RESUMEN
In a prospective randomized trial the frequency of infectious complications and natural killer cell function were investigated in 197 patients undergoing elective colorectal surgery and having either no blood transfusion (n = 93), transfusion with whole blood (n = 56), or filtered blood free from leucocytes (n = 48). Postoperative infections developed in 13 patients transfused with whole blood (23%), in one patient transfused with blood free from leucocytes (2%) and in two non-transfused patients (2%) (p < 0.01). Natural killer cell function was significantly (p < 0.001) impaired up to 30 days after surgery in patients transfused with whole blood. These data provide a strong case against the use of whole blood transfusion in patients undergoing elective colorectal surgery.
Asunto(s)
Enfermedades del Colon/cirugía , Enfermedades del Recto/cirugía , Infección de la Herida Quirúrgica/etiología , Reacción a la Transfusión , Adolescente , Adulto , Anciano , Contraindicaciones , Femenino , Humanos , Células Asesinas Naturales/inmunología , Leucaféresis , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Infección de la Herida Quirúrgica/inmunologíaRESUMEN
Heat-stable antigens from Helicobacter pylori were investigated for the detection of serum IgG, IgA and IgM antibodies against H. pylori by an ELISA technique. Antibody titers against H. pylori were measured in 167 dyspeptic patients, of whom 96 were H. pylori positive confirmed by culture or microscopy, and in 482 controls (0-98 years). Increased IgG antibody titers were found significantly more often in dyspeptic patients with active chronic gastritis than in patients with normal morphology, as well as in H. pylori-positive patients as compared to H. pylori-negative patients, independent of the endoscopic findings. The heat-stable antigens were compared with acid glycine-extracted antigens and a high degree of concordance was found in the results obtained with the two antigen preparations. The differences in the IgA antibody titers against H. pylori between H. pylori-positive and H. pylori-negative dyspeptic patients were significant and may be useful to confirm a borderline IgG result. No differences were found in IgM antibody titer between H. pylori-positive and -negative patients. The greatest age-dependent increase in IgG and IgA antibody titers was found in children, and if a lower cut-off level is used for children than for adults, as has been proposed, the proportion of people with increased antibody titers against H. pylori would be almost constant from the age of between five and 10 years until the time between 61 and 80 years. Comparison of H. pylori IgG antibodies with IgG antibodies against Campylobacter jejuni and total antibodies against cytomegalovirus (CMV) showed a greater similarity between H. pylori and C. jejuni (R = 0.51) than between H. pylori and CMV (R = 0.22). This may possibly be caused by cross-reactions between H. pylori and C. jejuni. The H. pylori heat-stabile antigen seems not to be very different from other crude H. pylori antigens like acid glycine-extracted antigens, but purification and characterization of the antigens are needed to improve antibody assays.
Asunto(s)
Anticuerpos Antibacterianos/análisis , Antígenos Bacterianos/inmunología , Dispepsia/microbiología , Helicobacter pylori/inmunología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Endoscopía , Calor , Humanos , Inmunoglobulina A/análisis , Inmunoglobulina G/análisis , Lactante , Recién Nacido , Persona de Mediana Edad , PrevalenciaRESUMEN
The frequency of infection in 197 patients undergoing elective colorectal surgery and having either no blood transfusion, transfusion with whole blood, or filtered blood free from leucocytes and platelets was investigated in a prospective randomized trial. Natural killer cell function was measured before operation and 3, 7 and 30 days after surgery in 60 consecutive patients. Of the patients 104 required blood transfusion; 48 received filtered blood and 56 underwent whole blood transfusion. Postoperative infections developed in 13 patients transfused with whole blood (23 per cent, 95 per cent confidence interval 13-32 per cent), in one patient transfused with blood free from leucocytes and platelets (2 per cent, 95 per cent confidence interval 0.05-11 per cent) and in two non-transfused patients (2 per cent, 95 per cent confidence interval 0.3-8 per cent) (P less than 0.01). Natural killer cell function was significantly (P less than 0.001) impaired up to 30 days after surgery in patients transfused with whole blood. These data provide a strong case against the use of whole blood transfusion in patients undergoing elective colorectal surgery.
Asunto(s)
Colon/cirugía , Infecciones/etiología , Células Asesinas Naturales/inmunología , Recto/cirugía , Reacción a la Transfusión , Adulto , Anciano , Anciano de 80 o más Años , Transfusión de Componentes Sanguíneos/efectos adversos , Citotoxicidad Inmunológica/inmunología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Estudios ProspectivosRESUMEN
Primary urethral cancer in male subjects is briefly described, and a case is presented in which the formation of a scrotal abscess was the unusual presenting symptom.
Asunto(s)
Absceso/etiología , Escroto , Neoplasias Uretrales/complicaciones , Absceso/patología , Anciano , Biopsia , Diagnóstico Diferencial , Epididimitis/diagnóstico , Fístula/patología , Humanos , Masculino , Neoplasias Uretrales/diagnósticoRESUMEN
81 otherwise healthy men with an average age of 67 years and verified prostatic hypertrophy were randomized into two groups for either 'minimal' or 'total' transurethral prostatic resection (TUR-P). Interviews on sexual life were made preoperatively and 6 and 12 months postoperatively. 58 men (72%) were prior to the operation sexually active. 18 (31%), mainly men of advanced age, discontinued sexual activity following TUR-P. 40 (69%) remained active. 19 had retrograde ejaculation. No significant difference was found between 'minimal' and 'total' TUR-P concerning the effect on sexual activity and the occurrence of retrograde ejaculation.
Asunto(s)
Disfunción Eréctil/etiología , Prostatectomía/métodos , Hiperplasia Prostática/cirugía , Conducta Sexual , Anciano , Eyaculación , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Uretra/cirugíaRESUMEN
A follow-up investigation of 19 patients with carcinoma in situ per se of the urinary bladder (Tis) has been performed. Ten patients developed invasive cancer during a mean observation period of about 4 years. The natural history is unpredictable and therapeutic management of this potentially malignant neoplasm should be individualised. Early radical cystectomy is advocated in selected cases of Tis.
Asunto(s)
Carcinoma in Situ/patología , Neoplasias de la Vejiga Urinaria/patología , Anciano , Biopsia , Carcinoma in Situ/cirugía , Carcinoma in Situ/terapia , Femenino , Estudios de Seguimiento , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Recurrencia Local de Neoplasia/patología , Neoplasias de la Vejiga Urinaria/cirugía , Neoplasias de la Vejiga Urinaria/terapiaRESUMEN
A retrospective analysis of external radiation therapy of 43 patients with carcinoma of the prostate limited to the pelvis is presented. The tumours were classified according to the UICC TNM system and in the range T2-4, Nx, 0-2, M0; 86 per cent had extracapsular disease. The 5-year crude survival rate was 52 per cent, the corrected survival 62 per cent compared with an expected survival of 81 per cent. Eight patients (18%) had clinical recurrence, all with distant metastases in bones and one with local recurrence as well. After 6 months mild side effects were found in 10 patients (23%), severe complications in none. In conclusion, external radiation therapy offers the possibility of partial or complete regression of carcinoma of the prostate limited to the pelvis and apparently improves the 5-year survival. If radical prostatectomy and lymphadenectomy is not used or impossible, external radiation therapy is recommended instead of hormone therapy with oestrogens.
Asunto(s)
Adenocarcinoma/radioterapia , Neoplasias de la Próstata/radioterapia , Adenocarcinoma/mortalidad , Anciano , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Próstata/mortalidad , Radioterapia/efectos adversos , Estudios RetrospectivosRESUMEN
The efficient in vitro inhibition of hepatitis B virus DNA polymerase by trisodium phosphonoformate (PFA, INN: foscarnet sodium) and its low toxicity suggested that PFA could be used as a therapeutic agent for hepatitis B infection. PFA was also found to inhibit woodchuck hepatitis virus (WHV) DNA polymerase in vitro. As a model to test PFA's eventual effect, chronically WHV infected woodchucks were treated with PFA. The animals were treated twice daily in a dosage which gave a minimum serum level of PFA corresponding to an in vitro inhibiting effect on WHV DNA polymerase of about 40%. The concentration in liver tissue was found to be 15% below serum level. The amount of WHV particles in serum was followed by DNA polymerase assay. No effect on WHV production could be seen during 2 weeks' treatment. No change of the in vitro sensitivity to PFA of the WHV DNA polymerase was seen. These results indicate that the WHV associated DNA polymerase has no role in the production of viral particles.