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Sample records for angioplastia coronaria renac

  1. RENAC: National Registry of Congenital Anomalies of Argentina.

    PubMed

    Groisman, Boris; Bidondo, María Paz; Barbero, Pablo; Gili, Juan A; Liascovich, Rosa

    2013-12-01

    The National Registry of Congenital Anomalies (Registro Nacional de Anomalías Congénitas, RENAC) is a hospital-based surveillance system for newborn infants with major morphological congenital anomalies (CAs). The objective of this study was to describe the characteristics and operation of the RENAC registry and the prevalence at birth of 56 specifc selected CAs, compared to other registries. The organization of the RENAC registry was initiated in public hospitals with 1000 or more births per year or which are the referral hospitals in a determined health region. Neonatologists are in charge of data collection, and a central coordination department is in charge of encoding, statistical analyses and regular reports. The RENAC registry uses an online forum for data submission and for guidance and interaction regarding the initial management of cases. Between November 1st, 2009 and June 30th, 2012, 98 hospitals were included in the registry, the annual coverage of these hospitals is 65% in the public sector and 35% of births in Argentina. In this period, 294 005 newborn infants were examined, and 5165 cases with major CAs were detected (1.76%; 95% CI: 1.71-1.80). The most frequent CAs were septal heart defects (prevalence per 10 000: 28.6), Down's syndrome (prevalence per 10 000: 19.2), cleft lip +/- palate (prevalence per 10 000: 12), and a set of neural tube defects (prevalence per 10 000: 11.9). The RENAC has reached a high coverage in the public sector and the differences in prevalence with other registries can be related to operational aspects or actual differences, depending on the case. The RENAC deals with the collection, analysis and dissemination of information about CAs in Argentina, and also contributes with local interventions.

  2. Anthocyanins from the scarlet flowers of Anemone coronaria.

    PubMed

    Toki, K; Saito, N; Shigihara, A; Honda, T

    2001-04-01

    Three acylated anthocyanins were isolated from the scarlet flowers of Anemone coronaria 'St. Brigid Red' along with a known pigment, pelargonidin 3-lathyroside. The structures of the acylated pigments were based on a pelargonidin 3-lathyroside skeleton acylated at different positions with malonic acid. The first pigment was identified as pelargonidin 3-O-[2-(beta-D-xylopyranosyl)-6-O-(malonyl)-beta-D-galactopyranoside], the second was pelargonidin 3-O-[2-O-(beta-D-xylopyranosyl)-6-O-(methyl-malonyl)-beta-D-galactopyranoside], and the third was (6''-O-(pelargonidin 3-O-[2''-O-(beta-D-xylopyranosyl)-beta-D-galactopyranosyl]))((4-O-(beta-D-glucopyranosyl)-trans-caffeoyl)-O-tartatryl)malonate.

  3. Morphometric analysis and bioclimatic distribution of Glebionis coronaria s.l. (Asteraceae) in the Mediterranean area

    PubMed Central

    Cano, Eusebio; Musarella, Carmelo Maria; Cano-Ortiz, Ana; Fuentes, José Carlos Piñar; Spampinato, Giovanni; Gomes, Carlos José Pinto

    2017-01-01

    Abstract We present a revision of Glebionis coronaria in the Mediterranean area based on: a) micro-morphology of the disc floret cypselas observed with a high-resolution confocal microscopy; b) measurements of the disc cypsela with a stereoscopic microscope – duly scaled; c) its distribution in several bioclimatic belts; d) field observations; e) comparisons of herbarium samples. Because of this study, we propose the elevation of Glebionis coronaria var. discolor to the rank of species, as Glebionis discolor comb. & stat. nov., based on morphological and ecological characteristics such as the disposition of the intercostal glands, the size of the disc cypsela wings and its distribution according to the bioclimatic belts. Glebionis coronaria, with totally yellow ray florets and intercostal glands aligned, is exclusive to the thermo-Mediterranean bioclimatic belt, while Glebionis discolor, with white ray florets on a yellow base and intercostal glands arranged randomly, is found in the thermo- and meso-Mediterranean belt. Illustrations of micromorphological characteristics of the cypselas, an identification key, a taxonomic synopsis including information on nomenclatural types, synonyms, descriptions of the taxa, and, as supplementary information, a list of the specimens examined and bioclimatic classification of samples localities are also presented. PMID:28785167

  4. Changes in chloroplast lipid contents and chloroplast ultrastructure in Sulla carnosa and Sulla coronaria leaves under salt stress.

    PubMed

    Bejaoui, Fatma; Salas, Joaquín J; Nouairi, Issam; Smaoui, Abderrazak; Abdelly, Chedly; Martínez-Force, Enrique; Youssef, Nabil Ben

    2016-07-01

    The possible involvement of chloroplast lipids in the mechanisms of NaCl tolerance was studied in leaves of two varieties of Fabaceae: Sulla carnosa and Sulla coronaria, which were subjected to 200mM NaCl over 20days. Changes in membrane lipid peroxidation, chloroplast lipids content, fatty acids (FA) composition and the ultrastructure of chloroplasts under salt stress were investigated. Chloroplast lipids were separated and quantified by high performance liquid chromatography coupled to evaporative light scattering detection (HPLC/ELSD). The results showed that salinity induced a significant decrease in digalactosyldiacylglycerol (DGDG), phosphatidylglycerol (PG) and sulfoquinovosylglycerol (SQDG) content in both S. carnosa and S. coronaria leaves, whereas monogalactosyldiacylglycerol (MGDG) content did not change significantly in S. carnosa leaves. The MGDG/DGDG ratio remained stable in S. coronaria leaves but increased in those of S. carnosa. In addition, the unsaturated-to-saturated fatty acids ratio (UFAs:SFAs) did not change under salt stress in S. coronaria leaves, while it decreased significantly in S. carnosa leaves. Moreover, salinity did not induce significant changes in MGDG and DGDG unsaturation level in S. carnosa leaves, in contrast to S. coronaria, in which salinity seems to enhance the unsaturation level in MGDG, DGDG and PG. Furthermore, the level of membrane lipid peroxidation, as expressed by malondialdehyde (MDA) levels, increased at 200mM in S. carnosa leaves, while it did not change significantly in those of S. coronaria. With respect to the ultrastructure of chloroplasts at 200mM NaCl, investigated by transmission electron microscopy (TEM), salt-stress caused the swelling of thylakoids in S. carnosa mesophyll. These ultrastructural changes were observed especially in the spongy tissue in S. coronaria. Taken together, these findings suggest that the stability of MGDG/DGDG ratio, the unchanged unsaturation level, and increasing unsaturation

  5. Physiological responses and antioxidant enzyme changes in Sulla coronaria inoculated by cadmium resistant bacteria.

    PubMed

    Chiboub, Manel; Jebara, Salwa Harzalli; Saadani, Omar; Fatnassi, Imen Challougui; Abdelkerim, Souhir; Jebara, Moez

    2017-08-14

    Plant growth promoting bacteria (PGPB) may help to reduce the toxicity of heavy metals on plants growing in polluted soils. In this work, Sulla coronaria inoculated with four Cd resistant bacteria (two Pseudomonas spp. and two Rhizobium sullae) were cultivated in hydroponic conditions treated by Cd; long time treatment 50 µM CdCl2 for 30 days and short time treatment; 100 µM CdCl2 for 7 days. Results showed that inoculation with Cd resistant PGPB enhanced plant biomass, thus shoot and root dry weights of control plants were enhanced by 148 and 35% respectively after 7 days. Co-inoculation of plants treated with 50 and 100 µM Cd increased plant biomasses as compared to Cd-treated and uninoculated plants. Cadmium treatment induced lipid peroxidation in plant tissues measured through MDA content in short 7 days 100 µM treatment. Antioxidant enzyme studies showed that inoculation of control plants enhanced APX, SOD and CAT activities after 30 days in shoots and SOD, APX, SOD, GPOX in roots. Application of 50 µM CdCl2 stimulated all enzymes in shoots and decreased SOD and CAT activities in roots. Moreover, 100 µM of CdCl2 increased SOD, APX, CAT and GPOX activities in shoots and increased significantly CAT activity in roots. Metal accumulation depended on Cd concentration, plant organ and time of treatment. Furthermore, the inoculation enhanced Cd uptake in roots by 20% in all treatments. The cultivation of this symbiosis in Cd contaminated soil or in heavy metal hydroponically treated medium, showed that inoculation improved plant biomass and increased Cd uptake especially in roots. Therefore, the present study established that co-inoculation of S. coronaria by a specific consortium of heavy metal resistant PGPB formed a symbiotic system useful for soil phytostabilization.

  6. The Effect on the Transcriptome of Anemone coronaria following Infection with Rust (Tranzschelia discolor)

    PubMed Central

    Laura, Marina; Borghi, Cristina; Bobbio, Valentina; Allavena, Andrea

    2015-01-01

    In order to understand plant/pathogen interaction, the transcriptome of uninfected (1S) and infected (2I) plant was sequenced at 3’end by the GS FLX 454 platform. De novo assembly of high-quality reads generated 27,231 contigs leaving 37,191 singletons in the 1S and 38,393 in the 2I libraries. ESTcalc tool suggested that 71% of the transcriptome had been captured, with 99% of the genes present being represented by at least one read. Unigene annotation showed that 50.5% of the predicted translation products shared significant homology with protein sequences in GenBank. In all 253 differential transcript abundance (DTAs) were in higher abundance and 52 in lower abundance in the 2I library. 128 higher abundance DTA genes were of fungal origin and 49 were clearly plant sequences. A tBLASTn-based search of the sequences using as query the full length predicted polypeptide product of 50 R genes identified 16 R gene products. Only one R gene (PGIP) was up-regulated. The response of the plant to fungal invasion included the up-regulation of several pathogenesis related protein (PR) genes involved in JA signaling and other genes associated with defense response and down regulation of cell wall associated genes, non-race-specific disease resistance1 (NDR1) and other genes like myb, presqualene diphosphate phosphatase (PSDPase), a UDP-glycosyltransferase 74E2-like (UGT). The DTA genes identified here should provide a basis for understanding the A. coronaria/T. discolor interaction and leads for biotechnology-based disease resistance breeding. PMID:25768012

  7. Characterization of efficient plant-growth-promoting bacteria isolated from Sulla coronaria resistant to cadmium and to other heavy metals.

    PubMed

    Chiboub, Manel; Saadani, Omar; Fatnassi, Imen Challougui; Abdelkrim, Souhir; Abid, Ghassen; Jebara, Moez; Jebara, Salwa Harzalli

    2016-01-01

    The inoculation of plants with plant-growth-promoting rhizobacteria has become a priority in the phytoremediation of heavy-metal-contaminated soils. A total of 82 bacteria were isolated from Sulla coronaria root nodules cultivated on four soil samples differently contaminated by heavy metals. The phenotypic characterization of these isolates demonstrated an increased tolerance to cadmium reaching 4.1mM, and to other metals, including Zn, Cu and Ni. Polymerase Chain Reaction/Restriction Fragment Length Polymorphism (PCR/RFLP) analysis showed a large diversity represented by genera related to Agrobacterium sp., R. leguminosarum, Sinorhizobium sp., Pseudomonas sp., and Rhizobium sp. Their symbiotic effectiveness was evaluated by nodulation tests. Taking into consideration efficiency and cadmium tolerance, four isolates were chosen; their 16SrRNA gene sequence showed that they belonged to Pseudomonas sp. and the Rhizobium sullae. The selected consortium of soil bacteria had the ability to produce plant-growth-promoting substances such as indole acetic acid and siderophore. The intracellular Cd accumulation was enhanced by increasing the time of incubation of the four soil bacteria cultivated in a medium supplemented with 0.1mM Cd. The existence of a cadmium-resistant gene was confirmed by PCR. These results suggested that Sulla coronaria in symbiosis with the consortium of plant-growth-promoting rhizobacteria (PGPR) could be useful in the phytoremediation of cadmium-contaminated soils.

  8. Crystallization and preliminary X-ray diffraction studies of the cysteine protease ervatamin A from Ervatamia coronaria

    SciTech Connect

    Chakraborty, Sibani; Biswas, Sampa; Chakrabarti, Chandana; Dattagupta, Jiban K.

    2005-06-01

    Ervatamin A is a papain-family cysteine protease with high activity and stability. It has been isolated and purified from the latex of the medicinal flowering plant E. coronaria and crystallized by the vapour-diffusion technique. Crystals diffracted to 2.1 Å and the structure was solved by molecular replacement. The ervatamins are highly stable cysteine proteases that are present in the latex of the medicinal plant Ervatamia coronaria and belong to the papain family, members of which share similar amino-acid sequences and also a similar fold comprising two domains. Ervatamin A from this family, a highly active protease compared with others from the same source, has been purified to homogeneity by ion-exchange chromatography and crystallized by the vapour-diffusion method. Needle-shaped crystals of ervatamin A diffract to 2.1 Å resolution and belong to space group C222{sub 1}, with unit-cell parameters a = 31.10, b = 144.17, c = 108.61 Å. The solvent content using an ervatamin A molecular weight of 27.6 kDa is 43.9%, with a V{sub M} value of 2.19 Å{sup 3} Da{sup −1} assuming one protein molecule in the asymmetric unit. A molecular-replacement solution has been found using the structure of ervatamin C as a search model.

  9. Isolation and 1H/13C-NMR Studies on 19,20-Dihydrocondylocarpine: An Alkaloid from the Leaves of Ervatamia coronaria and Alstonia scholaris.

    PubMed

    Atta-ur-Rahman; Alvi, K A; Muzaffar, A

    1986-08-01

    Studies on the alkaloidal constituents of the leaves of Ervatamia coronaria Stapf and Alstonia scholaris have resulted in the isolation of (20 S)-19,20-dihydrocondylocarpine which has not been previously reported from these plants. The stereochemistry at C-20 was established with the help of n. O. e. difference measurements. (13)C-NMR assignments have been made by polarisation transfer techniques.

  10. Variation of Chemical Composition in Flowers and Leaves Essential Oils Among Natural Population of Tunisian Glebionis coronaria (L.) Tzvelev (Asteraceae).

    PubMed

    Haouas, Dalila; Cioni, Pier Luigi; Flamini, Guido; Ben Halima-Kamel, Monia; Ben Hamouda, Mohamed Habib

    2016-10-01

    The aim of this study was to assess the percentage and constituents variations in flowers and leaves essential oil of three Glebionis coronaria (L.) Tzvelev population, growing wildly in three different ecotypes (Utique, M'saken, and Sahara Lektar) in Tunisia. The chemical compositions of these essential oils were analyzed by the GC and GC/MS systems. Qualitative and quantitative differences were recorded between essential oils extracted from plants collected from the three geographical provinces and between organs of the same plant (leaves and flowers). In fact, 161 components representing 87.2 - 96.5% of the whole oils were identified. Myrcene (3.2 - 35.7%), (Z)-β-ocimene (0.6 - 23.0%), camphor (0.6 - 17.2%), cis-chrysanthenol (0 - 6.9%), cis-chrysanthenyl acetate (1.1 - 17.9%), isobornyl acetate (1.6 - 3.5%), (E)-β-farnesene (0 - 6.0%), germacrene D (0 - 8.7%), and (E,E)-α-farnesene (0.7 - 12.4%) were the predominant components in the oils. These major constituents occur in different amounts depending on the organs (leaves or flowers) and the geographical origin of the plant. The chemotaxonomic usefulness of these data was discussed according to results of principal component analysis (PCA). The scores, together with the loadings, revealed a different chemical pattern for each population.

  11. El Renacer de Maestras Bilingues: Actualizing Cultural Efficaciousness

    ERIC Educational Resources Information Center

    Garcia, Claudia Trevino

    2016-01-01

    This study focused attention on three constructs as they relate to bilingual education teachers' (BETs) dispositions working with culturally and linguistically diverse students (CLDS). The three constructs are sociocultural consciousness, affirming advocacy, and culturally responsive teaching. The quantitative data was collected via a Likert-based…

  12. El Renacer de Maestras Bilingues: Actualizing Cultural Efficaciousness

    ERIC Educational Resources Information Center

    Garcia, Claudia Trevino

    2016-01-01

    This study focused attention on three constructs as they relate to bilingual education teachers' (BETs) dispositions working with culturally and linguistically diverse students (CLDS). The three constructs are sociocultural consciousness, affirming advocacy, and culturally responsive teaching. The quantitative data was collected via a Likert-based…

  13. PubMed

    Fernandez-Gallego, V; Hernández Herrera, G; Moreno Arciniegas, A; Moreno Rolando, E

    2016-12-30

    Presentamos el caso de un paciente que sufrió una parada cardiorrespiratoria extrahospitalaria en helicóptero sanitario, refractaria a tratamiento médico y eléctrico convencional. El paciente recuperó la circulación espontánea tras 58 minutos en paro cardiaco y 31 descargas eléctricas, estando monitorizado en todo momento de la reanimación cardiopulmonar con capnografía (valores > 20 mm/Hg). A su llegada al hospital, se le realizó una angioplastia primaria, colocándosele un stent en la arteria coronaria derecha. El paciente fue dado de alta hospitalaria, sin secuelas neurológicas (categoría de función cerebral 1).

  14. Amlodipine reduces predicted risk of coronary heart disease in high-risk patients with hypertension in Spain (The CORONARIA Study).

    PubMed

    Zamorano, J; Rodriguez Padial, L; Cosín, J; Hernandiz, A; Gutierrez-Chico, J L; Pérez de Isla, L; Arístegui, R; Masramon, X

    2008-01-01

    We evaluated the efficacy and safety of amlodipine besylate alone or in combination with other antihypertensive agents in high-risk hypertensive patients in Spanish primary care. In this 1-year, open-label, prospective cohort study, 7468 patients were treated with amlodipine 5 - 10 mg as a monotherapy or as an add-on therapy to attain blood pressure control (target of < 140/90 mmHg or, in patients with conditions such as diabetes or chronic kidney disease, < 130/85 mmHg). At 12 months, the primary outcome (change from baseline in predicted 10-year coronary heart disease risk) was -8.6%, down from 24.7% at baseline (relative risk reduction, 31.6%). Change in blood pressure from baseline (162.5/95.3 mmHg) was -26.7/-14.6 mmHg, and 38.6% of patients achieved their blood pressure target. In summary, significant reductions in predicted coronary heart disease risk and blood pressure were observed with amlodipine both as a monotherapy and as an add-on therapy. Amlodipine was well tolerated and compliance with treatment was good.

  15. Descriptive study on neural tube defects in Argentina.

    PubMed

    Sargiotto, Carla; Bidondo, María Paz; Liascovich, Rosa; Barbero, Pablo; Groisman, Boris

    2015-06-01

    Neural tube defects (NTDs) are the most common congenital anomalies of the central nervous system. Prevalence of NTDs varies depending on geographic region and folic acid fortification. The main objectives of this study are to analyze the prevalences of NTDs reported to the National Registry of Congenital Anomalies of Argentina (RENAC) during the period 2009 to 2013, to compare them with data from other selected surveillance systems of the Americas, and to evaluate the impact of folic acid fortification on the prevalence of NTDs in Argentina. We analyzed changes in prevalence between 2009 and 2013 for the RENAC, and differences in prevalence between RENAC and other surveillance systems. We evaluated changes for the pre and postfortification time periods in Argentina. In Argentina, anencephaly and spina bifida showed no statistically significant variation between 2009 and 2013, and encephalocele showed a statistically significant decline. The RENAC showed a statistically significant higher prevalence for all three defects when compared with surveillance systems from Chile, Colombia, and Costa Rica, and a statistically significant lower birth prevalence than Cuba for anencephaly. No differences were observed when comparing it to the Atlanta-USA and Mexico systems. A significant decrease in prevalence was observed for all three anomalies for the postfortification period in Argentina. The characteristics of cases reported to the RENAC are similar to those already reported in the literature. The differences in prevalence between the RENAC and other surveillance systems could be artifactual or real. We confirmed the decrease of prevalence of NTDs after folic acid fortification. © 2015 Wiley Periodicals, Inc.

  16. [Variability in the in-hospital management of acute myocardial infarction in Spain. IBERICA Study (Investigación, Búsqueda Específica y Registro de Isquemia Coronaria Aguda)].

    PubMed

    Fiol, M; Cabadés, A; Sala, J; Marrugat, J; Elosua, R; Vega, G; José Tormo Díaz, M; Segura, A; Aldasoro, E; Moreno-Iribas, C; Muñiz, J; Hurtado de Saracho, I; García, J

    2001-04-01

    Introduction and objective. Although some in-hospital studies have described the management of acute myocardial infarction (MI) patients in Spain, none has been able to guarantee the exhaustiveness of patient registry. This study sought to determine the clinical characteristics and in-hospital management of patients with MI in eight Spanish population registries.Methods. The IBERICA study is a population-based MI registry carried out in the 25 to 74 year-old population, in eight Spanish regions in 1997. A standardized methodology was used to register and investigate all MI arriving alive to a hospital. Clinical characteristics, cardiovascular risk factors prevalence, pharmacological treatment, invasive and non-invasive procedures performed and complications at 28 days of evolution were recorded. A descriptive analysis was performed and the variation coefficient (VC) was calculated.Results. In 1997, 4,041 MI patients were registered, 79.9% were men with a mean age of 61.1 years. Although 10.9% (95% CI: 9.9-11.9%) were not admitted to the coronary care unit, a large variability existed among different areas (VC = 53%). There was a high variability in the utilization and performance of non-invasive and invasive procedures among regions, as well as in the use of pharmacological treatment. Only the use of antiaggregants (91.5%) and thrombolytic therapy (41.8%) showed a low variability (VC < 10%). Twenty-eight day mortality was 16.2% (95% CI: 15.1-17.4%) with a high variability being observed among the different regions (VC = 20.6%).Conclusion. Patient characteristics vary among the different Spanish regions. The differences in management and prognosis suggest a lack of equality in the health care provided to MI patients in the different regions in Spain.

  17. Macroanatomy of coronary arteries in Bactrian camel (Camelus bactrianus).

    PubMed

    Yuan, Guoqiang; Ma, Jinghong; Ye, Wenling; Bai, Zhongtian; Wang, Jianlin

    2009-04-01

    The aim of present study was to determine the origin, distribution and course of the coronary arteries in Bactrian camels. Ten hearts of adult healthy Bactrian camels of different sex constituted the material. Following exposition of the arteries by means of injection of 15% ABS coloured with red carmine to a. coronaria sinistra and a. coronaria dextra, dissection was performed. The arterial vascularization of the heart in Bactrian camels was determined to be supplied by a. coronaria sinistra and a. coronaria dextra which originate from the aorta. The results showed that ramus interventricularis subsinuosus is one branch of a. coronaria dextra in Bactrian camels, which is characteristic of a. coronaria dextra pattern. Ramus septi interventricularis that supplied the interventricular septum mainly originates from ramus interventricular paraconalis. Two muscular bridges ware observed crossing ramus interventricular paraconalis in the middle third of sulcus interventricularis paraconalis. Muscular bridge was not found above ramus interventricularis subsinuosus in this study.

  18. Cell-specific expression of epithelial sodium channel alpha, beta, and gamma subunits in aldosterone-responsive epithelia from the rat: localization by in situ hybridization and immunocytochemistry

    PubMed Central

    1994-01-01

    A highly selective, amiloride-sensitive, epithelial sodium channel from rat colon (rENaC), composed of three homologous subunits termed alpha, beta, and gamma rENaC, has been cloned by functional expression and was proposed to mediate electrogenic sodium reabsorption in aldosterone- responsive epithelia. To determine whether rENaC could account for sodium absorption in vivo, we studied the cellular localization of the sodium channel messenger RNA subunits by in situ hybridization and their cellular and subcellular distribution by immunocytochemistry in the kidney, colon, salivary, and sweat glands of the rat. In the kidney, we show that the three subunit mRNAs are specifically co- expressed in the renal distal convoluted tubules (DCT), connecting tubules (CNT), cortical collecting ducts (CCD), and outer medullary collecting ducts (OMCD), but not in the inner medullary collecting ducts (IMCD). We demonstrate co-localization of alpha, beta, and gamma subunit proteins in the apical membrane of a majority of cells of CCD and OMCD. Our data indicate that alpha, beta, and gamma subunit mRNAs and proteins are co-expressed in the distal nephron (excepting IMCD), a localization that correlates with the previously described physiological expression of amiloride-sensitive electrogenic sodium transport. Our data, however, suggest that another sodium transport protein mediates electrogenic amiloride-sensitive sodium reabsorption in IMCD. We also localized rENaC to the surface epithelial cells of the distal colon and to the secretory ducts of the salivary gland and sweat gland, providing further evidence consistent with the hypothesis that the highly selective, amiloride-sensitive sodium channel is physiologically expressed in aldosterone-responsive cells. PMID:7806569

  19. Bioactivity-guided isolation of cytotoxic constituents from three medicinal plants.

    PubMed

    Hullatti, Kirankumar; Pathade, Namrata; Mandavkar, Yuvaraj; Godavarthi, Ashok; Biradi, Mahesh

    2013-05-01

    The ethanol extracts and their fractions of three Indian medicinal plants, Ervatamia coronaria (Jacq.) Stapf, (Apocynaceae), Mimosa pudica L. (Mimosaceae) and Caesalpinia bonduc (L.) Roxb. (Caesalpiniaceae) were tested for their cytotoxic activity in the brine shrimp lethality (BSL) bioassay and in various cancer cell lines. The plants were selected based on their traditional use in the treatment of cancer/tumors. To investigate the in vitro cytotoxicity of Ervatamia coronaria, Mimosa pudica and Caesalpinia bonduc. Ethanolic extracts and their fractions of E. coronaria, M. pudica and C. bonduc were subjected to cytotoxicity studies using BSL bioassay method with concentrations of 10, 50, 100, 500 and 1000 µg/ml. The alkaloid fraction of E. coronaria with significant cytotoxicity in BSL bioassay was subjected to in vitro cytotoxicity studies with HT-29, A-549, HepG-2, MCF-7 and L-6 cell lines at concentrations of 12.5, 25, 50, 100 and 200 µg/ml and a DNA fragmentation study using the HT-29 cell line. The alkaloid fractions of E. coronaria and M. pudica showed significant cytotoxicity with LC50 values of 65.83 and 85.10 µg/ml in the BSL bioassay, respectively. The purified alkaloid fraction of E. coronaria exhibited highest cytotoxicity in HT-29, A-549 and MCF-7 cell lines with IC50 values of 32.5, 47.5 and 72.5 µg/ml, respectively, and induced DNA fragmentation in the HT-29 cell line at a concentration of 65 µg/ml. The alkaloid fraction of E. coronaria exhibited significant cytotoxicity. Alkaloids such as ervatamine, apparicine and coronaridine that were earlier reported may be responsible for this activity.

  20. Absence of prenatal ultrasound surveillance: Data from the Portuguese congenital anomalies registry.

    PubMed

    Correia, Sandrina; Machado, Ausenda; Braz, Paula; Rodrigues, Ana Paula; Matias-Dias, Carlos

    2016-06-01

    In Portugal, prenatal care guidelines advocate two prenatal ultrasound scans for all pregnant women. Not following this recommendation is considered inadequate prenatal surveillance. The National Registry of Congenital Anomalies (RENAC in Portuguese) is an active population-based registry and an important instrument for the epidemiological surveillance of congenital anomalies (CA) in Portugal. Regarding pregnancies with CA, this study aims to describe the epidemiology of absent prenatal ultrasound scans and factors associated with this inadequate surveillance. A cross-sectional comparative study from 2008 to 2013 was carried out using data from RENAC. Associations of nonuptake of prenatal ultrasound screening with socio-demographic health behaviors and obstetric history data were evaluated using multiple logistic regression. Potential confounders were investigated and included if they changed the crude odds ratio estimate by at least 10% after adjustment by the Mantel-Haenszel method. The statistical significance level was set at 5%. Overall, 6090 notifications of congenital anomalies were reported to RENAC, and 2% of the pregnant women reported no prenatal ultrasound screening surveillance. These women were on average aged 30.0 years, and 52.8% had no professional occupation. The odds of not performing an ultrasound scan during their pregnancy increased 2.47 times with lack of professional activity, 4.67 times in non-Caucasian women, and decreased 46% for any previous miscarriage. For pregnant women who did not receive an ultrasound screening examination during pregnancy, the strongest statistically associated factors were professional occupation, ethnicity, and number of miscarriages in previous gestations. Birth Defects Research (Part A) 106:489-493, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  1. [Endovascular treatment of critical basilar stenosis with a Solitaire® stent device: a first experience in our centre].

    PubMed

    Mulero, Patricia; Cortijo-García, Elisa; Ruiz-Piñero, Marina; Pérez-Fernández, Santiago; Arenillas-Lara, Juan F; Martínez-Galdámez, Mario

    2014-08-01

    Introduccion. Aunque la arterioesclerosis intracraneal es una causa importante de ictus, la actitud terapeutica no esta claramente establecida. En este sentido, el estudio SAMMPRIS comparo el tratamiento medico intensivo con la angioplastia y colocacion de stent, con resultados favorables al tratamiento farmacologico. Estos resultados podrian, en parte, deberse al dispositivo utilizado (stent Wingspan ®). Caso clinico. Varon de 71 años con una estenosis grave de la arteria basilar, en quien se repetian episodios de focalidad neurologica transitoria a pesar del tratamiento con doble antiagregacion y estatinas. En estas circunstancias se decidio realizar una arteriografia terapeutica con angioplastia y colocacion de un stent Solitaire ® para optimizar resultados y se logro una estenosis residual del 40%. La evolucion fue favorable y los controles posteriores muestran una minima progresion. Conclusion. Segun nuestro conocimiento, este es el primer caso publicado de tratamiento de una estenosis critica de la arteria basilar mediante la colocacion de un stent Solitaire ®.

  2. Ovicidal and repellent activities of botanical extracts against Culex quinquefasciatus, Aedes aegypti and Anopheles stephensi (Diptera: Culicidae)

    PubMed Central

    Govindarajan, M; Mathivanan, T; Elumalai, K; Krishnappa, K; Anandan, A

    2011-01-01

    Objective To determine the ovicidal and repellent activities of methanol leaf extract of Ervatamia coronaria (E. coronaria) and Caesalpinia pulcherrima (C. pulcherrima) against Culex quinquefasciatus (Cx. quinquefasciatus), Aedes aegypti (Ae. aegypti) and Anopheles stephensi (An. stephensi). Methods The ovicidal activity was determined against three mosquito species at various concentrations ranging from 50-450 ppm under the laboratory conditions. The hatch rates were assessed 48 h after treatment. The repellent efficacy was determined against three mosquito species at three concentrations viz., 1.0, 2.5 and 5.0 mg/cm2 under the laboratory conditions. Results The crude extract of E. coronaria exerted zero hatchability (100% mortality) at 250, 200 and 150 ppm for Cx. quinquefasciatus, Ae. aegypti and An. stephensi, respectively. The crude extract of C. pulcherrima exerted zero hatchability (100% mortality) at 375, 300 and 225 ppm for Cx. quinquefasciatus, Ae. aegypti and An. Stephensi, respectively. The methanol extract of E. coronaria found to be more repellenct than C. pulcherrima extract. A higher concentration of 5.0 mg/cm2 provided 100% protection up to 150, 180 and 210 min against Cx. quinquefasciatus, Ae. aegypti and An. stephensi, respectively. The results clearly showed that repellent activity was dose dependent. Conclusions From the results it can be concluded the crude extracts of E. coronaria and C. pulcherrima are an excellent potential for controlling Cx. quinquefasciatus, Ae. aegypti and An. stephensi mosquitoes. PMID:23569723

  3. Sirenomelia in Argentina: Prevalence, geographic clusters and temporal trends analysis.

    PubMed

    Groisman, Boris; Liascovich, Rosa; Gili, Juan Antonio; Barbero, Pablo; Bidondo, María Paz

    2016-07-01

    Sirenomelia is a severe malformation of the lower body characterized by a single medial lower limb and a variable combination of visceral abnormalities. Given that Sirenomelia is a very rare birth defect, epidemiological studies are scarce. The aim of this study is to evaluate prevalence, geographic clusters and time trends of sirenomelia in Argentina, using data from the National Network of Congenital Anomalies of Argentina (RENAC) from November 2009 until December 2014. This is a descriptive study using data from the RENAC, a hospital-based surveillance system for newborns affected with major morphological congenital anomalies. We calculated sirenomelia prevalence throughout the period, searched for geographical clusters, and evaluated time trends. The prevalence of confirmed cases of sirenomelia throughout the period was 2.35 per 100,000 births. Cluster analysis showed no statistically significant geographical aggregates. Time-trends analysis showed that the prevalence was higher in years 2009 to 2010. The observed prevalence was higher than the observed in previous epidemiological studies in other geographic regions. We observed a likely real increase in the initial period of our study. We used strict diagnostic criteria, excluding cases that only had clinical diagnosis of sirenomelia. Therefore, real prevalence could be even higher. This study did not show any geographic clusters. Because etiology of sirenomelia has not yet been established, studies of epidemiological features of this defect may contribute to define its causes. Birth Defects Research (Part A) 106:604-611, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. [Biofeedback effectiveness in patients with fecal incontinence].

    PubMed

    Guerra-Mora, José Raúl; Buenrostro-Acebes, José María; Erciga-Vergara, Nancy; Zubieta-O'Farrill, Gregorio; Castillo-Calcáneo, Juan de Dios; Mosqueda, Maria Elena; Monroy-Argumedo, Montserrat; González-Alvarado, Carlos; Villanueva-Saenz, Eduardo

    2015-01-01

    Introducción: el origen anómalo de la arteria coronaria izquierda del seno coronario derecho (ACAOS) se caracteriza porque la arteria coronaria principal izquierda se origina anómalamente del seno de valsalva aórtico coronario derecho y cuyo trayecto puede seguir cuatro diferentes caminos hacia el lado izquierdo del corazón. Caso clínico: masculino de 73 años de edad, que ingresó al hospital por dolor precordial de tipo opresivo, intensidad 10/10 con irradiación a brazo izquierdo y cuello, acompañado de diaforesis y nausea. El diagnóstico fue de un síndrome isquémico coronario agudo sometido a terapia trombolítica Su evolución posterior fue no satisfactoria debido a diferentes complicaciones que lo llevaron a la muerte. Conclusiones: el diagnóstico del origen anómalo de la arteria coronaria izquierda del seno opuesto (ACAOS), se establece únicamente a través de métodos de diagnósticos como la angiotomografía computada cardiaca o un cateterismo cardiaco como parte del abordaje de un síndrome isquémico coronario agudo que permiten establecer las características morfológicas de las arterias coronarias como las diferentes variantes anatómicas y sus características particulares respecto a las estructuras adyacentes.

  5. [Anomalous origin of the left coronary artery from the opposite breast. Pathological case].

    PubMed

    Valencia-Sánchez, Jesús Salvador; Moreno-Vázquez, Alejandra; González-Díaz, Belinda; Valencia-Palacios, Beatriz Elizabeth

    2015-01-01

    Introducción: el origen anómalo de la arteria coronaria izquierda del seno coronario derecho (ACAOS) se caracteriza porque la arteria coronaria principal izquierda se origina anómalamente del seno de valsalva aórtico coronario derecho y cuyo trayecto puede seguir cuatro diferentes caminos hacia el lado izquierdo del corazón. Caso clínico: masculino de 73 años de edad, que ingresó al hospital por dolor precordial de tipo opresivo, intensidad 10/10 con irradiación a brazo izquierdo y cuello, acompañado de diaforesis y nausea. El diagnóstico fue de un síndrome isquémico coronario agudo sometido a terapia trombolítica Su evolución posterior fue no satisfactoria debido a diferentes complicaciones que lo llevaron a la muerte. Conclusiones: el diagnóstico del origen anómalo de la arteria coronaria izquierda del seno opuesto (ACAOS), se establece únicamente a través de métodos de diagnósticos como la angiotomografía computada cardiaca o un cateterismo cardiaco como parte del abordaje de un síndrome isquémico coronario agudo que permiten establecer las características morfológicas de las arterias coronarias como las diferentes variantes anatómicas y sus características particulares respecto a las estructuras adyacentes.

  6. Impact of pneumococcal conjugate vaccine in children morbidity and mortality in Peru: Time series analyses.

    PubMed

    Suarez, Victor; Michel, Fabiana; Toscano, Cristiana M; Bierrenbach, Ana Luiza; Gonzales, Marco; Alencar, Airlane Pereira; Ruiz Matus, Cuauhtemoc; Andrus, Jon K; de Oliveira, Lucia H

    2016-09-07

    Streptococcus pneumoniae is the leading cause of bacterial pneumonia, meningitis and sepsis in children worldwide. Despite available evidence on pneumococcal conjugate vaccine (PCV) impact on pneumonia hospitalizations in children, studies demonstrating PCV impact in morbidity and mortality in middle-income countries are still scarce. Given the disease burden, PCV7 was introduced in Peru in 2009, and then switched to PCV10 in late 2011. National public healthcare system provides care for 60% of the population, and national hospitalization, outpatient and mortality data are available. We thus aimed to assess the effects of routine PCV vaccination on pneumonia hospitalization and mortality, and acute otitis media (AOM) and all cause pneumonia outpatient visits in children under one year of age in Peru. We conducted a segmented time-series analysis using outcome-specific regression models. Study period was from January 2006 to December 2012. Data sources included the National information systems for hospitalization, mortality, outpatient visits, and RENACE, the national database of aggregated weekly notifications of pneumonia and other acute respiratory diseases (both hospitalized and non-hospitalized). Study outcomes included community acquired pneumonia outpatient visits, hospitalizations and deaths (ICD10 codes J12-J18); and AOM outpatient visits (H65-H67). Monthly age- and sex-specific admission, outpatient visit, and mortality rates per 100,000 children aged <1year, as well as weekly rates for pneumonia and AOM recorded in RENACE were estimated. After PCV introduction, we observed significant vaccine impact in morbidity and mortality in children aged <1year. Vaccine effectiveness was 26.2% (95% CI 16.9-34.4) for AOM visits, 35% (95% CI 8.6-53.8) for mortality due to pneumonia, and 20.6% (95% CI 10.6-29.5) for weekly cases of pneumonia hospitalization and outpatient visits notified to RENACE. We used secondary data sources which are usually developed for other non

  7. Strategies to achieve sustainability and quality in birth defects registries: the experience of the National Registry of Congenital Anomalies of Argentina.

    PubMed

    Groisman, Boris; Bidondo, Maria Paz; Gili, Juan Antonio; Barbero, Pablo; Liascovich, Rosa

    2013-01-01

    In many low-and middle-income countries, birth defects are not considered a public health priority and are perceived by the medical community as rare, unpreventable events. In this context, a registry of birth defects should address not only the collection, analysis, and dissemination of information but also contribute to local interventions like prevention, diagnosis, and treatment. We describe the National Registry of Congenital Anomalies of Argentina (RENAC) in terms of case definition, data collection, quality assurance, and data sending, coding, analysis, and information dissemination and we present the strategies used to ensure its sustainability. We emphasize strategies for motivating the people collecting data, such as training activities, participation in research projects, returning the processed data, making useful clinical information available, giving non-monetary rewards, and linking cases to genetic services.

  8. Mechanisms of EGF-induced stimulation of sodium reabsorption by alveolar epithelial cells.

    PubMed

    Danto, S I; Borok, Z; Zhang, X L; Lopez, M Z; Patel, P; Crandall, E D; Lubman, R L

    1998-07-01

    We investigated the effects of epidermal growth factor (EGF) on active Na+ absorption by alveolar epithelium. Rat alveolar epithelial cells (AEC) were isolated and cultivated in serum-free medium on tissue culture-treated polycarbonate filters. mRNA for rat epithelial Na+ channel (rENaC) alpha-, beta-, and gamma-subunits and Na+ pump alpha1- and beta1-subunits were detected in day 4 monolayers by Northern analysis and were unchanged in abundance in day 5 monolayers in the absence of EGF. Monolayers cultivated in the presence of EGF (20 ng/ml) for 24 h from day 4 to day 5 showed an increase in both alpha1 and beta1 Na+ pump subunit mRNA but no increase in rENaC subunit mRNA. EGF-treated monolayers showed parallel increases in Na+ pump alpha1- and beta1-subunit protein by immunoblot relative to untreated monolayers. Fixed AEC monolayers demonstrated predominantly membrane-associated immunofluorescent labeling with anti-Na+ pump alpha1- and beta1-subunit antibodies, with increased intensity of cell labeling for both subunits seen at 24 h following exposure to EGF. These changes in Na+ pump mRNA and protein preceded a delayed (>12 h) increase in short-current circuit (measure of active transepithelial Na+ transport) across monolayers treated with EGF compared with untreated monolayers. We conclude that EGF increases active Na+ resorption across AEC monolayers primarily via direct effects on Na+ pump subunit mRNA expression and protein synthesis, leading to increased numbers of functional Na+ pumps in the basolateral membranes.

  9. Epidermal growth factor regulation in adult rat alveolar type II cells of amiloride-sensitive cation channels.

    PubMed

    Kemp, P J; Borok, Z; Kim, K J; Lubman, R L; Danto, S I; Crandall, E D

    1999-12-01

    Using the patch-clamp technique, we studied the effects of epidermal growth factor (EGF) on whole cell and single channel currents in adult rat alveolar epithelial type II cells in primary culture in the presence or absence of EGF for 48 h. In symmetrical sodium isethionate solutions, EGF exposure caused a significant increase in the type II cell whole cell conductance. Amiloride (10 microM) produced approximately 20-30% inhibition of the whole cell conductance in both the presence and absence of EGF, such that EGF caused the magnitude of the amiloride-sensitive component to more than double. Northern analysis showed that alpha-, beta- and gamma-subunits of rat epithelial Na(+) channel (rENaC) steady-state mRNA levels were all significantly decreased by EGF. At the single channel level, all active inside-out patches demonstrated only 25-pS channels that were amiloride sensitive and relatively nonselective for cations (P(Na(+))/P(K(+)) approximately 1.0:0.48). Although the biophysical characteristics (conductance, open-state probability, and selectivity) of the channels from EGF-treated and untreated cells were essentially identical, channel density was increased by EGF; the modal channel per patch was increased from 1 to 2. These findings indicate that EGF increases expression of nonselective, amiloride-sensitive cation channels in adult alveolar epithelial type II cells. The contribution of rENaC to the total EGF-dependent cation current under these conditions is quantitatively less important than that of the nonselective cation channels in these cells.

  10. Mosquito larvicidal, ovicidal, and repellent properties of botanical extracts against Anopheles stephensi, Aedes aegypti, and Culex quinquefasciatus (Diptera: Culicidae).

    PubMed

    Govindarajan, M; Mathivanan, T; Elumalai, K; Krishnappa, K; Anandan, A

    2011-08-01

    Mosquito-borne diseases have an economic impact, including loss in commercial and labor outputs, particularly in countries with tropical and subtropical climates; however, no part of the world is free from vector-borne diseases. In mosquito control programs, botanical origin may have the potential to be used successfully as eggs, larvae, and adult. The larvicidal, ovicidal, and repellent activities of crude benzene and ethyl acetate extracts of leaf of Ervatamia coronaria and Caesalpinia pulcherrima were assayed for their toxicity against three important vector mosquitoes, viz., Anopheles stephensi, Aedes aegypti, and Culex quinquefasciatus (Diptera: Culicidae). The larval mortality was observed after 24 h of exposure. All extracts showed moderate larvicidal effects; however, the highest larval mortality was found in benzene extract of E. coronaria against the larvae of Anopheles Stephensi, Aedes aegypti, and Culex quinquefasciatus with the LC(50) and LC(90) values were 79.08, 89.59, and 96.15 ppm and 150.47, 166.04, and 174.10 ppm, respectively. Mean percent hatchability of the ovicidal activity was observed 48 h posttreatment. The percent hatchability was inversely proportional to the concentration of extract and directly proportional to the eggs. The leaf extract of E. coronaria was found to be most effective than Caesalpinia pulcherrima against eggs/egg rafts of three vector mosquitoes. For E. coronaria, the benzene extract exerted 300, 250, and 200 ppm against Anopheles stephensi, Aedes aegypti, and Culex quinquefasciatus, respectively. The results of the repellent activity of benzene and ethyl acetate extract of E. coronaria and Caesalpinia pulcherrima plants at three different concentrations of 1.0, 2.5, and 5.0 mg/cm(2) were applied on skin of fore arm in man and exposed against adult female mosquitoes. In this observation, these two plant crude extracts gave protection against mosquito bites without any allergic reaction to the test person, and also, the

  11. Trombosis primaria de la descendente anterior en un paciente con síndrome de anticuerpos antifosfolípidos.

    PubMed

    Acuña-Valerio, Jorge; Peña-Duque, Marco Antonio; Contreras-Villaseñor, Álvaro

    2017-01-01

    El síndrome de anticuerpos antifosfolípidos es una situación clínica y bioquímica heterogénea. Presentamos el caso de un varón joven con antecedente de tromboembolia venosa que se presentó en esta ocasión por dolor precordial, con elevación del ST en el electrocardiograma. Fue llevado a sala de angiografía para realizar angioplastia primaria y se observó una oclusión total ostial de la descendente anterior. Se realizó aspiración manual del trombo. No se realizó angioplastia con balón ni stent. En la angiografía de control a las 48 horas se observó ausencia de trombo y de placas aterosclerosas, lo cual se corroboró mediante ultrasonido intracoronario. Antiphospholipid antibody syndrome is a heterogeneous clinical and biochemical entity. We present the case of a young male with history of venous thromboembolism. This time he presents because of chest ischemic pain associated with ST segment elevation. He was taken to the cath lab to perform a primary percutaneous coronary intervention and a total occlusion of the left anterior descending artery was noted. Successful thrombus aspiration was performed. No stent was deployed. He was taken to the cath lab for a second look angiography and no atherosclerotic lesions were observed, which was confirmed by intravascular ultrasound.

  12. The epithelial sodium channel (ENaC) is intracellularly located as a tetramer.

    PubMed

    Dijkink, Lisette; Hartog, Anita; van Os, Carel H; Bindels, René J M

    2002-07-01

    The epithelial sodium channel (ENaC) plays an important role in Na(+) homeostasis by determining the Na(+) transport rate in so-called end-organs such as the renal collecting duct, distal colon, salivary and sweat gland ducts. ENaC is formed by heteromultimerization of three homologous subunits, termed alpha, beta, and gamma ENaC. The number of subunits and stoichiometry remain a matter of debate. In this study, sucrose gradient analysis of Xenopus laevis oocytes expressing rENaC revealed that ENaC forms heterotetramers, when the membrane fraction was solubilized in 0.1% (wt/vol) Na-deoxycholate. However, solubilization of the membrane proteins in higher concentrations of detergents dissociated the ENaC subunits of the tetramers in dimers. Co-immunoprecipitation studies with FLAG-tagged ENaC subunits suggest that during dissociation of ENaC tetramers the composition of dimers is completely random. Glycosidase digestion studies show that the ENaC subunits are retarded in the endoplasmic reticulum (ER) and pre-Golgi, whereas only a small fraction is inserted into the plasma membrane. Immunocytochemical analysis confirmed that ENaC is primarily located intracellularly. In addition, these findings are not restricted to the oocyte expression system, since identical results were found in rabbit connecting tubule and cortical collecting duct cells in primary culture and in rabbit colon.

  13. Evaluation of air pollution tolerance index and anticipated performance index of plants and their application in development of green space along the urban areas.

    PubMed

    Kaur, Mandeep; Nagpal, Avinash Kaur

    2017-06-26

    Air pollution due to vehicular emissions has become one of the most serious problems in the whole world and has resulted in huge threat to both the environment and the health of living organisms (plants, humans, animals, microorganisms). Plants growing along the roadsides get affected at the maximum as they are the primary recipients to different air pollutants and show varied levels of tolerance and sensitivity. Taking this into account, the present work was based on assessment of seasonal variation in air pollution tolerance index (APTI) and anticipated performance index (API) of four roadside plants, namely, Alstonia scholaris, Nerium oleander, Tabernaemontana coronaria, and Thevetia peruviana belonging to family Apocynaceae. APTI was calculated by the determination of four important biochemical parameters, viz., pH, relative water content (RWC), total chlorophyll (TChl), and ascorbic acid (AsA) content of leaves. The leaf samples were collected from plants growing at seven different sites of Amritsar (Punjab), India, for pre-monsoon and post-monsoon seasons. Highest APTI (82.14) was reported in N. oleander during the pre-monsoon season while the lowest was recorded in T. coronaria (18.59) in the post-monsoon season. On the basis of API score, A. scholaris was anticipated to be an excellent performer during the pre-monsoon and post-monsoon seasons followed by N. oleander, T. coronaria, and T. peruviana. Linear regression analysis and Pearson's correlation coefficient depicted significant positive correlation between APTI and ascorbic acid content during the pre-monsoon and post-monsoon seasons.

  14. Analysis of complications of prone position in acute respiratory distress syndrome: quality standard, incidence and related factors.

    PubMed

    Jové Ponseti, E; Villarrasa Millán, A; Ortiz Chinchilla, D

    The monitoring system based on standards of quality allows clinicians to evaluate and improve the patient's care. According to the quality indicators recommended by Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias, and due to the importance of prone position (PP) as a treatment in patients with acute respiratory distress syndrome, it is fundamental to keep accurate record of serious adverse events occurring during the prone position procedure and its posterior analysis. To establish fulfilment of the Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias standards of quality according to the register of serious complications. To identify the incidence of serious complications registered as well as to identify possible factors related to these complications. Retrospective, cross-sectionsl descriptive study, polyvalent ICU (16 beds). Study population Patients with acute respiratory distress syndrome treated with PP (January 2012-December 2013). Study variables PP recording, accidental extubation, removal of catheters, decubitus ulcers (DU), ETT obstruction, urgency of the procedure, hours in PP, nutritional intake, type of feeding tube, food regurgitation/retention and use of prokinetics/muscle relaxant. The study sample comprised 38 cases, with an adequate record of complications in 92.1% of the cases. DU were the only serious complication recorded, with a 25.7% incidence. Possible factors related to DU: more hours in PP in patients developing DU (p= .067). Less incidence of DU in well-nourished patients (p= .577). 82.9% of patients were not appropriately nourished. The percentage of records duly completed is very high. The presence of DU (grade 1-2 mostly) is to be noted. There is no stastistical significance, although a trend is obversed, between DU and hours in PP. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. In situ phytostabilisation capacity of three legumes and their associated Plant Growth Promoting Bacteria (PGPBs) in mine tailings of northern Tunisia.

    PubMed

    Saadani, Omar; Fatnassi, Imen Challougui; Chiboub, Manel; Abdelkrim, Souhir; Barhoumi, Fathi; Jebara, Moez; Jebara, Salwa Harzalli

    2016-08-01

    PGPBs-legumes associations represent an alternative procedure for phytostabilisation of heavy metals polluted soils mainly generated by industrial and agricultural practices. In this study we evaluated the capacity of Vicia faba, Lens culinaris and Sulla coronaria, inoculated in situ by specific heavy metals resistant inocula, for the phytostabilisation of copper, lead and cadmium respectively. The experimentation was performed in mine tailings of northern Tunisia. Results proved that inoculation enhanced roots and shoots biomass production of faba bean by 14% and 12%, respectively, and significantly improved pods yield by 91%. In lentil, the inoculation ameliorated shoot biomass up to 27%. The highest nitrogen fixation was recorded by Sulla coronaria. The three symbioses accumulated heavy metals essentially in roots, and poorly in shoots. In addition, cadmium accumulation in roots of inoculated sulla was enhanced by 39%. Furthermore, inoculations decreased heavy metals availability in the soil up to -10% of Cu and -47% of Pb respectively in roots of faba bean and lentil. Our results suggested a positive effect of co-inoculation of legumes by appropriate heavy metals resistant PGPBs for the phytostabilisation of mine tailings. Elsewhere, the enhancement in the antioxidant enzymes activities demonstrated the role of the three inocula to alleviate the heavy metals induced stress. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Analytical evaluation of two automatic methods to measure blood CK-MB mass and troponin I

    PubMed Central

    Curos, Antonio; Duran, Jordi; Corominas, Augusto; Valle, Vicente

    2002-01-01

    The lack of standardization of methods to measure cardiac markers for coronaria ischaemia, particularly troponin, led us to perform an analytical evaluation of two new immunoassays to quantify CK-MB mass and troponin I using the Dimension R×L automatic analyser. The reliability and analytical intervals of the methods were studied as well as reference values (0.010— 0.228 μg l-1 for troponin I, 0.20—3.90 mg μg l-1 for CK-MB mass) and cuto¡ values (0.77 μg l-1 for troponin I, 5 μg l-1 for CK-MB mass) established. The cutoff values were established from 37 patients with acute myocardial infarction and from 20 with unstable angina. The absence of method cross-reactivity was corroborated using myocardial, brain and skeletal muscle tissue. Both methods were highly specific and showed good reliability and practicability in the diagnosis of coronaria ischaemia after 6 h of precordial pain. PMID:18924744

  17. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): respiratory failure].

    PubMed

    Grau Carmona, T; López Martínez, J; Vila García, B

    2011-11-01

    Severe acute respiratory failure requiring mechanical ventilation is one of the most frequent reasons for admission to the intensive care unit. Among the most frequent causes for admission are exacerbation of chronic obstructive pulmonary disease and acute respiratory failure with acute lung injury (ALI) or with criteria of acute respiratory distress syndrome (ARDS). These patients have a high risk of malnutrition due to the underlying disease, their altered catabolism and the use of mechanical ventilation. Consequently, nutritional evaluation and the use of specialized nutritional support are required. This support should alleviate the catabolic effects of the disease, avoid calorie overload and, in selected patients, to use omega-3 fatty acid- and antioxidant-enriched diets, which could improve outcome. Copyright © 2011 Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L. All rights reserved.

  18. [Evaluation of antimicrobial activity of indol alkaloids].

    PubMed

    Rojas Hernández, N M

    1979-01-01

    In pursuing the study of the antimicrobial properties of alkaloids prepared from Cuban plants the activity of 10 indol alkaloids and 4 semisynthetic variables obtained from three plants--Catharanthus roseus G. Don., Vallesia antillana Wood and Ervatamia coronaria Staph, of the family Apocynaceae--growing in Cuba was assessed in vitro. The alkaloids and the variables used were catharantine, vindoline, vindolinine, perivine, reserpine, tabernaemontanine, tetrahydroalstonine, aparicine, vindolinic acid, reserpic acid and vindolininol. These were faced to 40 bacterial strains from the genera Salmonella, Shigella, Proteus, Escherichia, Pseudomonas, Staphylococcus and Corynebacterium as well as to fungi and yeasts from the genera Aspergillus, kCunnighamella, kCandida and Saccharomyces. The method involving cylindric sections in a double agar layer was applied and lectures were obtained at 24-48 hours of incubation at 25 degrees C for fungi and yeasts and 37 degrees C for bacteria. Inhibition zones are reported in millimeters.

  19. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): neurocritical patient].

    PubMed

    Acosta Escribano, J; Herrero Meseguer, I; Conejero García-Quijada, R

    2011-11-01

    Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral-parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calore intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dL. Copyright © 2011 Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L. All rights reserved.

  20. Synthesis and antifungal activity of the derivatives of novel pyrazole carboxamide and isoxazolol pyrazole carboxylate.

    PubMed

    Sun, Jialong; Zhou, Yuanming

    2015-03-09

    A series of pyrazole carboxamide and isoxazolol pyrazole carboxylate derivatives were designed and synthesized in this study. The structures of the compounds were elucidated based on spectral data (infrared, proton nuclear magnetic resonance and mass spectroscopy). Then, all of the compounds were bioassayed in vitro against four types of phytopathogenic fungi (Alternaria porri, Marssonina coronaria, Cercospora petroselini and Rhizoctonia solani) using the mycelium growth inhibition method. The results showed that some of the synthesized pyrazole carboxamides displayed notable antifungal activity. The isoxazole pyrazole carboxylate 7ai exhibited significant antifungal activity against R. solani, with an EC50 value of 0.37 μg/mL. Nonetheless, this value was lower than that of the commercial fungicide, carbendazol.

  1. [Organic and functional limitations due to milking phenomenon: a clinical case report].

    PubMed

    Gómez-Henry, Juan Carlos; Rodríguez-Pérez, Francisco Antonio

    2014-01-01

    INTRODUCCIÓN: según series angiográficas, la incidencia del fenómeno de milking oscila entre 0.6 y 4 %, sin embargo, en estudios de autopsias hasta en 85 % se ha identificado puente miocárdico, patognómónico de este trastorno. La malformación del fenómeno de milking no es identificada en la mayoría de las ocasiones, pero puede tener grandes repercusiones. El propósito es ejemplificar un caso de fenómeno de milking con consecuencias de incapacidad permanente y consecuencias laborales. CASO CLÍNICO: hombre de 44 años de edad que laboralmente se ocupaba como peón albañil y peón agrícola. Como antecedentes refirió amigdalectomía y artrosis, tabaquismo de 10 cigarrillos diarios, dos o tres tazas de café diarias y dos o tres copas de vino en fin de semana. Mediante electrocardiograma se identificó ritmo sinusal y bloqueo incompleto de la rama derecha del fascículo atrioventricular. Su frecuencia cardiaca fue de 90 latidos por minuto. Para la prueba de esfuerzo se utilizó el protocolo de Bruce, que se detuvo en el primer estadio debido a crisis hipertensiva y fibrilación auricular paroxística. El cateterismo mostró tronco común izquierdo, arteria coronaria cincunfleja y arteria coronaria derecha sin lesiones, arteria descendente anterior sin lesiones con trayecto intramiocárdico y compresión sistólica en segmento medio, con lo cual se integró el diagnóstico de milking coronario. El paciente requirió incapacidad permanente total con limitación para actividades que necesitaran esfuerzo moderado.

  2. Endovascular revascularization of TASC C and D femoropopliteal occlusive disease using carbon dioxide as contrast.

    PubMed

    Mendes, Cynthia de Almeida; Teivelis, Marcelo Passos; Kuzniec, Sergio; Fukuda, Juliana Maria; Wolosker, Nelson

    2016-01-01

    To analyze the results of ten angioplasties of TASC C and D femoropopliteal lesions using CO2 as primary contrast in patients with no formal contraindication to iodine, aiming to decrease allergic reactions and potential nephrotoxicity in high-risk patients. We describe the results of ten angioplasties of TASC C and D femoropopliteal lesions using CO2 as primary contrast in patients with high risk for open revascularization and no formal contraindication to iodine. We analyzed feasibility of the procedures, complications, quality of the angiographic images, clinical and surgical outcomes, and costs of C and D lesions treated using CO2 as contrast medium. The use of CO2 in C and D lesions needed iodine complementation in most of the cases (nine cases) but decreased the potential nephrotoxicity of iodine contrast medium by the reduction of its volume in this group of high-risk patients. The extension of the arterial lesions was the factor that most contributed to the need for iodine supplementation due to the difficulty to visualize the refill after a long arterial occlusion. The use of CO2 as contrast in patients with C and D lesions with no restriction for iodine contrast medium was an alternative that did not dismiss the need of iodine supplementation in most of the cases, but could decrease the potential nephrotoxicity of iodine constrast medium. Analisar os resultados de dez angioplastias de lesões fêmoro-poplíteas TASC C e D utilizando CO2 como meio de contraste primário em pacientes sem restrição ao meio de contraste iodado com o objetivo de diminuir reações alérgicas e potencial de nefrotoxicidade em pacientes de alto risco. Descrevemos os resultados de dez angioplastias de lesões fêmoro-poplíteas TASC C e D utilizando CO2 como meio de contraste primário em pacientes de alto risco para revascularização aberta e sem contraindicação formal a iodo. Analisamos possibilidade de execução dos procedimentos, complicações, qualidade das imagens

  3. Protein kinase regulation of a cloned epithelial Na+ channel

    PubMed Central

    1996-01-01

    activated with PKA and Mg-ATP added to either side of the membrane, as Po remained at 0.63 +/- 0.06 (n = 7) and 0.45 +/- 0.05 (n = 9), respectively. We conclude that: alpha beta gamma-rENaC is inhibited by PKC, and that alpha beta gamma- rENaC is not activated by PKA. PMID:8817384

  4. [Face replantation using labial artery for revascularization. Case report].

    PubMed

    de la Parra-Márquez, Miguel; Mondragón-González, Sergio; López-Palazuelos, Jaime; Naal-Mendoza, Norberto; Rangel-Flores, Jesús María

    2013-01-01

    antecedentes: la restauración cosmética y funcional de la cara luego de un traumatismo complejo es todo un reto para el cirujano plástico. En el ámbito internacional se han reportado pocos casos de reimplante facial. Objetivo: reportar el caso del primer reimplante parcial de cara con la utilización de la arteria labial como aporte vascular. Caso clínico: paciente masculino de siete años de edad. Ingresó al servicio de Cirugía Plástica en el mes de junio de 2011 por lesiones secundarias en la cara ocasionadas por la mordedura de un perro. A la exploración física se encontró avulsión de 75% del labio superior, 33% del labio inferior, incluida la comisura oral, y 75% de la mejilla izquierda. Los músculos avulsionados incluían: el orbicular de los labios, depresor del ángulo oral y depresor del labio inferior. El tiempo total de isquemia fue de ocho horas. La anastomosis término-terminal de la arteria coronaria labial se efectuó con nylon 11-0, posteriormente se escogió la vena con mejor retorno y la anastomosis se realizó con nylon 11-0. Se hizo miorrafía de los músculos mencionados con vicril 4-0, la sutura de la mucosa oral se realizó con vicril 5-0, y de la piel con nylon 5-0. Seis meses después de la cirugía, el resultado cosmético y funcional se consideró excelente, con restablecimiento total de la continencia labial y articulación completa de las palabras. Conclusiones: las amputaciones de cualquier componente facial deben ser inicialmente tratadas con reimplante. La arteria coronaria labial es una buena opción para revascularización, incluso en 25% del total de la cara (labios y mejilla).

  5. [Not Available].

    PubMed

    Vila Nova, Larissa Pessoa; Araújo Tavares de Sá, Cristiane Maria; Freire Clementino da Silva, Maria Cleide; Lustosa, Marinaldo Freire; Batista de Medeiros, Rafael Augusto; Calado Brito, Daniel; De Araújo Burgos, Maria Goretti Pessoa

    2016-07-19

    Introducción: en los últimos años la importancia de identificar la resistencia a la insulina (RI) en pacientes con enfermedades cardiovasculares isquémicas viene siendo debatida. Métodos alternativos, como los indicadores antropométricos y de composición corporal, han sido señalados como una buena opción y contribuyen para identificar anomalías metabólicas y prevenir complicaciones.Objetivo: asociar indicadores antropométricos y de composición corporal como predictores de la resistencia a la insulina (RI) en pacientes con enfermedad de las arterias coronarias.Métodos: estudio transversal realizado en el hospital de referencia cardiológica de Pernambuco, en el periodo de junio a septiembre de 2014, con pacientes adultos y ancianos hospitalizados, de ambos sexos. Se verificaron los siguientes parámetros: estilo de vida, la presencia del síndrome metabólico (SM) y otras comorbilidades. Se analizó la RI por el cálculo del HOMA-IR. Los pacientes se sometieron a la impedancia bioeléctrica (BIA) y a las verificaciones antropométricas.Resultados: la muestra fue constituida por 75 pacientes con edad media de 63,75 ± 12,43 años, con un 64% de ancianos. Se encontró el diagnóstico de SM en el 65,3% de los pacientes, el 81,3% de sedentarios y el 37,4% con exceso de peso. Se diagnosticó la RI en el 28% de los pacientes. Se observó correlación entre el HOMA-IR y el diámetro abdominal sagital (DAS) (r = 0,476; p = 0,016), el índice de masa corporal (r = 0,233; p = 0,040) y el porcentual de grasa corporal (r = 0,276; p = 0,016).Conclusión: el DAS fue el indicador antropométrico que presentó mejor correlación con la RI en pacientes con enfermedad de las arterias coronarias hospitalizados.

  6. High-quality permanent draft genome sequence of Rhizobium sullae strain WSM1592; a Hedysarum coronarium microsymbiont from Sassari, Italy.

    PubMed

    Yates, Ron; Howieson, John; De Meyer, Sofie E; Tian, Rui; Seshadri, Rekha; Pati, Amrita; Woyke, Tanja; Markowitz, Victor; Ivanova, Natalia; Kyrpides, Nikos; Loi, Angelo; Nutt, Brad; Garau, Giovanni; Sulas, Leonardo; Reeve, Wayne

    2015-01-01

    Rhizobium sullae strain WSM1592 is an aerobic, Gram-negative, non-spore-forming rod that was isolated from an effective nitrogen (N2) fixing root nodule formed on the short-lived perennial legume Hedysarum coronarium (also known as Sulla coronaria or Sulla). WSM1592 was isolated from a nodule recovered from H. coronarium roots located in Ottava, bordering Sassari, Sardinia in 1995. WSM1592 is highly effective at fixing nitrogen with H. coronarium, and is currently the commercial Sulla inoculant strain in Australia. Here we describe the features of R. sullae strain WSM1592, together with genome sequence information and its annotation. The 7,530,820 bp high-quality permanent draft genome is arranged into 118 scaffolds of 118 contigs containing 7.453 protein-coding genes and 73 RNA-only encoding genes. This rhizobial genome is sequenced as part of the DOE Joint Genome Institute 2010 Genomic Encyclopedia for Bacteria and Archaea-Root Nodule Bacteria (GEBA-RNB) project.

  7. Intensity of interprofessional collaboration among intensive care nurses at a tertiary hospital.

    PubMed

    Serrano-Gemes, G; Rich-Ruiz, M

    To measure the intensity of interprofessional collaboration (IPC) in nurses of an intensive care unit (ICU) at a tertiary hospital, to check differences between the dimensions of the Intensity of Interprofessional Collaboration Questionnaire, and to identify the influence of personal variables. A cross-sectional descriptive study was conducted with 63 intensive care nurses selected by simple random sampling. Explanatory variables: age, sex, years of experience in nursing, years of experience in critical care, workday type and work shift type; variable of outcome: IPC. The IPC was measured by: Intensity of Interprofessional Collaboration Questionnaire. Descriptive and bivariate statistical analysis (IPC and its dimensions with explanatory variables). 73.8% were women, with a mean age of 46.54 (±6.076) years. The average years experience in nursing and critical care was 23.03 (±6.24) and 14.25 (±8.532), respectively. 77% had a full time and 95.1% had a rotating shift. 62.3% obtained average IPC values. Statistically significant differences were found (P<.05) between IPC (overall score) and overall assessment with years of experience in critical care. This study shows average levels of IPC; the nurses with less experience in critical care obtained higher IPC and overall assessment scores. Copyright © 2016 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  8. A qualitative study about experiences and emotions of emergency medical technicians and out-of-hospital emergency nurses after performing cardiopulmonary resuscitation resulting in death.

    PubMed

    Fernández-Aedo, I; Pérez-Urdiales, I; Unanue-Arza, S; García-Azpiazu, Z; Ballesteros-Peña, S

    To explore the experiences, emotions and coping skills among emergency medical technicians and emergency nurses after performing out-of-hospital cardiopulmonary resuscitation manoeuvres resulting in death. An exploratory qualitative research was performed. Seven emergency medical technicians and six emergency nurses were selected by non-probability sampling among emergency medical system workers. The meetings took place up to information saturation, achieved after six individual interviews and a focal group. The meetings were then transcribed and a manual and inductive analysis of the contents performed. After a failed resuscitation several short and long-term reactions appear. They can be negatives, such as sadness or uncertainty, or positives, such as the feeling of having done everything possible to save the patient's life. Emotional stress increases when ambulance staff have to talk with the deceased's family or when the patient is a child. The workers don't know of a coping strategy other than talking about their emotions with their colleagues. Death after a failed resuscitation can be viewed as a traumatic experience for rescuers. Being in contact with the suffering of others is an emotional, stress-generating factor with direct repercussions on the working and personal lives of emergency staff. Nevertheless, structured coping techniques are not common among those professionals. Copyright © 2016 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. High-quality permanent draft genome sequence of Rhizobium sullae strain WSM1592; a Hedysarum coronarium microsymbiont from Sassari, Italy

    DOE PAGES

    Yates, Ron; Howieson, John; De Meyer, Sofie E.; ...

    2015-07-24

    Rhizobium sullae strain WSM1592 is an aerobic, Gram-negative, non-spore-forming rod that was isolated from an effective nitrogen (N2) fixing root nodule formed on the short-lived perennial legume Hedysarum coronarium (also known as Sulla coronaria or Sulla). WSM1592 was isolated from a nodule recovered from H. coronarium roots located in Ottava, bordering Sassari, Sardinia in 1995. WSM1592 is highly effective at fixing nitrogen with H. coronarium, and is currently the commercial Sulla inoculant strain in Australia. Here we describe the features of R. sullae strain WSM1592, together with genome sequence information and its annotation. The 7,530,820 bp high-quality permanent draft genomemore » is arranged into 118 scaffolds of 118 contigs containing 7.453 protein-coding genes and 73 RNA-only encoding genes. In conclusion, this rhizobial genome is sequenced as part of the DOE Joint Genome Institute 2010 Genomic Encyclopedia for Bacteria and Archaea-Root Nodule Bacteria (GEBA-RNB) project.« less

  10. High-quality permanent draft genome sequence of Rhizobium sullae strain WSM1592; a Hedysarum coronarium microsymbiont from Sassari, Italy

    SciTech Connect

    Yates, Ron; Howieson, John; De Meyer, Sofie E.; Tian, Rui; Seshadri, Rekha; Pati, Amrita; Woyke, Tanja; Markowitz, Victor; Ivanova, Natalia; Kyrpides, Nikos; Loi, Angelo; Nutt, Brad; Garau, Giovanni; Sulas, Leonardo; Reeve, Wayne

    2015-07-24

    Rhizobium sullae strain WSM1592 is an aerobic, Gram-negative, non-spore-forming rod that was isolated from an effective nitrogen (N2) fixing root nodule formed on the short-lived perennial legume Hedysarum coronarium (also known as Sulla coronaria or Sulla). WSM1592 was isolated from a nodule recovered from H. coronarium roots located in Ottava, bordering Sassari, Sardinia in 1995. WSM1592 is highly effective at fixing nitrogen with H. coronarium, and is currently the commercial Sulla inoculant strain in Australia. Here we describe the features of R. sullae strain WSM1592, together with genome sequence information and its annotation. The 7,530,820 bp high-quality permanent draft genome is arranged into 118 scaffolds of 118 contigs containing 7.453 protein-coding genes and 73 RNA-only encoding genes. In conclusion, this rhizobial genome is sequenced as part of the DOE Joint Genome Institute 2010 Genomic Encyclopedia for Bacteria and Archaea-Root Nodule Bacteria (GEBA-RNB) project.

  11. [Evaluation of the status of patients with severe infection, criteria for intensive care unit admittance. Spanish Society for Infectious Diseases and Clinical Microbiology. Spanish Society of Intensive and Critical Medicine and Coronary Units].

    PubMed

    Olaechea, Pedro M; Alvarez-Lerma, Francisco; Sánchez, Miguel; Torres, Antonio; Palomar, Mercedes; Fernández, Pedro; Miró, José M; Cisneros, José Miguel; Torres, Manuel

    2009-06-01

    Recent studies have shown that early attention in patients with serious infections is associated with a better outcome. Assistance in intensive care units (ICU) can effectively provide this attention; hence patients should be admitted to the ICU as soon as possible, before clinical deterioration becomes irreversible. The objective of this article is to compile the recommendations for evaluating disease severity in patients with infections and describe the criteria for ICU admission, updating the criteria published 10 years ago. A literature review was carried out, compiling the opinions of experts from the Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC, Spanish Society for Infectious Diseases and Clinical Microbiology) and the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC, Spanish Society for Intensive Medicine, Critical Care and Coronary Units) as well as the working groups for infections in critically ill patients (GEIPC-SEIMC and GTEI-SEMICYUC). We describe the specific recommendations for ICU admission related to the most common infections affecting patients, who will potentially benefit from critical care. Assessment of the severity of the patient's condition to enable early intensive care is stressed.

  12. [Prevalence of silent cerebrovascular lesions in patients with obstructive sleep apnea syndrome].

    PubMed

    Colla-Machado, Pedro E; Luzzi, Ariel A; Balian, Natalia R; Pigretti, Santiago G; Zurrú-Ganen, M Cristina; Cristiano, Edgardo; Valiensi, Stella M

    2016-02-01

    Introduccion. El sindrome de apnea/hipopnea obstructiva del sueño (SAHOS) confiere mayor riesgo de enfermedad cardiovascular, dada su asociacion con otros factores de riesgo vascular. Tanto el SAHOS como otros factores de riesgo vascular se asocian con lesiones cerebrales silentes. Objetivo. Evaluar la prevalencia de lesiones cerebrales silentes en pacientes con SAHOS. Pacientes y metodos. Se evaluo retrospectivamente una cohorte de 137 pacientes con SAHOS, con una edad media de 65 ± 12 años, el 45% mujeres. Las lesiones cerebrales silentes en resonancia magnetica se evaluaron con la escala visual de Fazekas, y se consigno la presencia de infartos corticales, lacunares y microsangrados. Resultados. La prevalencia de factores de riesgo vascular fue: hipertension, 64%; dislipidemia, 58%; diabetes, 18%; tabaquismo, 34%; ateromatosis carotidea, 26%; enfermedad coronaria, 13%; y fibrilacion auricular, 4%. El SAHOS fue leve en el 47%, moderado en el 31% y grave en el 22% de los casos. El 91% de los pacientes tenia hiperintensidades periventriculares y el 66% presentaba lesiones en la sustancia blanca subcortical. El valor medio del indice de apnea/hipopnea fue mayor en los pacientes con mayor carga de lesiones, aunque sin significacion estadistica. Conclusiones. Los pacientes con SAHOS presentan una elevada prevalencia de lesiones cerebrales silentes, fundamentalmente con un patron microangiopatico. Posiblemente esto se explique por la asociacion entre el SAHOS, la hipertension arterial y otros factores de riesgo vascular.

  13. Antituberculosis potential of some ethnobotanically selected Malaysian plants.

    PubMed

    Mohamad, Suriyati; Zin, Nabihah Mohd; Wahab, Habibah A; Ibrahim, Pazilah; Sulaiman, Shaida Fariza; Zahariluddin, Anis Safirah Mohd; Noor, Siti Suraiya Md

    2011-02-16

    Many local plants are used in Malaysian traditional medicine to treat respiratory diseases including symptoms of tuberculosis. The aim of the study was to screen 78 plant extracts from 70 Malaysian plant species used in traditional medicine to treat respiratory diseases including symptoms of tuberculosis for activity against Mycobacterium tuberculosis H37Rv using a colorimetric microplate-based assay. Plant extracts were prepared by maceration in methanol (80%) and antituberculosis screening was carried out using Tetrazolium bromide microplate assay (TEMA) method to determine the minimum inhibitory concentration (MIC). Thirty-eight plant extracts from 36 plant species exhibited antituberculosis activity with MICs in the range of 1600-400 μg/ml. The leaf extract of Angiopteris evecta exhibited the highest activity with MIC of 400 μg/ml. Five other extracts, namely, Costus speciosus (stem and flower), Piper sarmentosum (whole plant), Pluchea indica (leaf), Pluchea indica (flower), and Tabernaemontana coronaria (leaf) exhibited antituberculosis activity, each with MIC of 800 μg/ml. To the best of our knowledge, this is the first report of in vitro high throughput screening of Malaysian medicinal plants for antituberculosis activity. Antituberculosis activity of extracts of some plants justifies, to a certain extent their ethnomedicinal uses as remedies for symptoms of tuberculosis. These results also support the general view that, selecting the plants based on ethnobotanical criteria would enhance the probability of finding species with antituberculosis activity. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  14. [Femoral venous catheterization. Does it really need to be avoided?].

    PubMed

    Lorente, L; León, C

    2009-12-01

    The guidelines to prevent central venous catheter related bloodstream infections (CVCBSI) of the Centers for Disease Control and Prevention (CDC) of 2002, Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias/ Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEMICYUC/SEIMC) of 2004, and the recently published guidelines of the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA(IDSA) of 2008 have recommended using the subclavian vein and avoiding the use of the femoral vein. They also recommend considering the use of antiseptic- or antimicrobial-impregnated CVCs for hospital units or groups of patients with a high incidence of CVCBSI. When implementing these guidelines, two questions could be asked: 1) Could the abuse of the subclavian vein and avoiding the use of the femoral vein imply a decrease in the incidence of CVCBSI, but an increase in the rate of mechanical complications as pneumothorax and/or hemothorax? 2) Couldn't antimicrobial-impregnated CVCs be used to prevent CVCBSI when the femoral venous access is used?

  15. Assessment of the food habits of the Moroccan dorcas gazelle in M'Sabih Talaa, west central Morocco, using the trnL approach.

    PubMed

    Ait Baamrane, Moulay Abdeljalil; Shehzad, Wasim; Ouhammou, Ahmed; Abbad, Abdelaziz; Naimi, Mohamed; Coissac, Eric; Taberlet, Pierre; Znari, Mohammed

    2012-01-01

    Food habits of the Moroccan dorcas gazelle, Gazella dorcas massaesyla, previously investigated in the 1980s using microhistological fecal analysis, in the M'Sabih Talaa Reserve, west central Morocco, were re-evaluated over three seasons (spring, summer and autumn 2009) using the trnL approach to determine the diet composition and its seasonal variation from fecal samples. Taxonomic identification was carried out using the identification originating from the database built from EMBL and the list of plant species within the reserve. The total taxonomic richness in the reserve was 130 instead of 171 species in the 1980s. The diet composition revealed to be much more diversified (71 plant taxa belonging to 57 genus and 29 families) than it was 22 years ago (29 identified taxa). Thirty-four taxa were newly identified in the diet while 13 reported in 1986-87 were not found. Moroccan dorcas gazelle showed a high preference to Acacia gummifera, Anagallis arvensis, Glebionis coronaria, Cladanthus arabicus, Diplotaxis tenuisiliqua, Erodium salzmannii, Limonium thouini, Lotus arenarius and Zizyphus lotus. Seasonal variations occurred in both number (40-41 taxa in spring-summer and 49 taxa in autumn vs. respectively 23-22 and 26 in 1986-1987) and taxonomic type of eaten plant taxa. This dietary diversification could be attributed either to the difference in methods of analysis, trnL approach having a higher taxonomic resolution, or a potential change in nutritional quality of plants over time.

  16. The microangioarchitecture of the conducting system in cattle.

    PubMed

    Teixeira, A F; Szabo, K; König, B

    1999-09-01

    Macroscopic researches on heart vascularization have indicated that the angioarchitecture of the conducting system differs from that of the normal myocardium. In order to observe this variance, eight cow hearts were dissected for perfusion through the Ramus ventricularis dexter and Ramus septalis of the A. coronaria dextra with Ringer's solution, and then injected with Mercox. After corrosion in KOH the casts were prepared for observation in a SEM. In the region of the sinoatrial node no special capillary arrangement was observed, but only valves on the venous side. At the atrioventricular node and the bundle of His, the arterioles showed a diffuse formation, filling this area with a regular caliber, without any special capillary orientation. The arteries that reach the right bundle dichotomized and ran collateral to the opposite extremity of this structure, lying parallel. The vessels with the biggest caliber were deeply positioned. In the left bundle the arterioles showed a net like figure, mainly in one plane. Following the form of the bundle, and below the conducting tissue a big anastomotic venous arrangement is observable.

  17. [Epileptic seizures complicated by Takotsubo syndrome].

    PubMed

    Garea Garcia-Malvar, M J; Gonzalez-Silva, Y; Epureanu-Epureanu, V

    2014-11-01

    Introduccion. El sindrome de takotsubo es un trastorno caracterizado por disfuncion ventricular reversible, dolor precordial de tipo anginoso y cambios electrocardiograficos sin evidencia de obstruccion coronaria en coronariografia. Se desencadena por estres, y es frecuente tras crisis epilepticas. Presentamos el caso de una paciente que inicia esta miocardiopatia tras una crisis epileptica al finalizar su sesion de hemodialisis. Caso clinico. Mujer de 55 años en hemodialisis por insuficiencia renal cronica, con epilepsia secundaria a lesion residual frontoparietal derecha por un hematoma que preciso evacuacion quirurgica. Tras una sesion de hemodialisis experimenta una crisis epileptica focal con generalizacion secundaria y, horas despues de esta, dolor centrotoracico. En seriacion enzimatica se objetiva elevacion de troponina I y, electrocardiograficamente, ondas T negativas en derivaciones precordiales (V2-V6). Se realiza coronariografia, cuyo resultado es normal, y se demuestran alteraciones de la contractilidad, confirmadas como de caracter transitorio en un estudio ecocardiografico seriado. Todos los datos anteriores hacen sospechar el diagnostico de sindrome de takotsubo. Conclusion. Las complicaciones cardiacas son una de las causas de morbimortalidad en la epilepsia, y entre ellas se encuentra el sindrome de takotsubo. La incidencia real de dicho sindrome se desconoce, pero dada su implicacion en la mortalidad de causa cardiaca en la epilepsia es importante sospecharlo ante la presencia de disfuncion cardiaca tras una crisis epileptica.

  18. Patients' experience during weaning of invasive mechanical ventilation: A review of the literature.

    PubMed

    Merchán-Tahvanainen, M E; Romero-Belmonte, C; Cundín-Laguna, M; Basterra-Brun, P; San Miguel-Aguirre, A; Regaira-Martínez, E

    Weaning from invasive mechanical ventilation (IMV) is influenced by physiological and psychological factors, the latter being the least studied. The aim was to identify, through the literature, patients' experiences during weaning from IMV and report its influencing factors. The literature search was conducted using the Pubmed, CINAHL and PsycINFO databases. The search terms were: "patient", "experience" and "ventilator weaning". The research limits were: age (>19years) and language (English, Spanish and Finnish). Fifteen publications were analysed. The main results were grouped into three main categories according to patient's perceptions, feelings and experiences, influence of professionals' attention and determinants for successful weaning. Patients remember IMV weaning as a stressful process where they experience anxiety, frustration, despair or uncertainty. Nurses have a key role in improving communication with patients and foreseeing their needs. Family support and the care provided by the caregivers were shown as essential during the process. The patient's self-determination, self-motivation and confidence are identified as important factors to achieve successful IMV weaning. Psychological care, in addition to physical and technical care, is important at providing holistic care. Interventional studies are needed to improve the care during the weaning experience. Copyright © 2016 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  19. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): liver failure and transplantation].

    PubMed

    Montejo González, J C; Mesejo, A; Bonet Saris, A

    2011-11-01

    Patients with liver failure have a high prevalence of malnutrition, which is related to metabolic abnormalities due to the liver disease, reduced nutrient intake and alterations in digestive function, among other factors. In general, in patients with liver failure, metabolic and nutritional support should aim to provide adequate nutrient intake and, at the same time, to contribute to patients' recovery through control or reversal of metabolic alterations. In critically-ill patients with liver failure, current knowledge indicates that the organ failure is not the main factor to be considered when choosing the nutritional regimen. As in other critically-ill patients, the enteral route should be used whenever possible. The composition of the nutritional formula should be adapted to the patient's metabolic stress. Despite the physiopathological basis classically described by some authors who consider amino acid imbalance to be a triggering factor and key element in maintaining encephalopathy, there are insufficient data to recommend "specific" solutions (branched-chain amino acid-enriched with low aromatic amino acids) as part of nutritional support in patients with acute liver failure. In patients undergoing liver transplantation, nutrient intake should be started early in the postoperative period through transpyloric access. Prevention of the hepatic alterations associated with nutritional support should also be considered in distinct clinical scenarios. Copyright © 2011 Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L. All rights reserved.

  20. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): nutritional assessment].

    PubMed

    Ruiz-Santana, S; Arboleda Sánchez, J A; Abilés, J

    2011-11-01

    Current parameters to assess nutritional status in critically-ill patients are useful to evaluate nutritional status prior to admission to the intensive care unit. However, these parameters are of little utility once the patient's nutritional status has been altered by the acute process and its treatment. Changes in water distribution affect anthropometric variables and biochemical biomarkers, which in turn are affected by synthesis and degradation processes. Increased plasma levels of prealbumin and retinol -proteins with a short half-life- can indicate adequate response to nutritional support, while reduced levels of these proteins indicate further metabolic stress. The parameters used in functional assessment, such as those employed to assess muscular or immune function, are often altered by drugs or the presence of infection or polyneuropathy. However, some parameters can be used to monitor metabolic response and refeeding or can aid prognostic evaluation. Copyright © 2011 Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L. All rights reserved.

  1. Communication skills in ICU and adult hospitalisation unit nursing staff.

    PubMed

    Ayuso-Murillo, D; Colomer-Sánchez, A; Herrera-Peco, I

    In this study researchers are trying to analyse the personality factors related to social skills in nurses who work in: Intensive Care Units, ICU, and Hospitalisation units. Both groups are from the Madrid Health Service (SERMAS). The present investigation has been developed as a descriptive transversal study, where personality factors in ICU nurses (n=29) and those from Hospitalisation units (n=40) were compared. The 16PF-5 questionnaire was employed to measure the personality factors associated with communication skills. The comparison of the personality factors associated to social skills, communication, in both groups, show us that nurses from ICU obtain in social receptivity: 5,6 (A+), 5,2 (C-), 6,2 (O+), 5,1 (H-), 5,3 (Q1-), and emotional control: 6,1 (B+), 5,9 (N+). Meanwhile the data doesn't adjust to the expected to emotional and social expressiveness, emotional receptivity and social control, there are not evidence. The personality factors associated to communication skills in ICU nurses are below those of hospitalisation unit nurses. The present results suggest the necessity to develop training actions, focusing on nurses from intensive care units to improve their communication social skills. Copyright © 2016 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  2. The opinion of health professionals regarding the presence of relatives during cardiopulmonary resucitation.

    PubMed

    Asencio-Gutiérrez, J M; Reguera-Burgos, I

    2017-06-17

    The latest recommendations from the American Heart Association and the European Resuscitation Council invite allowance for the presence of relatives (PR) during cardiopulmonary resuscitation (CPR) as an extra measure of family care. To discover the opinion of health professionals on the PR during CPR. Cross-sectional observational study through an online survey in Spain, based on a non-probability sample (n=315). 45% consider that the PR during CPR is not demanded by users. 64% value the implementation of this practice in a negative or a very negative way. 45% believe that the practice would avoid the feeling of abandonment that is instilled in the relatives, this being the most widely perceived potential benefit. 30% do not believe that it can help reduce the anxiety of relatives. The majority remarked that PR would cause situations of violence, psychological harm in witnesses, and more mistakes during care. 48% feel prepared to perform the role of companion. Most professionals perceive more risks than benefits, and are not in favour of allowing PR due to a paternalistic attitude, and fear of the reactions that could be presented to the team. Extra-hospital emergency personnel seems to be the group most open to allowing this practice. Most professionals do not feel fully prepared to perform the role of companion. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Elemental characterization of wild edible plants from countryside and urban areas.

    PubMed

    Renna, Massimiliano; Cocozza, Claudio; Gonnella, Maria; Abdelrahman, Hamada; Santamaria, Pietro

    2015-06-15

    Thirteen elements (Na, K, Ca, Mg, Fe, Mn, Cu, Zn, Cr, Co, Cd, Ni and Pb) in 11 different wild edible plants (WEP) (Amaranthus retroflexus, Foeniculum vulgare, Cichorium intybus, Glebionis coronaria, Sonchus spp., Borago officinalis, Diplotaxis tenuifolia, Sinapis arvensis, Papaver rhoeas, Plantago lagopus and Portulaca oleracea) collected from countryside and urban areas of Bari (Italy) were determined. B.officinalis and P.rhoeas could represent good nutritional sources of Mn and Fe, respectively, as well as A.retroflexus and S.arvensis for Ca. High intake of Pb and Cd could come from P.lagopus and A.retroflexus (1.40 and 0.13 mg kg(-1) FW, respectively). WEP may give a substantial contribution to the elements intake for consumers, but in some cases they may supply high level of elements potentially toxic for human health. Anyway, both ANOVA and PCA analyses have highlighted the low influence of the harvesting site on the elements content. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. [Hormone modulation of organ donor. Utility of the steroids].

    PubMed

    Michelena, Juna C; Chamorro, Carlos; Falcón, Juan A; Garcés, Sandra

    2009-01-01

    Recently, the work group made up of the National Transplant Organization (Organización Nacional de Trasplantes, ONT), Spanish Society of Intensive, Critical Medicine and Coronary Units (Sociedad Española de Medicina Intensiva, Crítica y de Unidades Coronarias, SEMICYUC) and other Scientific Societies have recommended using 15 mg/kg of methyl prednisolone during the management of lung donors after brain death. This recommendation is based on descriptive and retrospective studies. However, the review of different experimental and clinical studies also suggests a potential benefit of using steroids in either thoracic or abdominal organ donors during management strategies. In brain death management, early steroid administration may decrease cytokine production and also may prevent alterations induced by proinflammatoy mediators, stabilize cell membranes, reduce expression of cell surface adhesion molecules and avoid lipid peroxidation after the ischemic period. This could be beneficial in increasing number and quality of organs harvested and in decreasing rejection episodes after transplant. It would be very recommendable to carry out prospective and comparative studies to demonstrate these potential utilities. Meanwhile and knowing the deleterious effects of inflammatory activity arising during and after brain death, we recommend using 15 mg/kg of methyl prednisolone in the organ donor management, as soon as possible. The potential benefit of its immunomodulation effects, its low cost and the absence of major side effects can justify this recommendation.

  5. Application of wearable optical coherence tomography (OCT) and loop-mediated isothermal amplification (LAMP) techniques for in situ real-time field inspection of apple Marssonina blotch disease

    NASA Astrophysics Data System (ADS)

    Wijesinghe, Ruchire Eranga; Lee, Seung-Yeol; Ravichandran, Naresh Kumar; Shirazi, Muhammad Faizan; Han, Sangyeop; Jeong, Hyosang; Kim, Pilun; Jung, Hee-Young; Jeon, Mansik; Kim, Jeehyun

    2017-04-01

    Here we describe the possible application of optical coherence tomography (OCT) to inspect Marssonina coronaria infected apple blotch disease of in situ apple leaves. To fulfill the in situ field inspection requirement, we developed a compact wearable OCT system. For the confirmation of OCT results, simultaneous experiment was performed in realtime using loop-mediated isothermal amplification (LAMP), which is frequently used in agriculture. LAMP method was developed as an alternative approach for the inspection of disease. We performed field inspection for 30 consecutive days, and all the acquired results from both OCT and lamp were compared to confirm the correlation. A clear identification between healthy specimens, apparently healthy but infected specimens, and infected specimens could be obtained through the real-time OCT images, and the correlation between OCT and lamp results was confirmed through the obtained realtime lamp results. Based on this feasibility study, we conclude that the combination of both these diagnosing modalities can be effective for various novel agricultural discoveries.

  6. Illustrated review of the leaf-mining Nepticulidae of the central Andes (Peru and Bolivia).

    PubMed

    Stonis, Jonas R; Diškus, Arūnas; Remeikis, Andrius; Karsholt, Ole; Torres, Nixon Cumbicus

    2017-04-24

    We review forty-five species of Nepticulidae (Lepidoptera) based on an analysis of samples collected in the central Andean region of Peru and Bolivia. Thirteen of these species are new to science, and are named and described here: Stigmella paracosma Remeikis & Stonis, sp. nov., S. expressa Remeikis & Stonis, sp. nov., S. acalyphae Diškus & Stonis, sp. nov., S. lepida Diškus & Stonis, sp. nov., S. misera Diškus & Stonis, sp. nov., S. inca Diškus & Stonis, sp. nov., S. eiffeli Diškus & Stonis, sp. nov., S. arequipica Remeikis & Stonis, sp. nov., S. coronaria Diškus & Stonis, sp. nov., S. azulella Diškus & Stonis, sp. nov., S. sparsella Diškus & Stonis, sp. nov., Manoneura forcipis Diškus & Stonis, sp. nov., and Acalyptris murex Diškus & Stonis, sp. nov. Some of the central Andean species are recorded here as leaf-miners on Euphorbiaceae (Acalypha), Fabaceae (Collaea), Rosaceae (Polylepis), Malvaceae (Sida), Calceolariaceae (Calceolaria), Lamiaceae (Clinopodium), and Asteraceae (Ageratina and Trixis). We create eleven new species groups based on morphological characters designated in Stigmella and one in Acalyptris. A pictorial key to the species groups and distribution maps are provided. All new species are illustrated with 150 photographs and drawings of the adults and genitalia, and, where known and/or available, photographs of host-plants and leaf-mines.

  7. [A GENETIC VIEW OF FAMILIAL HYPERCHOLESTEROLEMIA].

    PubMed

    Matías-Pérez, Diana; Pérez-Campos, Eduardo; García-Montalvo, Iván Antonio

    2015-12-01

    Objetivo: mostrar información revisada de manera sistemática de estudios publicados relacionados con la hipercolesterolemia familiar (HF), la nutrición y los genes que intervienen en el desarrollo de esta patología. Resultados: el análisis de los resultados de investigación consultados pone de manifiesto que la hipercolesterolemia familiar es un trastorno que se produce debido a mutaciones en genes que codifican el receptor de LDL, que se puede transmitir de forma autosómica dominante o bien autosómica recesiva. La importancia de su diagnóstico radica en que las personas afectas presentan una elevada frecuencia de enfermedad coronaria prematura, reduciéndose de forma importante su expectativa de vida. Conclusiones: no existen criterios clínicos específicos con un valor predictivo absoluto para el diagnóstico de HF; el diagnóstico genético permite demostrar defectos funcionales en el gen del receptor LDL, constituyendo la confirmación definitiva del diagnóstico, de ahí la importancia de presentar una visión genética del desarrollo de esta patología, que puede ser tratada para generaciones futuras de manera adecuada a través de la dietoterapia en la familia afectada.

  8. Assessment of the Food Habits of the Moroccan Dorcas Gazelle in M’Sabih Talaa, West Central Morocco, Using the trnL Approach

    PubMed Central

    Ait Baamrane, Moulay Abdeljalil; Shehzad, Wasim; Ouhammou, Ahmed; Abbad, Abdelaziz; Naimi, Mohamed; Coissac, Eric; Taberlet, Pierre; Znari, Mohammed

    2012-01-01

    Food habits of the Moroccan dorcas gazelle, Gazella dorcas massaesyla, previously investigated in the 1980s using microhistological fecal analysis, in the M’Sabih Talaa Reserve, west central Morocco, were re-evaluated over three seasons (spring, summer and autumn 2009) using the trnL approach to determine the diet composition and its seasonal variation from fecal samples. Taxonomic identification was carried out using the identification originating from the database built from EMBL and the list of plant species within the reserve. The total taxonomic richness in the reserve was 130 instead of 171 species in the 1980s. The diet composition revealed to be much more diversified (71 plant taxa belonging to 57 genus and 29 families) than it was 22 years ago (29 identified taxa). Thirty-four taxa were newly identified in the diet while 13 reported in 1986–87 were not found. Moroccan dorcas gazelle showed a high preference to Acacia gummifera, Anagallis arvensis, Glebionis coronaria, Cladanthus arabicus, Diplotaxis tenuisiliqua, Erodium salzmannii, Limonium thouini, Lotus arenarius and Zizyphus lotus. Seasonal variations occurred in both number (40–41 taxa in spring-summer and 49 taxa in autumn vs. respectively 23–22 and 26 in 1986–1987) and taxonomic type of eaten plant taxa. This dietary diversification could be attributed either to the difference in methods of analysis, trnL approach having a higher taxonomic resolution, or a potential change in nutritional quality of plants over time. PMID:22558187

  9. Myocardial Viability on Cardiac Magnetic Resonance.

    PubMed

    Souto, Ana Luiza Mansur; Souto, Rafael Mansur; Teixeira, Isabella Cristina Resende; Nacif, Marcelo Souto

    2017-05-01

    The study of myocardial viability is of great importance in the orientation and management of patients requiring myocardial revascularization or angioplasty. The technique of delayed enhancement (DE) is accurate and has transformed the study of viability into an easy test, not only for the detection of fibrosis but also as a binary test detecting what is viable or not. On DE, fibrosis equal to or greater than 50% of the segmental area is considered as non-viable, whereas that below 50% is considered viable. During the same evaluation, cardiac magnetic resonance (CMR) may also use other techniques for functional and perfusion studies to obtain a global evaluation of ischemic heart disease. This study aims to highlight the current concepts and broadly emphasize the use of CMR as a method that over the last 20 years has become a reference in the detection of infarction and assessment of myocardial viability. Resumo O estudo de viabilidade miocárdica é de grande importância para a orientação e manejo de pacientes que necessitam de cirurgia de revascularização miocárdica ou angioplastia. A técnica de realce tardio (RT) é precisa e transformou o estudo de viabilidade em um teste fácil, não só para a detecção de fibrose, mas também como um modelo binário para a detecção do que é ou não é viável. Uma fibrose identificada pelo RT é considerada como não viável quando igual ou maior do que 50% da área segmentar e como viável quando menor que 50%. A ressonância magnética cardíaca (RMC) também pode lançar mão de outras técnicas para estudo funcional e de perfusão para uma avaliação global da doença isquêmica do coração no mesmo exame. Este estudo tem como objetivo destacar os conceitos atuais e enfatizar amplamente o uso da RMC como um método que nos últimos 20 anos se tornou referência na detecção de infarto e avaliação de viabilidade miocárdica.

  10. Vestibular system paresis due to emergency endovascular catheterization.

    PubMed

    Simoceli, Lucinda; Sguillar, Danilo Anunciatto; Santos, Henrique Mendes Paiva; Caputti, Camilla

    2012-04-01

    Objetivo: O objetivo deste relato de caso é descrever uma causa incomum de vestibulopatia periférica associada à perda auditiva unilateral em paciente idoso pós- cateterismo de urgência.Relato de caso: Paciente do gênero masculino, 82 anos, submetido à correção de aneurisma roto de aorta abdominal, no intra-operatório sofreu infarto agudo do miocárdio necessitando de angioplastia primária. Após alta hospitalar refere queixa de hipoacusia acentuada à direita e vertigem incapacitante, sem sinais neurológicos focais. Ao exame clínico otorrinolaringológico apresentava: Teste de Weber lateralizado para a esquerda, nistagmo espontâneo para a esquerda , marcha oscilante, leve disbasia e ataxia, índex-nariz e diadococinesia normais, Teste de Romberg com oscilação sem queda e Fukuda com desvio lateral para a direita. O exame audiométrico evidenciava anacusia à direita e perda neurossensorial à esquerda em agudos, arreflexia vestibular à direita na prova calórica e, na tomografia computadorizada dos ossos temporais e tronco-encefálico, presença de haste metálica atravessando o osso temporal direito, a partir da veia jugular interna e bulbo jugular, atravessando os canais semicirculares posterior, superior e vestíbulo, projetando-se em lobo temporal. O diagnóstico radiológico foi lesão traumática por guia endovascular metálico durante cateterismo de urgência e a conduta, considerando que o paciente não havia compensado o equilíbrio, foi reabilitação vestibular.Conclusão: Queixas de tontura no paciente idoso devem ser criteriosamente avaliadas diante do seu histórico clínico patológico pois os antecedentes de doenças e tratamentos prévios, em geral, direcionam as hipóteses diagnósticas porém podem trazer alterações inesperadas.

  11. PubMed

    Izaola, Olatz; De la Fuente, Beatriz; Gómez Hoyos, Emilia; López Gómez, Juan José; Torres, Beatriz; Ortola, Ana; De Luis, Daniel A

    2017-02-01

    Objetivo: el objetivo de nuestro trabajo fue evaluar la tolerancia de una fórmula enteral con alta densidad energetica en pacientes hospitalizados en una unidad de coronarias con indicación de soporte enteral al menos durante cinco días.Métodos: estudio abierto, no comparativo, no aleatorizado, descriptivo, para evaluar la tolerancia de una fórmula enteral con alta densidad energética en pacientes ingresados en una unidad coronaria.Resultados: se incluyeron 31 pacientes con una media de edad de 67,32 ± 13,8 años y de los cuales el 66,7% eran varones. El volumen medio final prescrito de Nutrison Energy®fue de 928,5 ± 278,5 ml/día (rango: 800-1.500 ml/día). La duración media de la nutrición enteral fue de 11,2 ± 3,2 días. El aporte final promedio de calorías fue de 1.392 ± 417 cal/día, con 169,9 ± 50,9 g/día de hidratos de carbono, 53,8 ± 16,1 g/día de grasas y 55,7 ± 16,9 g/día de proteínas. Tras la administ racion existió un aumento significativo de los niveles de transferrina. Un total de 3 pacientes habían presentado algún episodio de diarrea (9,7%). El número de pacientes que presentaron al menos un episodio de residuo gástrico fue de 5 (16,1%) que no obligo en ningún caso a la suspensión de la nutrición enteral, obligando en 2 pacientes a disminuir el volumen del aporte nutricional durante 24 horas. Durante el soporte nutricional, solo en 3 pacientes fue necesario disminuir el volumen aportado el día previo de la fórmula energética. Con respecto a los vómitos, solo en 1 paciente se constató esta situación (3,2%). Ningún paciente presentó en el estudio otras complicaciones digestivas asociadas a la administración de la fórmula de nutrición enteral. Por último, no se registraron acontecimientos adversos relacionados con la fórmula administrada.Conclusiones: los resultados reflejan que una fórmula enteral con alta densidad energética es una fórmula bien tolerada con una muy baja frecuencia de s

  12. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): macro-and micronutrient requirements].

    PubMed

    Bonet Saris, A; Márquez Vácaro, J A; Serón Arbeloa, C

    2011-11-01

    Energy requirements are altered in critically-ill patients and are influenced by the clinical situation, treatment, and phase of the process. Therefore, the most appropriate method to calculate calorie intake is indirect calorimetry. In the absence of this technique, fixed calorie intake (between 25 and 35 kcal/kg/day) or predictive equations such as the Penn State formula can be used to obtain a more accurate evaluation of metabolic rate. Carbohydrate administration should be limited to a maximum of 4 g/kg/day and a minimum of 2g/kg/day. Plasma glycemia should be controlled to avoid hyperglycemia. Fat intake should be between 1 and 1.5 g/kg/day. The recommended protein intake is 1-1.5 g/kg/day but can vary according to the patient's clinical status. Particular attention should be paid to micronutrient intake. Consensus is lacking on micronutrient requirements. Some vitamins (A, B, C, E) are highly important in critically-ill patients, especially those undergoing continuous renal replacement techniques, patients with severe burns and alcoholics, although the specific requirements in each of these types of patient have not yet been established. Energy and protein intake in critically-ill patients is complex, since both clinical factors and the stage of the process must be taken into account. The first step is to calculate each patient's energy requirements and then proceed to distribute calorie intake among its three components: proteins, carbohydrates and fat. Micronutrient requirements must also be considered. Copyright © 2011 Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L. All rights reserved.

  13. [Acute coronary syndromes in Latin America: lessons from the ACCESS registry].

    PubMed

    Martínez-Sánchez, Carlos; Jerjes-Sánchez, Carlos; Nicolau, José Carlos; Bazzino, Oscar; Antepara, Norka; Mármol, Ricardo

    2016-01-01

    Introducción: se desconocen las características, la evolución y el tratamiento de pacientes latinoamericanos con síndromes coronarios agudos (SCA). Métodos: registro internacional multicéntrico y prospectivo para evaluar riesgo, terapéutica y evolución en SCA. Punto primario: toda causa de mortalidad durante el primer año y mortalidad a 30 días. Ingresaron pacientes con síntomas de isquemia coronaria aguda en las primeras 24 horas del inicio de los síntomas y evidencia electrocardiográfica de isquemia. El diagnóstico final requirió pruebas invasivas o no invasivas. Resultados: entre el 2007 y 2008 se ingresaron en ocho países latinoamericanos 4436 pacientes, 2562 con angina inestable o infarto sin elevación del ST y 2374 con infarto con elevación del ST. Al ingreso tuvieron síntomas agudos 79 y 90 %, respectivamente. Ambos grupos tuvieron retraso entre el inicio de síntomas y el ingreso hospitalario. En infarto y elevación del ST se observó baja accesibilidad a reperfusión farmacológica (29 %) y mecánica (32 %). Al ingreso en ambos el porcentaje de tratamiento basado en evidencia fue bajo. Las complicaciones hospitalarias fueron la insuficiencia cardiaca (angina inestable e infarto sin elevación del ST 10 % y el infarto con elevación del ST 20 %) e isquemia recurrente (8 y 11 %). La mortalidad a 30 días fue 2 % y a un año 8 %. Conclusiones: el registro ACCESS ofrece información contemporánea sobre el espectro de pacientes, el manejo hospitalario y la evolución clínica subsecuente.

  14. [Phase angle as an indicator of nutritional status and prognosis in critically ill patients].

    PubMed

    Reis de Lima e Silva, Renata; Porto Sabino Pinho, Cláudia; Galvão Rodrigues, Isa; Gildo de Moura Monteiro Júnior, José

    2014-09-12

    Introducción: El ángulo de fase (AF) viene siendo considerado una herramienta sensible para evaluar el estado nutricional y la efectividad de las intervenciones dietoterápicas. Objetivo: Evaluar el AF como indicador del estado nutricional y pronóstico en pacientes críticos. Métodos: Estudio prospectivo observacional con pacientes admitidos en Unidades de Cuidado Intensivo Coronarias, entre Mayo y Octubre de 2013. El AF se determinó por medio del análisis por Bioimpedancia Eléctrica, considerándose bajo AF valores inferiores a 5º para los hombres y 4,6º para las mujeres. Los valores obtenidos se relacionaron con otros parámetros de evaluación del estado nutricional: antropométricos (circunferencia del brazo – CB, pliegue cutáneo triciptal – PCT, área muscular del brazo corregida - AMBc circunferencia de pantorrilla – CP) y bioquímico (recuento total de linfocitos, hemoglobina, hematocrito), además de los pronósticos clínicos APACHE II (Acute Physiology and Chronic Health Disease Classification System II) y albúmina sérica. La tabulación y análisis de los datos se realizaron a través del paquete estadístico SPSS versión 13.0. Resultados: La muestra se compuso por 110 pacientes, en la cual se verificó asociación entre bajo AF e insuficiencia renal en diálisis (p.

  15. Time of elevation of head of bed for patients receiving mechanical ventilation and its related factors.

    PubMed

    Martí-Hereu, L; Arreciado Marañón, A

    2017-06-08

    The semirecumbent position is a widespread recommendation for the prevention of pneumonia associated with mechanical ventilation. To identify the time of elevation of head of bed for patients under mechanical ventilation and the factors related to such elevation in an intensive care unit. An observational, descriptive cross-sectional study. Conducted in an intensive care unit of a tertiary hospital from April to June 2015. The studied population were mechanically ventilated patients. Daily hours in which patients remained with the head of the bed elevated (≥30°), socio-demographic data and clinical variables were recorded. 261 head elevation measurements were collected. The average daily hours that patients remained at ≥30° was 16h28' (SD ±5h38'), equivalent to 68.6% (SD ±23.5%) of the day. Factors related to elevations ≥30° for longer were: enteral nutrition, levels of deep sedation, cardiac and neurocritical diagnostics. Factors that hindered the position were: sedation levels for agitation and abdominal pathologies. Sex, age and ventilation mode did not show a significant relationship with bed head elevation. Although raising the head of the bed is an easy to perform, economical and measurable preventive measure, its compliance is low due to specific factors specific related o the patient's clinical condition. Using innovations such as continuous measurement of the head position helps to evaluate clinical practice and allows to carry out improvement actions whose impact is beneficial to the patient. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. A case report: Nursing interventions on a patient with anaphylactic shock in ICU.

    PubMed

    Zariquiey-Esteva, G; Santa-Candela, P

    The care plan of a 42-year-old woman with anaphylactic shock, secondary to ingestion of amoxicillin/clavulanic acid, with upper airway involvement due to laryngeal angioedema, is presented. Previously she had had two episodes of angioedema of unknown origin. The incidence of this phenomenon is between 3.2 and 10 cases/100,000 people/year. An evaluation was made and three altered necessities stood out: breathing and circulation (she needed mechanical ventilation and noradrenalin perfusion), elimination (she required furosemide to keep an acceptable diuresis time), and hygiene and skin protection (she presented generalised hyperaemia, lip, lingual and oropharyngeal oedema). The hospital's Clinical Research Ethics Committee requested the patient's informed consent to access her clinical history. According to the altered necessities, seven diagnoses were prioritised according to NANDA taxonomy: risk of allergic response, risk of infection, risk of ineffective renal perfusion, decreased cardiac output, impaired spontaneous ventilation, risk of unstable blood glucose level, and risk of dysfunctional gastrointestinal motility. Scores of outcome criteria showed a favourable evolution after 24hours. The development of a standardised NANDA-NOC-NIC language in the clinical case presented allowed us to organise the nursing work, facilitating recording and normalising clinical practice. As a limitation of this case, we didn't have serial plasma levels of histamine and tryptase to assess the evolution of anaphylactic symptoms. Highlight the importance of health education in a patient with a history of angioedema. Copyright © 2016 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Quality of sleep in patients undergoing cardiac surgery during the postoperative period in intensive care.

    PubMed

    Navarro-García, M Á; de Carlos Alegre, V; Martinez-Oroz, A; Irigoyen-Aristorena, M I; Elizondo-Sotro, A; Indurain-Fernández, S; Martorell-Gurucharri, A; Sorbet-Amóstegui, M R; Prieto-Guembe, P; Ordoñez-Ortigosa, E; García-Aizpún, Y; García-Ganuza, R

    To describe the quality of sleep of patients undergoing cardiac surgery during the first two nights following surgery and identify some of the factors conditioning the nightly rest of these patients in the Intensive Care Unit. Observational descriptive study based on applying the Richards-Campbell Sleep Questionnaire through a consecutive sample of patients undergoing cardiac surgery with Intensive Care Unit admission. Simultaneously, a questionnaire assessing different environmental factors existing in the unit as possible conditioning of the night's rest was applied. The association between consumption of opioid and sleep quality was studied. Sample of 66 patients with a mean age of 65±11.57 years, of which 73% were men (N=48). The Richards-Campbell sleep questionnaire garnered average scores of 50.33mm (1.st night) and 53.30mm (2.nd night). The main sleep disturbing factors were discomfort with the different devices, 30.91mm and pain, 30.18mm. The problems caused by environmental noise, 27.5mm or through the voices of the professionals, 26.53mm were also elements of nocturnal discomfort. No statistical association was found between sleep and the distance of the patient with respect to the nursing control area or related to opioid analgesics. The quality of sleep during the first two nights of Intensive Care Unit admission was "regular". The environmental factors that conditioned the night-time rest of patients were discomfort, pain and ambient noise. Copyright © 2016 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Evaluation and handling of constipation in critical patients.

    PubMed

    Pérez-Sánchez, J; Fernández-Boronat, J; Martínez-Méndez, E; Marín-Cagigas, M L; Mota-Puerto, D; Pérez-Román, M C; Martínez-Estalella, G

    2017-06-07

    To evaluate the effectiveness of nursing care against constipation and to identify, analyze and evaluate causes and consequences. Observational, descriptive and prospective study in polyvalent ICU tertiary hospital (2013-2015). >18 years, stay >7 days, connected to respiratory support, with nasogastric tube and enteral or mixed nutrition. Patients with gastrointestinal pathology, encephalopathic and jejunostomy/ileostomy were excluded. The studied variables (age, sex, weight, height, pathology, medical treatment, nutrition and volume type, depositional characteristics, quantity and frequency, corrective measures and complications) were collected by ad hoc grill. It is authorized by the CEIC. 139 patients with a mean age of 62 years and average stay of 11 days were analyzed; 63% suffered from constipation. Opiates and antacid were the drugs administered most frequently (99%), even though patients who took muscle relaxants, iron supplements and/or calcium and anti-hypertensive were the ones who suffered most from constipation (77%; 75%; 70%) The fiber free diet was the most widely used (60% constipated), followed by dietary fiber (51% constipated), and the combination of both (85% constipated). 56% used laxatives as a corrective measure, Magnesium Hydroxide being the most widely used; 54% began the first day. Gastric retention was the most relevant complication (49%). Constipation is a real multifactorial problem. We recommend: • Intensified surveillance in patients with drugs that promote constipation. • Use high-fiber diets from the outset. • Apply laxatives and prokinetics early and in combination. We need to create a protocol for prophylaxis and management of constipation. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Prevention and treatment of skin lesions associated with non-invasive mechanical ventilation. Recommendations of experts.

    PubMed

    Raurell-Torredà, M; Romero-Collado, A; Rodríguez-Palma, M; Farrés-Tarafa, M; Martí, J D; Hurtado-Pardos, B; Peñarrubia-San Florencio, L; Saez-Paredes, P; Esquinas, A M

    In the last two decades, non-invasive mechanical ventilation (NIV) has been consolidated as an initial strategy for the management of respiratory failure in critical adult and paediatric patients. To identify risk factors and preventive strategies to reduce the incidence of skin lesions associated with clinical devices (LESADIC) related to NIV, as well as the most effective treatment for injuries that cannot be avoided. Review in the MEDLINE, CINAHL and Cochrane databases of studies published in the last 10years to reach consensus through an expert panel. Knowledge about how to measure correct mask size and protection of the skin with foam or hydrocolloids dressings are factors related to the incidence of LESADIC, as it conditions the degree of pressure-friction and shear that the interface exerts on the skin. The interface that causes fewer LESADIC and is better tolerated is the face mask. When there are injuries, the first thing is to remove the interface that causes pressure on damaged skin, recommending a Helmet(®) hood as an alternative, treating the infection, managing the exudate and stimulating perilesional skin. The mask of choice is the facial, always using foam or hydrocolloid dressings on the nasal bridge. Evaluate the condition of the skin under the interface and harness every 4hours (recommended) and 11hours (maximum). Evaluate the rotation strategy of the interface at 24hours if the NIV is still needed on an ongoing basis. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Validity of contents of a paediatric critical comfort scale using mixed methodology.

    PubMed

    Bosch-Alcaraz, A; Jordan-Garcia, I; Alcolea-Monge, S; Fernández-Lorenzo, R; Carrasquer-Feixa, E; Ferrer-Orona, M; Falcó-Pegueroles, A

    2017-07-28

    Critical illness in paediatric patients includes acute conditions in a healthy child as well as exacerbations of chronic disease, and therefore these situations must be clinically managed in Critical Care Units. The role of the paediatric nurse is to ensure the comfort of these critically ill patients. To that end, instruments are required that correctly assess critical comfort. To describe the process for validating the content of a paediatric critical comfort scale using mixed-method research. Initially, a cross-cultural adaptation of the Comfort Behavior Scale from English to Spanish using the translation and back-translation method was made. After that, its content was evaluated using mixed method research. This second step was divided into a quantitative stage in which an ad hoc questionnaire was used in order to assess each scale's item relevance and wording and a qualitative stage with two meetings with health professionals, patients and a family member following the Delphi Method recommendations. All scale items obtained a content validity index >0.80, except physical movement in its relevance, which obtained 0.76. Global content scale validity was 0.87 (high). During the qualitative stage, items from each of the scale domains were reformulated or eliminated in order to make the scale more comprehensible and applicable. The use of a mixed-method research methodology during the scale content validity phase allows the design of a richer and more assessment-sensitive instrument. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  1. [Registry of myocardial infarction in a tertiary hospital of the Instituto Mexicano del Seguro Social].

    PubMed

    González-Pliego, José Angel; Gudiño-Amezcua, Diego Armando; Celis, Alfredo; Gutiérrez-Díaz, Gonzalo Israel

    2014-01-01

    Introducción: dado que el pronóstico de infarto del miocardio con elevación del segmento ST (IMCEST) depende de su manejo inmediato y de las medidas de prevención secundaria, el no seguir las recomendaciones actuales impide mejorar las expectativas de la población afectada por este padecimiento. El objetivo es describir el perfil clínico-epidemiológico y el proceso de atención del IMCEST en un hospital de tercer nivel. Métodos: se analiza la información clínica, la estratificación de riesgo, la terapia de revascularización y los hábitos de prescripción al egreso de los casos con IMCEST atendidos en un año. Resultados: se incluyeron 246 pacientes con edad promedio de 61 años; el 76 % fueron varones. La mayoría (37.3 %) de IMCEST ocurrió entre los 60 y los 69 años. El sedentarismo fue el factor de riesgo predominante. El 81.7 % de los casos tuvo score TIMI de riesgo bajo. El 35 % tuvo isquemia/viabilidad y en todos los cateterizados se demostraron obstrucciones coronarias. El 76 % se revascularizó con stent, principalmente farmacológico (77.5 %). Al egreso más del 90 % de los casos recibió estatina y antiplaquetarios, mientras otras drogas se prescribieron al 64-82 % de los casos. Conclusiones: el IMCEST predomina en hombres sedentarios de la séptima década. Estratificar el riesgo, buscar isquemia/viabilidad residual y revascularizar con stent farmacológico son prácticas comunes; el cumplimiento de recomendaciones basadas en la evidencia es mejor que en el pasado, pero todavía no es óptimo.

  2. Nursing workload and adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia. A pilot study.

    PubMed

    Jam, R; Hernández, O; Mesquida, J; Turégano, C; Carrillo, E; Pedragosa, R; Gómez, V; Martí, L; Vallés, J; Delgado-Hito, P

    2017-09-07

    To analyse whether adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia (VAP) is associated with nursing workload. A prospective observational study performed in a single medical-surgical ICU. Nurses in charge of patients under ventilator support were assessed. knowledge questionnaire, application of non-pharmacological VAP prevention measures, and workload (Nine Equivalents of Nursing Manpower Use Score). Phases: 1) the nurses carried out a educational programme, consisting of 60-minute lectures on non-pharmacological measures for VAP prevention, and at the end completed a questionnaire knowledge; 2) observation period; 3) knowledge questionnaire. Among 67 ICU-staff nurses, 54 completed the educational programme and were observed. A total of 160 observations of 49 nurses were made. Adequate knowledge was confirmed in both the initial and final questionnaires. Application of preventive measures ranged from 11% for hand washing pre-aspiration to 97% for the use of a sterile aspiration probe. The Nine Equivalents of Nursing Manpower Use Score was 50±13. No significant differences were observed between the association of the nurses' knowledge and the application of preventive measures or between workload and the application of preventive measures. Nurses' knowledge of VAP prevention measures is not necessarily applied in daily practice. Failure to follow these measures is not subject to lack of knowledge or to increased workload, but presumably to contextual factors. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Extracorporeal life support for patients with acute respiratory distress syndrome: report of a Consensus Conference.

    PubMed

    Richard, Christian; Argaud, Laurent; Blet, Alice; Boulain, Thierry; Contentin, Laetitia; Dechartres, Agnès; Dejode, Jean-Marc; Donetti, Laurence; Fartoukh, Muriel; Fletcher, Dominique; Kuteifan, Khaldoun; Lasocki, Sigismond; Liet, Jean-Michel; Lukaszewicz, Anne-Claire; Mal, Hervé; Maury, Eric; Osman, David; Outin, Hervé; Richard, Jean-Christophe; Schneider, Francis; Tamion, Fabienne

    2014-01-01

    The influenza H1N1 epidemics in 2009 led a substantial number of people to develop severe acute respiratory distress syndrome and refractory hypoxemia. In these patients, extracorporeal membrane oxygenation was used as rescue oxygenation therapy. Several randomized clinical trials and observational studies suggested that extracorporeal membrane oxygenation associated with protective mechanical ventilation could improve outcome, but its efficacy remains uncertain. Organized by the Société de Réanimation de Langue Française (SRLF) in conjunction with the Société Française d'Anesthésie et de Réanimation (SFAR), the Société de Pneumologie de Langue Française (SPLF), the Groupe Francophone de Réanimation et d'Urgences Pédiatriques (GFRUP), the Société Française de Perfusion (SOFRAPERF), the Société Française de Chirurgie Thoracique et Cardiovasculaire (SFCTV) et the Sociedad Española de Medecina Intensiva Critica y Unidades Coronarias (SEMICYUC), a Consensus Conference was held in December 2013 and a jury of 13 members wrote 65 recommendations to answer the five following questions regarding the place of extracorporeal life support for patients with acute respiratory distress syndrome: 1) What are the available techniques?; 2) Which patients could benefit from extracorporeal life support?; 3) How to perform extracorporeal life support?; 4) How and when to stop extracorporeal life support?; 5) Which organization should be recommended? To write the recommendations, evidence-based medicine (GRADE method), expert panel opinions, and shared decisions taken by all the thirteen members of the jury of the Consensus Conference were taken into account.

  4. Extracorporeal life support for patients with acute respiratory distress syndrome: report of a Consensus Conference

    PubMed Central

    2014-01-01

    The influenza H1N1 epidemics in 2009 led a substantial number of people to develop severe acute respiratory distress syndrome and refractory hypoxemia. In these patients, extracorporeal membrane oxygenation was used as rescue oxygenation therapy. Several randomized clinical trials and observational studies suggested that extracorporeal membrane oxygenation associated with protective mechanical ventilation could improve outcome, but its efficacy remains uncertain. Organized by the Société de Réanimation de Langue Française (SRLF) in conjunction with the Société Française d’Anesthésie et de Réanimation (SFAR), the Société de Pneumologie de Langue Française (SPLF), the Groupe Francophone de Réanimation et d’Urgences Pédiatriques (GFRUP), the Société Française de Perfusion (SOFRAPERF), the Société Française de Chirurgie Thoracique et Cardiovasculaire (SFCTV) et the Sociedad Española de Medecina Intensiva Critica y Unidades Coronarias (SEMICYUC), a Consensus Conference was held in December 2013 and a jury of 13 members wrote 65 recommendations to answer the five following questions regarding the place of extracorporeal life support for patients with acute respiratory distress syndrome: 1) What are the available techniques?; 2) Which patients could benefit from extracorporeal life support?; 3) How to perform extracorporeal life support?; 4) How and when to stop extracorporeal life support?; 5) Which organization should be recommended? To write the recommendations, evidence-based medicine (GRADE method), expert panel opinions, and shared decisions taken by all the thirteen members of the jury of the Consensus Conference were taken into account. PMID:24936342

  5. Admission to Intensive Care for a trauma related to alcohol or drugs, a 'teachable moment' for the beginning of a change.

    PubMed

    Cordovilla-Guardia, S; Vilar-López, R; Lardelli-Claret, P; Navas, J F; Guerrero-López, F; Fernández-Mondéjar, E

    To estimate how many of the trauma patients admitted to ICU would be candidates for a secondary prevention programme for trauma related to alcohol or drug use by brief motivational intervention and to define what factors prevent that intervention being performed. All 16-70year old trauma patients (n=242) admitted to ICU in 32 non-consecutive months (November 2011 to March 2015) were included in the study, coinciding with the implementation of a screening and brief motivational intervention programme for trauma patients related to substance consumption. The programme includes screening for exposure to substances at admission. Sociodemographic and clinical variables were collected prospectively. The screening for substances was not performed in 38 (15.7%) of all admitted patients. Of the patients screened, 101 (49.5%) were negative. The variables that in greater proportion impeded intervention between screening positive patients were neurological damage due to the trauma with 23 patients (37.1%) and prior psychiatric disorder with 18 (29%). Both variables were associated with substance consumption: negatives 9.9% vs positive 22.3% (P=.001) and negatives 3% vs positive 17.5% (P=.016) respectively. The number of candidates for motivational intervention was 41, 16.9% of all admitted patients. Almost 2 out of 10 patients were potential candidates. The factors that in a greater proportion precluded the intervention were the same as those associated with consumption. Mortality in ICU was associated with non-compliance with the screening protocol. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  6. [Not Available].

    PubMed

    Moreno Villares, José Manuel

    2016-07-12

    El desarrollo durante el periodo fetal y los primeros años de vida se caracteriza por su crecimiento rápido y la maduración de órganos y sistemas. Los cambios tanto en la calidad como en la cantidad de los nutrientes que consumen la mujer embarazada y el niño en ese periodo pueden influir de forma permanente sobre esos órganos en desarrollo. Esos efectos se conocen como "programación" y constituyen un factor importante en la aparición de enfermedades no transmisibles a lo largo de toda la vida, fundamentalmente en la edad adulta; en especial, la enfermedad cardiovascular, el síndrome metabólico y la intolerancia a los hidratos de carbono. Las carencias nutricionales durante el embarazo que ocasionan un crecimiento intrauterino retardado se asocian a un riesgo aumentado de diabetes tipo 2 y de enfermedad coronaria en la descendencia. Esa influencia en la aparición de enfermedades no transmisibles en la vida adulta también está marcada por el tipo y duración de la lactancia y por la alimentación complementaria. La explicación más plausible es que estos factores nutricionales -junto a otros no nutricionales- modifican la expresividad de determinados genes, modificando la respuesta de determinados órganos y tejidos, remodelando su estructura y su función. Estos cambios epigenéticos pueden transmitirse de una generación a la siguiente, por lo que se pone aún más en evidencia la importancia del fenómeno de la programación metabólica temprana. Pero al mismo tiempo abren una ventana de oportunidad a que modificando las pautas de alimentación de la mujer embarazada y del niño pequeño podamos disminuir la carga asociada a este tipo de enfermedades.

  7. Simple extraction methods that prevent the artifactual conversion of chlorophyll to chlorophyllide during pigment isolation from leaf samples

    PubMed Central

    2013-01-01

    Background When conducting plant research, the measurement of photosynthetic pigments can provide basic information on the physiological status of a plant. High-pressure liquid chromatography (HPLC) is becoming widely used for this purpose because it provides an accurate determination of a variety of photosynthetic pigments simultaneously. This technique has a drawback compared with conventional spectroscopic techniques, however, in that it is more prone to structural modification of pigments during extraction, thus potentially generating erroneous results. During pigment extraction procedures with acetone or alcohol, the phytol side chain of chlorophyll is sometimes removed, forming chlorophyllide, which affects chlorophyll measurement using HPLC. Results We evaluated the artifactual chlorophyllide production during chlorophyll extraction by comparing different extraction methods with wild-type and mutant Arabidopsis leaves that lack the major isoform of chlorophyllase. Several extraction methods were compared to provide alternatives to researchers who utilize HPLC for the analysis of chlorophyll levels. As a result, the following three methods are recommended. In the first method, leaves are briefly boiled prior to extraction. In the second method, grinding and homogenization of leaves are performed at sub-zero temperatures. In the third method, N, N’-dimethylformamide (DMF) is used for the extraction of pigments. When compared, the first two methods eliminated almost all chlorophyllide-forming activity in Arabidopsis thaliana, Glebionis coronaria, Pisum sativum L. and Prunus sargentii Rehd. However, DMF effectively suppressed the activity of chlorophyllase only in Arabidopsis leaves. Conclusion Chlorophyllide production in leaf extracts is predominantly an artifact. All three methods evaluated in this study reduce the artifactual production of chlorophyllide and are thus suitable for pigment extraction for HPLC analysis. The boiling method would be a practical

  8. Simple extraction methods that prevent the artifactual conversion of chlorophyll to chlorophyllide during pigment isolation from leaf samples.

    PubMed

    Hu, Xueyun; Tanaka, Ayumi; Tanaka, Ryouichi

    2013-06-19

    When conducting plant research, the measurement of photosynthetic pigments can provide basic information on the physiological status of a plant. High-pressure liquid chromatography (HPLC) is becoming widely used for this purpose because it provides an accurate determination of a variety of photosynthetic pigments simultaneously. This technique has a drawback compared with conventional spectroscopic techniques, however, in that it is more prone to structural modification of pigments during extraction, thus potentially generating erroneous results. During pigment extraction procedures with acetone or alcohol, the phytol side chain of chlorophyll is sometimes removed, forming chlorophyllide, which affects chlorophyll measurement using HPLC. We evaluated the artifactual chlorophyllide production during chlorophyll extraction by comparing different extraction methods with wild-type and mutant Arabidopsis leaves that lack the major isoform of chlorophyllase. Several extraction methods were compared to provide alternatives to researchers who utilize HPLC for the analysis of chlorophyll levels. As a result, the following three methods are recommended. In the first method, leaves are briefly boiled prior to extraction. In the second method, grinding and homogenization of leaves are performed at sub-zero temperatures. In the third method, N, N'-dimethylformamide (DMF) is used for the extraction of pigments. When compared, the first two methods eliminated almost all chlorophyllide-forming activity in Arabidopsis thaliana, Glebionis coronaria, Pisum sativum L. and Prunus sargentii Rehd. However, DMF effectively suppressed the activity of chlorophyllase only in Arabidopsis leaves. Chlorophyllide production in leaf extracts is predominantly an artifact. All three methods evaluated in this study reduce the artifactual production of chlorophyllide and are thus suitable for pigment extraction for HPLC analysis. The boiling method would be a practical choice when leaves are not too

  9. Serum uric acid can predict higher C-reactive protein levels in apparently healthy men.

    PubMed

    de Carvalho Vidigal, Fernanda; de Lima Rosado, Lina Enriqueta Frandsen Paez; Paixão Rosado, Gilberto; Lanes Ribeiro, Rita de Cassia; Castro Franceschini, Sylvia do Carmo

    2014-04-01

    Introducción: Los estudios epidemiológicos han demostrado una asociación entre la enfermedad coronaria y nuevos factores de riesgo cardiovascular, como, los niveles de proteína C-reactiva ultrasensible (PCR-us) y fibrinógeno. Objetivos: Evaluar la capacidad de los indicadores bioquímicos en discriminar cambios en los niveles de PCRus y fibrinógeno, en hombres adultos sanos. Métodos: Se evaluaron 130 hombres (20-59 años). Se midió peso y talla. Se realizó mediciones bioquímicas (perfil lipídico, glucosa en ayunas, ácido úrico, PCR-us y fibrinógeno). Se calculó el índice de masa corporal, la relación colesterol total/HDL-c y la relación LDL-c/HDL-c. Se consideró como punto de corte para los valores de PCR-us ≥0,12 mg/dL y para el fibrinógeno se utilizó el percentil 50 de la muestra evaluada. Resultados: El ácido úrico mostró la mejor correlación (r = 0,325) y el área más alta bajo la curva ROC (0,704 ± 0,054), mostrando una mayor capacidad predictiva para detectar niveles más altos de PCR-us (p < 0,01). La relación colesterol total/HDL-c (r = 0,222) y la relación LDLc/ HDL-c (r = 0,235) mostraron una mejor correlación y el área más alta bajo la curva ROC (0,624 ± 0,049 y 0,624 ± 0,049) en la identificación de niveles más altos de fibrinógeno (p < 0,05). Conclusiones: El ácido úrico y la relación colesterol total/ HDL-c y la relación LDL-c/HDL-c mostraron una mayor capacidad predictiva para detectar cambios en los niveles de PCR-us y fibrinógeno, respectivamente. Se sugirió el uso de marcadores bioquímicos en la práctica clínica, a fin de establecer medidas preventivas para la enfermedad cardiovascular en hombres adultos sanos.

  10. [Guidelines for specialized nutritional and metabolic support in the critically ill-patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): obese patient].

    PubMed

    Mesejo, A; Sánchez Álvarez, C; Arboleda Sánchez, J A

    2011-11-01

    interpreting these data. Copyright © 2011 Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L. All rights reserved.

  11. Hemodynamic Changes in Left Anterior Descending Coronary Artery and Anterior Interventricular Vein during Right Ventricular Apical Pacing: A Doppler Ultrasound Study in Open Chest Beagles

    PubMed Central

    Fu, Ying; Long, Bin; Shen, Jie; Su, Li; Yin, Lixue

    2013-01-01

    Objective The aim of this study was to quantify the effects of right ventricular apical pacing (RVAP) on hemodynamics in left anterior descending coronary artery (LAD) and anterior interventricular vein (AIV) contrast to baseline condition in open chest beagles using Doppler ultrasound imaging. Methods In 6 anesthetized open chest beagles, the spectral Doppler waveforms of the middle segmental LAD and the AIV were acquired with a 5 MHz linear array transducer at baseline condition and during RVAP. The aortic pressure-time curves were recorded synchronously. The Doppler hemodynamic parameters of the LAD and AIV at both states were derived and compared. Results The spectral Doppler waveforms of the LAD had a principal diastolic positive wave (Dp), which heelled by a momentary negative wave and a positive wave during early systole at baseline condition. During RVAP, an additional negative wave appeared in the LAD at late systole. The duration of the Dp shortened (227.83±12.16 ms vs 188.50±8.97 ms, P<0.001), and the acceleration of the Dp decreased (11.85±2.22 m/s2 vs 3.54±0.42 m/s2, P<0.001). The spectral Doppler waveforms of the AIV only had a principal positive wave (Sp) at baseline condition, but an additional diastolic negative wave appeared during RVAP. The duration of the Sp shortened (242.99±7.98 ms vs 215.38±15.44 ms, P<0.001), and the acceleration of the Sp decreased (9.61±1.93 m/s2 vs 1.01±0.11 m/s2, P<0.001). Conclusions Obvious hemodynamic changes in the LAD and AIV during RVAP were observed, and these abnormal flow patterns in epicardial coronary arteries and vena coronaria may be sensitive and important hints of the disturbed cardiac electrical and mechanical activity sequences. PMID:23825640

  12. Metabolic syndrome and nutrition in a Granada's tropical coast population.

    PubMed

    Millán, S; Samaniego-Sánchez, C; Romero, A; Quesada-Granados, J J; López-García de la Serrana, H

    2013-01-01

    Antecedentes: El síndrome metabólico (SM) es una asociación de problemas de salud que pueden aparecer de forma simultánea o secuencial en un mismo individuo, y es importante porque se relaciona con un incremento significativo de riesgo de diabetes, enfermedad coronaria y enfermedad cerebrovascular. La nutrición junto a otros factores como es el ejercicio físico y la genetica del individuo, influyen en la prevención del SM. Objetivo: Conocer aspectos importantes como el diagnostico, prevalencia y prevención del síndrome metabólico en población de la Costa Tropical Granadina. Métodos: Se estudiaron en 119 individuos de la Costa Granadina parámetros como el indice de masa corporal, el porcentaje de grasa corporal, análisis clínicos de glucosa, colesterol total, colesterol HDL, colesterol LDL y estudiaron valores nutricionales mediante encuesta. Resultados: En el estudio se obtuvo una prevalencia el Síndrome metabólico del 20,2%, del que el 58,3% correspondía a mujeres. Los resultados obtenidos reflejan diferencias estadísticas significativas entre los individuos con síndrome metabólico y el grupo control, observándose dichas diferencias en parámetros tales como IMC o el porcentaje de grasa corporal. Sin embargo en parámetros como porcentaje de lípidos, porcentaje de hidratos de carbono, porcentaje de proteínas y kcal/día no hay diferencias significativas entre los individuos con SM y los individuos control. Conclusión: De esta manera podemos deducir del estudio que la prevalencia de síndrome metabólico en la población de la Costa Tropical Granadina se asemeja a la obtenida en EE.UU y a la obtenida en algunas zonas estudiadas en España. Igualmente, se puede apreciar en este estudio como el síndrome metabólico es más frecuente en personas con IMC y % de grasa corporal superior a 30.

  13. Coronary artery bypass grafting in the octogenarian. Is complete revascularization always necessary?

    PubMed

    Concistrè, Giovanni; Dell'Aquila, Angelo Maria; Gallo, Alina; Pansini, Stefano; Piccardo, Alessandro; Rapetto, Filippo; Passerone, Giancarlo; Regesta, Tommaso

    2015-01-01

    La rivascolarizzazione miocardica completa è importante nei pazienti giovani sottoposti ad intervento di bypass aortocoronarico (CABG), ma questo principio resta poco chiaro nei pazienti anziani. Lo scopo del nostro studio è valutare se la completezza della rivascolarizzazione influenzi gli outcomes negli ultraottantenni. Abbiamo analizzato retrospettivamente 130 pazienti ultraottantenni (età media: 82 ± 10 anni; range: 80-90 anni) sottoposti presso il nostro Istituto a CABG tra Gennaio 2003 e Settembre 2010. In accordo con la strategia operatoria utilizzata, i pazienti sono stati suddivisi in 2 gruppi: pazienti sottoposti a rivascolarizzazione completa (Gruppo RC) (96 pazienti) e pazienti sottoposti a rivascolarizzazione incompleta (Gruppo RI) (34 pazienti). Per rivascolarizzazione incompleta si è inteso l’assenza di bypass su un territorio miocardico vascolarizzato da una coronaria con una stenosi ≥ 50%. Il follow-up è stato completato al 98% (medio: 30 ± 25 mesi; range: 3 mesi – 7.5 anni). La mortalità intraospedaliera complessiva è stata del 13% ed è stata simile nei 2 gruppi (p=0.0553). L’analisi multivariata ha identificato la frazione di eiezione preoperatoria ≤ 40% (p=0.0060; OR=0.19) e la classe NYHA > II (p=0.0042; OR=0.17) fattori di rischio di mortalità intraospedaliera. L’analisi di Cox non ha identificato la rivascolarizzazione incompleta come fattore di rischio di mortalità precoce e tardiva (p=0.1381 e p=0.8865). Non sono state riscontrate differenze tra i 2 gruppi in termini di sopravvivenza a 5 anni e libertà da eventi cardiaci e cerebrovascolari maggiori (MACCE) (p=0.8865 e p=0.6283). Probabilmente i maggiori benefici di una rivascolarizzazione completa si hanno nei pazienti più giovani, che hanno un’aspettativa di vita maggiore. In conclusione il nostro studio mostra che, seppur con una limitata coorte di pazienti, negli ultraottantenni sottoposti a CABG la rivascolarizzazione incompleta non influenza la sopravvivenza

  14. Incidence of moisture-associated skin damage in an intensive care unit.

    PubMed

    Valls-Matarín, J; Del Cotillo-Fuente, M; Ribal-Prior, R; Pujol-Vila, M; Sandalinas-Mulero, I

    To determine the incidence of moisture-associated skin damage (MASD) in the nappy area, identify predisposing factors and know the preventive measures and nursing records. Descriptive longitudinal study (June 2014-April 2015) in a general ICU. Patients whose stay >48hours and without skin lesions were included. The skin was assessed daily until the appearance of MASD, discharge or a maximum of 14 days. Demographics, stay, MASD type, incontinence, number and consistency of stools, obesity, Braden scale and prevention were recorded. 145 patients (66.2% male) were studied, median age was 69 (P25=56.5, P75=76) and median length of stay was five days (P25=3, P75=11.25), 29.9% were obese. Incontinence-associated dermatitis (IAD) was detected in 26.2% and intertriginous dermatitis (ITD) in 15.9%. MASD was recorded in 23.8%. The variables causing IAD to develop were faecal incontinence, number of stools, liquid stools, and stay. Those for ITD were obesity and score on the Braden scale. Multivariate analysis selected faecal incontinence (OR=5.4, CI95%: 1.1-26) and the number of stools (OR=1.1, CI95%:1.0-1.2) as independent variables for developing IAD and obesity (OR=2.8, CI95%:1.0-8.2) and Braden (OR=0.8, CI95%:0.7-1.0) for developing ITD. Prevention to 23.8% of obese and 42.9% of incontinent was performed. There is a high incidence in MASD. Faecal incontinence and higher number of stools are the risk factors for developing IAD. Obesity and a lower score on the Braden scale may affect susceptibility to ITD. Recording of MASD and its prevention in patients at risk is insufficient. Copyright © 2016 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. [Anatomopathological findings during development of diabetic cardiomyopathy in rats].

    PubMed

    Manjarrez-Gutiérrez, Gabriel; Hernández-Chávez, Victor; Neri-Gómez, Teresa; Boyzo-Montes de Oca, Alfonso; Mondragón-Herrera, José Antonio; Hernández-Rodríguez, Jorge

    2014-01-01

    Antecedentes: la miocardiopatía diabética ocurre en ambos tipos de diabetes mellitus y en su patogenia intervienen la hiperglucemia y los cambios metabólicos asociados. Objetivo: caracterizar los diferentes cambios patológicos que aparecen durante la evolución de la miocardiopatía diabética en la rata. Material y métodos: estudio transversal comparativo en dos grupos de ratas diabéticas por la administración de estreptozotocina. A los 14, 21 y 30 días de la administración del tóxico se obtuvieron los corazones, que se colocaron en p-formaldehído al 4%. Se efectuaron cortes de 5 μm y se tiñeron con hematoxilina-eosina, tricrómica de Masson e inmunocitoquímica con anticuerpos anti β-tubulina. Resultados: a los 14 días de la aplicación de la estreptozotocina se observaron en el miocardio sinusoides dilatadas y depósito de colágena entre las fibras de Purkinje e intersticio cardiaco. A los 21 días disminuyó la luz arteriolar por hiperplasia de la capa media. A los 30 días del estudio se hicieron más evidentes los sinusoides cardiacos y los depósitos de colágena y un importante desarreglo del sistema microtubular de los cardiomiocitos. Conclusiones: los sinusoides cardiacos, que representan un patrón vascular fetal y la fibrosis intersticial en el miocardio y el desarreglo microtubular de los cardiomiocitos, apoyan el hecho de que el mecanismo fisiopatológico de la miocardiopatía diabética se inicia en la microcirculación coronaria debido a cambios en el metabolismo cardiaco que contribuyen a la disfunción miocárdica durante el estado diabético.

  16. PubMed

    Martín Castellanos, Ángel; Cabañas Armesilla, María Dolores; Barca Durán, Francisco Javier; Martín Castellanos, Pedro; Gómez Barrado, José Javier

    2017-02-01

    Introducción: la obesidad es un factor de riesgo asociado al infarto de miocardio aunque el índice cintura-cadera ha mostrado mayor poder predictivo.Objetivo: análisis antropométrico Receiver Operating Characteristic(ROC) en infartados para identificar la fuerza discriminatoria de mediciones, obesidad, ratios cintura-cadera, ratios cintura-talla e índice de conicidad.Métodos: estudio caso-control de infarto miocárdico en varones europeos. Ciento doce casos/112 controles de 30-74 años fueron reclutados. Se midieron: peso, talla, cintura, cintura umbilical y cadera. Se obtuvieron las áreas bajo la curva (ABC), las odds ratioy correlaciones de medidas e indicadores.Resultados: IMC [ABC: 0,686 (0,616-0,755); OR: 3,3], cintura [ABC: 0,734 (0,668-0,800); OR: 5,7], talla [ABC: 0,623 (0,550-0,696); OR: 2,3], cadera [ABC: 0,555 (0,479-0,631); OR: 1], cintura-cadera [ABC: 0,796 (0,737-0,855); OR: 9,9]; cintura umbilical-cadera [ABC:0,830 (0,775-0,885); OR: 5,5], cintura umbilical-talla [ABC: 0,788 (0,729-0,847); OR: 7,5]; conicidad [ABC: 0,795 (0,738-0,853); OR:9]. Cintura-talla y conicidad presentaron altas correlaciones de riesgo (todas r ≥ 0,85; p < 0,001).Conclusiones: cintura y talla son medidas con riesgo independiente asociado. La circunferencia de cadera no es discriminatoria. Obesidad e índices de cintura están asociados al infarto con diferente fuerza. La obesidad presenta una asociación débil. Los índices cintura-cadera presentan las mejores curvas ROC, pero sesgadas en su poder predictivo de riesgo. Cintura umbilical-talla y conicidad presentan alto poder discriminatorio y mejores correlaciones antropométricas de riesgo, por lo que se recomienda su uso en la identificación de la obesidad como factor asociado al infarto de miocardio y en todas las estrategias de promoción de la salud coronaria.

  17. [Evolution of contrast nephropathy in patients with chronic kidney disease undergoing a percutaneous coronary intervention].

    PubMed

    López-López, Bibiana; Pérez-López, María Juana; García-Rincón, Andrés; Vázquez-Vega, Benjamín

    2015-01-01

    Introducción: la transición epidemiológica de enfermedades infecciosas a enfermedades crónicodegenerativas está demandando mayor número de procedimientos que requieren medio de contraste, lo cual resulta ser un factor de riesgo para daño renal agudo de importancia en pacientes con enfermedad renal crónica, patología frecuente en pacientes con enfermedades crónicodegenerativas. El objetivo de este artículo es describir la frecuencia y evolución de nefropatía por medio de contraste en pacientes ambulatorios con enfermedad renal crónica sometidos a intervención coronaria percutánea. Métodos: se incluyeron 32 pacientes con daño renal al momento de su exposición al medio de contraste. Se les dio un riesgo y se les ajustaron las medidas de prevención con seguimiento a las 48 horas. El análisis estadístico se realizó con estadística descriptiva. Resultados: de 1236 cateterismos cardiacos realizados, 32 pacientes cumplieron los criterios de inclusión. El 78.13 % fueron hombres y el 21.88 % mujeres. El 96.87 % presentó enfermedades crónico-degenerativas como diabetes o hipertensión, el sobrepeso y la obesidad fueron una constante en el 65.62 % de los casos, en el 21.7 % de los pacientes la dosis de contraste fue ligeramente mayor a la recomendada. El 6.3 % desarrollaron nefropatía por medio de contraste a pesar de las medidas de prevención, sin embargo ninguno de ellos requirió sustitución de la función renal. Conclusiones: la frecuencia de nefropatía por medio de contraste en pacientes con factores de alto riesgo fue menor a la reportada en la literatura, en todos los casos se realizó valoración nefrológica y manejo previo al procedimiento.

  18. [Characteristics of diabetes mellitus patients under a chronic disease program].

    PubMed

    López, Ana Cristina; Aguirre, Ana Noemi; Roitter, Claudia Valentina; Aguirre, Jorge Alberto; Cecchetto, Eugenio; Bernet, Jorgelina; García, Adelaida Judith; Mantaras, José

    2015-01-01

    La Diabetes Mellitus (DM) es una enfermedad crónica no transmisible con una prevalencia en Argentina del 9,8%. El seguimiento de pacientes con DM se realiza en un Programa de Enfermedades Crónicas desarrollado en la obra social universitaria DASPU, de la Universidad Nacional de Córdoba Argentina. Objetivo: describir características clínicas de personas con DM de un programa de seguimiento. Identificar variables de control metabólico asociadas a la presencia de complicaciones. Material y método. Estudio observacional, transversal, descriptivo. Se incluyeron datos de pacientes con DM bajo programa del año 2010. Las variables categóricas se describen como proporciones y las numéricas como media ±DE. La comparación de medias se realizó mediante test de Student. Resultados: total 1017 casos, edad media 61 ±14 años, 54,6% masculinos, DM tipo 1: 8,5%, DM tipo 2: 90,9%, DM gestacional: 0,7%. Factores de riesgo cardiovascular: hipertensión arterial en 78%, dislipemia en 35%. Complicaciones microvasculares: 25,5%, macrovasculares: 18,6%. La enfermedad coronaria fue la complicación más frecuente: 14,5%. El 69% presentó valores de hemoglobina glicosilada (HbA1C) ≤7,4%; el promedio de colesterol total fue 185 mg/dl y de colesterol LDL 111 mg/dl. El promedio de HbA1C fue más elevado en pacientes con complicaciones microvasculares que sin complicaciones: 7,47% vs 7,18% (p=0,009). En pacientes con complicaciones macrovasculares hubo una tendencia inversa, no significativa (7,21% vs 7,26%; p=0,65). El promedio de colesterol total fue menor en el grupo con complicaciones macrovasculares (173 mg/dl vs 189 mg/dl; p=0,001). Igual comportamiento se observó en relación al C-LDL (101 vs 113 mg/dl; p=0,001). Conclusión: Las características clínicas evaluadas coinciden en su distribución y complicaciones con estudios epidemiológicos reportados en la bibliografía, los valores de HbA1C y colesterol total alcanzan valores óptimos en un gran porcentaje de nuestra

  19. Impact of obesity in patients infected with 2009 influenza A(H1N1).

    PubMed

    Díaz, Emili; Rodríguez, Alejandro; Martin-Loeches, Ignacio; Lorente, Leonardo; Del Mar Martín, María; Pozo, Juan Carlos; Montejo, Juan Carlos; Estella, Angel; Arenzana, Ángel; Rello, Jordi

    2011-02-01

    A large proportion of patients infected with 2009 influenza A(H1N1) (A[H1N1]) are obese. Obesity has been proposed as a risk factor influencing outcome in these patients. However, its role remains unclear. We evaluate the outcome of patients who are obese and infected with A(H1N1) in the ICU, determining whether obesity is a risk factor for mortality. This was a prospective, observational, and multicenter study performed in 144 ICUs in Spain. Data were obtained from the Grupo de Trabajo en Enfermedades Infecciosas de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (GTEI/SEMICYUC) registry. Adult patients with A(H1N1) that was confirmed by real-time polymerase chain reaction were included in the analysis. Patients who were obese (BMI > 30) were compared with patients who were nonobese. Cox regression analysis was used to determine adjusted mortality. Differences of P < .05 were considered significant. In January 2010, the GTEI/SEMICYUC registry had complete records for 416 patients. One hundred and fifty patients (36.1%) were obese, of whom 67 (44.7%) were morbidly obese (BMI > 40). Mechanical ventilation (MV) was more frequently applied in patients who were obese (64% vs 52.4%, P < .01) Patients with obesity remained on MV longer than patients who were nonobese (6.5 ± 10.3 days vs 9.3 ± 9.7 days, P = .02), had longer ICU length of stay (10.8 ± 12.1 days vs 13.7 ± 11.7 days, P = .03), and had longer hospitalization (18.2 ± 14.6 days vs 22.2 ± 16.5 days, P = .02). Mortality adjusted by severity and potential confounders identified that obesity was not significantly associated with ICU mortality (hazard ratio, 1.1; 95% CI, 0.69-1.75; P = .68). In our cohort, patients who were obese and infected with A(H1N1) did not have increased mortality. However, there was an association between obesity and higher ICU resource consumption.

  20. [Analysis of the situation of intensive care units].

    PubMed

    Cuenca, M; Asiain, M C; Marín, B

    1995-01-01

    Since 1990, the Sociedad Española de Enfermería Intensiva y Unidades Coronarias has carried out initiatives aiming to collect data which allows us to make an analysis of the status of the ICU nurses and the characteristics of the Units where these professionals develop their activity. This project was performed during 1992 and 1993, with a survey in 132 sanitary centres of the public network in the national territory, in which information about the number of ICUs and their number of beds, number of nurses and assistants in the institution and those ones specifically assigned to ICU, number of admissions, average stay, occupation percentage, admission causes, use of systems of valuation of the seriousness index, staff seniority, shift systems, staff stability, etc; all this data and others referring to 1991. From 53 hospitalary centres that answered the questionnaire, we obtained information of 94 ICUs in which there was an average of 10.4 beds, with 550 admissions per unit (average/year) and an index of occupation of 78%. The average number of nurses who work in each ICU was 22.7, with a nurse/bed ratio in the global calculation of staff of 2.18. In the analysis of shifts, the nurse/bed ratio was one nurse to every 2.08 patients (1:2.08) when there is a maximum of staff during the morning shift. This index is lower in the other shifts. The average of assistants is 12.1 with an assistant/bed ratio of 1.17. When studying the shifts systems, the rotatory shift outstands in 53.19% of ICUs and the existence of rotation systems of staff in other units is 8.5%. With reference to the characteristics of the staff, the average seniority of Nurses was 6.7 years, 76.4% have own their post and the percentage of new intake in 1991 was 22.5%. The lack of incentives to work in ICU is notable, the most problematic aspects being the insufficient economic remuneration, lack of motivation, scarce human resources and insufficient training, among others. Finally, according to the

  1. [Management of parenteral nutrition in intensive care units in Spain].

    PubMed

    Vaquerizo Alonso, Clara; Mesejo, Alfonso; Acosta Escribano, José; Ruiz Santana, Sergio

    2013-01-01

    y en glucosa, el 42% con SMOF (Soja, MCT, Oliva, Pescado) y el 33% con EBAO (Emulsiones Basadas en Aceite de Oliva) como emulsión lipídica. El 92% adiciona glutamina. Un 60% considera que la nueva fórmula puede estar indicada en sepsis, trauma, quemados y FMO (Fracaso Multiorgánico) y un 30% la utilizaría de rutina al ingreso. Un 40% considera que disminuye las necesidades de insulina, 50% un mejor manejo del volumen y un 60% destaca la relación proteínas/volumen. Evolutivamente, los pacientes con fórmula específica tienen menor afectación hepática, mayor aporte proteico y menor aporte de volumen, sin diferencias significativas, y precisaron menos dosis de insulina (p = 0,07). Conclusiones: En las doce UCIs seleccionadas, los patrones de práctica clínica en el manejo de la nutrición parenteral se adaptan a las recomendaciones de sociedades científicas como la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC), Sociedad Española de Nutrición Parenteral y Enteral (SENPE) y European Society for Clinical Nutrition and Metabolism (ESPEN). Las nuevas fórmulas diseñadas para el paciente grave pueden tener indicaciones en estas patologías.

  2. Satisfaction with medication in coronary disease treatment: psychometrics of the Treatment Satisfaction Questionnaire for Medication.

    PubMed

    Liberato, Ana Carolina Sauer; Rodrigues, Roberta Cunha Matheus; São-João, Thaís Moreira; Alexandre, Neusa Maria Costa; Gallani, Maria Cecília Bueno Jayme

    2016-06-07

    ão através da Morisky Self-Reported Measure of Medication Adherence Scale [Medida de Auto-Relato de Adesão ao Tratamento Medicamentoso] e proporção de aderência. Os efeitos Teto e Chão foram analisados considerando os 15% piores e 15% melhores escores possíveis obtidos no TSQM; Praticidade foi avaliada pelo tempo gasto na aplicação do TSQM durante a entrevista; Aceitabilidade foi verificada pela proporção de itens não respondidos e participantes que responderam todos os itens; Confiabilidade foi verificada com o coeficiente alfa de Cronbach e Validade através da validade de construto convergente entre o TSQM e as medidas de adesão. o TSQM foi facilmente aplicado. O efeito teto foi encontrado no domínio efeitos colaterais e o efeito chão foi encontrado nos domínios efeitos colaterais e satisfação global. Evidência de confiabilidade foi próxima de satisfatória em todos os domínios. A validade de construto convergente foi parcialmente apoiada. a versão brasileira do TSQM apresenta evidência de aceitabilidade e praticidade embora sua validade tenha sido pouco apoiada e consistência interna adequada foi observada em um domínio. testar las propiedades psicométricas de la versión brasileña del Treatment Satisfaction Questionnaire for Medication - TSQM (versión 1.4), considerando los efectos techo y suelo, factibilidad, aceptabilidad, confiabilidad y validez. participantes con enfermedad coronaria (n=190) fueron reclutados de una clínica ambulatoria de cardiología en un hospital universitario en el sudeste de Brasil y entrevistados para evaluar su satisfacción con la medicación con el TSQM (versión 1.4) y su adhesión con la Morisky Self-Reported Measure of Medication Adherence Scale y proporción de adhesión. Los efectos techo y suelo fueron analizados considerando los 15% peores y mejores puntuaciones en el TSQM; la factibilidad fue evaluada por el tiempo gasto durante las entrevistas de TSQM; la aceptabilidad por la proporción de ítems no