RESUMO
Early extubation, also known as fast track, is desirable after intracranial hematoma surgery to avoid ventilator-associated complications associated with admission to an intensive care unit (ICU). The objective of the present study was to determine whether ICU stay and ventilator-associated complications are reduced in patients who received surgery for intracranial hematoma if they are extubated early. A total of 17 patients were randomly assigned to two groups: In Group 1, patients were extubated early or using the fast track method, while those in Group 2 were conventionally extubated at a later stage and were managed at the ICU. Patients from both groups were assessed on admission to the operating room per the established standards and after the selection criteria had been confirmed, general anesthesia was applied. Extubation time and hemodynamic stability (number of anesthetic adjustments required to maintain hemodynamic parameters within 20% of the predicted values) were assessed post-operatively. Patients in the conventional group (n=10) were transferred to the ICU and extubated at 8 h post-operatively; hemodynamic stability and the presence of complications were evaluated. The fast track group had no complications associated with ventilation or any other parameter. All patients extubated in a conventional manner and who were transferred to the ICU presented with complications, including seizures, aspiration, atelectasis or failed extubation. In the future, fast track should be regarded as a routine technique in patients who meet the required criteria, so that they may be discharged quickly and with fewer complications. The present study was authorized by the ethics committee of the hospital and the research sub-directorate with the number AN14-003; it was submitted to and approved by the ISRCTN registry for clinical trials (ID, ISRCTN16924441).
RESUMO
We investigated the frequency of BKV, JCV and SV40 reactivation in three groups of Cuban patients by multiplex nested PCR assay of 40 paraffin-embedded colorectal neoplasm tissues, 113 urine samples, and 125 plasma samples from 27 transplant recipients, and cerebrospinal fluid (CSF) from 67 HIV-1-infected individuals with central nervous system (CNS) disorders. None of these polyomaviruses were detected in colorectal neoplasms. JCV DNA was detected in 2 of 67 patients (2.9%) with CNS disorders, but neither BKV nor SV40 was identified. BKV was found in urine from 38.5% and 28.6% of adult and pediatric transplant recipients, respectively. In adult renal transplant recipients, excretion of BKV in urine was significantly associated with episodes of acute rejection (p=0.012) and with excretion of HCMV in urine (p= 0.008). In Cuba, the polyomaviruses studied here could not be related to colorectal neoplasms, and JCV was rarely detected in CSFs of HIV-1-infected individuals, whilst BKV reactivation was found to occur frequently in organ transplant recipients.
Assuntos
Vírus BK/isolamento & purificação , Vírus JC/isolamento & purificação , Infecções por Polyomavirus/virologia , Vírus 40 dos Símios/isolamento & purificação , Infecções Tumorais por Vírus/virologia , Adulto , Vírus BK/genética , Vírus BK/fisiologia , Cuba , Feminino , Humanos , Vírus JC/genética , Vírus JC/fisiologia , Masculino , Pessoa de Meia-Idade , Vírus 40 dos Símios/genética , Vírus 40 dos Símios/fisiologia , Adulto JovemRESUMO
OBJECTIVE: To determine the efficacy of sedation in outpatient procedures performed by Pediatric Residents. MATERIAL AND METHODS: Observational, analytic, cross-sectional study in patients that require diagnostic and therapeutic procedures. Data were collected during the period between June 01 and September 2007 in the Pediatrics Department. Patients from 1 month to 15 years of age that required sedation were included. RESULTS: 97 sedations were carried out, with an average age of 3.5 years. 59.3% were males and 40.7% were females. 100% of the procedures were carried out with 12.3% adverse effects. CONCLUSIONS: The procedures were done successfully; the pediatric residents demonstrated the required preparation for sedating and reverting adverse effects.
Assuntos
Sedação Consciente/normas , Sedação Profunda/normas , Internato e Residência , Pediatria , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Pacientes AmbulatoriaisRESUMO
Paciente femenina de 20 años de edad con síndrome de Osler-Weber-Rendú (telangiectasia hemorrágica hereditaria) en trabajo de parto. Se presenta el manejo anestésico y preparación preoperatoria y se discuten los problemas específicos de este síndrome asociado al embarazo
Assuntos
Humanos , Feminino , Adulto , Complicações Cardiovasculares na Gravidez , Analgesia Obstétrica , Bupivacaína/administração & dosagem , Insuficiência Cardíaca , Telangiectasia Hemorrágica HereditáriaRESUMO
Paciente femenina de 39 años de edad con diagnóstico de Siringomielia a la que se le realiza cesárea. Se presenta el manejo anestésico y se discute el caso
Assuntos
Humanos , Feminino , Gravidez , Adulto , Complicações na Gravidez/etiologia , Siringomielia/cirurgia , Siringomielia/fisiopatologia , Injeções Epidurais , Anestesia Epidural , Anestesia Obstétrica/métodos , CesáreaRESUMO
Trabajo realizado de manera exploratoria y descriptiva resaltando las características generales de la región estudiada, y se identifican en terminos de salud los factores condicionantes, socio-económicos, saneamiento ambiental y se establece un diagnóstico de la atención en salud. Se escogieron para la investigación un conjunto de centros de información y archivos para la obtención de los datos y se realizaron entrevistas entre el personal. Los datos fueron procesados de manera sistemática (guión-programa) y se incluye una fase analítica e interpretativa en función de parámetros normalizados. Se concluye indicando cifras de los factores condicionantes, sistemas de salud, recursos para la atención de salud y se hacen algunas recomendaciones al sector salud