RESUMEN
Salivary cortisol levels and saliva alpha-amylase enzymatic activity are non-invasive markers of hypothalamic-pituitary-adrenal axis and autonomic nervous system related to stress, which could be associated with excessive energy intake in response to stressors. Aim: To describe the diurnal variation of salivary cortisol levels and á-amylase activity in prepubertal girls and to assess their change after meals and physical activity episodes. Subjects and Methods: Nine normal-weight girls aged 8 to 10 years were monitored for 14 hours, from 6:00 AM to 20:00 h. Three standardized meals were administered across the day with a controlled sport competition performed at the end of the day. Saliva samples were drawn upon awakening, 30 min after awakening, before and after lunch, before and after dinner, and before-after the controlled episode of physical activity. Results: A decreasing salivary cortisol diurnal pattern was confirmed, with an initial increase occurring 30 minutes after waking up. An ascending diurnal pattern was observed for salivary amylase activity. Meals significantly increased cortisol levels, with a non-significant trend to increase amylase activity. The magnitude of physical activity during acute exercise was associated with increased salivary amylase activity (rho = 0.84; P <0.01). Cortisol levels were positively correlated with body mass index z scores (rho = 0.87; P <0.01). Conclusions: We confirmed the existence of a diurnal pattern of salivary cortisol levels and á-amylase activity in saliva that is modulated by diet and exercise. Our preliminary results also show that salivary cortisol might be related with body weight...
Asunto(s)
Humanos , Femenino , Niño , Hidrocortisona/análisis , Ingestión de Alimentos/fisiología , Actividad Motora , Saliva/química , alfa-Amilasas Salivales/análisis , Antropometría , Presión Arterial , Ritmo Circadiano , Periodicidad , Ejercicio Físico , Estudio ObservacionalRESUMEN
Rubella virus (RV) infection has sporadically been linked to Guillain-Barré syndrome (GBS), but the association with RV has been based only on clinical and/or serological backgrounds. In the present case it was possible to isolate RV (genotype 1a) from cerebrospinal fluid and peripheral blood mononuclear cells of an 18-year-old woman diagnosed with GBS after clinical manifestations of rubella. This report contributes to confirm RV as one of the triggering pathogens of this peripheral nervous system disease.
Asunto(s)
Síndrome de Guillain-Barré/virología , Virus de la Rubéola/clasificación , Virus de la Rubéola/genética , Adolescente , Sangre/virología , Líquido Cefalorraquídeo/virología , Femenino , Humanos , Leucocitos Mononucleares/virología , Virus de la Rubéola/aislamiento & purificaciónRESUMEN
A formal training program for technicians who prepare cytotoxic agents and pharmacists who check the doses is described. To handle an overwhelming workload in an oncology satellite pharmacy and to enable the pharmacists there to increase their clinical involvement, a program was developed to train technicians to prepare antineoplastic doses and pharmacists to check the technicians' work. The program consists of two days of classroom instruction, three weeks of hands-on training, and a written examination. In addition to handling and preparation of antineoplastic drugs, other topics related to oncology are covered to give the participants a better understanding of cancer and its treatment. The technicians must complete a refresher program annually. From 1991 to 1993, 15 pharmacists and 14 technicians and pharmacy students completed the program. The technicians have taken on additional responsibilities in the satellite pharmacy, including managing the inventory of oncology drugs. Implementation of a comprehensive cancer chemotherapy training class for technicians and pharmacists has benefited the pharmacy in terms of labor and inventory control.
Asunto(s)
Antineoplásicos/química , Certificación , Educación Continua en Farmacia , Servicio de Farmacia en Hospital , Técnicos de Farmacia/educación , Química Farmacéutica , Hospitales con 300 a 499 Camas , Hospitales Universitarios , Humanos , Capacitación en Servicio , Missouri , Servicio de Farmacia en Hospital/normas , Desarrollo de Programa , Recursos HumanosRESUMEN
The authors report their experience in the study of bleeding aneurysms of the celiac arteries. Eleven patients were examined with US, CT, and angiography (8 hepatic artery aneurysms and 3 splenic artery aneurysms). Clinical findings included digestive bleeding, upper abdominal pain, palpable pulsating masses, and jaundice. Patient history included blunt abdominal trauma, penetrating trauma due to gunshot, acute pancreatitis, recent hepatic biopsy. In all cases US showed an abdominal mass ranging in size from 2 to 10 cm. US findings included cyst-like lesions (8 cases), a lobulated solid-like lesion, and complex lesions (2 cases). Continuity of the lesion with adjacent arterial vessels was noted in 5/11 cases, and pulsing activity in 3/11 cases. US patterns, although not specific, play an important role in the diagnosis when associated to other elements such as arterial continuity, mass pulsatility, patient history, and gastrointestinal bleeding. They suggest the need for more specific imaging exams, i.e. CT and angiography, and help avoid dangerous diagnostic biopsies. CT was performed to confirm US findings in 5 cases, and detected either hypodense cystic masses, or inhomogeneous masses with arterial enhancement after bolus injection of cm. CT was used to better demonstrate the lumen, patency of the vessel, the walls of the vessel, and the parietal thrombotic component. The typical arterial enhancement was the decisive finding for the diagnosis, even though a total continuity with arterial vessels was never observed. Angiography was the method of choice for the preoperative demonstration of hepatic artery aneurysms (10 cases) and for occlusive treatment with Gianturco coils (3 cases).