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Biomedical subjects

S Konichezky

Publications and source records attributed to S Konichezky.

26 records · Page 2Linked to original sources

Adult respiratory distress syndrome: roles of leukotriene C4 and platelet activating factor.

The relationship between leukotriene C4 (LTC4), platelet activating factor (PAF), and adult respiratory distress syndrome (ARDS) was studied in nine patients and 84 control subjects. A leukocyte adherence inhibition (LAI) assay induced by each of the ligands was used to monitor the subjects for 3 consecutive days or until clinical recovery was noted. LAI was considered to be positive if the nonadherence index (NAI) was greater than 30 for LTC4 or greater than 20 for PAF. LAI was negative in all healthy subjects using both ligands. LTC4-induced LAI was positive in all nine ARDS patients and reverted to negative after recovery from the syndrome, while three (33.3%) of nine patients responded to PAF. In contrast, of the 84 control subjects, LAI was induced by LTC4 in only three (3.3%) and by PAF in five (5.9%). The mean NAI (52.2 +/- 18) of LTC4-induced LAI in ARDS patients was significantly (p less than .05) higher when compared with the control group (-5 +/- 6.4), whereas that of PAF-induced LAI was less than 20 in both groups, indicating that LTC4 is a more specific ligand than PAF. All three patients in whom ARDS was caused by sepsis responded to both LTC4 and PAF, but results of specific receptor-antagonist experiments indicated that each compound acted independently. The mean NAI for LTC4 (58.5 +/- 10) and PAF (49.1 +/- 12) in patients with septic ARDS were significantly (p less than .05) higher when compared with those of patients with sepsis alone (0.5 +/- 9.9 and 4.4 +/- 17, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Cell-mediated immune suppression due to alfathesin in short-term anaesthesia.

The immunosuppressive effects on cell-mediated immunity of alfathesin, when used as the sole agent for short-term anaesthesia, were investigated in ten women undergoing pregnancy termination. Cell-mediated immunity was evaluated by E rosette formation in peripheral blood (reflecting the percentage of T lymphocytes) and by proliferative responses to the mitogens concanavalin A and phyto-haemagglutinin in various concentrations. Measurements were made before alfathesin was administered, and again after 60 minutes, two days and seven days. Significant reductions in the percentage of E rosettes in peripheral blood and in mitogenic responses to concanavalin A were observed 60 minutes after administration of alfathesin. A model is proposed in which alfathesin binds to lymphocytic membrane receptors, thus affecting in vitro cell-mediated immune reactions.

Abortion, Induced↗

Tracheal puncture. A complication of percutaneous internal jugular vein cannulation.

We report two cases in which tracheal puncture (diagnosed by puncture of the orotracheal tube cuff) followed internal jugular vein cannulation by the posterior approach. This complication is only likely to occur when using posterior approach and it may be followed by potentially dangerous subcutaneous emphysema, pneumomediastinum or air trapping between the chest wall and the pleura. This has led us to believe that the posterior approach should be substituted by the alternative central or anterior approach whenever it is possible.

Adult↗

Mechanical ventilation in fiberoptic-bronchoscopy: comparison between high frequency positive pressure ventilation and normal frequency positive pressure ventilation.

High frequency positive pressure ventilation (HFPPV) was compared with normal frequency positive pressure ventilation (NFPPV) during diagnostic fiberoptic-bronchoscopy. HFPPV was achieved by a simple modification of the Minivent, and gave satisfactory alveolar ventilation and oxygenation. In all 11 patients and over periods of at least 40 min, HFPPV gave normal PaCO2 and high levels of PAO2. Arterial blood pressures were higher and the airway pressures were lower than during NFPPV.

Adult↗

Pulse oximetry from the nasal septum.

STUDY OBJECTIVE: To evaluate the accuracy of the nasal septum site for pulse oximetry measurement of arterial oxyhemoglobin saturation (SpO2) in hypothermic patients. DESIGN: Prospective study. SETTING: Operating theater of a public hospital. PATIENTS: Fourteen hypothermic (temperature 34.6 degrees C to 36 degrees C) patients (eight males and six females) undergoing a major surgical abdominal procedure. INTERVENTIONS: Fifty estimations of SpO2 were simultaneously made by a flex sensor probe applied at the nasal septum site and by a finger sensor probe using a pulse oximeter. The results were compared with arterial oxygen saturation (SaO2) as measured by arterial blood gas sampling. MEASUREMENTS AND MAIN RESULTS: In 18% of the estimations, the finger probe produced unmeasurable results. The nasal septum probe did not produce any unmeasurable results (p = 0.0055). In the remaining 41 estimations, a comparison of the measurements from the nasal septum versus the controls showed a mean difference of 0.15 and a limit of agreement of -0.106 to +0.398. A comparison difference of 2.27 and a limit of agreement of 1.986 to 2.551. CONCLUSION: Monitoring SpO2 at the nasal septum site is more reliable than monitoring it at the finger site in hypothermic patients.

Adult↗

Respiratory function following premedication with droperidol or diazepam.

Respiratory function was measured before and 1 hour after premedication with diazepam (10 mg IM) or droperidol (5 mg IM) in 2 groups of 14 normal patients scheduled for elective surgery. Diazepam had no significant effects on respiratory rate, tidal volume, minute ventilation, dead space, VD/VT %, alveolar ventilation, expired Po2, or Pco2, end-tidal Pco2, arterial Po2 or Pco2, or alveolar-arterial Po2 or Pco2 gradients. Droperidol was associated with statistically significant but modest reductions in tidal volume (-13.3%) and minute ventilation (-8.4%) while other respiratory functions remained unaffected.

Adult↗