[Prevalence of infections in a third-level medicosurgical hospital (I). Infections and risk factors].
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Biomedical subjects
Publications and source records attributed to M Esteve.
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Irloxacin (E-3432) is a new quinolone derivative. In this study, the activity of irloxacin was compared with that of nalidixic acid, norfloxacin and ciprofloxacin against strains of clinical isolates. Irloxacin showed greater in vitro activity than nalidixic acid, similar activity to norfloxacin and lower activity than ciprofloxacin. Against Staphylococcus, the MIC range of E-3432 was 0.06-1 mg/l, better than the other compounds studied.
From a series of pyrrol-containing antibacterial agents, E-3604 was selected for development and compared with nalidixic acid, norfloxacin and ciprofloxacin against strains of clinical isolates. The in vitro activity of E-3604 was greater than that of nalidixic acid, similar to that of norfloxacin and lower than that of ciprofloxacin, except in the case of Staphylococcus where E-3604 showed the best in vitro activity of all the studied compounds, with a MIC range of 0.25-0.03 mg/ml. E-3604, like the other quinolones, presented a pH-dependent variation of activity, greater activity being observed in slightly acidic pH values.
A intrathecal injection of morphine has been given to 26 patients who present a tumor in activity with pain which withstand to heavy analgesic drugs. A intrathecal catheter with a sub-cutaneous tunnel is in connection with a subcutaneous reservoir. The hospitalisation for implantation is short. The mean efficient dosage is 3 mg of morphine chlorhydrate once or twice a day. About 50% of the patients are improved by this technic. In the future subcutaneous computerized pumps shall give better efficiency, shall decrease the dosage of drug, secondary effects and number of injections.
In our experience of 171 glossectomies for recurrence, salvage partial glossectomy yields 50% of local control. Myo-cutaneous flap allows wide total glossectomy without total laryngectomy. This procedure may improve the local control. Of 25 patients treated by this technique, 2 deceased before the 45th post-operative day, 15 swallow correctly and 11 have a good speech. The survival rate is 10/21 at 6 months, 7/16 at 12 and 6/13 at 18. A local failure was observed in 7 and 6 have a second primary in the upper respiratory and digestive tract. Total glossectomy without total laryngectomy is only indicated for patients with bulky tumor, without spread of the vallecula and with no palpable cervical node.
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Liver and biliary abnormalities are well-known complications of inflammatory bowel disease (IBD). It has been suggested that using total parenteral nutrition (TPN) may further impair liver function in these patients; this seems not to be so with total enteral nutrition (TEN). However, prospective trials comparing the incidence of liver function test (LFT) abnormalities with either TPN or TEN have not been carried out. Twenty-nine IBD inpatients with normal LFT, randomized to receive either TEN with a polymeric diet or isocaloric, isonitrogenous "all-in-one" TPN because of protein-energy malnutrition and/or severe disease, were included in the study. Sixteen patients (five with ulcerative colitis and 11 with Crohn's disease) received TEN, and 13 patients (eight ulcerative colitis and five Crohn's disease) were on TPN. All patients were on systemic steroids, and nine of them were on oral metronidazole. Both groups were homogeneous regarding age, sex, diagnosis, disease activity, nutritional status, daily nutrient supply, and days on artificial nutrition. Serum albumin levels significantly increased with TEN (32 +/- 1 to 38.2 +/- 1.6 g/liter, p less than 0.01), but not with TPN (32.1 +/- 2.2 to 33.9 +/- 1.4 g/liter, NS). Clinical improvement occurred in both groups of patients as shown by the change in the disease activity indexes. In all cases, measurements of serum alkaline phosphatase, serum bilirubin, aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltransferase were performed weekly. There were no significant differences in the initial LFT between both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
The effects of sucrose supplementation on body composition and heat production were studied in lean, dietary (cafeteria diet) and genetically (Zucker fa/fa) obese adult (60 days) rats. Sucrose supplement (29 kJ) for 10 days did not result in significant changes in the pattern of energy (fat) deposition or carcass composition. There were no alterations, either, in heat production measured by direct calorimetry. Under the conditions studied, sucrose intake did not affect lipid deposition or thermogenesis.
The rhythms of aortic core temperature and overall heat production in Wistar rats was analyzed by using long series of recordings of temperature obtained from implanted thermocouple probes and heat release values from a chamber calorimeter. There was a very high degree of repetitiveness in the presentation of actual heat rhythms, with high cross-correlation values ascertained wit paired periodograms. No differences were observed between heat production between male and female adult rats. The cross-correlation for temperature gave similar figures. The cross-correlation study between heat production and aortic core temperature in the same animals was significant and showed a displacement of about 30 minutes between heat release and aortic core temperature. The analysis of heat production showed a strong predominance of rhythms with periods of 24 hours (frequencies < 11.6 microHz) or more; other rhythms detected (of roughly the same relative importance) had periods of 8 or 2.2 hours (35 or 126 microHz, respectively). The analysis of aortic core temperature showed a smaller quantitative contribution of the 8 or 2.2 hours (35 or 126 microHz) rhythms, with other harmonic rhythms interspersed (5.1 and 4.0 hours, i.e. 54 and 69 microHz). The proportion of 'noise' or cycles lower than 30 minutes (< 550 microHz) was higher in internal temperature than in the actual release of heat. The results are in agreement with the existence of a basic period of about 130 minutes (126 microHz) of warming/cooling of the blood, with a number of other harmonic rhythms superimposed upon the basic circadian rhythm.
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In the present work the role of nursing in peripheric parenteral nutrition (PPN) is described. The main role is framed within the Unit of Nutritional Support along with the design of the corresponding protocols. The outstanding difference in the composition of our PPN vs those manufactured by the pharmaceutical industry, is the inclusion of glucose as the sole source of carbohydrates. These protocols secure similar nursing care in all patients. With respect to the local venous tolerance to our PPN, it was significantly better than that found in the group infused with a commercial PPN. By contrast, no differences in glycosuria were observed. The economical savings were of 1,980 pesetas per nutrition/day.
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