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Embolia , Enfermedades Pulmonares/diagnóstico , Sepsis , Humanos , Pulmón , Sepsis/complicaciones , Sepsis/diagnóstico por imagenRESUMEN
BACKGROUND: Sepsis is a condition characterized by organic dysfunction, leading to hemodynamic instability and high morbidity and mortality rates in humans and animals. Early identification of perfusion changes and appropriate management of sepsis are crucial for improving patient prognosis. Currently, the Systemic Inflammatory Response Syndrome (SIRS) and Sequential Organ Failure Assessment (SOFA) scores are widely studied for sepsis identification and evaluation of organ dysfunction. However, these scores do not assess gastrointestinal involvement, which is common in this condition. Contrast-enhanced ultrasound (CEUS) and Doppler have been considered promising diagnostic techniques for detecting changes in vascularization and microcirculation in a non-invasive and safe manner, particularly in the gastrointestinal system. This study aimed to evaluate duodenal perfusion using CEUS, as well as abdominal aortic and cranial mesenteric artery blood flow using Doppler ultrasound, and systolic arterial pressure (SAP) in 17 bitches with pyometra and in 10 healthy animals. RESULTS: The variables were compared between the pyometra and control groups, as well between patients with and without sepsis determined by the SOFA or SIRS scores. Pyometra was found to cause a reduction in abdominal aortic blood flow volume, aortic peak systolic velocity, and resistivity index as evaluated by Doppler ultrasound. Patients with sepsis according to the SOFA criteria only presented lower SAP. In contrast, sepsis animals identified by the SIRS score exhibited lower SAP, aortic peak systolic velocity, aortic blood flow volume, and aortic resistivity index and additionally, higher peak intensity of contrast in the duodenal wall. CONCLUSIONS: Pyometra causes a reduction in abdominal aortic blood flow, which is more pronounced in animals with sepsis identified by the SIRS criteria. These animals also exhibited a decrease in systolic blood pressure and an increase in duodenal perfusion, as evident by CEUS. However, these changes were not observed in patients with sepsis identified by the SOFA criteria. The alterations in intestinal perfusion observed in animals with sepsis indicate the presence of inflammation or dysfunction. In this regard, CEUS proves to be a valuable technique for detecting subtle changes in tissue hemodynamics that may not be apparent in conventional exams.
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Enfermedades de los Perros , Piómetra , Sepsis , Femenino , Humanos , Animales , Perros , Piómetra/veterinaria , Sepsis/diagnóstico por imagen , Sepsis/veterinaria , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico por imagen , Síndrome de Respuesta Inflamatoria Sistémica/veterinaria , Ultrasonografía Doppler , Pronóstico , Perfusión/veterinaria , Estudios Retrospectivos , Enfermedades de los Perros/diagnóstico por imagenRESUMEN
OBJECTIVES: To assess whether there is an association between abnormal common femoral vein (CFV) Doppler waveform and intensive care unit (ICU) mortality in patients with sepsis. METHODS: Patients admitted to the ICU with sepsis were included. Pulsed-wave Doppler was performed by examining the CFV in the short axis without angle correction and in the long axis with angle correction. An abnormal CFV Doppler waveform was determined by a retrograde velocity peak (RVP) > 10 cm/s in the long axis or RVP > 50% of the antegrade velocity peak in the short axis. TAPSE < 17 mm was defined as right ventricular (RV) dysfunction. The primary outcome was ICU mortality. RESULTS: One hundred and ten patients were included. There was no association between abnormal CFV Doppler waveforms in the long (p = 0.709) and short axes (p = 0.171) and ICU mortality. TAPSE measurements were performed in 16 patients. RV dysfunction was identified in 8 (50.0%) patients. There was no association between the diagnosis of RV dysfunction based on TAPSE measurement and the identification of abnormal CFV Doppler waveforms in the long axis (p = 1.000) and in the short axis (p = 1.000). CONCLUSION: Abnormal CFV Doppler waveforms were not associated with ICU mortality in patients with sepsis. Furthermore, in the exploratory analysis, these alterations were not useful in identifying RV dysfunction in these patients.
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Vena Femoral , Sepsis , Humanos , Pronóstico , Vena Femoral/diagnóstico por imagen , Estudios Prospectivos , Ultrasonografía Doppler , Sepsis/diagnóstico por imagenAsunto(s)
COVID-19/patología , Embolia/patología , Endocarditis Bacteriana/patología , Endocarditis/patología , Síndrome de Dificultad Respiratoria/patología , Sepsis/patología , Adulto , Angiografía , COVID-19/complicaciones , COVID-19/diagnóstico por imagen , COVID-19/virología , Embolia/complicaciones , Embolia/diagnóstico por imagen , Embolia/virología , Endocarditis/complicaciones , Endocarditis/diagnóstico por imagen , Endocarditis/virología , Endocarditis Bacteriana/complicaciones , Endocarditis Bacteriana/diagnóstico por imagen , Endocarditis Bacteriana/virología , Resultado Fatal , Humanos , Pulmón/diagnóstico por imagen , Pulmón/patología , Pulmón/virología , Masculino , Respiración Artificial , Síndrome de Dificultad Respiratoria/complicaciones , Síndrome de Dificultad Respiratoria/diagnóstico por imagen , Síndrome de Dificultad Respiratoria/virología , SARS-CoV-2/crecimiento & desarrollo , SARS-CoV-2/patogenicidad , Sepsis/complicaciones , Sepsis/diagnóstico por imagen , Sepsis/virología , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: The objective of this study was to investigate the accuracy of 18F-FDG-PET in the diagnosis of multibacterial abdominal sepsis by cecum ligation and puncture (CLP) in rats. METHODS: Adult Wistar rats ( Rattus norvegicus ), weighing 227±35g, were allocated into a sepsis group by CLP (n=10) and sham group (n=10). 18F-FDG-PET using microPET was performed on all rats after 24 hours. RESULTS: All animals survived for postoperative 24h. The abdomen/liver ratio of the standardized uptake value (SUV) percentage was significantly higher in the sepsis group than in the sham (p=0.004). The ROC curve showed an accuracy of 18F-FDG-PET to detect abdominal sepsis of 88.9% (p=0.001), sensitivity of 90% and specificity of 88.9%. When a cut-off point of 79% of the ratio between the SUV on the abdominal region and liver was established, the sensitivity was 90%, specificity of 88.9%; positive and negative predictive values of 90.0% and 88.9%, respectively. CONCLUSIONS: The diagnostic accuracy of 18F-FDG-PET in rats with abdominal sepsis was significantly high. It was also demonstrated the predictive ability of the abdomen/liver SUV ratio to diagnose abdominal sepsis. These findings may have implications for the clinical setting, locating septic foci with PETscan.
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Fluorodesoxiglucosa F18 , Infecciones Intraabdominales/diagnóstico por imagen , Tomografía de Emisión de Positrones/métodos , Radiofármacos , Sepsis/diagnóstico por imagen , Animales , Infecciones Intraabdominales/patología , Valor Predictivo de las Pruebas , Ratas , Ratas Wistar , Valores de Referencia , Reproducibilidad de los Resultados , Sepsis/patología , Factores de TiempoRESUMEN
The aetiology of septic acute kidney injury (AKI) is not completely elucidated. Early identification of AKI in septic patients is considered to improve survival rate since it allows rapid treatment onset. We evaluated clinical, haematological, urinary, B-mode, spectral Doppler, and contrast-enhanced ultrasound variables in 20 bitches with pyometra as sepsis models and 12 healthy controls. All animals with pyometra presented some degree of renal damage on histological examination; however, sequential organ failure assessment (SOFA) classified only 40% cases with sepsis. AKI derived from systemic infection was identified in 57% of cases with hypoperfusion and in 22% with inflammation, being an affection of multifactorial origin. Among the evaluated parameters, urinary protein/creatinine ratio >0.15, serum albumin <2.94 mg/dL, time-averaged minimum velocity <21.5 cm/s, renal length/aorta diameter ratio >5.93, pulsatility index >1.53, haematocrit <45%, time-averaged maximum velocity <45.7 cm/s, haemoglobin <16 g/dL, leukocytes >12.53 × 103/uL, and cortical contrast peak intensity <69%, in the order of accuracy, are significant indicators of septic AKI with an accuracy >80%. Thus, AKI is a very prevalent condition in septic patients, derived mainly from changes in renal perfusion and inflammation. Additionally, reviewing the SOFA score parameters is suggested to identify renal failure.
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Lesión Renal Aguda/diagnóstico , Enfermedades de los Perros/diagnóstico , Riñón/diagnóstico por imagen , Piómetra/complicaciones , Sepsis/complicaciones , Lesión Renal Aguda/diagnóstico por imagen , Lesión Renal Aguda/veterinaria , Animales , Estudios de Casos y Controles , Creatinina/orina , Enfermedades de los Perros/diagnóstico por imagen , Perros , Femenino , Frecuencia Cardíaca , Hematócrito , Riñón/patología , Puntuaciones en la Disfunción de Órganos , Piómetra/veterinaria , Sepsis/diagnóstico por imagen , Sepsis/fisiopatología , Albúmina Sérica/análisis , Ultrasonografía DopplerRESUMEN
RESUMEN Presentamos caso clínico de puérpera de cesárea de noveno día con cuadro febril en espigas, asintomática, en que se plantea desde su ingreso el diagnóstico de tromboflebitis séptica pelviana y se inicia tratamiento con antibióticos parenterales de amplio espectro y heparina de bajo peso molecular en dosis terapéuticas. La respuesta es a la mejoría al tercer día de tratamiento. Se discuten los métodos diagnósticos, el diagnóstico diferencial y el tratamiento.
ABSTRACT A case of a woman on her 9th post-operative day after childbirth by cesarean section (CS) consulting with febrile spikes, otherwise asymptomatic, is presented. The diagnosis of a septic pelvic thrombophlebitis is proposed from the admission and treated with parenteral broad-spectrum antibiotics and low-molecular-weight heparin at therapeutic doses. Patient significantly improved on her third day of treatment. The diagnostic procedures, differential diagnosis and treatment are discussed.
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Humanos , Femenino , Adulto , Ovario/irrigación sanguínea , Tromboflebitis/etiología , Cesárea/efectos adversos , Sepsis/etiología , Pelvis/irrigación sanguínea , Tromboflebitis/tratamiento farmacológico , Tromboflebitis/diagnóstico por imagen , Heparina/uso terapéutico , Tomografía Computarizada por Rayos X , Sepsis/tratamiento farmacológico , Sepsis/diagnóstico por imagen , Diagnóstico Diferencial , Antibacterianos/uso terapéutico , Anticoagulantes/uso terapéuticoRESUMEN
Abstract Purpose The objective of this study was to investigate the accuracy of 18F-FDG-PET in the diagnosis of multibacterial abdominal sepsis by cecum ligation and puncture (CLP) in rats. Methods Adult Wistar rats ( Rattus norvegicus ), weighing 227±35g, were allocated into a sepsis group by CLP (n=10) and sham group (n=10). 18F-FDG-PET using microPET was performed on all rats after 24 hours. Results All animals survived for postoperative 24h. The abdomen/liver ratio of the standardized uptake value (SUV) percentage was significantly higher in the sepsis group than in the sham (p=0.004). The ROC curve showed an accuracy of 18F-FDG-PET to detect abdominal sepsis of 88.9% (p=0.001), sensitivity of 90% and specificity of 88.9%. When a cut-off point of 79% of the ratio between the SUV on the abdominal region and liver was established, the sensitivity was 90%, specificity of 88.9%; positive and negative predictive values of 90.0% and 88.9%, respectively. Conclusions The diagnostic accuracy of 18F-FDG-PET in rats with abdominal sepsis was significantly high. It was also demonstrated the predictive ability of the abdomen/liver SUV ratio to diagnose abdominal sepsis. These findings may have implications for the clinical setting, locating septic foci with PETscan.
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Sepsis/diagnóstico por imagen , Radiofármacos , Fluorodesoxiglucosa F18 , Tomografía de Emisión de Positrones/métodos , Infecciones Intraabdominales/diagnóstico por imagen , Valores de Referencia , Factores de Tiempo , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Ratas Wistar , Sepsis/patología , Infecciones Intraabdominales/patologíaRESUMEN
PURPOSE: It has been acknowledged that implant wear correlates with the risk for periprosthetic osteolysis, being aggressive granulomatosis the worst expression of bone resorption. We sought to determine the clinical, radiological, and histological features of aggressive granulomatosis after primary total hip arthroplasty (THA). METHODS: We included nine cases with aggressive granulomatosis of the hip around cemented stems. Indications for revision THA consisted of progressive signs of extensive bone resorption or implant loosening. Mean follow-up since revision THA was 143 months (SD ± 59.4). We analysed clinical outcomes, component loosening and gross as well as histological characteristics of the granulomatous lesions. RESULTS: Overall mean time between primary THA and revision surgery was 81 months (SD ± 20.8). All of the cases evidenced multiple ovoid tumour-like lesions around the stem with extensive bone loss. Only one case reported thigh pain before revision surgery, with radiological evidence of stem loosening; the remaining cases were asymptomatic with well-fixed implants. Gross anatomy findings revealed metallosis in the femoral canal and inside the cystic lesions. Pathology analysis showed monocyte-macrophage-dominated adverse foreign-body-type tissue reaction with fibroblastic reactive zones and granulomatous inflammation. CONCLUSIONS: We found a prevalence of 1% of this aseptic mode of implant failure. Since most of the retrieved stems were not loose, we did not find any alarming clinical symptoms anticipating implant failure. In this scenario, surgeons should be aware of the rapidly progressive nature of this entity and propose a revision THA in a timely fashion.
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Artroplastia de Reemplazo de Cadera/efectos adversos , Prótesis de Cadera/efectos adversos , Sepsis/etiología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Falla de Prótesis , Radiografía , Reoperación , Sepsis/diagnóstico por imagenRESUMEN
PURPOSE:: To examine a correlation of micro-PET images with photographic images of the digestive organs in abdominal sepsis model. METHODS:: Male Wistar rats weighing 265±18g were used. Abdominal sepsis was induced by ligature and cecal puncture. Micro-PET Images from abdominal cavity septic foci were obtained using 18-Fluoro-deoxyglucose, looking for a correlation with photographic images of abdominal cavity organs. Pearson's correlation test was used. RESULTS:: The mean standard uptake values (SUV) and lesion areas were 2.58±0.63SUVbwg/ml and 546.87±300.95mm2, respectively. There was a strong positive correlation between the two variables (r=0.863, p=0.137), which resulted in a coefficient of determination r2?0.75, meaning that 75% of SUV variation is explained by the lesion areas of digestive organs. CONCLUSION:: Micro-PET allows high throughput assessment of lesion count and volume in pre-clinical rat model of CPL abdominal sepsis.
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Fluorodesoxiglucosa F18 , Infecciones Intraabdominales/diagnóstico por imagen , Tomografía de Emisión de Positrones/métodos , Radiofármacos , Sepsis/diagnóstico por imagen , Animales , Sistema Digestivo/diagnóstico por imagen , Sistema Digestivo/patología , Modelos Animales de Enfermedad , Infecciones Intraabdominales/patología , Masculino , Fotograbar/métodos , Ratas Wistar , Reproducibilidad de los Resultados , Sepsis/patología , Factores de TiempoRESUMEN
Abstract Purpose: To examine a correlation of micro-PET images with photographic images of the digestive organs in abdominal sepsis model. Methods: Male Wistar rats weighing 265±18g were used. Abdominal sepsis was induced by ligature and cecal puncture. Micro-PET Images from abdominal cavity septic foci were obtained using 18-Fluoro-deoxyglucose, looking for a correlation with photographic images of abdominal cavity organs. Pearson's correlation test was used. Results: The mean standard uptake values (SUV) and lesion areas were 2.58±0.63SUVbwg/ml and 546.87±300.95mm2, respectively. There was a strong positive correlation between the two variables (r=0.863, p=0.137), which resulted in a coefficient of determination r2?0.75, meaning that 75% of SUV variation is explained by the lesion areas of digestive organs. Conclusion: Micro-PET allows high throughput assessment of lesion count and volume in pre-clinical rat model of CPL abdominal sepsis.
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Animales , Masculino , Sepsis/diagnóstico por imagen , Radiofármacos , Fluorodesoxiglucosa F18 , Tomografía de Emisión de Positrones/métodos , Infecciones Intraabdominales/diagnóstico por imagen , Factores de Tiempo , Reproducibilidad de los Resultados , Ratas Wistar , Sepsis/patología , Sistema Digestivo/patología , Sistema Digestivo/diagnóstico por imagen , Modelos Animales de Enfermedad , Fotografía , Infecciones Intraabdominales/patologíaRESUMEN
BACKGROUND: Assessment of sepsis severity is challenging. Available scoring systems require laboratory data. Therefore, a rapid tool would be useful. OBJECTIVE: To determine the role of mitral valve tissue Doppler imaging (TDI) as a prognostic tool in septic patients. METHODS: For this prospective cohort, newly admitted septic patients received TDI measurements of s wave (s), e' wave (e'), and E/e' ratio (E/e') within 5 min of resuscitation. Results were compared with sepsis severity measured by Mortality in Emergency Department Sepsis (MEDS), Simplified Acute Physiology Score (SAPS) 3, and Sequential Organ Failure Assessment (SOFA). RESULTS: Over 3 months, 63 patients were enrolled. TDI parameters correlated with MEDS, SAPS 3, and SOFA (r = -0.53, r = -0.55, r = -0.36, respectively, for s, p < 0.005; r = -0.56, r = -0.49, r = -0.40, respectively, for e', p < 0.005; and r = 0.56; r = 0.48; r = 0.46, respectively, for E/e', p < 0.005). Mean s and e' decreased among sepsis, severe sepsis, and septic shock patients (14.2; 12.05; 10.14 cm/s, respectively, for s, p = 0.0048 and 18.28; 15.14; 12.12 cm/s, respectively, for e', p = 0.003), whereas mean E/e' increased among sepsis stages (4.76; 6.51; and 8.14, respectively, p = 0.001). Mean s and e' were higher in survivors (13.25 vs. 7.33 cm/s, for s, p < 0.0001; and 16.4 vs. 9 cm/s for e', p = 0.0025); mean E/e' was higher in nonsurvivors (10.85 vs. 5.63, p < 0.0001). On univariate analysis, odds ratios (ORs) for death related to s, e', and E/e' were, respectively, 0.517 (95% confidence interval [CI] 0.344-0.775), 0.60 (95% CI 0.433-0.833), and 1.953 (95% CI 1.256-3.008); p < 0.05 for all. Multiple logistic analysis showed an OR of 1.737 (95% CI 1.037-2.907, p = 0.035) for death related to E/e'. CONCLUSION: TDI may be useful to assess disease severity and prognosis in newly diagnosed septic patients.
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Ecocardiografía Doppler , Servicio de Urgencia en Hospital , Sepsis/diagnóstico por imagen , Disfunción Ventricular Izquierda/diagnóstico por imagen , Femenino , Indicadores de Salud , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Resucitación , Sepsis/terapia , Índice de Severidad de la EnfermedadRESUMEN
PURPOSE: Noninvasive evaluation of endothelial function may be accomplished by ultrasound assessment of flow-mediated vasodilation (FMD) of the brachial artery. This study aims to investigate the role of FMD analysis on intrahospital prognosis of patients with sepsis. METHODS: Adult patients admitted to the intensive care unit with severe sepsis or septic shock were consecutively included. Brachial artery FMD was measured upon admission, after 24 and 72 hours. A group of apparently healthy subjects paired for sex and age was used as controls. Patients were followed up to discharge or death. RESULTS: We studied 42 patients (mean age, 51 ± 19 years) with sepsis predominantly of abdominal or respiratory etiology (75%). Acute Physiology And Chronic Health Evaluation II risk score was 23 ± 7, and intrahospital mortality rate was 33%. Flow-mediated vasodilation in septic patients was significantly lower than in healthy controls (1.5 ± 7% vs 6 ± 4%, P < .001). Most of the nonsurvivors (86%) showed a decline in sequential FMD analyses, whereas only 43% of survivors showed a reduction of FMD (P = .01). In nonsurvivors, FMD was significantly lower 72 hours after sepsis onset (-3.3% ± 10% vs 5.2% ± 4%; P < .05; time-group interaction P value = .03). CONCLUSIONS: Brachial FMD is altered in septic patients with hemodynamic instability, and its deterioration may be an early marker of unfavorable prognosis.
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Arteria Braquial/diagnóstico por imagen , Endotelio Vascular/diagnóstico por imagen , Sepsis/diagnóstico por imagen , Vasodilatación , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Análisis por Apareamiento , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Choque Séptico/diagnóstico por imagen , Análisis de Supervivencia , UltrasonografíaRESUMEN
PURPOSE: To investigate inflammatory (zymosan) and infectious (Staphylococcus aureus) processes in experimental models in rats using technetium-99m-labeled ceftizoxime (CFT). METHODS: Male Wistar rats were used for the development of the inflammatory (zymosan) and infectious (S. aureus) processes in the medullary cavity of the left tibia. Sterile saline was used for the control group. At 48 h after induction of the processes, the animals were anesthetized and scintigraphic images were acquired at 1, 2, 4, and 6 h after intravenous injection of 0.1 ml of 99mTc-CFT (55 MBq). Quantitative analysis of the scintigraphic images was performed by counting the radioactivity in the regions of interest. Samples of tibia were taken for histopathological examination. RESULTS: The images showed that 99mTc-CFT presented higher tropism to infectious foci than with the inflammatory site. The average value of the target/nontarget ratio of the 99mTc-CFT was significantly higher in the infected (2.40+/-0.22) than in the inflamed tibia (1.50+/-0.05) and the control group (1.05+/-0.04) for all of the investigated times. The histological data showed a similar inflammatory response for both the S. aureus and zymosan groups. CONCLUSION: The 99mTc-CFT presented a high tropism and retention for an infected region in this model of osteomyelitis, thereby constituting an interesting strategy to distinguish aseptic from septic sites.
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Ceftizoxima/análogos & derivados , Compuestos de Organotecnecio/farmacología , Osteomielitis/diagnóstico por imagen , Osteomielitis/diagnóstico , Cintigrafía/métodos , Animales , Proteínas Sanguíneas/química , Ceftizoxima/farmacología , Modelos Animales de Enfermedad , Inflamación , Masculino , Radiofármacos/farmacología , Ratas , Ratas Wistar , Sepsis/diagnóstico , Sepsis/diagnóstico por imagen , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/diagnóstico por imagen , Factores de Tiempo , Zimosan/metabolismoRESUMEN
PURPOSE: To asses the dissemination of bacteria labeled with technetium-99m (99mTc) from peritoneal cavity after different surgical procedures. METHODS: Bacteria of the Escherichia coli species labeled with 99mTc were used in a concentration of 10(8) units of colony-makers for ml (UFC/ml) and 1 ml was inoculated through intra-peritoneal via. Forty-eight rats were divided into four groups: control, laparotomy, pneumoperitoneum with 10 mm Hg and pneumoperitoneum with 20 mm Hg of CO2. Procedures were performed 20 min after injection of the inoculum and lasted 30 min. Animals were sacrificed after six hours (Group 1) and 24 hours (Group 2). Samples of blood, liver and spleen were collected for radioactivity counting. RESULTS: After six hours, indirect detection of the bacteria in different organs was uniform in all groups. After 24 hours, a larger detection of technetium was observed in the livers of animals of the group insufflated with 20 mm Hg of CO2, when compared with those of control group (p<0.01). The other groups did not present statistically significant variations. CONCLUSIONS: The use of a higher intra-abdominal pressure was associated with a higher bacterial dissemination to the liver. The application of lower intra-abdominal pressures may be associated with a lower dissemination of the infectious status during laparoscopic approach of peritonitis status.
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Infecciones por Escherichia coli/diagnóstico por imagen , Escherichia coli/crecimiento & desarrollo , Peritonitis/cirugía , Neumoperitoneo Artificial/efectos adversos , Sepsis/diagnóstico por imagen , Animales , Recuento de Colonia Microbiana , Modelos Animales de Enfermedad , Escherichia coli/efectos de los fármacos , Infecciones por Escherichia coli/microbiología , Insuflación/efectos adversos , Laparoscopía/efectos adversos , Laparotomía/efectos adversos , Hígado/microbiología , Hígado/efectos de la radiación , Masculino , Cavidad Peritoneal/microbiología , Peritonitis/diagnóstico por imagen , Peritonitis/microbiología , Neumoperitoneo Artificial/métodos , Cintigrafía , Ratas , Ratas Wistar , Sepsis/microbiología , Bazo/microbiología , Bazo/efectos de la radiación , TecnecioRESUMEN
In any infant admitted with diagnosis of "clinical sepsis", a chest radiograph is commonly obtained as a routine work-up. The purpose of this study was to establish the relationship between an abnormal chest radiograph and "clinical sepsis" in a population of infants. The clinical records and chest radiographs of 81 infants, (less than 3 month old) were reviewed. The temperature, white blood cell count, respiratory signs, symptoms, and chief complaints were recorded and compared with positive or negative chest radiographs. A statistically significant correlation with abnormality in the chest radiograph was not established. Four patients, (31%), with any respiratory signs had abnormal chest radiographs, whereas only 13, (19%) asymptomatic patients did. It was concluded that chest radiographs do not add useful information to the evaluation of a febrile infant who does not have clinical findings of pulmonary diseases. However, due to the limited population studied, it seems appropriate to continue the current recommended practice of ordering chest radiographs in febrile infants 3 months old or less.