Pressure reducing valve prevents barotrauma during jet ventilation for microlaryngeal surgery.
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Barotrauma↗
Biomedical subjects
M Daniel
Publications and source records attributed to M Daniel.
[Non-Hodgkin malignant lymphomas of the uterus. Two cases. Review of the literature].
The initial manifestations of two cases of non-Hodgkin malignant lymphoma of the uterine body were a cauda equina syndrome in one and bowel occlusion in the other. A review of the literature on isolated non-Hodgkin malignant lymphomas of the uterine body was discussed.
Aged↗
A survey of information supplied to day-case patients.
The communication of information to day-case patients regarding post-anaesthetic precautions was reviewed. Deficiencies in the existing provision of information were identified and a proposal to improve on this is developed.
Adult↗
The baby chase.
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Ambulatory Care Facilities↗
Neuroprotective effects of riluzole on N-methyl-D-aspartate- or veratridine-induced neurotoxicity in rat hippocampal slices.
The neuroprotective activity of riluzole has been studied on N-methyl-D-aspartate (NMDA)- or veratridine-induced toxicity in immature rat hippocampal slices. Neurodegeneration was assessed by the measurement of LDH release and histology. Veratridine-induced LDH release can be inhibited by 100 microM riluzole (-90% and by tetrodotoxin (1 microM). Riluzole markedly reduced (-59%) the NMDA-induced LDH release and this protective effect was confirmed by histology. Riluzole inhibited the NMDA-induced LDH release in the presence of tetrodotoxin. Moreover, a pretreatment with pertussis toxin (1 microgram/ml) abolished the effect of riluzole against NMDA-induced neurotoxicity. These results support the view that the neuroprotective properties of riluzole could be exerted via two distinct mechanisms of action.
Animals↗
Lucilia sericata (Diptera: Calliphoridae) causing hospital-acquired myiasis of a traumatic wound.
A case of traumatic nosocomial myiasis caused by the green bottle fly Lucilia sericata (Meigen, 1826) occurred in a patient hospitalized following a serious road traffic accident. The patient had suffered extensive polytrauma particularly in the facial area of the skull. A total of 50 larvae was discovered in the oral cavity, nose, paranasal sinuses and enucleated eye-socket. Projected timing indicated that the eggs were laid while the patient was hospitalized. The development of myiasis was facilitated by the mental and physical debility and dependency of the patient, numerous and deep facial necrotic wounds and a lengthy period of hot weather which led to prolonged open window ventilation of his room.
Accidents, Traffic↗
Amino acid sequences of cytochromes c2 and c' from the moderately halophilic purple phototrophic bacterium Rhodospirillum salexigens.
Rhodospirillum salexigens is a moderately halophilic purple phototrophic bacterium which grows optimally in 8% NaCl. The amino acid sequences of the two principal soluble cytochromes c have been determined. One of these is a cytochrome c2, similar in size to mitochondrial cytochrome c. While clearly of the same sequence class as mitochondrial cytochrome c and the proteins from several other Gram-negative bacteria, it does not show particular affinity to any already known sequence in terms of the percentage sequence identity. The other protein is a cytochrome c', but is also a divergent member of this widespread group. The lack of appreciable sequence identity to other species is probably due to a limit of divergence which has been reached for the majority of purple bacterial species. However, the numbers of insertions and deletions and their locations in cytochromes c2 and c' suggest that R salexigens may be related to Rhodospirillum molischianum. Like other electron transport proteins from halophiles, both of these cytochromes are notable for their high content of arginine as compared with lysine and both are acidic. However, they do not show any particular sequence homology to electron transport proteins that have been characterized from the extremely halophilic phototrophes of the genus Ectothiorhodospira. Thus, it appears that adaptation to halophilic habitats has independently occurred more than once in purple bacteria.
Amino Acid Sequence↗
Fibre-mediated physiological effects of raw and processed carrots in humans.
Fibre-mediated physiological effects of raw and processed carrots were investigated in twenty-four young women under strict dietary control in two randomized crossover studies. For 3 weeks between 405 and 688 g of either raw frozen, blanched or canned carrots (first study), or raw or raw frozen carrots (second study) were consumed in addition to a low-fibre basal diet. Carrots provided 15 g dietary fibre (DF)/d. Total DF intake was 16.0 to 19.0 g (control periods) and 31 to 34 g (experimental periods). Faecal bulking effects of raw and processed carrots were similar (between 2.4 and 3.7 g additional stool/g carrot fibre in the diet). Faecal excretion of dry matter, fibre, and protein also increased significantly during carrot consumption. Fermentability of carrot fibre constituents was high (91-94%) and independent of processing, in spite of differences in the distribution of soluble and insoluble fibre and in the texture of raw and processed carrots. There was no effect of either type of carrot on serum total and high-density-lipoprotein-cholesterol or on faecal bile acid excretion.
Adult↗
Digestibility of energy, protein, fat and non-starch polysaccharides in mixed diets: comparative studies between man and the rat.
The apparent digestibility of energy, protein, fat and non-starch polysaccharides (NSP) of low and high dietary fibre (DF) mixed diets were studied in three series of experiments with man and the rat. Low DF diets were used as control diets in each experimental series and the DF level was increased by adding fruits and vegetables (Study 1), citrus fibre concentrate (Study 2) and insoluble barley fibre (Study 3). In Study 3 the high DF diet was fed at two protein levels. There was in most cases good agreement between the digestibility of energy between man and the rat, with the digestibility of energy of the low DF control diets of 0.941-0.950 in man compared with 0.933-0.952 in the rat and of the high DF diets of 0.897-0.931 in man and 0.865-0.920 in the rat. The biggest difference in digestible energy between the two species was found for the diet enriched with fruits and vegetables (0.032 absolute units) and citrus fibre concentrate (0.025 absolute units). Apparent digestibility of protein was slightly lower in man than in the rat for all diets in Studies 1 and 2. In Study 3, however, apparent digestibility of protein was consistently lower in man than in the rat with differences in absolute digestibilities between the two species varying from 0.023 (high DF/high protein) to 0.071 (high DF/low protein). The digestibility of fat was the same in man and in the rat in all but the high DF diet of Study 2. The rat appears to have a lower capacity to digest fibre polysaccharides than man and the digestibility of NSP was consistently lower in the rat than in man. The biggest difference between the two species was found for the diets in Study 2 where the digestibility of NSP in man was measured to be 0.774-0.885 compared with only 0.501-0.517 in the rat. For the other diets the differences in NSP digestibility were 0.077-0.137 absolute units. In spite of some differences between man and the rat in their ability to digest nutrients the various diets are ranked in the same order by the two species.
Adult↗
Repetitive rapid increases in desflurane concentration blunt transient cardiovascular stimulation in humans.
BACKGROUND: Rapid increases in desflurane concentrations above minimum alveolar concentration (MAC) can cause transient (2-4-min) circulatory changes, possibly from stimulation of rapidly-adapting airway receptors. We hypothesized that the initial increase in concentration would produce greater changes than subsequent increases. METHODS: Anesthesia was induced with propofol in nine volunteers (25 +/- 1 yr old, mean +/- SE) and maintained with 4% end-tidal desflurane for 32 min. We increased the desflurane to 8% (1.1 MAC) in 1 min, maintained this concentration for 10 min, and then decreased it to 4% for 32 min. We repeated this process twice. After 1 week, 5 subjects were treated similarly except that the second increase in concentration occurred 10 min and (on a separate occasion) 75 min after the initial increase. Four subjects received the initial increase after 75 rather than 32 min of anesthesia. In four we applied the repeated sequences in a background of 60% nitrous oxide. When a minimal cardiovascular response followed an increase of anesthetic concentration, a 60-s supramaximal 100-Hz tetanic stimulus was applied to an ulnar nerve percutaneously to test for sympathetic responsiveness. RESULTS: The initial increase in concentration increased heart rate (HR) from 57 +/- 2 to a peak of 119 +/- 7 beats/min (P < 0.05); mean arterial blood pressure (MAP) from 66 +/- 3 to 119 +/- 5 mmHg (P < 0.05); and plasma epinephrine by > 10-fold (P < 0.05). The second and third increases in desflurane concentration increased HR and MAP by less than 20% of the initial increases, regardless of the timing of the later concentration increases. Responses to initial concentration increases after 75 min of anesthesia did not differ from those after 32 min. Increases in plasma epinephrine with the second and third increases in desflurane concentration were attenuated. Subjects who did not responded to the second or third increase in desflurane always responded to tetanic electrical stimulation with substantial increases in HR and MAP (P < 0.05). Addition of nitrous oxide did not change results except for a smaller increase in MAP (P < 0.05). Ulnar nerve stimulation increased HR and MAP but not epinephrine or norepinephrine concentrations. CONCLUSIONS: An initial rapid increase in desflurane to 1.1 MAC produces much more stimulation than do subsequent increases, regardless of the presence of nitrous oxide. The decreased response is consistent with the hypothesis that stimulation of rapidly-adapting airway receptors produce the initial response.
Adult↗
Fentanyl, esmolol, and clonidine blunt the transient cardiovascular stimulation induced by desflurane in humans.
BACKGROUND: A rapid increase in the end-tidal concentration of desflurane to greater than 1 MAC transiently increases heart rate, arterial blood pressure, and circulating epinephrine and vasopressin concentrations. We hypothesized that drugs that block sympathetic activity or decrease sympathetic outflow (an opioid, a beta-adrenergic antagonist, and an alpha 2-adrenergic agonist) would blunt these responses. METHODS: After induction of anesthesia with intravenous propofol 2 mg/kg in ten healthy male volunteers age 25 +/- 1 yr (mean +/- standard error), anesthesia was maintained with 4% end-tidal desflurane in oxygen (0.55 MAC) via an endotracheal tube for 32 min. Controlled ventilation provided normocapnia. We then increased the end-tidal desflurane concentration within 1 min to 8% (1.1 MAC) and maintained this concentration for 10 min. On separate days, five of these volunteers were similarly anesthetized except that 5 min before the increase to 8% desflurane, we administered intravenous fentanyl 1.5 micrograms/kg and on another day 4.5 micrograms/kg (dose randomly assigned). On 2 separate days, intravenous esmolol 0.75 mg/kg was given to five volunteers 1.5 min before, or clonidine 4.3 micrograms/kg by mouth to four volunteers 90 min before, the increase from 4% to 8% desflurane. RESULTS: Without pretreatment, the increase to 8% desflurane increased heart rate (from 57 +/- 2 to 118 +/- 6 beats/min at peak, mean +/- standard error) and mean arterial blood pressure (from 66 +/- 2 to 118 +/- 5 mmHg). At the time of peak hemodynamic changes (within 1-2 min of the increase in desflurane concentration), plasma epinephrine and norepinephrine concentrations increased (from 22 +/- 6 to 339 +/- 83 pg/ml and from 205 +/- 19 to 283 +/- 30 pg/ml, respectively). Fentanyl 1.5 and 4.5 micrograms/kg attenuated the heart rate increase by 61 +/- 14% and 70 +/- 7% and the mean arterial blood pressure increase by 31 +/- 16% and 46 +/- 11% but did not alter the epinephrine or norepinephrine response at the time of peak cardiovascular changes. Esmolol attenuated the heart rate response but no other response. Clonidine attenuated all responses except that of norepinephrine and also caused postanesthesia sedation. CONCLUSIONS: Fentanyl, esmolol, and clonidine blunt the transient cardiovascular response to a rapid increase in desflurane concentration. Fentanyl may be the most clinically useful of these drugs because it blunts the increase in heart rate and blood pressure, has minimal cardiovascular depressant effects, and imposes little postanesthetic sedation.
Adrenergic beta-Antagonists↗
Chigger mites (Acarina: Leeuwenhoekiidae) from Cuba.
The present paper comprises a systematic survey of the chigger mites (Acarina: Leeuwenhoekiidae) collected from bats and bat guano in Cuban caves in 1965-1985. Wagenaaria similis is recorded for the first time in Cuba. The first hosts known for Ischnothrombium diploctenum are noted. Antrohoekia inexpectata, g.n., sp. n., a parasite of bats, is described.
Animals↗
[Intramedullary nailing of mid-femoral fractures].
75 consecutive cases of mid-shaft femoral fractures were treated by open intramedullary nailing, using the solid, diamond-shaped Hansen-Street nail. The average age was 32.5 years; road accidents accounted for 43 cases; average operative time was 40 minutes. There were 2 systemic complications but no infections. 56 of the 75 were studied after an average of 5 years and 19 were followed for at least 6 months. At 4 months all fractures were united except 1. Average time to sound bone union was 4 months. There was no residual deformity in varus-valgus or in the sagittal plane. Malrotation was rare and did not exceed 10 degrees. There was shortening of 2 cm in 3 cases of comminuted fractures. All patients followed up returned to regular daily function. The Hansen-Street nail used in an open procedure is an accurate method of anatomic reduction. As opposed to close techniques, we found the procedure to be simple and quick, without undue exposure of the surgical team to radiation and without other complications, such as nerve damage due to traction. This device is indicated for use only in fractures of the middle third of the femoral shaft.
Adult↗
The use of the Hansen-Street intramedullary nail in midshaft fractures of the femur.
A retrospective study was conducted on 75 consecutive femoral midshaft fractures treated with intramedullary nailing using the solid-diamond-shape Hansen-Street nail with an open technique. The average age of patients was 32.5 years. Road accidents accounted for 43 cases. The average operative time was 40 minutes. There were two systemic complications. No infection occurred. Fifty-six cases could be gathered for this study, with an average follow-up of 5 years; 19 were followed for at least 6 months. At 4 months, all the fractures were united except one. The average time to sound bony union was 4 months. There was no residual deformity in varus-valgus or in the sagittal plane. Malrotation was rare and did not exceed 5 degrees. Shortening of 2 cm was found in 3 patients where the fracture was comminuted. All followed patients returned to regular daily function. The use of the Hansen-Street nail in an open procedure is an accurate method for anatomic reduction. As opposed to closed techniques, the procedure proved in our hands to be simple and quick, without undue exposure to radiation of the surgical team, and without such other complications as nerve complications due to traction. The procedure with this device is indicated for mid-third fractures of the femoral shaft only.
Adult↗
Cigarette smoking, steroid hormones, and bone mineral density in young women.
There are few studies of the effect of smoking on bone density in young women. The reported antiestrogenic effect of smoking could be a mechanism for a possible effect of smoking on bone. We measured bone mineral density (BMD) by dual-energy X-ray absorptiometry (whole body, proximal femur, lumbar spine), and serum levels (mid-follicular phase) of testosterone (T), estradiol (E2), sex hormone-binding globulin (SHBG), and cortisol in 52 women (25 smokers, 27 nonsmokers) aged 20-35 years. The two groups did not differ significantly in age, height, weight, or the sum of eight skinfold thicknesses. The mean number of cigarettes smoked per day and the number of years of smoking were 16.9 and 12.9, respectively. There were no significant differences in BMD between smokers and nonsmokers at any site. For both smokers and nonsmokers, SHBG and the free androgen index (T/SHBG) made significant contributions (P less than 0.005) to the variance in BMD at all sites except the lumbar spine. The free estradiol index (E2/SHBG) contributed to whole body BMD (P less than 0.05). For all subjects, there were significant inverse relationships between SHBG and BMD (P less than 0.002), and positive relationships between T/SHBG and BMD (P less than 0.02) for all sites except the lumbar spine. These data suggest that moderate smoking in young women is not associated with low BMD at any site. However, smokers had lower free estradiol and higher SHBG, both of which have been related to increased bone loss in older women.
Adult↗
Epidemiological role of arthropods detectable in health facilities.
A total of 161 arthropod specimens were collected from 55 sites in a health care facility during July and September 1990. Of the 116 bacterial isolates obtained from their body surfaces 6% were from parasites (mosquitoes), 59% from eusynanthropic arthropods (Tenebrionid beetles, flies, German cockroaches, wasps), 16% from hemisynanthropic arthropods (ants, spiders) and 19% from occasionally encountered insects (non-biting midges, moths, beetles). Most (88%) of the isolated bacteria were Gram-negative rods of the species E. coli, Enterobacter, Klebsiella, Citrobacter, Proteus, Serratia, Pseudomonas and Acinetobacter. Gram-positive cocci accounted for 13% of isolates and were primarily represented by coagulase-negative staphylococci. The highest isolation rates were from body surfaces of flies, German cockroaches, non-biting midges (Chironomids) and Tenebrionid beetles. About one third of all isolates were resistant to more than three antimicrobials using a standard disc diffusion assay. The presence of multiple resistance to antibiotics was observed in two thirds of Enterobacter isolates, namely those of Enterobacter cloacae from the body surface of Germany cockroaches, in 13% of Citrobacter spp and in 8% of Klebsiella spp as well as Acinetobacter calcoaceticus strains. Strains of Morganella and Hafnia species were very infrequent but all of them shared resistance to the antibiotics tested. In contrast, strains of Serratia spp were relatively antibiotic-sensitive. The group of isolated Gram-positive organisms was represented by two strains of Staphylococcus hominis and one strain of Enterococcus sp, all of them were multiply-resistant to antimicrobials.
Animals↗
Use of lentivirus-like particles alone and in combination with live vaccinia-virus-based vaccines.
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AIDS Vaccines↗
Opiate receptor blockade by naltrexone and mood state after acute physical activity.
Acute mood changes occur with various forms of physical activity. Increased levels of endogenous opioids (endorphins) in response to exercise may mediate activity-induced shifts in mood state. Thirteen female and six male aerobics class participants aged 20-46 years received the opiate receptor antagonist naltrexone and a placebo in randomized, double-blind crossover fashion on two separate occasions at the same 75-min high-intensity aerobics class. Mood states were assessed before and after each class, which were spaced 5 days apart, using the Profile of Mood States questionnaire (POMS), a mood adjective checklist, and a Visual Analogue Scale (VAS) which measured mood in relation to several emotional extremes. Mood changes over the course of each aerobics class were compared in the naltrexone and placebo groups. For men and women, significant differences between conditions were observed in overall mood by both the POMS (P less than 0.005) and VAS (P less than 0.02). There were significant differences between conditions for most subscales of each mood instrument (P less than 0.05); with the placebo, mood states became calmer, more relaxed and pleasant, tending away from depression, anger and confusion. Positive mood shifts did not occur when subjects were preloaded with naltrexone, suggesting that activity-generated mood changes are mediated through endorphinergic mechanisms.
Adult↗