RESUMEN
To evaluate in routine hospital practice the clinical response to ertapenem in comparison with other parenteral antibiotics in the treatment of community-acquired pneumonia (CAP), clinical records from patients with severe CAP treated with ertapenem from July 2002 to June 2006 in seven Spanish hospitals were retrospectively reviewed. Patients were classified according to the Pneumonia Severity Index (PSI). Each ertapenem-treated patient was matched with two patients in the same hospital treated with other antibiotics, according to age (difference
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Antibacterianos/uso terapéutico , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Neumonía/tratamiento farmacológico , beta-Lactamas/uso terapéutico , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Infecciones Comunitarias Adquiridas/patología , Infecciones Comunitarias Adquiridas/fisiopatología , Ertapenem , Femenino , Hospitales , Humanos , Tiempo de Internación , Masculino , Neumonía/patología , Neumonía/fisiopatología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , España , Resultado del TratamientoRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Aneurisma Falso/complicaciones , Arterias , Hemorragia Gastrointestinal/etiología , Seudoquiste Pancreático/complicacionesRESUMEN
Propranolol is a widely used drug for prophylaxis of variceal bleeding in patients with cirrhosis, but not all patients show an adequate clinical response. This variability may be in relation to beta adrenoceptor activity, but no information is available in this setting. Thirty-nine patients with advanced cirrhosis and presence of oesophageal varices were sequentially included. We studied the function of beta-2-adrenoceptor in isolated membranes of mature erythrocytes obtained from patients by measuring cyclic AMP (cAMP) production before and after isoproterenol. Blood samples obtained from 11 healthy volunteers were used as control. Patients showed a six-fold increase in the mean basal cAMP production as compared to healthy volunteers. Isoproterenol produced a small, non-significantly and highly variable increase in the AC activity in patients compared with controls. cAMP values remain stable after three months of continuous treatment with oral beta-blockers in both groups. Patients without antecedent of variceal bleeding or with an active alcohol intake showed a significantly higher isoproterenol effect. In conclusion, beta-receptor function in human erythrocytes membranes is altered in patients with cirrhosis and oesophageal varices.
Asunto(s)
Membrana Eritrocítica/enzimología , Várices Esofágicas y Gástricas/metabolismo , Cirrosis Hepática/metabolismo , Receptores Adrenérgicos beta 2/metabolismo , Adenilil Ciclasas/metabolismo , Agonistas Adrenérgicos beta/farmacología , Antagonistas Adrenérgicos beta/farmacología , Antagonistas Adrenérgicos beta/uso terapéutico , Consumo de Bebidas Alcohólicas/efectos adversos , AMP Cíclico/metabolismo , Membrana Eritrocítica/efectos de los fármacos , Várices Esofágicas y Gástricas/sangre , Várices Esofágicas y Gástricas/prevención & control , Femenino , Humanos , Hipertensión Portal/sangre , Hipertensión Portal/tratamiento farmacológico , Hipertensión Portal/metabolismo , Isoproterenol/farmacología , Cirrosis Hepática/sangre , Cirrosis Hepática/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Propranolol/farmacología , Propranolol/uso terapéutico , Receptores Adrenérgicos beta 2/efectos de los fármacosRESUMEN
OBJECTIVE: The purpose of this study was to describe a technique for percutaneous bile duct stone clearance by pushing the stones into the small bowel after balloon dilation of the papilla. SUBJECTS AND METHODS: During a 2-year period, 38 patients were treated percutaneously for stones in the biliary tree. Twenty-one patients were treated through a T tube or transcystic tract. Seventeen patients were treated through a transhepatic tract. Twenty-three patients had one stone each. Eight patients had two stones, and seven patients had three or more calculi. Stone size ranged from 3 to 16 mm in diameter (mean size, 6.7 nm). Balloon diameter based on the transverse diameter of the stones ranged from 7 to 18 mm (mean, 6.7 mm). An 11.5-mm occlusion balloon was used for pushing the stones through a 7- to 9-French vascular introducer. A catheter was left in the common bile duct from 1 to 6 days for external drainage. RESULTS: The technique was successfully used for clearance of stones in 36 (94.7%) of the 38 patients. With 29 patients, the procedure was performed with only one attempt. Two attempts were necessary for five patients, and three attempts were necessary for four patients. Two major complications were cholangitis and biliary pleural effusion. No deaths were related to the procedure. CONCLUSION: Percutaneous bile duct stone clearance by dilation of the papilla and evacuation of the stones in an antegrade fashion with an occlusion balloon is a safe and effective technique. It can be an alternative to basketing stones in selected patients.
Asunto(s)
Ampolla Hepatopancreática , Cateterismo , Cálculos Biliares/terapia , Adulto , Anciano , Anciano de 80 o más Años , Colangiografía , Femenino , Cálculos Biliares/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Radiografía IntervencionalRESUMEN
We present two cases of osteoid osteoma in adolescent boys. The lesions were located in the proximal metaphysis of the right tibia and left femoral diaphysis respectively. Doppler duplex color study demonstrated clearly the highly vascular nidus and its feeding artery in one case and only the feeding artery in the second. We believe these are the first descriptions of osteoid osteomas assessed with Doppler duplex color, which was also used as guidance for the percutaneous localization and biopsy.
Asunto(s)
Neoplasias Óseas/diagnóstico por imagen , Osteoma Osteoide/diagnóstico por imagen , Ultrasonografía Doppler Dúplex , Adolescente , Neoplasias Óseas/irrigación sanguínea , Neoplasias Óseas/cirugía , Ablación por Catéter , Arteria Femoral/diagnóstico por imagen , Fémur , Humanos , Masculino , Osteoma Osteoide/irrigación sanguínea , Osteoma Osteoide/cirugía , Flujo Sanguíneo Regional , TibiaRESUMEN
The reliability of the Brånemark implant system has been well documented. In addition, the technique has been employed in the anterior portion of the mouth with good cosmetic results. Fundamental to the success of these procedures is the multidisciplinary approach. The "Drilling Guide" is the outcome of an intimate relationship between members of the therapeutic team, this allows for the control of all parameters of aesthetics. The preparation of the prosthetic cradle by selecting splaying and eversion is presented as a new approach. The impression method is atraumatic and employs personalized unitary transfers. This leads to the required emergence profile and guarantees the optimum aesthetic result.