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1.
Nanotechnology ; 31(20): 205601, 2020 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-31978898

RESUMEN

Zinc oxide nanostructures such as nanosheets (NS) and nanoflowers (NF) were obtained by a facile hydrothermal synthesis using zinc chloride (ZnCl2) as precursor with low molar concentrations and a short synthesis time (2 h) at 200 °C. By means of X-ray diffraction and Raman spectroscopy measurements, the wurtzite-type ZnO structure was confirmed with high crystalline quality. SEM micrographs showed the influence of ZnCl2 concentration on ZnO morphology; ZnO NF were obtained at low concentrations (0.02 and 0.05 M), while ZnO NS were seen for higher concentrations (0.2-0.6 M) and their thicknesses can be estimated from 15 to 60 nm. In addition, TEM images showed a large number of pores with sizes below 15 nm in both ZnO nanostructures. Raman and photoluminescence displayed the surface defects density for ZnO nanostructures. Raman spectra showed the E1(LO) mode localized at ∼581 cm-1, associated with oxygen vacancies and zinc interstitials, being more intense for ZnO NF, while photoluminescence results showed a strong yellow-orange emission (centered from 587 to 618 nm) relative to UV emission, being more intense for ZnO NF. These properties reveal further potential for high performance luminescent devices based on ZnO NF and NS.

2.
Actas Urol Esp (Engl Ed) ; 48(2): 177-183, 2024 Mar.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37574014

RESUMEN

INTRODUCTION AND OBJECTIVES: Transplant renal artery stenosis (TRAS) is a vascular complication after kidney transplantation which estimated incidence is 13%. It could cause refractory arterial hypertension, kidney dysfunction and premature death in transplant recipients. METHODS: We carried out a retrospective study including every patient who underwent renal transplantation between 2014 and 2020. They were evaluated with a systematic post-transplant renal Doppler ultrasound. To identify independent risk factors for transplant renal artery stenosis we performed a multivariate analysis. RESULTS: Seven hundred twenty-four kidney transplants were included, 12% ​​were living donors and 88% were deceased donors. The mean age was 54.8 in recipients and 53 in donors. Transplant renal artery stenosis was diagnosed in 70 (10%) recipients, the majority in the first 6 months after surgery. 51% of patients with transplant renal artery stenosis were managed conservatively. The multivariate analysis showed diabetes mellitus, graft rejection, arterial resuture and donor body mass index as independent risk factors for transplant renal artery stenosis. Survival of the grafts with transplant renal artery stenosis was 98% at 6 months and 95% at two years. CONCLUSIONS: The systematic performance of Doppler ultrasound in the immediate post-transplant period diagnosed 10% of transplant renal artery stenosis in our cohort. Despite the above risk factors, an adequate monitoring and treatment could avoid the increased risk of graft loss in patients with transplant renal artery stenosis.


Asunto(s)
Obstrucción de la Arteria Renal , Humanos , Persona de Mediana Edad , Obstrucción de la Arteria Renal/diagnóstico por imagen , Obstrucción de la Arteria Renal/epidemiología , Obstrucción de la Arteria Renal/etiología , Incidencia , Estudios Retrospectivos , Resultado del Tratamiento , Factores de Riesgo , Ultrasonografía Doppler/efectos adversos
3.
Rev Esp Sanid Penit ; 23(1): 9-19, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33847706

RESUMEN

OBJECTIVES: To describe inmates' perceptions of healthcare quality in Catalonian prisons. MATERIAL AND METHOD: Transversal study of 6,856 inmates in Catalan prisons in September 2017. Randomized simple screening was used to randomly distribute 1,048 polls in which different aspects of perceived quality of healthcare were evaluated. The results were also categorized according to age, sex, time spent in prison, background and academic levels. We also analysed the differences between results in healthcare quality according to socio-demographic variables. RESULTS: 84.87% of patients show satisfaction with the quality of healthcare received. Women are more satisfied with consultations than men (OR: 2.04; p = 0.009). Patients with a higher educational level are less satisfied than those with a lower educational level, with significant differences in 11 of the 14 items. Those over 65 years of age were more satisfied than the rest in 11 of the 14 items evaluated. Foreign patients were more satisfied than Spanish inmates in time flexibility (OR: 0.69; p = 0.018) and in waiting times for visits (OR: 0,63; p = 0.006), whereas they are less satisfied with the healthcare professionals' image (OR: 1.97; p = 0.03). DISCUSSION: Noteble features of our study include the fact that although global satisfaction is high, some dimensions, like reliability, could improve. The results were submitted to the General Directorate to enable more in-depth study of the variables where there is less satisfaction and to design further improvements.


Asunto(s)
Prisioneros , Prisiones , Atención a la Salud , Femenino , Humanos , Masculino , Tamizaje Masivo , Calidad de la Atención de Salud , Reproducibilidad de los Resultados
4.
Lett Appl Microbiol ; 50(6): 653-6, 2010 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-20406379

RESUMEN

AIMS: The objective of this study was to investigate whether bacterial cells could develop resistance (as a part of their adaptation strategy) to high-pressure CO(2) (HPCD) inactivation. METHODS AND RESULTS: Alternating cycles of exposure to pressurized CO(2) (10.5 MPa, 35 degrees C, 400 min(-1), 70% working volume ratio during 10 min) and re-growth of the surviving subpopulation were used to investigate possible increases in the resistance of Escherichia coli and Listeria monocytogenes to HPCD. The results show an increased resistance of both pathogens tested after seven cycles of inactivation. Increase in the resistance after 15 cycles resulted in a difference of 2.4 log CFU ml(-1) in log N(0)/N(i) when parental (N(0)) and treated cultures (N(i)) of E. coli and L. monocytogenes were compared. CONCLUSIONS: Current findings indicate the ability of micro-organisms to adapt to HPCD preservation technology. SIGNIFICANCE AND IMPACT OF THE STUDY: The occurrence of HPCD-resistant micro-organisms could pose a new hazard to the safety and stability of HPCD-processed foods.


Asunto(s)
Dióxido de Carbono/farmacología , Escherichia coli/fisiología , Listeria monocytogenes/fisiología , Escherichia coli/efectos de los fármacos , Microbiología de Alimentos , Conservación de Alimentos , Listeria monocytogenes/efectos de los fármacos , Viabilidad Microbiana/efectos de los fármacos , Presión
5.
Food Microbiol ; 27(4): 541-9, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20417405

RESUMEN

In this study, the relationship between (irreversible) membrane permeabilization and loss of viability in Escherichia coli, Listeria monocytogenes and Saccharomyces cerevisiae cells subjected to high pressure carbon dioxide (HPCD) treatment at different process conditions including temperature (35-45 degrees C), pressure (10.5-21.0 MPa) and treatment time (0-60 min) was examined. Loss of membrane integrity was measured as increased uptake of the fluorescent dye propidium iodide (PI) with spectrofluorometry, while cell inactivation was determined by viable cell count. Uptake of PI by all three strains indicated that membrane damage is involved in the mechanism of HPCD inactivation of vegetative cells. The extent of membrane permeabilization and cellular death increased with the severity of the HPCD treatment. The resistance of the three tested organisms to HPCD treatment changed as a function of treatment time, leading to significant tailing in the survival curves, and was dependent on pressure and temperature. The results in this study also indicated a HPCD-induced damage on nucleic acids during cell inactivation. Transmission electron microscopy showed that HPCD treatment had a profound effect on the intracellular organization of the micro-organisms and influenced the permeability of the bacterial cells by introducing pores in the cell wall.


Asunto(s)
Dióxido de Carbono/farmacología , Permeabilidad de la Membrana Celular/efectos de los fármacos , Escherichia coli/efectos de los fármacos , Presión Hidrostática , Listeria monocytogenes/efectos de los fármacos , Viabilidad Microbiana/efectos de los fármacos , Saccharomyces cerevisiae/efectos de los fármacos , Colorantes/metabolismo , Escherichia coli/crecimiento & desarrollo , Escherichia coli/ultraestructura , Listeria monocytogenes/crecimiento & desarrollo , Listeria monocytogenes/ultraestructura , Propidio/metabolismo , Saccharomyces cerevisiae/crecimiento & desarrollo , Saccharomyces cerevisiae/ultraestructura , Espectrometría de Fluorescencia , Temperatura , Factores de Tiempo
8.
Eur J Clin Nutr ; 61(1): 77-82, 2007 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-16835602

RESUMEN

OBJECTIVE: To analyse the changes in thiamin intake and blood levels of young, overweight/obese women following slightly hypocaloric diets based on the increased relative consumption of foods whose intakes were most removed from the ideal: cereals and vegetables. DESIGN: The women were randomly assigned to one of two slightly hypocaloric diets: diet V, in which the consumption of vegetables was increased, or diet C, in which the consumption of cereals (especially breakfast cereals) was increased. SUBJECTS: The study subjects were 67 young women with a body mass index of 24-35 kg/m2. INTERVENTIONS: Dietetic, anthropometrics and biochemical data were collected at the start of the study and again at 2 and 6 weeks. RESULTS: The reduction in energy intake was similar in both groups. However, diet C subjects lost significantly more weight. Blood thiamin concentration was higher in group C women than in group V women at 2 and 6 weeks. Compared to initial values, group C subjects showed a higher blood thiamin level at 2 weeks. The highest blood thiamin levels seen in group C women may have been due to their greater thiamin intake, their higher thiamin dietetic density, and a higher thiamin/carbohydrates ratio at both week 2 and 6 of the intervention period. CONCLUSIONS: Increasing the relative consumption of breakfast cereals within the context of a slightly hypocaloric diet can help in weight control and improve thiamine intake and blood levels.


Asunto(s)
Dieta Reductora , Grano Comestible , Obesidad/sangre , Tiamina/administración & dosificación , Tiamina/sangre , Verduras , Adulto , Análisis de Varianza , Ingestión de Energía , Femenino , Humanos , Obesidad/dietoterapia , Sobrepeso , Factores de Tiempo , Pérdida de Peso
9.
Int J Food Microbiol ; 117(1): 1-28, 2007 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-17475355

RESUMEN

Thermal pasteurization is a well known and old technique for reducing the microbial count of foods. Traditional thermal processing, however, can destroy heat-sensitive nutrients and food product qualities such as flavor, color and texture. For more than 2 decades now, the use of high-pressure carbon dioxide (HPCD) has been proposed as an alternative cold pasteurization technique for foods. This method presents some fundamental advantages related to the mild conditions employed, particularly because it allows processing at much lower temperature than the ones used in thermal pasteurization. In spite of intensified research efforts the last couple of years, the HPCD preservation technique has not yet been implemented on a large scale by the food industry until now. This review presents a survey of published knowledge concerning the HPCD technique for microbial inactivation, and addresses issues of the technology such as the mechanism of carbon dioxide bactericidal action, the potential for inactivating vegetative cells and bacterial spores, and the regulatory hurdles which need to be overcome. In addition, the review also reflects on the opportunities and especially the current drawbacks of the HPCD technique for the food industry.


Asunto(s)
Bacterias/crecimiento & desarrollo , Dióxido de Carbono/farmacología , Manipulación de Alimentos/métodos , Conservación de Alimentos/métodos , Presión Hidrostática , Recuento de Colonia Microbiana , Contaminación de Alimentos/prevención & control , Microbiología de Alimentos
10.
Nutr Hosp ; 20(6): 393-402, 2005.
Artículo en Español | MEDLINE | ID: mdl-16335023

RESUMEN

UNLABELLED: Obesity is a risk factor for a number of degenerative diseases common in industrial societies and the number of overweight/obese people continues to grow. The control of body weight is therefore a priority public health objective. OBJECTIVE: To analyze the response to a weight loss program based on approximating the diet to the theoretical ideal (by increasing the consumption of recommended foods under-represented in the diet: cereals and vegetables). SUBJECTS: The study involved 67 women aged between 20 and 35 years with a body mass index (BMI) of between 24 and 35 kg/m2. These women were randomly assigned to two groups with the aim of improving weight control and of approximating the diet to the theoretical ideal. INTERVENTIONS: Both groups were advised to follow a slightly hypocaloric diet, but with one group increasing the intake of greens and vegetables (H) and the other increasing the intake of cereals (especially breakfast cereals) (C). Dietary data were obtained via the keeping of a daily food record over three days, including a Sunday. Anthropometric data were obtained at the start of the study and again 2 and 6 weeks later. RESULTS: Both treatments approximated the energy profile of the diets to the theoretical ideal. The amount of energy gained from lipids fell and that gained from carbohydrates increased (both at 2 and 6 weeks), significantly more so for group C. Fifty seven women completed the study and showed a mean reduction in body weight of 2.4 +/-1.4 kg. The weight lost by group C was significantly greater than that lost by group H (2.8 +/- 1.4 kg compared to 2.0 +/- 1.3 kg; p < 0.05). The women who followed diet C showed a greater number of skin folds of significantly reduced size, both at 2 and 6 weeks. More group C women completed the study (93.5% compared to 77.8% of group H women). CONCLUSION: In overweight or slightly obese women, approximating the diet to the theoretical ideal (by increasing the intake of vegetables of cereals) can help to control body weight and improve the quality of the diet (both in terms of the number and size of food rations, and the overall energy profile). The present results show that increasing the consumption of breakfast cereals may be of particular use owing to their high fiber, vitamin and iron contents.


Asunto(s)
Obesidad/dietoterapia , Pérdida de Peso , Adulto , Femenino , Humanos
11.
An Otorrinolaringol Ibero Am ; 32(6): 537-44, 2005.
Artículo en Español | MEDLINE | ID: mdl-16475540

RESUMEN

Primary malignant melanoma of the nasal and paranasal sinusses is rare and represent 3% of malignant nasosinusal tumors. The prognosis of this tumor is poor. The evolution is unpredictable; there is very commonly a series of local recurrences which may be well controlled, followed by remote metastases remaining long quiescent. There are no statistical difference in local control or survival between patients receiving surgery alone and those receiving surgery and radiotherapy. Chemotherapy is used for metastatic forms. We present a case of a patient with a primary malignant melanoma of the nasal mucosa. Tree years after diagnosis we found intracranial metastases in left and right auditive internal meatus.


Asunto(s)
Neoplasias del Oído/secundario , Oído Interno/patología , Melanoma/secundario , Neoplasias de los Senos Paranasales/patología , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/secundario , Neoplasias Encefálicas/cirugía , Neoplasias del Oído/tratamiento farmacológico , Neoplasias del Oído/cirugía , Oído Interno/cirugía , Humanos , Masculino , Melanoma/tratamiento farmacológico , Melanoma/cirugía , Persona de Mediana Edad , Invasividad Neoplásica , Neoplasias de los Senos Paranasales/tratamiento farmacológico , Neoplasias de los Senos Paranasales/cirugía
12.
An Otorrinolaringol Ibero Am ; 32(6): 527-36, 2005.
Artículo en Español | MEDLINE | ID: mdl-16475539

RESUMEN

After introduction of antibiotics, endocranial complications in otitis media are less common. Lateral sinus thrombophlebitis (LST) incidence has markedly decreased but mortality is still high. This complication should be considered in patients with ear discharge, fever and neurological symptoms. CT-scan and MRI enables early diagnosis and have a role in detecting addition intracranial complications. Surgical intervention should be aggressive and anticoagulation should be considered. We present a case of a woman with othorrea, fever and neurological symptoms. The CT-scan shows us a cholesteatoma that grows intracranial and a LST as complication of it.


Asunto(s)
Colesteatoma del Oído Medio/complicaciones , Colesteatoma del Oído Medio/cirugía , Trombosis del Seno Lateral/etiología , Angiografía Cerebral , Colesteatoma del Oído Medio/diagnóstico por imagen , Femenino , Humanos , Trombosis del Seno Lateral/diagnóstico por imagen , Trombosis del Seno Lateral/cirugía , Persona de Mediana Edad , Tomografía Computarizada por Rayos X
13.
Acta Otorrinolaringol Esp ; 56(9): 428-33, 2005 Nov.
Artículo en Español | MEDLINE | ID: mdl-16353790

RESUMEN

INTRODUCTION: infection by oncogenic subtypes of human papillomavirus (HPV) and cyclin D1 gene (CCND1) amplification are frequent events in head and neck squamous cell carcinomas. The objective of this paper is to establish the relationship between the presence of human papillomavirus (HPV) gene sequences and the development of CCND1 gene amplification in these tumours. MATERIALS AND METHODS: 59 squamous cell carcinomas of the head and neck were studied for HPV types 6b and 16 and CCND1 gene amplification by polymerase chain reaction. RESULTS: HPV DNA was detected in 14 tumors (24%). Ten of them were positive for the HPV type 6b and 4 for the HPV type 16. CCND1 gene amplification was found in 15 cases (25%). Although we have found a higher frequency of CCND1 amplification in the HPV-positive cases (36%, versus 22% in the HPV-negative cases), these differences were not statistically significant (P= 0,32). CONCLUSIONS: The presence of HPV gene sequences does not seem to be related to a significative higher incidence of CCND1 gene amplification in the squamous cell carcinomas of the head and neck.


Asunto(s)
Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/virología , Ciclina D1/genética , Amplificación de Genes , Neoplasias de Cabeza y Cuello/genética , Neoplasias de Cabeza y Cuello/virología , Papillomavirus Humano 16/genética , Papillomavirus Humano 6/genética , Infecciones por Papillomavirus/genética , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad
14.
Biotechnol Adv ; 33(2): 243-60, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25656098

RESUMEN

Microalgae are a potential source for various valuable chemicals for commercial applications ranging from nutraceuticals to fuels. Objective in a biorefinery is to utilize biomass ingredients efficiently similarly to petroleum refineries in which oil is fractionated in fuels and a variety of products with higher value. Downstream processes in microalgae biorefineries consist of different steps whereof cell disruption is the most crucial part. To maintain the functionality of algae biochemicals during cell disruption while obtaining high disruption yields is an important challenge. Despite this need, studies on mild disruption of microalgae cells are limited. This review article focuses on the evaluation of conventional and emerging cell disruption technologies, and a comparison thereof with respect to their potential for the future microalgae biorefineries. The discussed techniques are bead milling, high pressure homogenization, high speed homogenization, ultrasonication, microwave treatment, pulsed electric field treatment, non-mechanical cell disruption and some emerging technologies.


Asunto(s)
Biomasa , Biotecnología/métodos , Microalgas/metabolismo , Biocombustibles , Microalgas/crecimiento & desarrollo
15.
Actas Urol Esp ; 39(2): 104-11, 2015 Mar.
Artículo en Inglés, Español | MEDLINE | ID: mdl-25301702

RESUMEN

OBJECTIVE: Although patients with urinary tract infections (UTIs) are usually managed as outpatients, a percentage of them requires hospitalization. To review risk factors and microbiological characteristics of community-associated UTIs (CAUTIs) requiring hospitalization has been our objective. MATERIAL AND METHODS: A prospective observational study was carried out from November 2011 to December 2013. Incidence, microbiological characteristics and antibiotic resistance patterns in patients with CAUTIs that required hospitalization were analyzed. Risk factors (including diabetes mellitus, urolithiasis, urinary catheterization) and resistance rates of each pathogen were also analyzed. RESULTS: Four hundred and fifty seven patients were hospitalized in our department with CAUTI. The mean age was 56.2±19.85 years. Of them, 52.1% patients were women, 19.7% had urinary indwelling catheter and 11.4% have had a previous UTI. The most frequently isolated pathogens were Escherichia coli (60.6%), followed by Klebsiella (9.2%), Enterococcus (8.4%) and Pseudomonas (7.2%). Enterobacteriaceae other than E.coli were more prevalent in male and older patients. On the other side the most frequently isolated pathogen in patients with a previous UTI and a urinary catheter was Entercoccus. The resistance rates E. coli against ampicillin/amoxicillin + ß lactamase inhibitor was 23.5%, against third-generation cephalosporins 16.6%, against fluoroquinolones 31.3% and 16.7% against aminoglycosides. 11.4% E. coli strains were producers of extended-spectrum Beta-lactamases (ESBL). Finally, the resistance rates of Enterococcus and Pseudomonas against quinolones were of 50.0% and 61.5%, respectively. CONCLUSIONS: CAUTIs that require hospitalization are most frequent in older age, male gender, and presence of urinary catheter, with urolithiasis and with previous episodes of UTI. These factors are also related to isolation of pathogens other than E. coli and higher resistance rates.


Asunto(s)
Infecciones Comunitarias Adquiridas/epidemiología , Farmacorresistencia Microbiana , Hospitalización/estadística & datos numéricos , Infecciones Urinarias/epidemiología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Bacterias/efectos de los fármacos , Bacterias/aislamiento & purificación , Infecciones Relacionadas con Catéteres/epidemiología , Infecciones Relacionadas con Catéteres/microbiología , Infecciones Comunitarias Adquiridas/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales , Infecciones Urinarias/microbiología , Urolitiasis/complicaciones
16.
Talanta ; 39(5): 459-67, 1992 May.
Artículo en Inglés | MEDLINE | ID: mdl-18965401

RESUMEN

Ion mobility spectrometry (IMS) was used as a flow-injection detector to quantitatively examine the ionization chemistry of aniline in hexane. A 5-microl sample was vaporized at 15-90-sec intervals in a flowing air stream and analyzed with an IMS equipped with acetone reactant ion chemistry, ambient temperature drift tube and membrane-based inlet. Precision was 3-11% relative standard deviation for 1-100 ppm aniline in hexane with 90-sec injection intervals and detection limits were ca. 0.5 ppm with 5-microl injections. Matrix effects with amine and organic solvent mixtures were observed and corrected for low and medium proton affinity interferences with standard addition methods. Pronounced fouling of the IMS occurred when a continuous water flow was introduced for aqueous flow injection-IMS. Continuous water monitoring without degraded IMS performance was possible by sampling air flow through a Silastic tube immersed in an aqueous sample.

17.
Arch Bronconeumol ; 35(1): 48-50, 1999 Jan.
Artículo en Español | MEDLINE | ID: mdl-10047920

RESUMEN

We report the case of a 61-year-old man with amyotrophic lateral sclerosis presenting with respiratory failure requiring long-term mechanical ventilation. Diagnostic difficulties are discussed along with the circumstances that give rise to suspicion of neuromuscular disease in a context of respiratory failure of unknown cause. The patient is at present in stable condition after 6 months of domiciliary mechanical ventilation. The treatment options in such cases and their indications are discussed.


Asunto(s)
Esclerosis Amiotrófica Lateral/diagnóstico , Insuficiencia Respiratoria/diagnóstico , Enfermedad Aguda , Esclerosis Amiotrófica Lateral/complicaciones , Resultado Fatal , Humanos , Hipercapnia/diagnóstico , Hipercapnia/etiología , Masculino , Persona de Mediana Edad , Enfermedad de la Neurona Motora/diagnóstico , Enfermedad de la Neurona Motora/etiología , Insuficiencia Respiratoria/etiología
18.
Nefrologia ; 24(3): 246-52, 2004.
Artículo en Español | MEDLINE | ID: mdl-15283315

RESUMEN

BACKGROUND: Periodic intra-access blood flow rate (QA) monitoring is the preferred method for vascular access (VA) surveillance (NKF-K/DOQI, update 2000). OBJECTIVES: 1) To determine the ultrafiltration (UF) method accuracy for early detection of VA stenosis. 2) To evaluate the hemodynamic effect of elective VA intervention (angioplasty or surgery). 3) To define the impact of periodic QA monitoring using the UF method combined by elective VA intervention on VA thrombosis. PATIENTS AND METHODS: We prospectively monitored QA during hemodialysis (HD) in 65 ESRD (mean age 64.9 +/- 11.4 years, 20% diabetes) patients over 1 year period. All patients undergoing HD in the Hospital de Mollet by arteriovenous fistula (89.2%) or graft 10.8%. QA was measured at least every 4 months by the UF method using the Crit Line III Monitor. Fifty (77%) patients were included at the beginning of the study period and the remaining 15 (23%) were added later when they started HD. All patients with absolute QA <700 ml/min or decreased >20% from baseline met criteria of positive evaluation (PE) and were referred for angiography (AG) plus subsequent preventive intervention (angioplasty or surgery) if VA stenosis >50%. We also studied 94 not QA monitored patients since the beginning of the study period (mean age 64.6 +/- 13.7 years; 12.8% diabetes) that undergoing HD simultaneous in the Institut Nefrològic Granollers. RESULTS: We performed 200 QA measurements in 509 months of follow-up. The overall mean QA was 1176.7 +/- 491.8 ml/min (range, 380.5-2904.0 ml/min). Three patients (4.6%) thrombosed VA. Nineteen (29.2%) patients had PE; none of them clotted VA. The AG was performed in 84.2% (16/19) patients with PE and all of them (16/16) showed VA stenosis > or =50%; 31.2% (5/16) were lost to follow-up (3 death, 2 transplantation); of the remaining explored patients (11/16), 72.7% (8/11) underwent intervention (3 angioplasty, 5 surgery). The mean QA increased from 577.2 +/- 108.2 ml/min to 878.1 +/- 264.4 ml/min postintervention (p=0.005). The positive predictive value, negative predictive value, sensitivity and specificity of UF method for VA stenosis were 84.2%, 93.5%, 84.2% and 93.5%, respectively. VA thrombosis rate in our 50 beginners QA monitored patients (mean age 64.5 +/- 1 1.4 years; 20% diabetes) was lower (2/50, 4%) compared to 94 not QA monitored patients (16/94, 17%) (p=0.024). CONCLUSIONS: 1) QA monitoring using the UF method allows an early diagnosis of VA stenosis. 2) Serial QA measurement by UF method can be used in assessing the functional response to corrective VA intervention. 3) Periodic VA surveillance by QA measurements using the UF method combined with elective intervention results in reduced VA thrombosis.


Asunto(s)
Catéteres de Permanencia , Oclusión de Injerto Vascular/diagnóstico , Hemodiafiltración/métodos , Adulto , Anciano , Anciano de 80 o más Años , Velocidad del Flujo Sanguíneo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Estudios Prospectivos , Flujo Sanguíneo Regional , Grado de Desobstrucción Vascular
19.
Rev Neurol ; 34(4): 358-63, 2002.
Artículo en Español | MEDLINE | ID: mdl-12022053

RESUMEN

INTRODUCTION: Several reports of new cases of CNS demyelination or reactivation of MS after hepatitis B vaccination have raised the possibility of a causal relationship. Conversely, some authors have concluded that the risk of developing a demyelinating CNS event after a hepatitis B vaccination is unknown. PATIENTS AND METHODS: We have observed a 40 year old man, with diabetes mellitus (DM) type 1 and a previous history of recurrent acute demyelinating encephalomyelitis (rADEM). The patient had experienced three episodes of neurological dysfunction and he fulfilled the criteria for definite clinical MS but MRI showed demyelinating lesions in the pons and cerebellum without MRI criteria of MS. CSF analysis showed oligoclonal banding. The patient had been clinically stable during the last 6 years. Yearly MRI during this period had not shown any new disease activity. He was admitted in our MS Clinic due to dizziness, nausea, vomiting and diplopia, 6 weeks after the first of the two injections for hepatitis B vaccine after participating in the national programme of vaccination in DM type 1 patients. Clinical examination showed intranuclear ophtalmoplegia, visual loss in the left eye and worsening of the previous cerebellar and pyramidal signs. MRI showed an increase in the old lesions with high intensity signals on T2 weighted sequences with post gadolinium enhancement on T1 weighted sequences located in the brainstem and mesencephalon. The patient s diabetes mellitus deteriorated with ketoacidosis that needed increased doses of insulin. His condition worsened and he developed partial motor seizures. He improved 15 days later but he still had involvement of the cerebellar and pyramidal systems and occasional dizziness. CONCLUSIONS: As pointed out by some authors and in view of this observation, it would seem reasonable, as a precautionary measure, to avoid hepatitis B vaccination in patients with a personal or family history of symptoms suggestive of a demyelinating disease of the CNS.


Asunto(s)
Encéfalo/patología , Encefalomielitis Aguda Diseminada/diagnóstico , Encefalomielitis Aguda Diseminada/etiología , Vacunas contra Hepatitis B/efectos adversos , Adulto , Antiinflamatorios/uso terapéutico , Azatioprina/uso terapéutico , Diagnóstico Diferencial , Encefalomielitis Aguda Diseminada/tratamiento farmacológico , Hepatitis B/prevención & control , Humanos , Inmunosupresores/uso terapéutico , Imagen por Resonancia Magnética , Masculino , Esclerosis Múltiple/diagnóstico , Prednisona/uso terapéutico , Recurrencia , Vacunación/efectos adversos
20.
An Otorrinolaringol Ibero Am ; 31(1): 77-86, 2004.
Artículo en Español | MEDLINE | ID: mdl-15074275

RESUMEN

Brain abscess (BA) as complication of sinusitis represent around 3% of the cases. Other suppurative intracraneal complications such as epidural abscess, subdural empyema and meningitis are more common than BA. The frontal and ethmoid sinuses form an integral part of anterior and to a lesser extent middle skull base to which the dura is intimately related. Thrombophlebitis of veins associated with paranasal sinuses is considered to be the main route of intracraneal spread of infection. However, osteitis is an uncommon mechanism that typically involves frontal sinus. Chronic sinusitis more than fulminant course of acute sinusitis is often responsible for BA. Epidemiology of BA has changed with the increasing incidence of this infection in inmunocompromised patient and the decreasing incidence related to sinus infection. Mortality rate of BA were around 35-55% before CT scan era and with surgical excision as the rule of surgical treatment.


Asunto(s)
Antibacterianos/uso terapéutico , Antiinflamatorios/uso terapéutico , Absceso Encefálico/etiología , Cefuroxima/uso terapéutico , Dexametasona/uso terapéutico , Sinusitis del Etmoides/complicaciones , Sinusitis del Etmoides/tratamiento farmacológico , Vancomicina/uso terapéutico , Absceso Encefálico/diagnóstico por imagen , Niño , Quimioterapia Combinada , Sinusitis del Etmoides/diagnóstico por imagen , Femenino , Humanos , Tomografía Computarizada por Rayos X
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