Asunto(s)
Prestación Integrada de Atención de Salud/organización & administración , Medicina Basada en la Evidencia/organización & administración , Programas Controlados de Atención en Salud/organización & administración , Modelos Organizacionales , Continuidad de la Atención al Paciente/organización & administración , Conducta Cooperativa , Prestación Integrada de Atención de Salud/tendencias , Medicina Basada en la Evidencia/tendencias , Humanos , Programas Controlados de Atención en Salud/tendencias , Atención Primaria de Salud/organización & administración , EspañaRESUMEN
This was a prospective study to determine the functional results in patients with obstetric palsy treated with the Sever L'Episcopo procedure using a simple five-grade scale consisting of the ability to reach the abdomen (grade 0), upper thorax (grade I), mouth (grade II), forehead (grade III), and occiput (grade IV), which translates into an improvement in basic daily activities. Forty-nine procedures were done in 48 patients (one bilateral) with a preoperative and postoperative evaluation of each case. Range of motion was also recorded for each patient both preoperatively and postoperatively. The overall results showed an improvement of two grades in 61% of our patients. The improvement in range of motion averaged 64 degrees for active abduction and 42 degrees for active external rotation. Functional goals must be the principal concern. With this method of evaluation, we can measure (in a simple way) improvement in the activities of daily living.
Asunto(s)
Parálisis Cerebral/fisiopatología , Articulación del Hombro/fisiopatología , Adolescente , Parálisis Cerebral/cirugía , Niño , Preescolar , Contractura/fisiopatología , Contractura/cirugía , Femenino , Estudios de Seguimiento , Humanos , Masculino , Estudios Prospectivos , Rango del Movimiento Articular , Escápula/fisiología , Articulación del Hombro/cirugía , Resultado del TratamientoRESUMEN
Little is known about the evolution of patients surviving an episode of adult respiratory distress syndrome (ADRS). In the present study the clinical and radiological evolution, and the course of pulmonary function changes were evaluated in nine patients that survived an episode of ADRS. There were six male and three female, with a mean age of 44 +/- 16 (mean +/- SD). The initial PaO2 was 39 +/- 10 with a FiO2 less than 35, and 59 +/- 23 with a FiO2 of 1. Four patients were smokers and one had a history of chronic bronchitis. Pulmonary function studies disclosed a peripheral obstructive ventilatory alteration in one patient, a peripheral and central alteration in four, and non-obstructive changes in three. Follow-up pulmonary functions studies were carried out in six cases and demonstrated a significant increase of DLCO (p less than 0.01). Airway obstruction was present in one case, the same degree of obstruction was maintained in two cases, a reversible bronchospasm appeared in one case, and respiratory fuction returned to normal in two cases. The severity of the ADRS was unrelated to the later evolution. The results suggest that residual functional abnormalities might be related to the administration of high concentrations of O2. No residual clinical or radiological alterations were observed. Because of the multifactorial etiology of ADRS and of the reduced number of patients studied the results are non-homogeneous. However, DLCO appears to be the best parameter to indicate functional recovery. Residual abnormalities are minimal and temporary, and full recovery is to be expected.
Asunto(s)
Síndrome de Dificultad Respiratoria/fisiopatología , Adulto , Anciano , Obstrucción de las Vías Aéreas/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oxígeno/sangre , Presión Parcial , Pronóstico , Radiografía , Síndrome de Dificultad Respiratoria/diagnóstico por imagen , Síndrome de Dificultad Respiratoria/etiología , Pruebas de Función RespiratoriaRESUMEN
A variety of colicinogenic factors were examined for their effect on the growth of phages related to T7. Col B1 and Col B4 inhibited the growth of every phage tested. Col B2, however, did not interfere with T3 and H. Col E2 interfered only with growth of T3, while Col Ib produced abortive infection with some T7 mutants. The abortive infection associated with Col Ib seems to be correlated with the absence of the virus phosphokinase; mixed infection with T7 wild type and a phosphokinase deficient mutant was productive but the phage yield was depressed. The abortively infected cells lysed.