Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 75
Filtrar
1.
Br Dent J ; 232(5): 286-287, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-35277602
2.
Br Dent J ; 225(9): 848-854, 2018 11 09.
Artículo en Inglés | MEDLINE | ID: mdl-30412540

RESUMEN

The oral rehabilitation of head and neck cancer patients is a vital and pivotal part of their care pathway, helping to restore function, aesthetics and improve patient well-being and quality of life. Patient-reported outcome data demonstrates that such patients consider that many of their continued and unmet needs relate to their oral and dental rehabilitation. It is therefore incumbent on all dental team members to be aware of the entire spectrum of restorative management options that can be utilised in both the prevention and rehabilitation of this patient cohort. The literature highlights that maxillary and mid-face tumours are challenging, as patients often suffer both profound functional and aesthetic consequences with significant physiological and psychological impact. Conversely, mandibular and floor of mouth tumours often result in issues primarily affecting oral function. This paper will summarise commonly encountered functional and aesthetic issues facing the restorative dental team and highlight widespread preventive challenges.


Asunto(s)
Neoplasias de Cabeza y Cuello , Neoplasias de la Boca , Estética Dental , Humanos , Maxilar , Calidad de Vida
3.
Dis Esophagus ; 31(6)2018 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-29800270

RESUMEN

Thoracic epidural (TE) analgesia has been the standard of care for transthoracic esophagectomy patients since the 1990s. Multimodal anesthesia using intrathecal diamorphine, local anesthetic infusion catheters (LAC) into the paravertebral space and rectus sheaths and intravenous opioid postoperatively represent an alternative option for postoperative analgesia. While TE can provide excellent pain control, it may inhibit early postoperative recovery by causing hypotension and reducing mobilization. The aim of this study is to determine whether multimodal analgesia with LAC was effective with respect to adequate pain management, and compare its impact on hypotension and mobility. Patients receiving multimodal LAC analgesia were matched using propensity score matching to patients undergoing two-phase trans-thoracic esophagectomy with a TE over a two-year period (from January 2015 to December 2016). Postoperative endpoints that had been evaluated prospectively, including pain scores on movement and at rest, inotrope or vasoconstrictor requirements, and hypotension (systolic BP < 90 mmHg), were compared between cohorts. Out of 14 patients (13 male) that received LAC were matched to a cohort of 14 patients on age, sex, and comorbidity. Mean and maximum pain scores at rest and movement on postoperative days 0 to 3 were equivalent between the groups. In both cohorts, 50% of patients had a pain score of more than 7 on at least one occasion. Fewer patients in the LAC group required vasoconstrictor infusion (LAC: 36% vs. TE: 57%, P = 0.256) to maintain blood pressure or had episodes of hypotension (LAC: 43% vs. TE: 79%, P = 0.05). The LAC group was more able to ambulate on the first postoperative day (LAC: 64% vs. TE: 43%, P = 0.14) but these differences were not statistically significant. Within the epidural cohort, three patients had interruption of epidural due to dislodgement or failure of block compared to no disruption in the multimodal local anesthesia catheters group (P = 0.05). Therefore, multimodal anesthesia using spinal diamorphine with combined paravertebral and rectus sheath local anesthetic catheters appears to provide comparable pain relief post two-phase esophagectomy and may provide more reliable and safe analgesia than the current standard of care.


Asunto(s)
Analgesia Epidural/métodos , Analgesia/métodos , Analgésicos Opioides/administración & dosificación , Esofagectomía/efectos adversos , Heroína/administración & dosificación , Dolor Postoperatorio/tratamiento farmacológico , Toracotomía/efectos adversos , Anciano , Analgesia/instrumentación , Catéteres , Esofagectomía/métodos , Esofagectomía/rehabilitación , Femenino , Humanos , Inyecciones Espinales , Masculino , Persona de Mediana Edad , Dolor Postoperatorio/etiología , Estudios Retrospectivos , Toracotomía/métodos , Toracotomía/rehabilitación , Resultado del Tratamiento
4.
Br Dent J ; 218(10): 591-6, 2015 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-25998353

RESUMEN

Critical incident reporting is widely used across healthcare and other sectors for reporting adverse events or behaviours. More recently it has been used in medical education as a means of assessing student professionalism. The aims of this study were to determine the usage of critical incident forms when reporting behaviours related to professionalism demonstrated by undergraduate dental students, and the types of behaviours exhibited. Three types of form could be awarded for highly professional (green), minor unprofessional (yellow) and serious unprofessional (red) behaviours. All forms completed over a two-year period were analysed recording the year of student, type of card and demographic of the member of staff reporting the incident. All text relating to the nature of the incident was entered into a qualitative data analysis software package and analysed thematically. In total, 583 cards were awarded, 55% green, 34% yellow and 11% red. Seventy-four percent of cards were awarded in a clinical environment, with administrative staff using them the most (29%). The overwhelming professional behaviours demonstrated related to altruism. The most common unprofessional behaviours related to a lack of conscientiousness, although a greater range of common unprofessional behaviours were reported. In conclusion, critical incidents forms were widely used for reporting both professional and unprofessional behaviours particularly in clinical environments by a range of staff. Such forms may be a valuable addition to the professionalism assessment portfolio, capturing behaviours not previously reported using traditional methods.


Asunto(s)
Errores Médicos/psicología , Estudiantes de Odontología/psicología , Humanos , Errores Médicos/estadística & datos numéricos , Profesionalismo , Reino Unido
5.
Eur J Dent Educ ; 17(1): e16-21, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23279405

RESUMEN

OBJECTIVE: The aim of this study was to compare the grades awarded by two experienced assessors with peer-assessment marks and measurements from a digital scanning device (Prepassistant; KaVo, Biberach, Germany), for full gold crown preparations completed in a pre-clinical operative skills course on typodont teeth. METHODS: Seventy-eight preparations on typodont teeth were randomised and assessed by all three methods. Agreement was measured using weighted kappa statistics, and mean rank scores given by the Friedman test. RESULTS: The highest agreement was seen between the experienced assessors (0.38), closely followed by peer assessment and experienced assessor agreement (0.36, 0.29). Despite this, the results indicate poor levels of agreement. No agreement was seen between any of the assessment methods when compared to the digital scanning device. CONCLUSIONS: The findings of this study could be related to the difficulty of calculating a single grade from the output of the device, in addition to the inability of the machine to assess all the factors necessary for an acceptable preparation. From this study, it can be concluded that this device is not suitable for calculating grades when used in isolation. Further research could explore the role of the Prepassistant in providing student feedback, its potential to enhance the learning experience and the subsequent effect on performance.


Asunto(s)
Competencia Clínica/normas , Educación en Odontología/organización & administración , Evaluación Educacional/métodos , Imagenología Tridimensional , Grupo Paritario , Educación en Odontología/métodos , Femenino , Humanos , Masculino
6.
Psychol Med ; 42(5): 1103-15, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22011359

RESUMEN

BACKGROUND: We examined the relationship between the onset and pattern of childhood mental health disorders and subsequent current smoking status at age 17 years. METHOD: Data were from a prospective cohort study of 2868 births of which 1064 supplied information about their current smoking at 17 years of age. The association between the onset and pattern of clinically significant mental health disorders in the child and subsequent smoking at age 17 years was estimated via multivariable logistic regression. RESULTS: Relative to 17 year olds who never had an externalizing disorder, 17-year-olds who had an externalizing disorder at age 5, 8 or 14 years were, respectively, 2.0 times [95% confidence interval (CI) 1.24-3.25], 1.9 (95% CI 1.00-3.65) or 3.9 times (95% CI 1.73-8.72) more likely to be a current smoker. Children with an ongoing pattern of externalizing disorder were 3.0 times (95% CI 1.89-4.84) more likely to be smokers at the age of 17 years and those whose mothers reported daily consumption of 6-10 cigarettes at 18 weeks' gestation were 2.5 times (OR 2.46, 95% CI 1.26-4.83) more likely to report smoking at 17 years of age. Associations with early anxiety and depression in the child were not found. CONCLUSIONS: Current smoking in 17-year-olds may be underpinned by early emergent, and then, ongoing, externalizing disorder that commenced as young as age 5 years as well as exposure to early prenatal maternal smoking. The associations documented in adults and adolescents that link tobacco smoking and mental health are likely to be in play at these early points in development.


Asunto(s)
Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Fumar/epidemiología , Fumar/psicología , Adolescente , Edad de Inicio , Australia/epidemiología , Causalidad , Niño , Preescolar , Estudios de Cohortes , Comorbilidad , Femenino , Estudios de Seguimiento , Humanos , Control Interno-Externo , Estudios Longitudinales , Masculino , Madres/psicología , Madres/estadística & datos numéricos , Oportunidad Relativa , Embarazo , Efectos Tardíos de la Exposición Prenatal/epidemiología , Efectos Tardíos de la Exposición Prenatal/psicología , Estudios Prospectivos , Factores de Riesgo , Encuestas y Cuestionarios
7.
Proc Natl Acad Sci U S A ; 106(4): 1027-32, 2009 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-19164562

RESUMEN

Recombinase-activating gene-2-deficient (Rag2(-/-)) mice lacking functional lymphocytes provide a useful model of chronic inflammatory bowel disease-emulating events in human colon cancer. Infection of Rag2(-/-) mice with Helicobacter hepaticus led to accumulation of macrophages and neutrophils in the colon, a process temporally related to up-regulation of tissue inducible nitric oxide synthase (iNOS) expression at the site of infection and increased nitric oxide (NO) production, as evidenced by urinary excretion of nitrate. Progressive development of increasingly severe inflammation, hyperplasia, dysplasia, and cancer accompanied these changes. Concurrent administration of an iNOS inhibitor prevented NO production and abrogated epithelial pathology and inhibited the onset of cancer. The presence of Gr-1(+) neutrophils and elevated tumor necrosis factor-alpha (TNF-alpha) expression in colon were required for increased iNOS expression and cancer, whereas interleukin-10 (IL-10) down-regulated TNF-alpha and iNOS expression and suppressed cancer. Anti-inflammatory CD4(+) regulatory lymphocytes also down-regulated iNOS and reduced cancer formation. Collectively, these results confirm essential roles for inflammation, increased TNF-alpha expression, and elevated NO production in colon carcinogenesis.


Asunto(s)
Colon/patología , Neoplasias del Colon/patología , Proteínas de Unión al ADN/deficiencia , Infecciones por Helicobacter/microbiología , Helicobacter hepaticus/inmunología , Óxido Nítrico/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Animales , Arginina/farmacología , Colon/enzimología , Colon/inmunología , Colon/microbiología , Neoplasias del Colon/complicaciones , Neoplasias del Colon/inmunología , Neoplasias del Colon/microbiología , Proteínas de Unión al ADN/metabolismo , Inhibidores Enzimáticos/farmacología , Infecciones por Helicobacter/enzimología , Infecciones por Helicobacter/inmunología , Infecciones por Helicobacter/orina , Inflamación/inmunología , Inflamación/microbiología , Mediadores de Inflamación/metabolismo , Ratones , Nitratos/orina , Óxido Nítrico Sintasa de Tipo II/antagonistas & inhibidores , Óxido Nítrico Sintasa de Tipo II/metabolismo
10.
Sex Transm Infect ; 82(3): 227-8, 2006 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-16731674

RESUMEN

Imiquimod 5% cream, an immune response modifier licensed for treatment of external ano-genital warts and superficial basal cell carcinomata, is known to cause local erythema, oedema and, rarely, exacerbation of psoriasis. We describe a case of exacerbation of eczema following application of this cream in a man with penile warts.


Asunto(s)
Adyuvantes Inmunológicos/efectos adversos , Aminoquinolinas/efectos adversos , Condiloma Acuminado/tratamiento farmacológico , Erupciones por Medicamentos/etiología , Eccema/inducido químicamente , Enfermedades del Pene/tratamiento farmacológico , Adulto , Humanos , Imiquimod , Masculino , Pomadas
11.
Eur J Immunogenet ; 29(2): 87-93, 2002 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11918632

RESUMEN

cDNA encoding a marsupial polymeric immunoglobulin receptor (pIgR) was isolated from Macropus eugenii (tammar wallaby) mammary lymph node primarily by reverse transcriptase coupled polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE) PCR. This resulted in a 5' truncated clone and, in order to obtain the full-length sequence, genomic walking PCR was utilized. The complete sequence consists of 2696 bp of cDNA and encodes a predicted polypeptide of 732 amino acids. The wallaby sequence is highly conserved in relation to the only other reported marsupial pIgR sequence, that of Trichosurus vulpecula (brushtail possum), having a nucleotide identity of 86.7% and a deduced amino acid identity of 79.9%. The wallaby nucleotide sequence also has a moderate degree of similarity with the pIgR sequences of eutherian mammals, being most similar to that of the rat, with an identity of 63.1%. At the amino acid level, in comparison to eutherian sequences, the wallaby pIgR is most similar to that of humans with an identity of 52.6%. pIgR phylogenetic trees were constructed for tammar wallaby, brushtail possum and several eutherian mammal cDNA and deduced amino acid sequences. In both DNA and protein analyses, the eutherian sequences formed a sister clade to the exclusion of the marsupial sequences, in agreement with the current view of mammalian evolution.


Asunto(s)
Macropodidae/genética , Receptores de Inmunoglobulina Polimérica/genética , Secuencia de Aminoácidos , Animales , Secuencia de Bases , ADN Complementario , Evolución Molecular , Ganglios Linfáticos , Macropodidae/clasificación , Datos de Secuencia Molecular , Filogenia , Reacción en Cadena de la Polimerasa
12.
Oncogene ; 21(6): 909-20, 2002 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-11840336

RESUMEN

The mechanisms through which the oncoprotein c-Myc initiates locus-specific gene amplification are not understood. When analysing the initiation mechanism of c-Myc-dependent amplification of the mouse ribonucleotide reductase R2 (R2) gene, we observe c-Myc-dependent initiation of illegitimate DNA replication of the R2 gene. We demonstrate multiple simultaneous c-Myc-induced R2 replication forks, whereas R2 normally replicates with a single fork. In contrast, cyclin C replicates with only a single replication fork irrespective of c-Myc deregulation. In addition to de novo replication forks, c-Myc also initiates bi-allelic replication of R2, abrogating its normal mono-allelic replication pattern. Moreover, several chromosomal regions also display c-Myc-induced illegitimate replication profiles. Thus, c-Myc can act as an illegitimate replication-licensing factor that promotes de novo replication initiation and illegitimate replication timing that adversely impacts upon genomic stability.


Asunto(s)
Proteínas Proto-Oncogénicas c-myc/fisiología , Recombinación Genética/fisiología , Ribonucleósido Difosfato Reductasa/genética , Factores de Transcripción , Alelos , Animales , Factores de Transcripción Básicos con Cremalleras de Leucinas y Motivos Hélice-Asa-Hélice , Factores de Transcripción con Cremalleras de Leucina de Carácter Básico , Bromodesoxiuridina/análisis , Ciclo Celular/genética , Células Cultivadas , Bandeo Cromosómico , Cromosomas/genética , Cromosomas/ultraestructura , Ciclina C , Ciclinas/genética , Replicación del ADN/fisiología , Proteínas de Unión al ADN/química , Dimerización , Electroforesis en Gel Bidimensional , Ensayo de Cambio de Movilidad Electroforética , Amplificación de Genes , Regulación de la Expresión Génica , Genes myc , Células Madre Hematopoyéticas/efectos de los fármacos , Células Madre Hematopoyéticas/metabolismo , Humanos , Ratones , Índice Mitótico , Unión Proteica , Proteínas Proto-Oncogénicas c-myc/química , Proteínas Recombinantes de Fusión/química , Proteínas Recombinantes de Fusión/fisiología , Recombinación Genética/genética , Secuencias Reguladoras de Ácidos Nucleicos , Transfección
13.
Contraception ; 62(3): 149-54, 2000 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-11124363

RESUMEN

Nonoxynol-9 (N-9) containing spermicides and other N-9 containing products are commonly used as lubricants during rectal intercourse. We have previously demonstrated that rectal application of N-9 products in mice can cause exfoliation of epithelial cells, increasing the probability of infection by HSV-2. To determine if N-9-containing products would have a similar effect on the rectal epithelium in humans, the application of K-Y Plus and ForPlay, both over-the-counter (OTC) N-9 products, were compared to the application of two formulations, carrageenan and methyl cellulose, that do not contain N-9. The effects of each formulation were evaluated in 4 human participants. Light and electron microscope examination of rectal lavage specimens collected 15 min post application of N-9 products revealed the presence of sheets of epithelium. Each sheet contained hundreds of epithelial cells that included columnar and goblet cells, varieties of cells typical of rectal epithelial morphology. Sheets of epithelium were not observed in rectal lavage specimens collected 8 to 12 hr post N-9 product use or in either of the timed lavages involving non-N-9 containing formulations. In addition, no sheets of epithelial cells were observed in the baseline lavage specimens. We conclude that the rectal use of N-9-containing products causes a rapid exfoliation of extensive areas of the rectal epithelium. Exfoliation of the epithelium is no longer observed at 8 hr. It is reasonable to assume that the loss of the protective epithelium would render a person more at risk for infection by HIV and other sexually transmitted pathogens. We, therefore, caution against the use of N-9-containing products during rectal intercourse.


Asunto(s)
Nonoxinol/efectos adversos , Recto/efectos de los fármacos , Espermicidas/efectos adversos , Adulto , Animales , Método Doble Ciego , Epitelio/efectos de los fármacos , Homosexualidad Masculina , Humanos , Ratones , Microscopía Electrónica , Microscopía de Contraste de Fase , Irrigación Terapéutica
14.
Am J Audiol ; 9(1): 50-5, 2000 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-10943024

RESUMEN

The purpose of this research was to obtain the sensitivity and specificity of transient evoked otoacoustic emission (TEOAE) screening procedures compared with conventional audiometric pure-tone screening and tympanometry. Pass/refer values were obtained from a group of 297 ears of 152 preschool and school-aged children, 3 to 8 years of age. The sensitivity and specificity of the TEOAE screenings compared with the pure-tone screenings were 81% and 95%, respectively. The sensitivity and specificity of TEOAE screenings compared with tympanometric screenings were 60% and 91%, respectively.


Asunto(s)
Oído Medio/fisiopatología , Trastornos de la Audición/diagnóstico , Trastornos de la Audición/fisiopatología , Niño , Preescolar , Femenino , Trastornos de la Audición/epidemiología , Humanos , Masculino , Sensibilidad y Especificidad
15.
Am J Respir Crit Care Med ; 162(2 Pt 1): 539-45, 2000 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-10934084

RESUMEN

Measurement of exhaled nitric oxide (FE(NO)) is a noninvasive and practical method for assessing airway inflammation. We conducted this investigation to determine the most appropriate flow rate for FE(NO) measurement and to obtain normal values for FE(NO). We determined which expiratory flow was easy to sustain, generated reproducible values, and provided good correlation between offline and online measurements. Thirty-two healthy subjects (15- 18 yr old) underwent spirometry and FE(NO) measurements, using a chemiluminescent NO analyzer at expiratory flow rates of 46, 31, 23, 15, 10, 7, 5, and 4 ml/s. The major findings were as follows: (1) FE(NO) increased as flow rates decreased, with strong correlation between FE(NO) values and flow rates at the four highest flows (0. 85- 0.93, p < 0.001); (2) there were no significant differences and good agreement between offline bag and online FE(NO) values for the four highest flows (p < 0.09-0.83); (3) online FE(NO) values increased with age 15-17 yr at all flow rates, but decreased at age 18 yr; and (4) using multiple regression, significant predictors of FE(NO) were flow, body surface area, age, and FEF(25-75). On the basis of these results, we provide FE(NO) values for healthy adolescents and propose that the ideal flow rate for children is between 30 and 50 ml/s.


Asunto(s)
Pruebas Respiratorias/métodos , Óxido Nítrico/análisis , Adolescente , Femenino , Humanos , Mediciones Luminiscentes , Masculino , Valores de Referencia , Reproducibilidad de los Resultados , Espirometría
16.
Neurosurg Clin N Am ; 11(2): 365-75, 2000 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10733851

RESUMEN

The accurate diagnosis of acute ischemic stroke is possible using clinical skills and diagnostic tools that are familiar to all neurosurgeons. Avoidance of immediate complications relies on the fundamentals of critical care. Effective treatment for ischemic stroke is available in the form of intravenous thrombolysis, but many stroke patients are denied this therapy because of the narrow window of opportunity for safe administration. Intra-arterial delivery may extend this benefit to a greater number of patients and may eventually prove more effective than intravenous treatment. Surgical treatment in a small number of ischemic stroke patients can be lifesaving and may afford reasonable functional recovery. This article discusses typical clinical presentations and differential diagnosis, diagnostic imaging for ischemic stroke, and possible treatments.


Asunto(s)
Isquemia Encefálica/cirugía , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Encéfalo/fisiopatología , Isquemia Encefálica/fisiopatología , Angiografía Cerebral/métodos , Circulación Cerebrovascular , Humanos , Imagen por Resonancia Magnética , Terapia Trombolítica/métodos , Tomografía Computarizada por Rayos X
17.
Behav Neurosci ; 113(1): 62-77, 1999 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-10197907

RESUMEN

Neuronal activity was recorded in the cingulate cortex and the limbic thalamus in Dutch-belted rabbits (Oryctolagus cuniculus) exposed to cocaine (8 mg/kg/day i.v.) or saline in utero during acquisition and reversal learning of a discriminative avoidance response. Anterior cingulate cortical excitatory training-induced activity (TIA) was attenuated in cocaine-exposed female rabbits during acquisition and reversal learning, but only during reversal learning in male rabbits. Posterior cingulate cortical excitatory TIA was lessened in cocaine-exposed rabbits during acquisition, whereas discrimination between the positive and negative cues was enhanced. Neuronal firing was attenuated in the anterior ventral thalamus in cocaine-exposed rabbits during acquisition and reversal learning. Behavioral learning was normal in cocaine-exposed rabbits. Other data suggest that rabbits exposed to cocaine in utero exhibit a learning deficit when trained with nonsalient cues.


Asunto(s)
Reacción de Prevención/efectos de los fármacos , Cocaína/toxicidad , Aprendizaje Discriminativo/efectos de los fármacos , Giro del Cíngulo/efectos de los fármacos , Efectos Tardíos de la Exposición Prenatal , Aprendizaje Inverso/efectos de los fármacos , Diferenciación Sexual/efectos de los fármacos , Tálamo/efectos de los fármacos , Animales , Nivel de Alerta/efectos de los fármacos , Atención/efectos de los fármacos , Mapeo Encefálico , Femenino , Masculino , Recuerdo Mental/efectos de los fármacos , Neuronas/efectos de los fármacos , Embarazo , Conejos , Transmisión Sináptica/efectos de los fármacos
18.
J Neurosurg Anesthesiol ; 11(2): 102-11, 1999 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10213437

RESUMEN

We compared intracranial pressure (ICP) and cerebral blood flow (CBF) in dogs after inflating a subdural intracranial balloon to increase ICP to 20 mm Hg, inducing hemorrhagic shock (mean arterial pressure [MAP] of 55 mm Hg), and infusing a single bolus of fluid consisting of either 54 mL/kg of 0.8% saline (SAL), 6 mL/kg of 7.2% hypertonic saline (HS), 20% hydroxyethyl starch (HES) in 0.8% SAL, or a combination fluid (HS/HES) containing 20% HES in 7.2% saline. Twenty-six dogs were ventilated with 0.5% halothane in N2O and O2 (60:40 ratio). As ICP was maintained at 20 mm Hg, rapid hemorrhage reduced MAP to 55 mm Hg (time interval of zero [T0]) which was maintained at that level for 30 minutes (until T30). Subsequently, over a 5-minute interval (T30-T35), one of the four randomly assigned resuscitation fluids was infused. Data were collected at baseline; after subdural balloon inflation; at T0, T30, T35, and 30-minute intervals thereafter for 2 hours (T65, T95, T125, and T155). CBF and ICP were compared using repeat-measure ANOVA. Cerebral blood flow was greater at T35 in the HS and HS/HES groups than in the HES group (P = .025). In the SAL group, ICP increased significantly from T0 to T35, remaining unchanged thereafter. At T35, ICP in the HS group was significantly lower than in the SAL group (P < .05) but subsequently increased. ICP in the HS/HES group exceeded that in all other groups at T95 and T125 (P < .05). After a severe reduction in cerebral perfusion pressure (CPP), HS solutions (both HS and HS/HES) were associated with a delayed rise in ICP and did not improve global forebrain CBF in comparison with conventional saline solutions.


Asunto(s)
Soluciones Hipertónicas , Hipertensión Intracraneal/fisiopatología , Resucitación/efectos adversos , Choque Hemorrágico/fisiopatología , Choque Hemorrágico/terapia , Animales , Presión Sanguínea , Cateterismo/efectos adversos , Circulación Cerebrovascular/fisiología , Perros , Derivados de Hidroxietil Almidón , Hipertensión Intracraneal/etiología , Presión Intracraneal/fisiología , Solución Salina Hipertónica , Factores de Tiempo
19.
Pediatr Neurosurg ; 29(2): 92-5, 1998 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-9792963

RESUMEN

Neurocytomas are uncommon intracranial neoplasms that have only recently been characterized pathologically. Neurocytomas are histologically benign neoplasms that are often quite large when diagnosed, and previous reports have commonly described presentation with mass effect or cerebrospinal fluid outflow obstruction. We describe the first case of neurocytoma presenting with intraparenchymal cerebral hemorrhage.


Asunto(s)
Neoplasias Encefálicas/complicaciones , Hemorragia Cerebral/etiología , Neurocitoma/complicaciones , Adolescente , Humanos , Lactante , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X
20.
Neurosurg Clin N Am ; 9(4): 673-9, 1998 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-9738099

RESUMEN

Temporary artery occlusion is an effective way to reduce the detrimental effects of intraoperative aneurysm rupture and to facilitate aneurysm dissection. The major risk incurred is of cerebral infarction. Dilemmas in the use of this technique include the amount of time that arterial flow may be interrupted safely and whether or not there is benefit to intermittent reperfusion. Protocol for the use of temporary occlusion is described.


Asunto(s)
Aneurisma Roto/prevención & control , Encéfalo/irrigación sanguínea , Aneurisma Intracraneal/cirugía , Complicaciones Intraoperatorias/prevención & control , Aneurisma Roto/cirugía , Humanos , Complicaciones Intraoperatorias/cirugía , Monitoreo Intraoperatorio , Instrumentos Quirúrgicos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA