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2.
Front Pediatr ; 8: 173, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32432060

RESUMEN

Ceftolozane-tazobactam is a novel fifth-generation cephalosporin/ß-lactamase inhibitor combination recently approved for treatment of both complicated intra-abdominal and urinary tract infections in adults. Considering its potent bactericidal activity against Pseudomonas aeruginosa, it might represent an important option also for treating children with exacerbations of cystic fibrosis due to Pseudomonas aeruginosa when other alternative treatments have been exhausted. We hereby review available data on the use of ceftolozane-tazobactam in children, focusing on cystic fibrosis.

3.
Thorax ; 71(3): 230-7, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26612687

RESUMEN

BACKGROUND: In a lung cancer survey in 2000 we showed significantly less favourable stage distribution and lower resection rate in Teesside (UK) than in the comparable industrialised area of Varese (Italy). Lung cancer services in Teesside were subsequently reorganised according to National Cancer Plan recommendations. METHODS: For all new lung cancer cases diagnosed in Teesside (n=324) and Varese (n=260) during the 12 months October 2010 to September 2011 (hereafter 'the 2010 cohort'), demographic, clinico-pathological and disease management data were prospectively recorded using the same database and protocol as the 2000 survey. Findings were analysed focusing on resection rate. RESULTS: In the 2010 cohort compared with 2000, both in Teesside and Varese emergency referral decreased (p<0.001), performance status improved (p<0.001), but cancer stage shift was not seen; resection rate improved in Teesside, from 7% to 11% (p=0.054), and was unchanged in Varese (24%). Moreover, in Teesside compared with Varese the stage distribution remained less favourable, stage I-II non-small cell lung cancer (NSCLC) proportion being respectively 12% and 19% (p=0.040), and resection rate in all lung cancers remained lower (11% and 24%; p<0.001). On multivariate analysis, resection predictors in Teesside were as follows: stage I-II NSCLC (OR 86.14; 95% CI 31.80 to 233.37), performance status 0-1 (OR 5.02; 95% CI 1.48 to 17.07), belonging to 2010 cohort (OR 2.85; 95% CI 1.06 to 7.64). CONCLUSIONS: In Teesside the main independent predictor of resection was disease stage; in 2010-2011 compared with 2000, lung cancer service improved but stage shift did not occur, and resection rate increased but remained significantly lower than in Varese.


Asunto(s)
Neoplasias Pulmonares/cirugía , Planificación de Atención al Paciente/estadística & datos numéricos , Neumonectomía/estadística & datos numéricos , Anciano , Femenino , Estudios de Seguimiento , Humanos , Italia/epidemiología , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiología , Masculino , Morbilidad/tendencias , Estadificación de Neoplasias , Estudios Retrospectivos , Factores de Riesgo , Reino Unido/epidemiología
4.
Reprod Biomed Online ; 12(4): 423-7, 2006 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-16740214

RESUMEN

The clomiphene citrate challenge test is a tool to predict ovarian reserve and fertility. It has mainly been used as a predictor of success of IVF/intracytoplasmic sperm injection (ICSI) cycles. Infertile young women with diminished ovarian reserve have a worse prognosis than women with adequate ovarian reserve attempting IVF/ICSI cycles. Nothing is known regarding the outcome of young women with diminished ovarian reserve undergoing low-complexity assisted reproductive treatment such as ovulation induction plus intrauterine insemination (IUI). This study included all women under 37 years who consulted in the authors' centre between May 2004 and August 2005 who underwent ovulation induction and IUI. Ninety-six women younger than 37 years with adequate ovarian reserve, and 50 women with diminished ovarian reserve were found. The pregnancy rate and pregnancy rate per cycle in the adequate ovarian reserve group were significantly higher than those of the diminished ovarian reserve group (46.7% versus 25%, P < 0.02 ; 15.9% versus 7.6%, P < 0.02 respectively). It is concluded that the clomiphene citrate challenge test is a good predictor of low-complexity infertility intervention outcome, and represents an effective tool to establish a prognosis. Therefore, it is very useful in planning therapy, and advising the infertile couple.


Asunto(s)
Clomifeno , Fármacos para la Fertilidad Femenina , Infertilidad Femenina/diagnóstico , Inseminación Artificial , Índice de Embarazo , Adulto , Factores de Edad , Clomifeno/administración & dosificación , Consejo , Femenino , Fármacos para la Fertilidad Femenina/administración & dosificación , Humanos , Valor Predictivo de las Pruebas , Embarazo , Pronóstico
5.
Rev. biol. trop ; 51(2): 305-312, jun. 2003. tab, graf
Artículo en Español | LILACS | ID: lil-365922

RESUMEN

The venoms of Latrodectus sp. have been reported to induce contraction probably mediated by adrenergic and cholinergic transmitters. We have demonstrated that the venom of Chilean Latrodectus mactans contains neurotoxins that induce a contraction partially independent of transmitters release. Transmembrane mobility of Na+ and Ca2+ ions and more specifically, the increase of cytoplasmic calcium concentration are responsible for tonic contraction in smooth muscle. Calcium may enter the cell by several ways, such as the voltage-dependent Ca2+ L-type channels and the Na+/Ca2+ exchanger. This study aimed to examine the participation of this exchanger in the tonic contraction of smooth muscle in vas deferent of rat induced by the venom of the Chilean spider L. mactans. Blockers of Na+ channels (amiloride) and Ca2+ L-type channels (nifedipine), and a stimulator of the exchanger (modified Tyrode, Na+ 80 mM) were used. Simultaneously, variations of the cytoplasmic concentration of Ca2+ were registered by microfluorimetry (Fura-2 indicator) in the presence of nifedipine. In presence of amiloride, dose-dependent inhibition of venom-induced contraction was observed, suggesting the participation of voltage-dependent Ca2+ L-type channels. The contraction was only partially inhibited by nifedipine and the Ca2+ cytoplasmic concentration increased, as assessed by the microfluorimetric registration. Finally, the venom-induced contraction increased in the presence of modified Tyrode, probably due to the action of the Na+/Ca2+ exchanger. Taken together, our results support the idea that the Na+/Ca2+ exchanger is active and may be, at least in part, responsible for the contraction induced by the venom of Chilean L. mactans.


Asunto(s)
Animales , Masculino , Femenino , Ratas , Araña Viuda Negra , Contracción Isométrica , Músculo Liso , Venenos de Araña , Amilorida , Bloqueadores de los Canales de Calcio , Chile , Citofotometría , Nifedipino , Ratas Wistar
6.
Rev Biol Trop ; 51(2): 305-12, 2003 Jun.
Artículo en Español | MEDLINE | ID: mdl-15162722

RESUMEN

The venoms of Latrodectus sp. have been reported to induce contraction probably mediated by adrenergic and cholinergic transmitters. We have demonstrated that the venom of Chilean Latrodectus mactans contains neurotoxins that induce a contraction partially independent of transmitters release. Transmembrane mobility of Na+ and Ca2+ ions and more specifically, the increase of cytoplasmic calcium concentration are responsible for tonic contraction in smooth muscle. Calcium may enter the cell by several ways, such as the voltage-dependent Ca2+ L-type channels and the Na+/Ca2+ exchanger. This study aimed to examine the participation of this exchanger in the tonic contraction of smooth muscle in vas deferent of rat induced by the venom of the Chilean spider L. mactans. Blockers of Na+ channels (amiloride) and Ca2+ L-type channels (nifedipine), and a stimulator of the exchanger (modified Tyrode, Na+ 80 mM) were used. Simultaneously, variations of the cytoplasmic concentration of Ca2+ were registered by microfluorimetry (Fura-2 indicator) in the presence of nifedipine. In presence of amiloride, dose-dependent inhibition of venom-induced contraction was observed, suggesting the participation of voltage-dependent Ca2+ L-type channels. The contraction was only partially inhibited by nifedipine and the Ca2+ cytoplasmic concentration increased, as assessed by the microfluorimetric registration. Finally, the venom-induced contraction increased in the presence of modified Tyrode, probably due to the action of the Na+/Ca2+ exchanger. Taken together, our results support the idea that the Na+/Ca2+ exchanger is active and may be, at least in part, responsible for the contraction induced by the venom of Chilean L. mactans.


Asunto(s)
Contracción Isométrica , Músculo Liso/efectos de los fármacos , Intercambiador de Sodio-Calcio/antagonistas & inhibidores , Venenos de Araña/farmacología , Amilorida/farmacología , Animales , Bloqueadores de los Canales de Calcio/farmacología , Canales de Calcio Tipo L/efectos de los fármacos , Canales de Calcio Tipo L/fisiología , Chile , Citofotometría , Femenino , Masculino , Nifedipino/farmacología , Ratas , Ratas Wistar
7.
Rev. chil. med. intensiv ; 17(1): 12-14, mar. 2002. tab
Artículo en Español | LILACS | ID: lil-340290

RESUMEN

There is currently no consensus as to expected levels of serum cortisol (SC) in critical patients. Some authors, based on the ACTH test, consider 18 ug/dL and up as normal while others start >25-30 ug/dL. There are no reports of critical patients with Systemic Inflammatory Response Syndrome (SIRS). In this study we determine the SC in a group of critical patients with SIRS and correlate this value with the hemodynamic response and vasoactive drug requirements. SC was measured under conditions of stree defined by important hemodynamic instability within the SIRS context. We studied patients with no known history of steroid therapy nor use of other drugs that could alter the adrenal axis, and with no suspicion of adrenal failure. Enzimuntests Roche ES 300(CV 6 percent) was used. Based on our experience and on different studies, patients were classified into theree groups according to the SCvalue under stress. Group 1: SC <18 ug/dL, Group 2: SC 18,1 to 28 ug/dL, and Group 3: CS > 28 ug/dL. We studied 20 patients, 15 men and 5 women, all presenting SIRS, 17 with septic schock, 1 with severe head injuries, 1 hypovolemic shock, 1 postsurgery. The initial PA median was 80/50 mmHg. CS values varied between 10,3 and > 46 ug/dL. Group 1: 8/20 patients (40 percent) with a variation between 10,3 and 17,3 ug/dL; Group 2: 7/20 patients (35 percent) between 19,9 and 27,8 ug/dL, and Group 3: 5/20 (25 percent) between 30,8 and > 46 ug/dL. The most significant difference among groups was found in Group 1 patients who required maximun dosage of DVA and presented hemodynamic stabilization with 150 to 300 mg of hydrocortisone perc day. There were no differences between groups 2 and 3 in DVA dosage, which was lower than for Group 1, and these did not evidence hemodynamic stabilization with hydrocortisone. In conclusion: A SC level > 18 ug/dL can be expected in critical patients undergoing SIRS during periods of hemodynamic instability. 2.- SC values lower than 18 ug/dL contribute to the hemodynamic instability determined by the initial sickness, and these cases require the administration of hydrocortisone in stress dosage. 3.- Patients with cortisol levels over 18 ug/dL receive no benefits from hydrocortisone. 4.- More studies in this field are requires to establish different patterns of steroidad response in critical patients


Asunto(s)
Humanos , Masculino , Adulto , Femenino , Persona de Mediana Edad , Enfermedad Crítica/terapia , Hidrocortisona , Síndrome de Respuesta Inflamatoria Sistémica/fisiopatología , Traumatismos Craneocerebrales , Hemodinámica , Hidrocortisona , Síndrome de Respuesta Inflamatoria Sistémica/sangre
8.
Rev. chil. obstet. ginecol ; 51(4): 351-60, 1986. ilus
Artículo en Español | LILACS | ID: lil-45987

RESUMEN

Se presenta el método para obtener rápidamente, mediante un microcomputador y software específico, los gráficos de curvas hormonales promedio de hormona luteinizante (LH) de 15 ciclos concepcionales, en los que se determinan los valores plasmáticos de LH, de hormona folículo-estimulante (FSH), de prolactina (PRL), de estradiol (E2) y progesterona (P). Se establecen las ventajes para el investigador del uso de un sistema de informática personal


Asunto(s)
Adulto , Humanos , Femenino , Diagnóstico por Computador/tendencias , Microcomputadores , Reproducción , Estradiol/sangre , Hormona Folículo Estimulante/sangre , Hormona Luteinizante/sangre , Ciclo Menstrual , Progesterona/sangre , Prolactina/sangre
10.
Rev. chil. obstet. ginecol ; 49(5): 330-6, 1984.
Artículo en Español | LILACS | ID: lil-24559

RESUMEN

El presente estudio analiza la relacion existente entre la concentracion diaria de estradiol en plasma y la morfologia del complejo cumulo-corona-ovocitos (CCO), obtenidos de aspiracion folicular en un programa de fecundacion in vitro (FIV). De un total de 99 ovocitos pertenecientes a 27 mujeres incorporadas en este estudio, 66% fueron morfologicamente del tipo II; 12% del tipo III, y 16% del tipo IV. El 80,6% de los ovocitos que se fertilizaron corespondian al tipo II, y 89,6% de los ovocitos que se segmentaron eran de esta misma caracterizacion morfologica. La concentracion diaria de estradiol en los dias que preceden a la aspiracion folicular supera al 100% cuando se obtienen ovocitos del tipo II. Sin embargo, en aquellos casos en que se obtienen ovocitos tipo III o IV el estradiol experimenta una estabilizacion en las 48 horas que preceden a la aspiracion folicular, y el incremento acumulativo total no sepera el 80%. Por otra parte, el aumento del volumen folicular total presenta un paralelismo con el incremento diario de estradiol. Cuando este paralelismo se quiebra, la probabilidad de encontrar ovocitos no fertilizables aumenta significativamente


Asunto(s)
Humanos , Masculino , Femenino , Estradiol , Fertilización In Vitro , Oocitos
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