Search PubMed⌕ Search

Biomedical subjects

A Rantala

Publications and source records attributed to A Rantala.

43 records · Page 3Linked to original sources
PubMed1991

Diagnostic factors for postoperative candidosis in abdominal surgery.

Abdominal surgery patients with postoperative septicaemia and a deep septic focus were analyzed in an attempt to identify characteristics typical of postoperative candidosis. There were 36 patients, 10 with candidosis and 26 with bacterial septicaemia. Typical for candidosis when the septic signs appeared was a history of prolonged antibiotic treatment before the operation (10/10), long courses of antibiotics (7/10), and therapy with combinations containing aminoglycoside (7/10). Operations on the small intestine were characteristic of candidosis patients (4/10). A poor clinical condition (9/10) on admission to the hospital, late onset of septicaemic symptoms postoperatively (7/10), long hospitalization (9/10), parenteral nutrition (10/10) and reoperations (9/10) were also features associated with the development of candidosis. Patients with postoperative candidosis have several characteristics on the basis of which the developing serious infection can be suspected and empirical therapy started. It may be appropriate to initiate antifungal prophylaxis in connection with operations when necrotic intestine is resected. Avoiding long courses of postoperative antibiotics could also be a measure to diminish the incidence of postoperative candidosis.

Abscess↗
PubMed1989

Yeasts in blood cultures: impact of early therapy.

Patients with growth of yeast in blood cultures were analyzed during the 6-year-period 1981-1986, with special regard to predisposing factors, mortality, severity of the disease and therapy. There were 80 isolations of yeasts in blood cultures in 39 patients and Candida albicans was the most common. The majority of the patients in the material had multiple predisposing factors. The overall mortality was 58%. Patients with d disseminated disease had a mortality of 79% in contrast to 32% in patients with transient fungemia. Disseminated disease was more common in surgical patients. The prognosis of patients treated within 4 days from the onset of septic symptoms was significantly better than that of patients with a later start of therapy. On the basis of these results we emphasize the importance of early empiric therapy.

Antifungal Agents↗
PubMed1982

Pulmonary inactivation of 5-hydroxytryptamine is decreased during cigarette smoke ventilation of rat isolated lungs.

1 The effect of cigarette smoke ventilation on the inactivation of [14C]-5-hydroxytryptamine (5-HT) was studied in isolated perfused lungs of the rat. 2 [14C]-5-HT 9.6 nmol was infused into the pulmonary circulation of rat lungs in 3 min. The nonrecirculating perfusion effluent was collected during the 5-HT infusion in three consecutive 1 min fractions. The amount of metabolites of 5-HT was determined from the perfusion effluent and from the perfused lungs. 3 The amount of metabolites of 5-HT in the perfused lungs was also decreased by cigarette smoke ventilation, although the total amount of radioactivity in the lung tissue was not significantly changed. 5 The decreased pulmonary inactivation of 5-HT may cause increased circulating levels of 5-HT, which would explain some cardiovascular changes during smoking.

Animals↗
PubMedDate not supplied

Small bowel anastomosis with the biofragmentable anastomosis ring and manual suture: a prospective, randomized study.

A total of 170 patients undergoing upper gastrointestinal surgery requiring a jejuno-jejunal enteroanastomosis were randomized into two groups according to the method to be employed at the enteroanastomosis. The most common procedures were partial gastrectomy for benign disease (84 patients), partial or total gastrectomy for malignant disease (35 patients), and bilioenteral bypass (31 patients, 25 for malignant disease). The enteroanastomosis was created by manual suture (3-0 Dexon, two layers) in 89 patients and with the Biofragmentable Anastomosis Ring (Valtrac-BAR) in 81 patients. Both end-to-side (101 patients) and side-to-side (69 patients) reconstructions were done. No ruptures or obstructions of the jejuno-jejunal anastomosis occurred. The postoperative recovery of the gastrointestinal tract was similar in the two groups in duration of nasogastric drainage, intravenous fluid therapy, and intestinal paralysis. Nor was there any difference between the groups in the duration of the postoperative hospital stay. Ten patients, 7 in suture-group and 3 in BAR-group, died postoperatively of causes unrelated to the enteroanastomosis. Thus the mortality rate was 7.9% in the suture group and 3.7% in the BAR group. The biofragmentable ring offers a safe alternative to manual sutures for small bowel anastomoses.

Anastomosis, Surgical↗
PubMedDate not supplied

Pathogenesis of postoperative candidosis: no detectable fungemia during reoperations after abdominal surgery.

Pathogenesis of systemic candidosis in surgical patients is unsettled. Results from animal models suggest that invasion from colonized intestine is the major portal of entry into circulation. To study the mechanisms of systemic candidosis in surgical patients after intestinal surgery, multiple blood cultures were taken during reoperations with manipulation of the intestinum to detect possible perioperative fungemia. The lysis centrifugation method (Isolator) was used for blood cultures. Of the 30 subjects in the material, 12 were demonstrated to be colonized with yeast before the reoperation. Three patients had positive blood cultures during reoperation, but no yeasts were found in the 146 perioperative blood cultures. Three patients had severe nonsuperficial yeast infection after reoperation, but none had disseminated candidosis. This finding in high risk patients supports the view that immediate perioperative fungemia and persorption from colonized intestinum is rare. However, persorption may occur later via healing wounds of the colonized intestinum. Both persorption and the exogenous route (e.g. vascular catheters) are possible in the pathogenesis of postoperative candidosis.

Abdomen↗