Asunto(s)
FN-kappa B/metabolismo , Monoéster Fosfórico Hidrolasas/metabolismo , Psoriasis/metabolismo , Tensinas/metabolismo , Adulto , Regulación hacia Abajo/fisiología , Humanos , Sistema de Señalización de MAP Quinasas/fisiología , Persona de Mediana Edad , Fosfatidilinositol 3-Quinasas/metabolismo , Estudios Prospectivos , Proteínas Proto-Oncogénicas c-akt/metabolismoRESUMEN
We investigated the effects of head rotation on the cross-sectional area of the right internal jugular vein and its relative position to the carotid artery. Eighty-eight subjects were divided into infants and children groups. The cross-sectional area of the right internal jugular vein and the degree of the carotid artery overlap were measured at 0 degrees (neutral), 40 degrees and 80 degrees of head rotation. The cross-sectional area of the right internal jugular vein was significantly larger at 40 degrees and 80 degrees head rotation compared with the neutral position in both infants and children (p < 0.001). As the head was rotated, the percentage overlap of the carotid artery increased significantly (p < 0.001). We suggest that 40 degrees head rotation appears to be optimal for right internal jugular vein cannulation in paediatric patients.
Asunto(s)
Movimientos de la Cabeza/fisiología , Venas Yugulares/anatomía & histología , Factores de Edad , Anestesia General , Arterias Carótidas/anatomía & histología , Arterias Carótidas/diagnóstico por imagen , Cateterismo Venoso Central/métodos , Niño , Preescolar , Femenino , Humanos , Lactante , Venas Yugulares/diagnóstico por imagen , Venas Yugulares/fisiología , Masculino , Rotación , UltrasonografíaRESUMEN
BACKGROUND: Confirmatory tests for failure of transfer of passive immunity (FTPI) in dairy calves require direct measurements of the serum immunoglobulin G concentration. Enzyme-linked immunosorbent assay (ELISA) has advantages over single radial immunodiffusion (SRID) in terms of cost and time. OBJECTIVES: To evaluate the agreement between ELISA and SRID, and to compare the diagnostic performance of ELISA with indirect methods, in the detection of FTPI in calves. ANIMALS: One hundred and fifteen dairy calves (aged 0-10 days) from 23 calf-rearing facilities. METHODS: Prospective, observational study. The agreement between SRID and ELISA was determined by the Bland-Altman method. Fixed bias (SRID - ELISA) was calculated. For comparison of the diagnostic performance of ELISA with indirect methods, sensitivity, specificity, and area under the curve (AUC) of receiver operating characteristic (ROC) curves were calculated at cut-off values of 500 and 1,000 mg/dL. RESULTS: The agreement between SRID and ELISA was 94%. Fixed bias (SRID - ELISA) was 140 +/- 364 mg/dL. The AUC and sensitivity of ELISA at the cut-off value of 1,000 mg/dL were higher than those of indirect methods (P<.004). The specificity of ELISA at the cut-off value of 1,000 mg/dL was not higher than that of indirect methods, except for serum total protein concentration assay. CONCLUSION AND CLINICAL IMPORTANCE: ELISA exhibited good diagnostic performance and good agreement with SRID. ELISA is an adequate method for both screening and confirmatory tests for FTPI in dairy calves at the cut-off value of 500 mg/dL.