[Intrathecal catheter after wet tap in labour: headache prevention?].
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Biomedical subjects
Publications and source records attributed to R Servais.
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We report the case of a 28-year-old secundipari with a history of severe hypertriglycideremia-induced pancreatitis 3 years ago who was admitted in the 37th week of gestation with abdominal pain. A blood sample had a milky aspect and plasma concentrations were as follows: triglycerides 8,5g/l, cholesterol 1000 mg/dl, amylase 574 IU/l, lipase 1310 IU/l. Acute pancreatitis was diagnosed, a caesarean was performed under spinal anaesthesia. The diagnosis was confirmed by CT-scan. Treatment with 15,000 IU heparin per day and intravenous nutrition decreased triglycerides level to less than 1g/l within 48 h. She was discharged 28 days later. Heparin could be a low-cost alternative to plasmapheresis in hypertriglycideremia-induced pancreatitis.
This investigation was designed to evaluate sequential spinal epidural analgesia with a needle through needle technique for pain relief in labour. The spinal injection was made using a Becton Dickinson 29 gauge Quincke point needle. Bupivacaine 1 mg, sufentanil 5 microg and adrenaline 25 microg (2 ml) were injected intrathecally. Analgesia was maintained using bupivacaine 12.5 mg, sufentanil 10 microg and adrenaline 12.5 microg in a 10 ml bolus given through an epidural catheter in the epidural space. This dosage was also used for the test dose. Pain relief was obtained in less than ten minutes and lasted for a mean of 134 min. Of the 620 parturients in the investigation, 500 had a mean dose of 4.3 mg bupivacaine per hour. Hypotension and paresis were of no concern. Patient satisfaction was excellent, 85% of the parturients being very satisfied and 10% satisfied.
The purpose of this study was to determine if consumption of appropriate amounts of carbohydrate during a period of increased exercise training would protect the athletes from becoming overtrained. Eight male competitive cyclists were monitored and tested during three training periods: a) normal training (moderate intensity, long duration, 7 d, NORM); b) overtraining (high intensity training, 15 d, OVER); and c) recovery (minimal training, 6 d, REC). Throughout the training 160 g of liquid carbohydrate were consumed within the first 2 h after the daily exercise bout. Mean dietary intake (NORM = 13.7 +/- 1.6, OVER = 14.1 +/- 1.0 MJ.d-1) and carbohydrate percent (NORM = 64.0 +/- 2.1, OVER = 67.4 +/- 2.5%) were not different during the different training periods. Similarly, resting muscle glycogen levels were not different (NORM = 530.9 +/- 42.5, OVER = 571.2 +/- 27.5 mumol.g-1 dry weight). Five criteria were used to determine if overtraining occurred in a subject (decreased maximal workload, maximal heart rate, ratio of maximal lactate to rating of perceived exertion (HLa:RPE), and resting plasma cortisol levels, increased affirmative response to a daily questionnaire). All subjects met at least three of the five criteria and thus were classified as overtrained. Therefore, short-term overtraining may occur even when resting muscle glycogen levels are maintained.
The authors briefly describe different aspects of rectal cancer: epidemiology, etiological factors, screening procedures, pathology, tumor spread and clinical classification.
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