Analysis of the relationship between fluconazole consumption and non-C. albicans Candida infections.

The effect of fluconazole consumption on the incidence of nosocomial non-C. albicans Candida infections remains unclear. In this study we investigated such a relationship in an intensive care unit (Poland) over an 11-year period (2002-2012). Statistics relating to the number of candidiasis cases and the number of defined daily doses of fluconazole showed that only a very weak and not statistically significant linear correlation existed between these two variables (r(2) = 0.36, P = 0.052). However, the assumption of a 1-year delay in the infection response to changes in fluconazole concentrations resulted in a strong and statistically significant linear correlation (r(2) = 0.64, P = 0.0053). To more accurately determine the nature of this relationship, a simple epidemiological model was proposed that provided a better than linear correlation (r(2) = 0.78, P = 0.00077). We successfully used this approach to analyze results from the literature that were interpreted as evidence that fluconazole use is not a risk factor for development of non-C. albicans Candida infections. If a time delay in the infection response was assumed, a strong and statistically significant correlation was obtained. These findings suggest the need for a closer look at fluconazole therapy as a possible risk factor for development of non-C. albicans Candida infections.

Randomized comparison of sugammadex and neostigmine for reversal of rocuronium-induced muscle relaxation in morbidly obese undergoing general anaesthesia.

BACKGROUND: Complete and fast recovery of neuromuscular function is very important in morbidly obese patients because of the possible influence of postoperative residual curarization (PORC) on respiratory function in the postoperative period. Recent reports underline incidences of the residual influence of neuromuscular blocking agents. METHODS: Seventy morbidly obese (BMI >40 kg m(-2)) patients requiring general anaesthesia and receiving rocuronium for muscle relaxation were randomly assigned into two groups: at the end of the anaesthetic procedure, one group received sugammadex 2 mg kg(-1) of corrected body weight (Group SUG) and the other group received neostigmine 0.05 mg kg(-1) of CBW (Group NEO). At the end of surgery and when response reached a train-of-four (TOF) score of 2, patients received the study drugs. The neuromuscular function was recorded and time to achieve 90% of TOF (safe extubation) was measured. Patients were examined directly after arrival to the post-anaesthesia care unit (PACU) by a blinded investigator for the presence of PORC. RESULTS: Thirty-five patients received sugammadex and 35 neostigmine. Mean dose of rocuronium was 87.9 vs 85.6 mg (P>0.05), mean time to 90% of TOF was 2.7 vs 9.6 min (P<0.05), and TOF at the PACU was 109.8% vs 85.5% (P<0.05) in Groups SUG and NEO, respectively. CONCLUSIONS: Administration of sugammadex provides fast recovery of neuromuscular function and prevents PORC in the morbidly obese, however neostigmine does not.

Total intravenous anaesthesia with methohexitone or propofol for knee arthroscopy in day-case surgery.

The aim of the study was to assess the usefulness of methohexitone and propofol in total intravenous anaesthesia applied during planned knee joint arthroscopy in day-case surgery. Studies comprised 186 patients divided into 2 groups depending on the anaesthetic used (methohexitone n = 112 or propofol n = 74). ECG, heart rate, systolic and diastolic blood pressure and blood saturation using pulsoxymetry were monitored during anaesthesia. The time of regaining consciousness was measured and the orientation test was performed 5 and 10 minutes after regaining consciousness. Our results and observations confirm that total intravenous anaesthesia is useful in day-case surgery for knee joint arthroscopy. Both methohexitone and propofol cause cardiac and respiratory depression. Patients on propofol regain psychomotoric efficiency earlier then patients who received methohexitone.

[The effect of degenerative cervical spine lesions and blood flow velocity in vertebrobasilar system in Doppler measurement]. / Wplyw zmian zwyrodnieniowych odcinka szyjnego kregoslupa na predkosc przeplywu krwi badanego metoda dopplerowska w ukladzie tetniczym kregowo-podstawnym.

The purpose of the study was to establish the effect of degenerative lesions of cervical vertebrae on blood flow velocity in the vertebrobasilar system measured by means of Doppler phenomenon using Transpect--TCD device according to generally accepted principles. The study was carried out in 20 healthy controls and 40 individuals with these lesions (aged 16-60 years). It was found that blood flow velocity in this arterial system is highly variable individually. In patients with degenerative changes pathological reduction of this velocity was found in this system which is an unquestionable evidence of the influence of these lesions on blood flow in vertebral arteries.

[Administration of the cervical torsion test by the examination of Doppler's blood flows in vertebral arteries and basilar artery in patients with degenerative cervical spine changes]. / Zastosowanie testu skretu szyi przy badaniu predkosci przeplywu krwi metoda doplerowska w ukladzie tetnic kregowych i podstawnej u osób ze zmianami zwyrodnieniowymi odcinka szyjnego kregoslupa.

Using the neck rotation test during examination of Doppler's blood flows in vertebral arteries and basilar artery, the authors examined 60 subjects aged 16-60 years, including 20 healthy ones and 40 with cervical spondylarthrosis. The Transpect-TCD was used. Half the patients with cervical spine changes had also receptive hearing damage of low degree. The study demonstrated that neck rotation affected of patological Doppler's blood flows in one or in both vertebral arteries at 50% patients with cervical spondylarthrosis, but without clinical symptoms, and at 70% patients with cervical spondylarthrosis and clinical symptoms. The neck rotation test can have diagnostic significance by examination of sufficiency in vertebrobasilar system, or qualitative significance to microsurgical treatment.

[Psychological evaluation of postoperative pain and its significance for treatment]. / Psychologiczna ocena bólu pooperacyjnego i jej znaczenie w leczeniu.

The results of tests applied to two groups of the patients who underwent elective surgeries are being discussed. The patients were selected with the aid of J.C. Raven's Intelligence Quotient, H.J. Eysenck's Personality Inventory, J. Taylor's Personality Scale, and Spielberg's S.T.A.I. The patients were operated at the Casualty and Orthopaedic Surgery Department of the Surgical Institute, Military Academy of Medicine. Postoperative analgesia was achieved with i.m. pethidine (1 mg/kg b.w.) in the group of 30 patients with low intensity of neurosis and anxiety while the group of 60 patients with high level of neurosis and anxiety required three different techniques: pethidine (dose as above) intravenously, electric stimulation and placebo stimulation. The following tests were applied to all patients before surgery and on the three postoperative days: 1) evaluation of anxiety level, 2) determination and detection of pain points, 3) pain intensity determination, 4) determination of the dose of analgetic agent required for pain abolishment. Other factors determined included: 1) efficiency of both electric and placebo efficacy, 2) analgesic drug dose vs. pain intensity, 3) pain vs. anxiety ratio. The obtained results indicated that considerable oscillations of the emotional tension are observed in both pre- and postoperative periods. Intensity of pain and its compliance to the treatment are closely related to the level of anxiety. Psychological examination performed in patients preoperatively enables to foresee the postoperative pain intensity and to plan the course of therapy.

The role of polymorphonuclear leukocyte (PMNL) granule factors in the control of T cell dependent response in mice.

Factors isolated from human PMNL lysosomes granules enhance the immune response of BALB/c mice immunized with SRBC, augment allogeneic DTH reaction and accelerate skin graft rejection. The immunostimulatory effects does not depend only on proteolytic enzymes. Removal of proteolytic enzymes using DFP as irreversible inactivator did not alter the immunostimulatory effect of PMNL lysosome factors on PFC formation in mice. The PMNL factors have marked potentiating effect on the uptake and retention of labeled CRBC in mouse lymphoid system. This effect suggests an alternative pathway which can provide chronic immunological stimulus and play a significant role in augmentation of immune response. Data presented in this paper suggest that factors responsible for augmentation of the immune response are localized mostly in secondary PMNL granules.

Concentration of 2,3-diphosphoglycerate and adenosine triphosphate in erythrocytes following acute blood loss in the beagle.

The effect of experimental anaemia induced by phlebotomy and the effect of infusion of various fluids on the 2,3-DPG, ATP and total organic phosphate (Porg) concentration were examined in the red cells of beagles made anaemic by withdrawal of 30% of the circulating blood. Particular groups of dogs 30 min after phlebotomy were infused with own blood, blood with inosine, pyruvate and phosphate (IPP), Fluigel and Fluigel with IPP. The changes were most distinct in dogs which were not infused with any fluid. After 24 hours the content of 2,3-DPG, ATP and Porg increased by 17, 27 and 20%, respectively, in comparison with the results obtained before blood loss. Twenty-four hours following the reinfusion of own blood, a slight increase occurred in the 2,3-DPG and Porg content. Infusion of Fluigel caused a decrease of the phosphate compounds concentration after 3 and 6 hours and then the concentration almost returned to normal. Infusion of own blood as well as Fluigel enriched with inosine, pyruvate and phosphate did not lead to any change in 2,3-DPG concentration. The red cells of dogs do not utilize inosine for 2,3-DPG or nucleotide synthesis. The increased cardiac output seems to the main mechanism for oxygen transport to tissues after an acute haemorrhage.

[Experimental gluing of the pleural cavity]. / Das Kleben der Pleurahöhle in der experimentellen Forschung.

In experimental research on rabbits the authors assessed the usefulness of tissue adhesive-GRF in obtaining tissue union in the pleural cavity to replace aspiration drainage after thoracosurgical operations. The experiments were carried out on rabbits under general anaesthesia in two groups. First group had thoracotomy and after expansion of the lungs the chest was closed tightly. In second group after thoracotomy the lungs were stabilized with gelatin-resorcin-formaldehyde glue. Aspiration drainage was not used. The observation included: radiologic examination, measurements of pulmonary ventilation using Wright's volumometer and gasometric determination. Moreover the alveolar-capillary oxygen difference and the percent of lung shunt were determined. The authors underline good function glued lungs.

The role of adrenergic receptors in the motility of duodenum and choledochoduodenal junction in the pig.

The role of adenergic receptors in the motility of duodenum and choledochoduodenal junction in the pig. Acta Physiol. Pol., 1977, 28 (6): 521-528. The choldeochoduodenal junction in the Vietnamese pig is functionally and anatomically a part of duodenal wall. In view of this, investigations were carried out for establishing the role of adrenergic receptors in the development of motor function of this part of the intestinal tract. The experiments were performed on domestic Vietnamese pigs (Sus scrofa domestica) and they showed that after stimulation of alpha and beta adrenergic receptors the motor activity of the duodenal muscular coat and the choledochoduodenal junction is inhibited. The obtained results suggest similar reactions of the adrenergic receptors in both examined parts of the intestinal tract in the pig.