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At least 1,603 records · Page 89Linked to original sources
PubMed1998

[Effect of perioperative antibiotic prophylaxis on hemodynamic stability during surgery: detection of complex interaction in a simulated clinical randomized animal study].

In a clinic modelling randomised trial (CMRT) in three groups of 10 land-race pietren pigs each it could be shown that the influence of prophylactic antibiotic administration on intraoperative hemodynamic stability and histamine release is only evident, if by stepwise addition of complicating factors the overall complexity of the experimental setting is increased. Different antibiotic regimen for prophylaxis significantly affected the incidence of cardiovascular instabilities only after relevant blood loss, restoration of circulation and subsequent submaximal induction of anaphylactoid reactions by the histamine liberator Polymyxin B. In conclusion, preclinical testing of therapeutic agents in complex clinic modelling randomised trials should be mandatory to avoid the possible hazards of misconducted clinical trials.

Amoxicillin-Potassium Clavulanate Combination↗
PubMed2002

Report recommends that HIV become reportable in BC.

The Provincial Health Officer has recommended that HIV be nominally reportable and that a well-funded partner notification system be established. However, he also recommended that people be allowed to choose non-nominal HIV testing.

British Columbia↗
PubMedDate not supplied

[Organization of tuberculosis surveillance in France].

In France, reporting tuberculosis has been mandatory since 1964. Selected criteria for the report to the Public Health Control System. Tuberculosis-disease. Confirmed case: disease due to a mycobacterium of the tuberculosis complex proven by culture (Mycobacterium tuberculosis, M. bovis or M. africanum). Probable case: clinical and/or radiological signs compatible with tuberculosis, decision to treat the patient with a standard antimycobacterial treatment. Latent tuberculosis-infection (primary infection) in a child under 15 years of age. Positive Intradermal reaction to the tubertest 5 TU without neither clinical nor para-clinical sign (induration > 15 mm after BCG or a 10 mm increase compared to an IDR performed less than 2 years before) or a phlyctenar IDR. Infections due to atypical mycobacteria do not have to be declared.

France↗
PubMed1984

The diagnosis of clinically suspected venous thrombosis.

The clinical diagnosis of venous thrombosis is highly non-specific. The reason for this is that none of the symptoms or signs of venous thrombosis is unique to this condition--that is, each can be caused by nonthrombotic disorders. Objective testing to confirm or exclude the diagnosis of venous thrombosis, then, is mandatory in patients with clinically suspected deep vein thrombosis.

Cost-Benefit Analysis↗
PubMed1994

Hypersensitivity reactions during haemodialysis: the choice of methods and assays.

Our considerations about assays to assess agents and mechanisms involved in hypersensitivity reactions can be summarized as follows. The measurement of total IgE is recommended since it confirms a history of atopy of the patient and is a quick and inexpensive laboratory assay. If, based on the anamnesis, a particular allergen can be suspected to be involved in the clinical reaction a RAST against this compound is highly recommended. In any case of a severe clinical reaction the RAST against ethylene oxide is mandatory to confirm or exclude the involvement of ethylene oxide. The radioallergosorbent test (RAST) should not be used as a screening test for an entirely unknown allergen. The determination of histamine in plasma samples can be applied for specific scientific questions but cannot be recommended as a routine test with first priority. In contrast, the measurement of bradykinin should be established as soon as possible as a routine test for all new materials which are developed for application in the extracorporeal circuit. An initiative of the haemodialysis community is recommended to assure the commercial availability of a reliable bradykinin immunoassay.

Anaphylatoxins↗
PubMed1996

[Prevention of sexually transmitted diseases. The norwegian experience].

A significant decrease in the incidence of most STDs has been reported in Norway during the last decade, especially the last 5 years. Today, syphilis, hepatitis B and gonorrhoea are almost non-existent with incidence rates (IR) of 1.1, 0.9 and 4.4 per 100,000 respectively. The frequency of genital herpes, however, has remained unchanged (IR = 45), while chlamydial infection has shown a decrease of 13% during the last year (IR women = 240). The Chlamydia epidemic became evident in the early 1980-ies and since then has represented the major threat to the reproductive condition in young women resulting in PID, tubal occlusions and ectopic pregnancies. In Norway a preoperative screening program in connection with the performance of abortions was introduced 8-9 years ago. Since then a gradual decrease in the frequency of chlamydial positivity has been notified. At our hospital a reduction of 75% (from 11.7% to 3.1%) in the prevalence of C. trachomatis has been observed in women seeking abortion. The decrease is evident is all age groups, but predominantly in those below 25 years. At the same time the frequency of PID has decreased by 80%, while so far only a slight reduction in the frequency of ectopic pregnancies has been observed. Public and professional awareness, together with an increased prescription of anti-chlamydial drugs to women with genital infections may have contributed to this decrease. Partner tracing is not satisfactory, being performed in only one out of 5 cases. A new act for the prevention of communicable diseases will be introduced next year. This act will make partner notification mandatory and STD treatment free of charge. In Norway, 350,000 chlamydial tests (8 per 100 inhabitants) are performed per year, 39% in women < 25 years. Even today the age-specific prevalence of these women are so high that Chlamydia screening is cost-effective.

Contact Tracing↗
PubMed1997

[Diagnosis and follow-up of post-transplantation osteopathies].

The skeletal status of transplant recipients needs routine assessment both before and after organ transplantation for the following questions: 1) is the patient on risk for developing osteoporosis independently of transplantation? 2) are there signs of significant pre-transplantation bone disease? 3) does the patient develop post-transplantation osteopathy? Although biochemical markers of bone metabolism provide useful data to each of these questions, the complex metabolic pertubations seen in chronic organ failure make it mandatory to interpret biochemical findings only within the framework of other clinical tests and imaging techniques. Pre-transplantation osteopathies require specific and often broad clinical and laboratory evaluation, and biochemical tests should be chosen according to the underlying disease and type of organ failure. In this respect, biochemical markers of bone metabolism may provide information on the degree of the skeletal dysbalance. Likewise, biochemical markers of bone turnover may be helpful in monitoring skeletal metabolism after organ transplantation.

Bone Density↗
PubMedDate not supplied

[Cardiac dysfunction in children with thalassemia major].

Evaluation of the cardiac function of seven patients with beta-thalassemia major was performed by continuous electrocardiography recording during a 24 hr period and during a short term exercise program. A reduction in left ventricular function was assessed by echocardiography and radiocardiography during resting and during exercise. Serious arrhythmias of various forms in the oldest patients (17 and 20 years) were observed during these tests. The younger patients were asymptomatic and their cardiac function tests showed no abnormality. In order to prevent transfusion related cardiac iron toxicity it would seem mandatory to motivate patients for better compliance while on chelation therapy.

Adolescent↗
PubMed1990

[Anesthetics responsible for anaphylactic shock. A French multicenter study].

Combined allergological and anaesthetic consultations have been started in the last few years in eight French Teaching Hospitals so as to explore peranaesthetic anaphylactoid shocks. A survey was carried out in these centers in order to collect patients investigated with the same protocol, for the assessment of the incidence of anaphylaxis in France, as well as the involved drugs. Investigations were always carried out at least 6 to 8 weeks after the accident. The tests used to diagnose IgE-dependent anaphylaxis were skin tests (prick and intradermal tests, carried out in all eight centers), the radioimmunological assay of specific anti-quaternary ammonium IgE, together with an inhibition test with thiopentone and propofol (six centers), leukocyte histamine release (five centers) and human basophil degranulation tests (three centers) for those drugs for which no specific antibody assay exists. The collected data involved 1,240 patients, investigated within the last four years. Anaphylaxis was diagnosed in 821 patients (66.2%). Muscle relaxants were responsible in 668 cases (80% of cases of anaphylaxis). Suxamethonium was the main cause (54.3% of shocks due to muscle relaxants), followed by vecuronium (15.3%). General anaesthetics (hypnotics and benzodiazepines) were responsible for 9.2% of all cases of anaphylaxis opioids for 2.6%. There were only three cases of shock due to local anaesthetic agents. Latex and ethylene oxide are becoming increasingly involved. It would therefore seem mandatory to carry out after any anaphylactoid accident an assessment with sensitive and specific tests for anaphylaxis. Diagnosing anaphylaxis means that the involved drug should be used never again in that patient. Because muscle relaxants are by far the most involved drugs, anaesthetists should use them only when really required.

Analgesics, Opioid↗
PubMed1998

Mandatory prenatal screening for the human immunodeficiency virus: the experience in south-eastern France of a national policy, 1992-1994.

OBJECTIVE: To evaluate the impact of the 1993 French National Policy which made it mandatory to offer screening for the presence of human immunodeficiency virus (HIV) to all pregnant women who planned to give birth, although women remained free to refuse the test. DESIGN: Successive surveys in April 1992 and May 1994 in south-eastern France. Logistic regressions were performed to identify factors which affected access to HIV testing for women who gave birth and those who terminated their pregnancy, and for each year of study. MAIN OUTCOME MEASURES: Attitudes and access to HIV testing among pregnant women, irrespective of pregnancy outcome. SETTING: All obstetrics and gynaecology departments and abortion clinics in the region. POPULATION: 3497 women in 1992 (2775 who were delivered and 722 who chose termination) and 3407 in 1994 (2701 who were delivered and 766 who chose termination). The response rates were 82% and 88%, respectively. RESULTS: In 1994 of women who were delivered, 73% had an HIV test, compared with 63% in 1992 (P < 0.001); however of women who terminated their pregnancy, only 28% had an HIV test, compared with 24.5% in 1992 (P not significant), although they were more at risk for HIV infection. Socioeconomic differences affecting access to testing were reduced between 1992 and 1994, but only among women who gave birth. CONCLUSION: Introduction of a policy which makes it mandatory to offer HIV screening to all women who intended to have their baby improved access to screening but did not improve the rate of preventative counselling. A mandatory requirement to offer HIV screening should be extended to women who request termination of pregnancy.

Abortion, Induced↗
PubMedDate not supplied

Spermatic cord torsion, reactive oxygen and nitrogen species and ischemia-reperfusion injury.

Mammalian testes are highly sensitive to oxidative free radical damage. Acute scrotum is a clinical syndrome mainly caused by torsion of the spermatic cord that constitutes a surgical emergence affecting newborns, children and adolescents. This syndrome often leads to infertility of the ipsilateral (torted) and contralateral (not torted) testis, an outcome that makes surgical intervention mandatory. There is a controversy involving the effects of ischemia and reperfusion on ipsilateral and contralateral testes after unilateral torsion and detorsion of the spermatic cord. Conflicting reports have led to two distinct and opposite recommendations regarding surgical intervention: detortion and preservation of the ipsilateral testis, or ipsilateral orchiectomy to preserve contralateral fertility. Early detortion surgery in humans preserves fertility, but after prolonged torsion periods followed by preservation of the ipsilateral fertility of both testis is jeopardized. Lowered contralateral blood flow after unilateral testicular torsion is associated with reactive oxygen species (ROS) overgeneration and therefore with the corresponding tissue damage. Reperfusion time appears to be determinant of contralateral testes damage due to the consequent oxidative insult that accompanies the rise in ROS following ischemia-reperfusion. Nevertheless, more investigations on the molecular mechanisms and the antioxidant status in testis are necessary to ascertain the contribution of ROS to the tissue damage produced by spermatic cord torsion in experimental animals and humans.

Animals↗
PubMed1989

Pulmonary function in preterm infants whose lungs were ventilated conventionally or by high-frequency oscillation.

To test the hypothesis that high-frequency ventilation may reduce the risk of barotrauma and thus the incidence of chronic pulmonary damage in preterm infants who need mechanical ventilation, we measured lung function before discharge in 53 infants who needed mechanical ventilation on the first day after birth and were randomly assigned to receive intermittent mandatory ventilation (n = 26) or to receive high-frequency oscillatory ventilation (n = 27). There were no significant differences between the groups in birth weight (mean +/- SD: 1010 +/- 240 vs 1030 +/- 230 gm), gestational age (29.1 +/- 2.0 vs 28.9 +/- 2.1 weeks), initial ventilatory support (mean airway pressure 7.2 +/- 1.8 vs 8.1 +/- 2.1 cm H2O; FiO2 0.62 +/- 0.24 vs 0.75 +/- 0.22), duration of mechanical ventilation (median (range): 6 (1 to 61) vs 10 (1 to 50) days) and duration of oxygen therapy (13 (1 to 109) vs 27 (4 to 227) days) for the intermittent mandatory ventilation group and the high-frequency oscillatory ventilation group, respectively. At the time of testing, weight was 1830 +/- 340 vs 1830 +/- 290 gm, and age was 68 +/- 24 vs 70 +/- 31 days. Respiratory flows were determined by pneumotachygraphy, esophageal pressure through a water-filled feeding tube, and functional residual capacity by N2 washout. Both groups had abnormal lung function with decreased lung compliance (1.65 +/- 0.51 vs 1.54 +/- 0.36 ml/cm H2O) and elevated pulmonary resistance (102 +/- 24 vs 107 +/- 36 cm H2O/L/sec). Functional residual capacity was in the normal range (30.6 +/- 6.0 vs 28.2 +/- 10.7 ml) in both groups. There were no significant differences in lung function between the two treatment groups. These results do not support the hypothesis that high-frequency oscillatory ventilation reduces the risk of lung damage in preterm infants.

Female↗