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1.
Somnologie (Berl) ; 26(3): 187-198, 2022.
Artículo en Alemán | MEDLINE | ID: mdl-35937970

RESUMEN

Owing to the COVID-19 pandemic and the associated post-COVID syndrome, the concept "fatigue" has gained significant importance. However, both the definition and the causes of fatigue differ depending on the disease pattern in question. Moreover, individuals who describe their symptoms in everyday clinical settings seem almost universally to use the terms tiredness, fatigue and exhaustion synonymously. In 2007, Olson described these three terms as being distinct states in her view, but that they can be placed in relation to each other on a continuum. Taking up this consideration, an overview of current research is provided. For this purpose, the published literature of the last 2 years was searched for the terms "tiredness", "fatigue" and "exhaustion". Some common diagnostic instruments can be found. However, the great variety of instruments used to capture the three terms is striking. Despite these different diagnostic and definition possibilities, different therapeutic measures can be derived for each of the three symptoms. It is crucial, especially with regard to further therapy, to separate the three terms tiredness, fatigue and exhaustion from each other and to consider each of them separately on the common continuum. This is the only way to establish both an accurate diagnosis and the successful individual therapy that goes along with it.

2.
J Neural Transm (Vienna) ; 127(6): 977-985, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32212016

RESUMEN

The premonitory urge for tics scale (PUTS) is a common self-report measure of premonitory sensations preceding tics. The present study aimed to examine the internal consistency and concurrent validity of the PUTS by sex and psychiatric comorbidity status; and explored interactions between sex and psychiatric comorbidity in predicting premonitory urge and tic symptom severity. Seventy-four youth and young adults with persistent tic disorders completed the PUTS, while their parents completed the parent tic questionnaire (PTQ) and a demographic measure. Independent samples t-tests revealed no significant sex differences in PUTS items or total score. The PUTS total score also did not significantly differ between participants with and without attention-deficit hyperactivity disorder (ADHD) and/or obsessive-compulsive disorder (OCD) comorbidity. Internal consistency did not significantly differ between females (α = 0.85) and males (α = 0.75), and those with comorbid ADHD and/or OCD (α = 0.83) relative to those without (α = 0.69). With respect to concurrent validity, the PUTS total was significantly correlated with PTQ tic frequency, intensity, number, and severity for males but not for females. Among those with ADHD and/or OCD, the PUTS total score was correlated significantly and strongly with tic number and moderately with tic intensity. Interactions between sex and psychiatric comorbidity performed using 2 × 2 analysis of variance did not significantly predict the PUTS total or PTQ subscale scores. Findings suggest sex and comorbidity status may influence premonitory urge expression. Results have implications for understanding and measurement of the premonitory urge.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Pruebas Neuropsicológicas/normas , Trastorno Obsesivo Compulsivo , Trastornos de la Sensación/diagnóstico , Trastornos de Tic/diagnóstico , Adolescente , Adulto , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Comorbilidad , Femenino , Humanos , Masculino , Trastorno Obsesivo Compulsivo/epidemiología , Reproducibilidad de los Resultados , Autoinforme , Trastornos de la Sensación/epidemiología , Índice de Severidad de la Enfermedad , Factores Sexuales , Trastornos de Tic/epidemiología , Adulto Joven
3.
J Prev Med Hyg ; 60(4): E293-E299, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31967086

RESUMEN

INTRODUCTION: It is recognized that mobile phones may play a role in microorganism transmission and that hand hygiene, is considered the most important action for preventing infections and the spread of pathogens. The objective of this study was to determine presence and circulation bacteria on hands and mobile phones capable of causing infections in people and also determine if disinfection with gel-alcohol is useful to reduce the bacterial colonization. METHODS: The bacterial evaluation included 596 hands of participants and 256 mobile phones. Isolated colonies were identified by biochemical test and confirmed by gene 16S rRNA sequencing. Antimicrobial susceptibility was performed using the automated instrument Vitek®2-Compact and disk-diffusionmethod. RESULTS: In total, 92.9% of mobile phones and 98.3% of participants in study demonstrated evidence of bacterial contamination with different types of bacteria. Surprisingly, we observed that 18.6% plaques inoculated with disinfected fingers showed bacterial growth. In general, Gram negative isolates showed resistance to a higher number of antibiotics tested than Gram positive isolates. CONCLUSIONS: Our results could help to raise awareness in our society about the importance of hand hygiene, as well as frequently used devices, reducing bacterial contamination and limiting the possibility of transmission of resistant multi-drug bacteria.


Asunto(s)
Antibacterianos/farmacología , Teléfono Celular , Farmacorresistencia Bacteriana Múltiple , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Grampositivas/efectos de los fármacos , Desinfectantes para las Manos/farmacología , Mano/microbiología , Estudios Transversales , Bacterias Gramnegativas/genética , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Gramnegativas/fisiología , Bacterias Grampositivas/genética , Bacterias Grampositivas/aislamiento & purificación , Bacterias Grampositivas/fisiología , Desinfección de las Manos , Higiene de las Manos , Humanos , Pruebas de Sensibilidad Microbiana , ARN Bacteriano/análisis , ARN Ribosómico 16S/genética
4.
Lymphology ; 46(2): 64-74, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24354105

RESUMEN

We sought to develop a formula to quantify breast cancer-related lymphedema (BCRL) after bilateral breast surgery, which functions independently of the contralateral arm and accounts for fluctuations in patient weight. Perometer arm measurements from 265 unilateral breast surgery patients were analyzed. We assessed the relationship between change in patient weight and contralateral arm volume and developed a weight-adjusted volume change formula (WAC). The WAC formula and previously-established RVC formula were compared for classification of BCRL (> or = 10% volume increase) in unilateral breast surgery patients. We then evaluated BCRL incidence using the WAC formula in 225 bilateral mastectomy patients. Change in patient weight and contralateral arm volume demonstrated an approximately linear relationship. Weight-adjusted arm volume change (WAC) was therefore calculated as WAC = (A2*W1)/(W2*A1) - 1 where A1 is pre-operative and A2 is post-operative arm volume, and W1, W2 are the patient's corresponding weights. In the unilateral analysis, there was no significant difference in number of patients classified as having BCRL using the RVC and WAC formulas (p = 0.65). In bilateral mastectomy patients 11.1% (25/225) developed BCRL, defined as > or = 10% WAC. Independent risk factors for lymphedema included axillary lymph node dissection (ALND) and higher pre-operative BMI (p<0.05). Use of this weight-adjusted arm volume change formula should be of value for quantification of BCRL after bilateral breast surgery.


Asunto(s)
Neoplasias de la Mama/cirugía , Linfedema/etiología , Linfedema/patología , Extremidad Superior/patología , Adulto , Anciano , Peso Corporal , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/radioterapia , Terapia Combinada , Femenino , Humanos , Mastectomía , Persona de Mediana Edad , Factores de Riesgo
5.
Mol Psychiatry ; 16(6): 647-63, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20368705

RESUMEN

The lifetime prevalence of panic disorder (PD) is up to 4% worldwide and there is substantial evidence that genetic factors contribute to the development of PD. Single-nucleotide polymorphisms (SNPs) in TMEM132D, identified in a whole-genome association study (GWAS), were found to be associated with PD in three independent samples, with a two-SNP haplotype associated in each of three samples in the same direction, and with a P-value of 1.2e-7 in the combined sample (909 cases and 915 controls). Independent SNPs in this gene were also associated with the severity of anxiety symptoms in patients affected by PD or panic attacks as well as in patients suffering from unipolar depression. Risk genotypes for PD were associated with higher TMEM132D mRNA expression levels in the frontal cortex. In parallel, using a mouse model of extremes in trait anxiety, we could further show that anxiety-related behavior was positively correlated with Tmem132d mRNA expression in the anterior cingulate cortex, central to the processing of anxiety/fear-related stimuli, and that in this animal model a Tmem132d SNP is associated with anxiety-related behavior in an F2 panel. TMEM132D may thus be an important new candidate gene for PD as well as more generally for anxiety-related behavior.


Asunto(s)
Ansiedad/metabolismo , Predisposición Genética a la Enfermedad/genética , Proteínas de la Membrana/metabolismo , Polimorfismo de Nucleótido Simple/genética , Adulto , Animales , Ansiedad/genética , Ansiedad/patología , Ansiedad/fisiopatología , Modelos Animales de Enfermedad , Femenino , Lóbulo Frontal/metabolismo , Estudio de Asociación del Genoma Completo , Humanos , Masculino , Proteínas de la Membrana/genética , Ratones , Persona de Mediana Edad , Fenotipo , Escalas de Valoración Psiquiátrica , ARN Mensajero/metabolismo , Índice de Severidad de la Enfermedad
6.
Br J Anaesth ; 101(6): 798-803, 2008 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18845649

RESUMEN

BACKGROUND: The Simplified Acute Physiology Score (SAPS) 3 has recently been developed, but not yet validated in surgical intensive care unit (ICU) patients. We compared the performance of SAPS 3 with SAPS II and the Acute Physiology and Chronic Health Evaluation (APACHE) II score in surgical ICU patients. METHODS: Prospectively collected data from all patients admitted to a German university hospital postoperative ICU between August 2004 and December 2005 were analysed. The probability of ICU mortality was calculated for SAPS II, APACHE II, adjusted APACHE II (adj-APACHE II), SAPS 3, and SAPS 3 customized for Europe [C-SAPS3 (Eu)] using standard formulas. To improve calibration of the prognostic models, a first-level customization was performed, using logistic regression on the original scores, and the corresponding probability of ICU death was calculated for the customized scores (C-SAPS II, C-SAPS 3, and C-APACHE II). RESULTS: The study included 1851 patients. Hospital mortality was 9%. Hosmer and Lemeshow statistics showed poor calibration for SAPS II, APACHE II, adj-APACHE II, SAPS 3, and C-SAPS 3 (Eu), but good calibration for C-SAPS II, C-APACHE II, and C-SAPS 3. Discrimination was generally good for all models [area under the receiver operating characteristic curve ranged from 0.78 (C-APACHE II) to 0.89 (C-SAPS 3)]. The C-SAPS 3 score appeared to have the best calibration curve on visual inspection. CONCLUSIONS: In this group of surgical ICU patients, the performance of SAPS 3 was similar to that of APACHE II and SAPS II. Customization improved the calibration of all prognostic models.


Asunto(s)
Indicadores de Salud , Unidades de Cuidados Intensivos/estadística & datos numéricos , Cuidados Posoperatorios/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Cuidados Críticos/métodos , Métodos Epidemiológicos , Femenino , Alemania , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pronóstico , Resultado del Tratamiento , Adulto Joven
7.
Rev Argent Microbiol ; 40(1): 41-6, 2008.
Artículo en Español | MEDLINE | ID: mdl-18669052

RESUMEN

A descriptive retrospective study was carried out to describe an epidemic outbreak of enteroviral meningitis in Misiones. We reviewed records of 143 children from 1 month to 14 years of age who were hospitalized with aseptic meningitis in the Pediatric Hospital of Posadas from August to December 2005. Increased number of cases was observed between weeks 33 to 50 which reached a maximum peak in weeks 47 and 48, confirming an outbreak. The median of age was 8 years old, 55.2% were males. Eighty percent of cases were in 5 to 14 years old children. The average length of time spent in the hospital was 4.5+/-1.7 days, no deaths were reported. We performed cell counts, chemical and bacterial studies of CSF, and culture or RT-Nested/PCR for enteroviruses. Isolates were serotyped by RT-PCR amplification and genetic sequencing. Cell counts were from 6 to 5040 cells/mm3. Ninety two percent had less than 500 cells/mm3 and 43.5% had lymphocyte predominance. Glucose levels were normal with slightly elevated protein counts in 56% of cases. Of the cultured samples, 28% (17/60) showed cytopathic effect compatible with enterovirus. RT-n-PCR detected enterovirus in 73% (43/59) of the analyzed CSF. Echovirus type 4 was identified in 6 of them. The positive indicator obtained by combining both techniques was 83% (58/70).


Asunto(s)
Brotes de Enfermedades , Infecciones por Echovirus/epidemiología , Meningitis Viral/epidemiología , Adolescente , Argentina/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Estudios Retrospectivos
8.
Rev. argent. microbiol ; 40(1): 41-46, ene.-mar. 2008. graf, tab
Artículo en Español | LILACS | ID: lil-634574

RESUMEN

Se realizó un estudio retrospectivo a fin de describir un brote epidémico de meningitis causado por enterovirus, que comprometió a 143 niños de 1 mes a 14 años internados en el Hospital Pediátrico de Posadas (Misiones) con diagnóstico de meningitis aséptica, entre agosto y diciembre de 2005. Se observó un aumento de casos entre las semanas 33 a 50, con un pico máximo entre las semanas 47 y 48, lo que confirmó el brote. La mediana de edad de los niños afectados fue de 8 años y el 55,2% fueron varones. El 80% de los casos se observó entre escolares (5 a 14 años). El promedio del tiempo de internación fue de 4,5 ± 1,7 días, y no se registraron fallecidos. Los LCR se estudiaron mediante examen citoquímico y estudios bacteriológicos y virológicos (aislamiento viral, RT- PCR anidada e identificación molecular mediante secuenciación génica). Los recuentos de células en LCR variaron entre 6 y 5040 células /mm3, el 92% fueron inferiores a 500 células/mm3 y el 43,5% mostró predominio linfocitario. El 56% presentó concentraciones de glucosa normal, con proteínas ligeramente elevadas. El 28% de las muestras estudiadas por cultivo (17/60) mostró efecto citopático, compatible con enterovirus. La RT-PCR anidada permitió detectar enterovirus en un 73% de las muestras (43/59), con 6 casos que se tipificaron como echovirus tipo 4. El índice de positividad al combinar ambas técnicas alcanzó el 83%.


A descriptive retrospective study was carried out to describe an epidemic outbreak of enteroviral meningitis in Misiones. We reviewed records of 143 children from 1 month to 14 years of age who were hospitalized with aseptic meningitis in the Pediatric Hospital of Posadas from August to December 2005. Increased number of cases was observed between weeks 33 to 50 which reached a maximum peak in weeks 47 and 48, confirming an outbreak. The median of age was 8 years old, 55.2% were males. Eighty percent of cases were in 5 to 14 years old children. The average length of time spent in the hospital was 4.5±1.7 days, no deaths were reported. We performed cell counts, chemical and bacterial studies of CSF, and culture or RT-Nested/PCR for enteroviruses. Isolates were serotyped by RT-PCR amplification and genetic sequencing. Cell counts were from 6 to 5040 cells/mm3. Ninety two percent had less than 500 cells/mm3 and 43.5% had lymphocyte predominance. Glucose levels were normal with slightly elevated protein counts in 56% of cases. Of the cultured samples, 28% (17/60) showed cytopathic effect compatible with enterovirus. RT-n-PCR detected enterovirus in 73% (43/59) of the analyzed CSF. Echovirus type 4 was identified in 6 of them. The positive indicator obtained by combining both techniques was 83% (58/70).


Asunto(s)
Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Brotes de Enfermedades , Infecciones por Echovirus/epidemiología , Meningitis Viral/epidemiología , Argentina/epidemiología , Estudios Retrospectivos
10.
Acta Anaesthesiol Scand ; 47(10): 1276-83, 2003 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-14616327

RESUMEN

BACKGROUND: Because few studies have addressed postoperative hypoalbuminaemia in relation to hospital mortality, we evaluated this association and the prognostic value of increased procalcitonin (PCT) after cardiopulmonary bypass (CPB) surgery. METHODS: In 454 consecutive patients undergoing CPB, minimal serum albumin, colloid osmotic pressure (COP) and maximal PCT were retrospectively obtained from the 2nd to 10th postoperative day. Receiver operating characteristic (ROC) and multiple regression analyses determined independent predictive strength for 28-day mortality from preoperative albumin, Euroscore, postoperative minimal albumin and COP, and maximal PCT. Cut-off points for the four strongest predictors were calculated by the area under the curve (AUC) in the ROC for the 28-day mortality. RESULTS: Maximal PCT showed the largest AUC (0.85; 95% CI 0.79-0.90) and the highest relative risk (RR 12.17; 95%CI 5.26-28.16; P < 0.001), compared with postoperative albumin (AUC 0.72; 95% CI 0.62-0.81; RR 5.35; 95%CI 2.99-9.56; P < 0.001) and EuroSCORE (AUC 0.73; 95%CI 0.63-0.83; RR 4.48; 95%CI: 1.78-11.28; P < 0.01). By logistic regression, postoperative albumin was the strongest predictor of mortality (odds ratio 0.86; 95% CI 0.84-0.89). Cut-off values for predicting 28-day mortality were found for postoperative albumin and PCT at 17.8 g l(-1) and 2.5 ng l(-1), respectively. A slight but significant inverse correlation between PCT and albumin was found. Patients with albumin less than the cut-off showed significantly higher median values for PCT levels (2.5 vs. 1.0 g l-1), a higher 28-day mortality rate (20.8% vs. 4.5%), and a longer ICU stay (6 vs. 3 days) in comparison with patients with minimal albumin greater than 18 g l(-1). CONCLUSIONS: Post-operative serum albumin <18 g l(-1) and PCT >2.5 ng l(-1) are predictive for a higher 28-day mortality rate in cardiosurgical patients. Both peak PCT and minimal albumin were better outcome predictors than the Euroscore, which better represents the preoperative condition of the patient.


Asunto(s)
Calcitonina/sangre , Puente de Arteria Coronaria/mortalidad , Hipoalbuminemia/etiología , Complicaciones Posoperatorias , Precursores de Proteínas/sangre , Anciano , Péptido Relacionado con Gen de Calcitonina , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Presión Osmótica , Pronóstico , Curva ROC , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia
11.
Surg Endosc ; 16(11): 1538-41, 2002 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-12089632

RESUMEN

BACKGROUND: Autoaugmentation gastrocystoplasty has been previously performed successfully. This set of experiments was conducted to determine the feasibility of performing autoaugmentation gastrocystoplasty laparoscopically. METHODS: Hand-assisted laparoscopic autoaugmentation gastrocystoplasty was performed on 15 mongrel dogs. The surgery was carried out with two 10-mm trocars and a 6-cm Pfannenstiel incision. The gastric wedge, supplied by the right gastroepiploic artery, was resected with two applications of an endoscopic gastrointestinal anastomosis (GIA) stapler. The pedicle was demucosalized, and the anastomosis to the bladder was completed through the Pfannenstiel incision. RESULTS: All of the dogs were successfully treated laparoscopically and were eating at 48 h. There was no evidence of anastomotic leak dehiscence at the gastric resection staple line. CONCLUSION: Hand-assisted laparoscopic autoaugmentation gastrocystoplasty can be performed successfully in dogs. This operation may offer a superior alternative to standard bladder autoaugmentation procedures in children suffering from congenital bladder disorders.


Asunto(s)
Laparoscopía/métodos , Estómago/trasplante , Colgajos Quirúrgicos , Vejiga Urinaria/cirugía , Animales , Anastomosis Arteriovenosa/cirugía , Modelos Animales de Enfermedad , Perros , Endoscopios Gastrointestinales , Femenino , Arteria Gastroepiploica/cirugía , Engrapadoras Quirúrgicas , Grapado Quirúrgico/métodos
12.
Surgery ; 130(6): 936-40, 2001 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-11742320

RESUMEN

BACKGROUND: Recent studies suggest that mitogen-activated protein (MAP) kinase contributes to the growth and tumorigenesis of human epithelial cancers. Furthermore, blockade of this pathway may inhibit the growth of epithelial cancers. To determine whether MAP kinase is activated in human papillary thyroid carcinomas (PTCs), we analyzed the presence of native MAP kinase (MAPK) and activated phosphorylated MAP kinase (pMAPK) in papillary thyroid cancers and thyroid carcinoma cell lines. METHODS: Protein from paired specimens of 10 patients with PTC was analyzed by immunoblot for MAPK and pMAPK. In addition, MAPK protein expression and cell growth were analyzed in 3 thyroid tumor cell lines treated with a mitogen extracellular kinase inhibitor, U0126. RESULTS: All 10 PTCs had equal expression of MAPK in the tumors and adjacent normal tissue. Six of the 10 tumors demonstrated increased expression of the pMAPK in the tumor specimen compared to the adjacent normal tissue. Interestingly, 3 of 4 patients without differential expression had multifocal PTC. The pMAPK was expressed constitutively in 3 thyroid cancer cell lines. The MAPK inhibitor treatment decreased pMAPK expression and decreased serum-induced growth in all 3 cell lines. CONCLUSIONS: MAP kinase activation is common in PTCs and may offer a potential target for growth inhibition of PTCs.


Asunto(s)
Carcinoma Papilar/enzimología , Proteínas de Drosophila , Proteína Quinasa 1 Activada por Mitógenos/metabolismo , Proteínas Quinasas Activadas por Mitógenos/metabolismo , Neoplasias de la Tiroides/enzimología , Western Blotting , Carcinoma Papilar/genética , Activación Enzimática , Genes ras , Humanos , Proteína Quinasa 3 Activada por Mitógenos , Proteínas Proto-Oncogénicas/genética , Proteínas Proto-Oncogénicas c-ret , Proteínas Tirosina Quinasas Receptoras/genética , Neoplasias de la Tiroides/genética
13.
Urology ; 58(4): 625-30, 2001 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-11597557

RESUMEN

OBJECTIVES: To perform experiments to determine whether a new tissue sealant (SynthaSeal) could be an alternative for suture closure in minimally invasive bladder autoaugmentation gastrocystoplasty using demucosalized stomach. Alternative methods to suture closure for tissue approximation such as laser tissue welding and fibrin glue have been reported. METHODS: Minimally invasive autoaugmentation gastrocystoplasty with demucosalized stomach was performed on 14 female mongrel dogs. Two dogs were used to refine the technique. The remaining dogs were assigned to a suture group (n = 6) or a SynthaSeal group (n = 6). Anastomoses were performed using either SynthaSeal or suture. The in vivo bladder volumes and pressures of the groups were measured before and after gastrocystoplasty. The animals were studied on day 14. Samples of the anastomotic area were taken to measure the tensile strength and stress. Histologic analysis was conducted to assess tissue healing. The anastomotic time was recorded for each group. RESULTS: The tensile strength of the anastomoses in the SynthaSeal group was significantly increased (9.99 +/- 1.14 Newtons) compared with the suture group (5.66 +/- 0.97 Newtons) (P <0.05). The breaking stress comparisons and anastomosis times were equivalent between the two groups. The histologic evaluation revealed minor tissue devitalization and a normal inflammatory response in both groups. CONCLUSIONS: Minimally invasive gastrocystoplasty using demucosalized stomach can be successfully performed with SynthaSeal tissue sealant. This may provide a reliable alternative to suture closure.


Asunto(s)
Ensayo de Materiales , Estómago/trasplante , Adhesivos Tisulares , Vejiga Urinaria/cirugía , Anastomosis Quirúrgica/instrumentación , Anastomosis Quirúrgica/métodos , Animales , Perros , Femenino , Mucosa Gástrica , Gastroplastia/métodos , Estrés Mecánico , Técnicas de Sutura , Resistencia a la Tracción , Vejiga Urinaria/patología , Vejiga Urinaria/fisiopatología
14.
J Am Coll Surg ; 193(4): 367-72, 2001 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-11584963

RESUMEN

BACKGROUND: Recently local/regional anesthesia has been reintroduced as an alternative to general anesthesia for thyroidectomy. This study was undertaken to analyze characteristics and outcomes of patients who had thyroid surgery performed under regional anesthesia compared with those who had thyroidectomy under general anesthesia. STUDY DESIGN: One hundred seventy-five consecutive patients who underwent thyroid surgery under regional or general anesthesia during a 3-year period were analyzed. Fifty-eight operations were performed under regional anesthesia and 116 under general anesthesia. Patient characteristics analyzed included age, gender, obesity, anesthesia class, and tumor pathology. Postoperative complications, including nausea or vomiting, were compared. Additionally, operative times and length of stay in each group were compared. RESULTS: Patient characteristics including age, gender, tumor pathology, and anesthesia class were similar in both groups. But only 2% of patients treated under regional anesthesia were obese compared with 23% under general anesthesia. Although not significant, there was a trend toward decreased incidence of nausea and vomiting in the regional group. Other complications for the regional and general anesthesia groups were equal at 3%. Two patients required conversion to general anesthesia. Complications in the general anesthesia group included one episode of transient symptomatic hypocalcemia, two patients with transient vocal cord paralysis, and one episode of hematoma. Finally, there was a statistically significant increase in total operating room time and length of stay for the general anesthesia group. CONCLUSIONS: Regional anesthesia is a safe alternative to general anesthesia for patients undergoing thyroid surgery. Patients who cannot communicate verbally with the surgical team or who are obese may not be ideal candidates for regional anesthesia. The use of regional anesthesia results in a decreased length of stay and similar operative and operating room times.


Asunto(s)
Anestesia de Conducción , Anestesia General , Enfermedades de la Tiroides/cirugía , Tiroidectomía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Distribución de Chi-Cuadrado , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento
15.
Appl Environ Microbiol ; 67(9): 4158-65, 2001 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-11526019

RESUMEN

The yeast Trichosporon mucoides, grown on either glucose or phenol, was able to transform biphenyl into a variety of mono-, di-, and trihydroxylated derivatives hydroxylated on one or both aromatic rings. While some of these products accumulated in the supernatant as dead end products, the ortho-substituted dihydroxylated biphenyls were substrates for further oxidation and ring fission. These ring fission products were identified by high-performance liquid chromatography, gas chromatography-mass spectrometry, and nuclear magnetic resonance analyses as phenyl derivatives of hydroxymuconic acids and the corresponding pyrones. Seven novel products out of eight resulted from the oxidation and ring fission of 3,4-dihydroxybiphenyl. Using this compound as a substrate, 2-hydroxy-4-phenylmuconic acid, (5-oxo-3-phenyl-2,5-dihydrofuran-2-yl)acetic acid, and 3-phenyl-2-pyrone-6-carboxylic acid were identified. Ring cleavage of 3,4,4'-trihydroxybiphenyl resulted in the formation of [5-oxo-3-(4'-hydroxyphenyl)-2,5-dihydrofuran-2-yl]acetic acid, 4-(4'-hydroxyphenyl)-2-pyrone-6-carboxylic acid, and 3-(4'-hydroxyphenyl)-2-pyrone-6-carboxylic acid. 2,3,4-trihydroxybiphenyl was oxidized to 2-hydroxy-5-phenylmuconic acid, and 4-phenyl-2-pyrone-6-carboxylic acid was the transformation product of 3,4,5-trihydroxybiphenyl. All these ring fission products were considerably less toxic than the hydroxylated derivatives.


Asunto(s)
Compuestos de Bifenilo/metabolismo , Trichosporon/metabolismo , Biodegradación Ambiental , Compuestos de Bifenilo/química , Cromatografía Líquida de Alta Presión , Medios de Cultivo , Cromatografía de Gases y Espectrometría de Masas , Hidroxilación , Espectroscopía de Resonancia Magnética , Trichosporon/crecimiento & desarrollo
16.
Clin Neurophysiol ; 112(8): 1388-99, 2001 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-11459678

RESUMEN

OBJECTIVES: The quadratic phase-coupling (QPC) within burst patterns during electroencephalic burst suppression has been quantified. METHODS: It can be shown that a QPC exists between the frequency ranges 0-2.5 and 3-7.5 Hz and between the frequency ranges 0-2.5 and 8-12 Hz. By means of time-variant bicoherence analysis, a strong phase-locking between the modulating and the modulated component can be identified. The phase-locking is demonstrable within the first 250 ms after the burst onset and comes up to the maximum between 750 and 1250 ms. RESULTS: The effect is maintained over the whole first part of the burst (2 s) with a decreasing tendency after 1250 ms. All these effects cannot be found in the EEG before entering the burst suppression period (BSP). The transient coupling phenomena in the EEG bursts during BSP can be regarded as indicators for short-term interrelations between the underlying electrophysiologic processes. CONCLUSIONS: It can be suggested that the method introduced for the quantification of the sedation depth should be used.


Asunto(s)
Sedación Consciente , Electroencefalografía/efectos de los fármacos , Presión del Líquido Cefalorraquídeo , Humanos , Narcóticos/farmacología , Valores de Referencia
17.
Rev Argent Microbiol ; 33(1): 47-51, 2001.
Artículo en Español | MEDLINE | ID: mdl-11407020

RESUMEN

Susceptibility to beta-lactam antibiotics was investigated in Aeromonas spp. Microorganisms were isolated from both, clinical and water creek samples, as well as from processed raw chicken carcasses. Aeromonas like colonies were identified by means of Aerokey II and API 20 E System (Bio-Merieux). A. hydrophila prevailed both of human origin (44%) and water creek samples (41%), while A. caviae ranked first among raw chicken samples (65%). Dilution testing by Agar Method was performed to determine minimum inhibitory concentration (MIC), following NCCLS standards. All tested microorganisms were susceptible to third generation cephalosporin, cefepime, imipenem, aztreonam, and resistant to ampicillin. Only with cefepime and aztreonam exceptions, strains of human origin showed higher values of MIC90 than environmental ones. These results suggest that antibiotic resistance is mainly due to a steady environmental pressure, on account of the widely used above mentioned compounds.


Asunto(s)
Aeromonas/efectos de los fármacos , Antibacterianos/farmacología , Infecciones por Bacterias Gramnegativas/microbiología , Microbiología del Agua , Resistencia betalactámica , Aeromonas/clasificación , Aeromonas/aislamiento & purificación , Animales , Antibacterianos/química , Antibacterianos/clasificación , Argentina , Pollos/microbiología , Contaminación de Alimentos , Microbiología de Alimentos , Infecciones por Bacterias Gramnegativas/veterinaria , Humanos , Especificidad de la Especie , beta-Lactamas
18.
Appl Environ Microbiol ; 67(4): 1551-7, 2001 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11282604

RESUMEN

We examined the pathway by which the fungicide biphenyl is metabolized in the imperfect fungus Paecilomyces lilacinus. The initial oxidation yielded the three monohydroxylated biphenyls. Further hydroxylation occurred on the first and the second aromatic ring systems, resulting in the formation of five di- and trihydroxylated metabolites. The fungus could cleave the aromatic structures, resulting in the transformation of biphenyl via ortho-substituted dihydroxybiphenyl to six-ring fission products. All compounds were characterized by gas chromatography-mass spectroscopy and proton nuclear magnetic resonance spectroscopy. These compounds include 2-hydroxy-4-phenylmuconic acid and 2-hydroxy-4-(4'-hydroxyphenyl)-muconic acid, which were produced from 3,4-dihydroxybiphenyl and further transformed to the corresponding lactones 4-phenyl-2-pyrone-6-carboxylic acid and 4-(4'-hydroxyphenyl)-2-pyrone-6-carboxylic acid, which accumulated in large amounts. Two additional ring cleavage products were identified as (5-oxo-3-phenyl-2,5-dihydrofuran-2-yl)-acetic acid and [5-oxo-3-(4'-hydroxyphenyl)-2,5-dihydrofuran-2-yl]-acetic acid. We found that P. lilacinus has a high transformation capacity for biphenyl, which could explain this organism's tolerance to this fungicide.


Asunto(s)
Compuestos de Bifenilo/metabolismo , Fungicidas Industriales/metabolismo , Paecilomyces/metabolismo , Biotransformación , Compuestos de Bifenilo/química , Fungicidas Industriales/química , Hidroxilación , Paecilomyces/crecimiento & desarrollo
19.
Rev. argent. microbiol ; 33(1): 47-51, ene.-mar. 2001.
Artículo en Español | LILACS | ID: lil-332502

RESUMEN

Susceptibility to beta-lactam antibiotics was investigated in Aeromonas spp. Microorganisms were isolated from both, clinical and water creek samples, as well as from processed raw chicken carcasses. Aeromonas like colonies were identified by means of Aerokey II and API 20 E System (Bio-Merieux). A. hydrophila prevailed both of human origin (44) and water creek samples (41), while A. caviae ranked first among raw chicken samples (65). Dilution testing by Agar Method was performed to determine minimum inhibitory concentration (MIC), following NCCLS standards. All tested microorganisms were susceptible to third generation cephalosporin, cefepime, imipenem, aztreonam, and resistant to ampicillin. Only with cefepime and aztreonam exceptions, strains of human origin showed higher values of MIC90 than environmental ones. These results suggest that antibiotic resistance is mainly due to a steady environmental pressure, on account of the widely used above mentioned compounds.


Asunto(s)
Humanos , Animales , Aeromonas , Resistencia betalactámica , Infecciones por Bacterias Gramnegativas/microbiología , Lactamas , Microbiología del Agua , Aeromonas , Argentina , Pollos , Especificidad de la Especie , Contaminación de Alimentos , Microbiología de Alimentos , Infecciones por Bacterias Gramnegativas/veterinaria , Lactamas
20.
Rev. argent. microbiol ; 33(1): 47-51, ene.-mar. 2001.
Artículo en Español | BINACIS | ID: bin-6751

RESUMEN

Susceptibility to beta-lactam antibiotics was investigated in Aeromonas spp. Microorganisms were isolated from both, clinical and water creek samples, as well as from processed raw chicken carcasses. Aeromonas like colonies were identified by means of Aerokey II and API 20 E System (Bio-Merieux). A. hydrophila prevailed both of human origin (44) and water creek samples (41), while A. caviae ranked first among raw chicken samples (65). Dilution testing by Agar Method was performed to determine minimum inhibitory concentration (MIC), following NCCLS standards. All tested microorganisms were susceptible to third generation cephalosporin, cefepime, imipenem, aztreonam, and resistant to ampicillin. Only with cefepime and aztreonam exceptions, strains of human origin showed higher values of MIC90 than environmental ones. These results suggest that antibiotic resistance is mainly due to a steady environmental pressure, on account of the widely used above mentioned compounds.(AU)


Asunto(s)
Estudio Comparativo , Humanos , Animales , Aeromonas/efectos de los fármacos , Antibacterianos/farmacología , Infecciones por Bacterias Gramnegativas/microbiología , Microbiología del Agua , Resistencia betalactámica , Aeromonas/clasificación , Aeromonas/aislamiento & purificación , Antibacterianos/química , Antibacterianos/clasificación , Argentina , Pollos/microbiología , Contaminación de Alimentos , Microbiología de Alimentos , Infecciones por Bacterias Gramnegativas/veterinaria , Especificidad de la Especie
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