RESUMEN
The geometries and the static dipole (hyper)polarizabilities (alpha, beta, gamma) of a series of aromatic anions were investigated at the ab initio (HF, MP2, and MP4) and density functional theory DFT (B3LYP) levels of theory. The anions chosen for the present study are the benzenethiolate (Ph-S-), benzenecarboxylate (Ph-CO2-), benzenesulfinate (Ph-SO2-), benzenesulfonate (Ph-SO3-), and 1,3-benzenedicarboxylate (1,3-Ph-(CO2)2(2-)). For benzenethiolate anion, additional alpha, beta, and gamma calculations were performed at the coupled cluster CCSD level with MP2 optimized geometries. The standard diffuse and polarized 6-31+G(d,p) basis set was employed in conjunction to the ab initio and DFT methods. Additional HF calculations were performed with the 6-311++G(3d,3p) basis set for all the anions. The correlated electric properties were evaluated numerically within the formalism of finite field. The optimized geometries were analyzed in terms of the few reports about the phenolate and sulfonate ions. The results show that electron correlation effects on the polarizabilities are very important in all the anion series. Was found that Ph-SO2- is highly polarizable in terms of alpha and beta, and the Ph-S- is the highest second hyperpolarizable in the series. The results of alpha were rationalized in terms of the analysis of the polarization of charge based in Mulliken atomic population and the structural features of the optimized geometries of anions, whereas the large differences in the beta and gamma values in the series were respectively interpreted in terms of the bond length alternation BLA and the separation of charge in the aromatic ring by effects of the substitution. These results allowed us to suggest the benzenesulfinate and benzenethiolate anions as promising candidates that should be incorporated in ionic materials for second and third-order nonlinear optical devices.
Asunto(s)
Derivados del Benceno/química , Modelos Químicos , Teoría Cuántica , Aniones/química , Estructura MolecularRESUMEN
OBJECTIVE: To evaluate the usefulness of a tracer of 1% ethanol in 1. 5% glycine in the early detection of irrigation fluid absorption during transurethral resection of the prostate (TURP). PATIENTS AND METHODS: Patients (120) undergoing TURP were irrigated with 1% ethanol in 1.5% glycine solution and their expired air tested for alcohol every 10 min during the procedure. RESULTS: In all, 112 patients were assessed; over half of the patients absorbed the irrigation fluid and they had a significantly lower postoperative serum sodium concentration (P < 0.002). Fourteen patients (12.5%) absorbed over 500 mL and two (1.8%) developed clinical features of the TUR syndrome. The experience of the surgeon, the weight of resected chips and the operative duration were not significantly predictive of absorption. CONCLUSION: A tracer amount of ethanol in the irrigant is reliable for detecting absorption. Irrigating fluid absorption was unpredictable, thus supporting the case for routine monitoring.
Asunto(s)
Etanol , Glicina , Enfermedades de la Próstata/cirugía , Irrigación Terapéutica/métodos , Resección Transuretral de la Próstata/métodos , Absorción , Anciano , Anciano de 80 o más Años , Combinación de Medicamentos , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To assess the feasibility and advantages of urology clinical nurse specialists (NSs) extending their professional role to include inserting initial suprapubic catheters in selected patients in the hospital and community setting. PATIENTS AND METHODS: A urology NS, who is also the district continence adviser, was formally taught by a consultant urologist how to insert suprapubic catheters using the 'Add-a-Cath' introducer technique (Femcare, UK). Once deemed competent, the NS was indemnified by the Trust to carry out the procedure in carefully selected patients using a safe and unequivocal protocol. RESULTS: Over a period of 40 months, the NS undertook the procedure in 164 patients, with 64 being catheterized in the community. There were no serious complications in the series and during the period studied, only 17 patients were referred back to the urologists for catheterization under formal theatre conditions. CONCLUSION: Initial suprapubic catheterization can be carried out safely by trained NSs in selected patients. This extended professional role has helped to improve the continuity and quality of care for patients who require long-term catheterization. The NS was also a valuable source of training for junior medical staff who have limited experience with suprapubic catheterization.
Asunto(s)
Enfermeras Clínicas , Cateterismo Urinario/enfermería , Trastornos Urinarios/enfermería , Enfermería en Salud Comunitaria , Estudios de Factibilidad , Hospitalización , HumanosRESUMEN
OBJECTIVE: To assess the contribution of a plain X-ray of the kidney, ureters and bladder (KUB) to the assessment of patients presenting with symptoms of bladder outlet obstruction. PATIENTS AND METHODS: All patients presenting to the 'Prostate' clinic at Weston General Hospital during the 12 months from 1 May 1993 to 30 April 1994 were assessed clinically by a history, examination and routine investigations that included a KUB examined and reported by a radiologist. Patients were followed and treatment instituted as deemed appropriate. The contribution made to the management of the patient by the KUB was assessed. RESULTS: Of the 292 patients, 234 had no relevant abnormality detected: four patients had evidence of a bladder calculus, whilst in four osteosclerotic areas were noted on the pelvis and lumbar spine. Of the remainder, 14 (5%) had upper urinary tract calcification. In no patients did the KUB influence their immediate management. Those with asymptomatic upper tract stones were offered a yearly follow-up. CONCLUSIONS: The routine use of the KUB as a means of investigating lower urinary tract symptoms in the male may no longer be necessary.
Asunto(s)
Enfermedades de la Próstata/diagnóstico por imagen , Trastornos Urinarios/diagnóstico por imagen , Calcinosis/diagnóstico por imagen , Estudios de Seguimiento , Humanos , Enfermedades Renales/diagnóstico por imagen , Masculino , Estudios Prospectivos , Radiografía , Enfermedades Ureterales/diagnóstico por imagen , Enfermedades de la Vejiga Urinaria/diagnóstico por imagen , Trastornos Urinarios/etiologíaAsunto(s)
Colipasas/química , Modelos Moleculares , Precursores de Proteínas/química , Secuencia de Aminoácidos , Animales , Dicroismo Circular , Precursores Enzimáticos , Humanos , Espectroscopía de Resonancia Magnética , Homología de Secuencia de Aminoácido , Espectroscopía Infrarroja por Transformada de FourierRESUMEN
Although the cognitive impairments in dementia are the defining aspect, the non-cognitive changes such as behavioural disturbance and personality change are very common and may cause great distress to the patient and the carer. This article reviews the definition, prevalence and nature of behavioural disturbance in dementia. In addition, we review assessment scales and published reports of psychological, physical and psychosocial management strategies. Finally, we present the results of a successful randomized controlled trial of an individualized intervention package for behavioural manifestations of dementia. We conclude that this approach can help alleviate some of the distressing symptoms of dementia.
Asunto(s)
Hematuria/etiología , Auditoría Médica , Urografía , Inglaterra , Humanos , Derivación y ConsultaRESUMEN
We present two patients known to have prostate cancer who presented with acute cerebellar signs. The neurological deficit of the first patient was due to a paraneoplastic cerebellar manifestation and progressed, despite evidence of response of the primary prostate tumour to hormonal manipulation. The second case, resulting from a solitary cerebellar metastasis, was amenable to surgical intervention and subsequent hormonal manipulation. This latter patient has experienced no recurrent neurological signs after a period of 7 years follow-up. This is the first report of a paraneoplastic cerebellar deficit and, to our knowledge, only the sixth case of parenchymatous cerebellar metastasis of prostatic origin to appear in the literature.
Asunto(s)
Enfermedades Cerebelosas/etiología , Neoplasias Cerebelosas/secundario , Síndromes Paraneoplásicos/etiología , Neoplasias de la Próstata/complicaciones , Enfermedad Aguda , Anciano , Estudios de Seguimiento , Humanos , Masculino , Neoplasias de la Próstata/patologíaAsunto(s)
Administración Hospitalaria/educación , Comercialización de los Servicios de Salud/organización & administración , Canadá , Recolección de Datos , Educación de Postgrado , Conocimientos, Actitudes y Práctica en Salud , Administración Hospitalaria/estadística & datos numéricos , Comercialización de los Servicios de Salud/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud , Estados Unidos , Universidades/organización & administración , Universidades/estadística & datos numéricosRESUMEN
The correlation between a new tumor marker, B5, and tumour behaviour in bladder cancer was recorded and an assessment made of the value of combining the B5 test with urine cytology for predicting the presence of tumour. The study group included 57 new patients, of whom 32 were B5 positive at diagnosis and were well marked by B5 on follow-up. There were no false positive shifts in new patients who became free of observable tumour, whilst 1 of 13 patients with persistent disease showed a false negative shift. When the findings from 199 cystoscopies were compared with the results of B5 and urine cytology, B5 was found to improve the prediction of recurrent tumour over cytology alone. Moreover, a high incidence of occult malignancy (7/19) was found in patients where cystoscopy had failed to show recurrence but whose combined marker results were both positive.
Asunto(s)
Biomarcadores de Tumor/sangre , Carcinoma de Células Transicionales/sangre , Neoplasias de la Vejiga Urinaria/sangre , Carcinoma de Células Transicionales/diagnóstico , Carcinoma de Células Transicionales/orina , Estudios de Seguimiento , Humanos , Valor Predictivo de las Pruebas , Neoplasias de la Vejiga Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/orina , Orina/citologíaRESUMEN
The use of combined isotope and ultrasonic scanning in the diagnosis of amoebic liver abscess is described, together with details of three cases of this condition seen in the Bristol area in a period of two years. The addition of ultrasonic scanning greatly increases the accuracy of diagnosis by demonstrating a fluid-filled, space-occupying lesion and should ideally be employed whenever liver abscess is suspected.