascido , Masculino , Tiroxina/sangue , Tri-Iodotironina/sangueRESUMO
Multiple sclerosis (MS) is a chronic debilitating disease with no cure. There has been increasing interest in the use of alternative therapies in combination with or in place of traditional therapies. Nurses and other health care professionals must become more aware of reasons persons with MS are using alternative therapies and identify any risks or potential benefits. The role of the health care professional is to educate persons with MS on contemporary research, cost and regulation of these therapies.
Assuntos
Terapias Complementares/métodos , Esclerose Múltipla/terapia , Terapias Complementares/economia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Esclerose Múltipla/enfermagem , Esclerose Múltipla/psicologia , Educação de Pacientes como Assunto , Resultado do TratamentoRESUMO
Open heart surgery has previously been associated with the use of large volumes of blood products. This paper describes methods of blood conservation and a simple method of intraoperative autotransfusion that together have resulted in minimal blood product usage in elective open heart surgery cases. This has reduced our dependence on blood bank supplies for the performance of elective open heart surgery.