Multi-organ failure in a patient with sepsis due to Salmonella precipitated by liver trauma.
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Biomedical subjects
Publications and source records attributed to M Cid.
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Anti-Sia-lb (formerly anti-Gd) cold agglutinins (CAs) recognize sialylated carbohydrates on both adult and neonate red blood cells (RBCs). RBC CA activity inhibition experiments reported here indicate that the domain NeuNAc alpha2-3Gal, as found in sialyllactose, synthetic sialyl(s) Lewis(Le)(x) and sLe(a), sialyllactosamine, sialyl-fucosyllactose, and nonfucosylated sLe(a), constitutes the minimal epitope for these CAs, implicating that these autoantibodies could be able to bind this domain in sLe(x) and sLe(a) and related carbohydrates expressed on nucleated cells and in soluble cancer-related mucins. The following data obtained with the previously characterized monoclonal IgMk anti-Sia-lb CA, GAS, show that this is the case. GAS epitope expression among leukocytes that lack sLe(a) parallels that of sLe(x) determinant as detected by mouse monoclonal antibodies (MoAbs), especially MoAb KM-93. It is also found on epithelial malignant cells bearing both sLe(x) and sLe(a). GAS epitope on these nucleated cells, (1) like that present on RBC, is abolished by sialidase, unaffected by proteases, and inhibited by sialyllactose; and (2) is overlapping and/or proximal to that recognized by anti-sLe(x) MoAb, CSLEX-1, and KM-93. Moreover, CAGAS binds soluble cancer-associated mucins bearing sLe(x) and sLe(a) determinants. This binding is inhibited by sialyllactose and these mucins inhibit the RBC CA activity of CAGAS. The possible significance of anti-Sia-lb (anti-Gd) CAs as autoantibodies directed to carbohydrate ligands of host adhesion molecules that might be receptors of microbial adhesins of some CA-inducing pathogens is discussed.
PURPOSE: To report a case of trabeculectomy-associated endophthalmitis caused by penicillin-resistant Streptococcus pneumoniae. METHOD: Case report. RESULTS: The patient developed endophthalmitis 1 month after an uncomplicated trabeculectomy for primary open-angle glaucoma. Vitreous cultures grew abundant, highly penicillin-resistant S pneumoniae. Despite aggressive treatment with vitrectomy and intravitreal injections of vancomycin hydrochloride and amikacin sulfate, the patient had a poor visual outcome. CONCLUSION: Penicillin-resistant S pneumoniae can cause endophthalmitis after trabeculectomy.
A method to determine the three orthogonal components of the angular momentum of a human body about its center of gravity is applied to the pole-vault. The angular momentum and the pole force are used in the analysis of pole-vaulting and are also compared with Gros's data (1982, Ph.D. thesis, University of Alberta) and Hubbard and Barlow's results (1980, Proc. Biomechanics Symp. Indian State Board of Health, pp. 33-48). This study tries to show how such results can be useful in many sporting activities and are necessary for optimization of athletic movement.
All sick leaves during 1989 among academics and students of a Faculty of Medicine were analyzed. Twenty three percent of academics and 60.5% of students had at least one sick leave during the year. The mean general rate of absenteeism among academics was 3.55% (1.6% among men and 8.09% among women). The mean length of sick leaves was 13.5 days. Eighteen percent of lost working days were due to pregnancy, lactation or care needs of less than one year children. Tumors, trauma, respiratory, digestive and mental illnesses accounted for 72.8% of lost working days. Medical students had a mean general absenteeism rate of 2.66% (ranging between 1.8% among male sixth year and 4.8% among female fourth year students). Mean length of sick leaves was 3.5 days (ranging from 2.98 among female fifth year and 6.7 among male sixth year students). Respiratory, digestive and infectious diseases accounted for 74% of lost days. No sick leaves were observed, due to pregnancy or lactation among students or due to occupational diseases among academics.
Two patients who developed pain and tenderness in their calf muscles, without other organ system involvement, are described. A gastrocnemius biopsy disclosed necrotizing muscular arteritis. Five other reported cases are reviewed and we conclude that there is a limited form of polyarteritis nodosa localized to calf muscles, with a differentiated and more benign clinical course, a differential diagnosis restricted to local pathological processes and prompt response to treatment with corticosteroids alone.
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Authors present, a series of 73 infantile appendicular interventions, the high incidence of coproliths found in the appendix lumen (30.13%) which contrasts with the number presented by other authors which oscillate between 0.64 and 15%. The radiologic study of the extirpated appendix shows coproliths which has not been visualized in the preintervention-radiologic exploration. Due to this, authors consider convenient the study of the extirpated piece in order to the exact evaluation of the number of coproliths. Microscopic analysis and infrared spectrophotometry show the existence in the composition of the coproliths abundant in-organic material as well as organic acids and hydrocarbons.
OBJECTIVES: To study the clinical applicability of the expert system URGSANT as a help in making up decisions in emergencies. MATERIAL AND METHODS: URGSANT is an expert system implemented in INSIGT 2+ which is structured in a modular and hierarchical form. It contemplates 44 urgent situations relating to the central nervous system, hematopoietic, cardiovascular, respiratory, gastrointestinal, genitourinary, endocrinological, and miscellaneous group. Validation of the program was made by four anesthesiologists who evaluated the performance of the program in 25 emergency cases and in 25 other situations that were treated by other specialists. RESULTS: The rationale of the system was basically correct. In most cases the program was considered efficient or very efficient during the different clinical situations and only in one case its guidance was wrong. CONCLUSIONS: The URGSANT expert system is an efficient and useful method for the clinician during emergency situations.
We report the case of a male patient with a carcinoma of the upper third of the esophagus who presented a tracheal rupture during a transhiatal esophagectomy. The clinical picture was characterized by a severe alteration of the ventilatory function that required selective intubation and, later on, a right thoracotomy for repairing the tracheal lesion. After surgery the patient was treated at the Recovery Unit. He received high-frequency mechanic ventilation (jet ventilation type) during nine days in a attempt to decrease the risk for dehiscence of the tracheal suture and to ensure an adequate oxygenation and hemodynamic control. The clinical course was favourable.
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Based on the importance of document files and first-hand bibliographic sources for studying the history, we have recently investigated the chapter of Doctoral Thesis and Reports on anesthetic topics since we believe that these are fundamental to gain insight into the knowledge of our history. This investigation was planned to find such documents by reviewing the data of several Spanish archives and libraries. We collected 80 works: 14 Reports and 66 Doctoral Theses performed during a period of 95 years (heuristic limits 1847-1942). These papers were classified in several subgroups according to the subjects they deal with: 21 works on inhalation anesthesia, 7 on intravenous general anesthesia, 20 on spinal anesthesia, 10 on locoregional, 7 on anesthesia and metabolism, 12 on obstetric anesthesia, and 3 works on varied anesthesia issues. Analysis of these documents revealed that the authors (physicians and Spanish medical corporations) undertook an accurate consideration of the more relevant scientific subjects at the time of their investigation. We conclude that the works analyzed in the present study represented the beginning of the Spanish investigation on anesthesia. Further investigations may contribute to enrich our historiography.