RESUMEN
ABSTRACT: Bacillus cereus spores have the ability to adhere to solid surfaces, including stainless steel, a material widely used in food industries. Adhesion of spores allows recontamination during food processing, and cleaning and disinfection are largely used by industries to control them. Hence, this study aims to assess the detachment capacity (or removing activity) of detergents based on sodium hydroxide, nitric acid, phosphoric acid, and chlorine against two adhered B. cereus spores (one hydrophobic and other hydrophilic) to stainless steel surfaces. Microorganism adhesion on the surfaces reached 5.5 log CFU/cm2 for the two strains studied. Two protocols composed of combinations of chemical compounds, concentration, temperature, and contact time were tested. The inactivation kinetics shapes were convex and modeled by the Weibull model. The effects of temperature and biocide concentration were quantified using a Bigelow-like model. The temperature applied during the cleaning-in-place treatment is an important factor acting on the speed of inactivation or detachment of B. cereus spores. However, this efficiency depends on the hydrophobic characteristics of B. cereus spores. The concentration of detergent and acid also affects the inactivation rate, whereas the characteristic of hydrophobicity does not intervene for the chlorine alkaline treatments.
Asunto(s)
Detergentes , Desinfectantes , Bacillus cereus , Detergentes/farmacología , Desinfectantes/farmacología , Interacciones Hidrofóbicas e Hidrofílicas , Esporas Bacterianas/fisiología , Acero InoxidableRESUMEN
Among 498 patients hospitalised for myocardial infarction during a three year period, 194 (39%) were aged over 70 (mean age: 78.6 +/- 6), including 99 women and 95 men. Comparison of this group of patients with those aged under 70 showed a significantly higher hospital mortality (17.5% v. 6.5%) (p < 0.01) and a higher acute complication rate (60.8% v. 23.7% (p < 0.01), in particular after the age of 75. Twenty-eight patients were treated by thrombolysis (14.4% v. 50.6%) (p < 0.05), with a 79.2% patency rate in follow-up angiography at 48 h, and only one non-fatal hemorrhagic complication. Eighty-six patients were investigated by coronary arteriography (44.9% v. 87.2% (p < 0.05) without any complication. Mean ejection fraction was 57.3 +/- 13.5%. Fifty patients were treated by angioplasty (24.6% v. 57%) (p < 0.01) including 15 during the acute phase, with primary success in 40 of them (80%). Ten patients underwent coronary bypass following their infarction (5.1% v. 6.25%) (NS) with two per- or postoperative deaths (20%). Follow-up study revealed high secondary mortality with an overall survival rate at one year of 59.6% v. 81% in patients aged under 70 (p < 0.01). In total, infarction in the elderly is characterised by high mortality and morbidity as compared with infarctions in patients aged under 70, and requires active management during the acute phase, assessed according to the physiological status and age of the patient.
Asunto(s)
Infarto del Miocardio/epidemiología , Anciano , Anciano de 80 o más Años , Envejecimiento , Angioplastia , Femenino , Estudios de Seguimiento , Hospitalización , Humanos , Masculino , Infarto del Miocardio/mortalidad , Infarto del Miocardio/terapia , Factores de Riesgo , Encuestas y Cuestionarios , Terapia Trombolítica , Resultado del TratamientoRESUMEN
Many enzyme systems such as glutathione peroxidase (GPx) or superoxide dismutase (SOD) neutralise the oxygen derived free radicals produced during myocardial reperfusion by thrombolysis. Erythrocytic SOD, plasma and erythrocytic GPx and their cofactor selenium, substances reacting with thiobarbituric acid (TBARS) were analysed by repeated sampling between T0 and 48 hours in 24 patients treated by thrombolysis for acute myocardial infarction. Angiographic control was undertaken systematically between 60 and 180 minutes after initiating thrombolytic therapy: 18 patients had a patent vessel and 6 patients had an occluded vessel recanalised in 5 cases by angioplasty. Biological analysis was performed in the 23 patients successfully revascularised by thrombolysis, eventually completed by angioplasty. The plasma GPx decreased non-significantly between T0 and 2 hours from 246.8 +/- 53.3 to 233 +/- 39 U/ml with a significant increase between 2 and 48 hours from 233 +/- 39.2 to 294 +/- 76 U/ml, whereas the erythrocytic GPx rose significantly and constantly between T0 and 48 hours from 34.8 +/- 7.1 to 37.6 +/- 7.5 U/gHb with significant consumption of selenium between T0 and 4 hours from 81.2 +/- 14 to 68.5 +/- 12.6 micrograms/l. The erythrocytic SOD increased significantly between T0 and 48 hours from 318.9 +/- 40.8 to 337 +/- 59 U/gHb. Finally, the analysis of plasma TBARS showed a non-significant rise between T0 and 30 minutes from 1.59 +/- 0.30 to 1.71 +/- 1.43 mm/l with a return to the basic line values after about 2 hours. These results show a significant increase in the activity of enzymes protecting against the liberation of oxygen free radicals, such as erythrocyte or plasma GPx and erythrocyte SOD between T0 and 48 hours with consumption of selenium, cofactor of GPx, and an increase in circulating lipid peroxydes in acute myocardial infarction treated by thrombolysis. They also illustrate the oxidative stress which occurs in this situation.
Asunto(s)
Fibrinolíticos/uso terapéutico , Glutatión Peroxidasa/sangre , Malondialdehído/sangre , Infarto del Miocardio/metabolismo , Oxígeno/metabolismo , Superóxido Dismutasa/sangre , Adulto , Anciano , Eritrocitos/enzimología , Femenino , Radicales Libres , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/sangre , Infarto del Miocardio/tratamiento farmacológico , Selenio/sangre , Terapia Trombolítica/métodosRESUMEN
Mixed venous oxygen saturation (SVO2) is an haemodynamic parameter of cardiovascular function. The object of this study was to measure SVO2 during percutaneous transluminal coronary angioplasty (PTCA) with prolonged balloon inflation in order to evaluate haemodynamic tolerance more precisely in two groups of patients. Twenty-six patients undergoing PTCA were divided into two groups: Group I, N = 15, with single vessel disease and good left ventricular function (EF: 61.63 +/- 10.1%); Group II, N = 11, with triple vessel disease and poor left ventricular function (EF: 48.05 +/- 14%; p < 0.05). Continuous monitoring of SVO2 with an oximetrix fiber optic catheter was performed in all patients during PTCA. Irrespective of the duration of balloon inflation, a significant correlation was observed between the changes in cardiac output and VSO2. Given that arterial oxygen pressure, global oxygen consumption and haemoglobin concentrations remained constant during balloon inflation, SVO2 was an indicator of cardiac output.
Asunto(s)
Angioplastia Coronaria con Balón , Enfermedad Coronaria/terapia , Oxígeno/sangre , Adulto , Anciano , Enfermedad Coronaria/sangre , Enfermedad Coronaria/fisiopatología , Femenino , Hemodinámica , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico , Oximetría , Volumen Sistólico , Venas , Función Ventricular IzquierdaRESUMEN
The authors report a case of myocardial infarction in a 27 year old patient by simultaneous thrombosis of the left anterior descending and right coronary arteries in an angiographically normal coronary circulation. The young age of the patient, the absence of the usual risk factors and a normal angiographic network after arterial recanalisation by angioplasty led to the search for a risk factor of thrombosis. This showed a qualitative deficiency of protein S and the absence of any other abnormality of coagulation or fibrinolysis. This case raises the question of a causal relationship between a hereditary protein S deficiency and thrombotic arterial occlusion.
Asunto(s)
Trombosis Coronaria/etiología , Infarto del Miocardio/etiología , Deficiencia de Proteína S , Adulto , Angioplastia Coronaria con Balón , Pruebas de Coagulación Sanguínea , Angiografía Coronaria , Trombosis Coronaria/terapia , Humanos , Masculino , Infarto del Miocardio/terapiaRESUMEN
This study reports two cases of acute severe Coxsackie virus B4 myocarditis in which the immediate clinical signs suggested the acute phase of myocardial infarction, apparently antero-lateral in the first case in a context of cardiogenic shock and infero-lateral in the second case, in the context of acute pulmonary edema. Both cases were characterized by the severity of the initial signs. Numerous other cases of acute Coxsackie virus B myocarditis, simulating myocardial infarction, have been reported in the literature and these contexts deserve to be recognized earlier as they call for specific treatment. The immediate outcome was favorable in both cases but required massive cardiological intensive care in the first patient. Long term follow-up was excellent.
Asunto(s)
Infecciones por Coxsackievirus , Enterovirus Humano B , Miocarditis/microbiología , Enfermedad Aguda , Adulto , Femenino , Humanos , Masculino , NecrosisRESUMEN
This study reports the results of routine evaluation to detect coronary and carotid atherosclerosis in 200 asymptomatic and hypercholesterolemic patients (48 +/- 10 years: 72.5% men). All patients underwent physical examination, blood lipid profile, an exercise test and cervical echo-doppler. If the exercise electrocardiogram was abnormal, a thallium isotope scan and/or coronary arteriography were performed. Hypercholesterolemia was severe (3.03 +/- 0.52 g/l). 77.5% of patients had pure hypercholesterolemia. Carotid atherosclerosis in the form of plaque (27.5%) or stenosis (3.5%) was found in 31% of patients. This carotid atheroma was commoner in older patients (51.9 +/- 9 years as against 47 +/- 10 years, p < 0.01). Twenty patients (10%) had electrical signs of ischemia provoked by exercise. Six of them had a normal thallium isotope scan and did not undergo coronary arteriography. Coronary arteriography was abnormal in 10 patients (5%): 7 had stenotic lesions and 3 showed evidence of spasm during the methylergometrine test. In total, the hypercholesterolemic patients investigated here were characterised by subclinical atherosclerosis which was frequent but certainly underestimated by non-invasive studies. The existence of an atherosclerotic lesion is an additional argument in favour of starting cholesterol-lowering treatment.
Asunto(s)
Arteriosclerosis/prevención & control , Enfermedades de las Arterias Carótidas/prevención & control , Enfermedad de la Arteria Coronaria/prevención & control , Hipercolesterolemia/complicaciones , Adulto , Anciano , Envejecimiento , Constricción Patológica/prevención & control , Angiografía Coronaria , Prueba de Esfuerzo , Femenino , Humanos , Hipercolesterolemia/diagnóstico por imagen , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Cintigrafía , UltrasonografíaRESUMEN
Reversible ventricular fibrillation occurred in a 35 year old multiparous woman after the administration of the association mifepristone (Mifegyne) and sulprostone (Nalador) for therapeutic abortion. A coronary spasm induced by the analogue of the prostaglandin PGE 2x was though to be the causative mechanism and was reproduced by the Ergonovine test. The evolution of the ECG and myocardial scintigraphy suggested a slowly regressive stunned myocardium.
Asunto(s)
Abortivos no Esteroideos/efectos adversos , Aborto Terapéutico/métodos , Vasoespasmo Coronario/inducido químicamente , Dinoprostona/análogos & derivados , Paro Cardíaco/inducido químicamente , Mifepristona/efectos adversos , Fibrilación Ventricular/inducido químicamente , Vasoespasmo Coronario/fisiopatología , Dinoprostona/efectos adversos , Combinación de Medicamentos , Cardioversión Eléctrica , Electrocardiografía , Femenino , Corazón/diagnóstico por imagen , Paro Cardíaco/fisiopatología , Humanos , Embarazo , Cintigrafía , Factores de Riesgo , Radioisótopos de Talio , Fibrilación Ventricular/terapiaRESUMEN
To determine if impairment of left ventricular filling is influenced by acute myocardial infarction in patients with arterial hypertension, left ventricular diastolic function was assessed by pulsed doppler echocardiography in 46 patients (pts) subdivided into four groups (Gr): G.1 (n = 12 pts) with acute myocardial infarction and hypertensive heart disease. G.2 (n = 12 pts) acute myocardial infarction without arterial hypertension. G.3 (n = 10 pts) arterial hypertension without history of coronary artery disease. G.4 (n = 12 pts) healthy subjects. Coronary angiography and left ventricular cineangiogram was performed in 24 pts (G.1 + G.2). Peak mitral flow velocity (cm/s) in early diastole (E), atrial systole (A), A/E and int A/int E ratios were measured by pulsed doppler. Age and heart rate were statistically similar in all groups. No difference was found among G.1 and G.2 in ejection fraction, and left ventricular segmental kinetic. (tables; see text) Conclusion left ventricular filling is impaired in pts with arterial hypertension and in pts with acute myocardial infarction; acute myocardial infarction increase the impairment of left ventricular diastolic function in pts with hypertensive heart disease.
Asunto(s)
Ecocardiografía Doppler , Hipertensión/fisiopatología , Infarto del Miocardio/fisiopatología , Anciano , Diástole , Ventrículos Cardíacos/fisiopatología , Humanos , Hipertensión/complicaciones , Persona de Mediana Edad , Infarto del Miocardio/complicacionesRESUMEN
Between October, 1985 and June, 1987, 125 patients aged 70 years or more were admitted to the Cardiology Department of Purpan Hospital, Toulouse for unstable angina pectoris. 107 of these patients have been followed up, i.e.: 76 men and 31 women aged from 70 to 85 years (mean 74.5 +/- 3.2 years). 49 patients (46 p. 100) had angina at rest of the intermediate syndrome type; 46 (43 p. 100) had rapidly progressive effort angina, and 12 (11 p. 100) had effort angina de novo. The patients' general condition was preserved in 85 p. 100 of the cases and altered in 15 p. 100. ECG was normal in only 10 p. 100 of the patients; it showed signs of established ischaemia in 70 p. 100 of the cases and sequelae of infarction in 23 p. 100. The mean cardiothoracic ration was 49.9 +/- 4.8 p. 100. The ejection fraction was 62 +/- 14.6 p. 100, the end-diastolic volume 86.9 +/- 32.2 ml/m2 and the left ventricular end-diastolic pressure 15.8 +/- 7.2 mmHg. 69 patients (64.5 p. 100) had calcifications in their coronary arteries. At coronary arteriography 21 patients (19.6 p. 100) showed stenosis of the main stem, 11 patients (10.3 p. 100) had a single vessel disease, 28 (26.2 p. 100) a two-vessel disease and 47 (43.9 p. 100) a three-vessel disease. Treatment was medical in 41 patients (38.3 p. 100) and surgical in 44 patients (41.12 p. 100); transluminal coronary angioplasty (TCA) was performed in 23 patients (21.5 p. 100).(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Angina de Pecho , Angina Inestable , Anciano , Anciano de 80 o más Años , Angina Inestable/complicaciones , Angina Inestable/terapia , Angioplastia de Balón , Angiografía Coronaria , Femenino , Estudios de Seguimiento , Hemodinámica , Humanos , Masculino , Factores de RiesgoRESUMEN
We report a study using Doppler echocardiography looking for pulmonary arterial hypertension (HTAP) in 36 patients presenting with chronic airflow obstruction (BPCO) who are in a stable state. 18 of these (group 1) had confirmed HTAP by right heart catheterisation which had been done the day before and was defined as a mean pulmonary arterial pressure (PAPm) of greater than 20 mm of mercury. The other 18 patients (group 2) did not have HTAP at rest. The systolic ejection flow and the duration of the peak (expressed in msec) was analysed at the time of each examination. The Doppler data was compared between the two groups of patients and also with the results obtained in ten healthy subjects. The Doppler examination was successfully performed in 35 patients in spite of a poor echographic window in 86% of cases. When there was HTAP, the systolic ejection flow had a triangular aspect which contrasted with the dome shaped appearance of the normals. In group 1 the peak time was significantly shortened (p less than 0.01) compared to group 2 and to the healthy subjects. On the other hand there was no linear correlation between the value of the peak time and the level of HTAP measured by the catheter. Thus the severity of HTAP could not be precisely measured using these parameters. In considering that the peak time is normally greater than 100 msec, the sensitivity and specificity of the Doppler examination for the detection of HTAP during the course of BPCO are 90 and 88% respectively, which appears to be superior to the values obtained using other non invasive methods in the diagnosis of HTAP.
Asunto(s)
Ecocardiografía , Hipertensión Pulmonar/diagnóstico , Enfermedades Pulmonares Obstructivas/fisiopatología , Adulto , Anciano , Presión Sanguínea , Cateterismo Cardíaco , Femenino , Insuficiencia Cardíaca/fisiopatología , Humanos , Hipertensión Pulmonar/fisiopatología , Enfermedades Pulmonares Obstructivas/complicaciones , Masculino , Persona de Mediana Edad , Arteria Pulmonar/fisiopatología , SístoleRESUMEN
Glomus tumours are uncommon, though not exceptional, benign growths developed from the constituents of the "neuromyoarterial glomus" initially described by Masson. Two cases of subungual glomus tumours of the hand in middle-aged women are reported. In spite of characteristic symptoms, with paroxysmal episodes of pain triggered off by cold and the most minute traumas, and of the finding in both cases of a violine++ tumour under the nail, the condition was belatedly diagnosed (7 and 27 years respectively after the onset of symptoms). Diagnosis rested not so much on standard radiography, which showed erosion of the distal phalanx in both patients, as on arteriography of the hand which displayed a small vascular pool at the arterial stage. Tumoral excision was successful.
Asunto(s)
Dedos , Tumor Glómico/diagnóstico , Angiografía , Femenino , Dedos/irrigación sanguínea , Humanos , Persona de Mediana Edad , UñasRESUMEN
The authors report the case of a 29 year old North African patient with Behçet's disease presenting with sudden thrombosis of the superior vena cava. Venous disorders are the fourth major sign of this disease. Although superficial thrombophlebitis is a common presenting sign, caval thrombosis is rare and usually occurs after several years' evolution. Superior vena caval thrombosis may be life threatening due to complications such as pulmonary embolism and haemoptysis. The anatomical substrate of this form of vascular disease is the same as that of the other visceral lesions of Behçet's disease: predominantly venous vasculitis with perivascularitis and secondary thrombosis. The pathogenesis of this thrombotic diathesis is discussed.