Síndrome compartimental abdominal en el paciente crítico con patología médica

Estudi observacional de 60 pacients ingressats a la UCI per patologia extraabdominal, que demostra alta incidència de HIA (90%) i que el valor de PIA màxima és marcador pronòstic del SCA però no prediu mortalitat. Els graus més elevats d’HIA s’associen amb VMI, shock, SDRA, insuficiència renal e ili. La PIA màxima del pacient crític no neurològic (sèptic, traumatològic i respiratori) és més elevada que la del no neurològic, 20 i 16 mmHg respectivament. El valor de PIA màxima que millor prediu insuficiència renal al pacient no neurològic és 18,5mmHg. La PIA màxima es correlaciona amb l’estada a UCI i hospitalària.

Detection of the acute phase of abdominal angiostrongyliasis with a parasite-specific IgG enzyme linked immunosorbent assay

Angiostrongylus costaricensis may cause intestinal lesions of varied severity when it accidentally infects man in Central and South America. First-stage larvae have never been detected in stools. Therefore, a parasite-specific IgG ELISA was evaluated for the determination of the acute phase of infection. The specificity and the sensitivity of the immunoassay was shown to be 76.2% and 91.1%, respectively. Eight serum samples taken from patients with histopathological diagnosis, at different time points (3 to 15 months) after surgical treatment, showed a sharp and early decline in antibody reactivity. The titration of anti-A. costaricensis antibodies has proved to be a useful method for the diagnosis of acute abdominal angiostrongyliasis.

Implicacions diagnòstiques del strem-1 (soluble triggering receptor expressed on myeloid cells) en malalts amb síndrom del distress respiratori agut (sdra) i patologia abdominal. estudi preliminar

Els pacients amb patologia abdominal aguda poden desenvolupar una insuficiència respiratòria secundària a la resposta inflamatòria generada o a una pneumònia nosocomial. El mesurament del “soluble *triggering receptor expressed on myeloid cells 1” (sTREM-1) en líquid alveolar, pleural, sinovial o cefalorraquidi ha demostrat la seva utilitat en el diagnòstic d'infecció. Es va determinar el sTREM-1 alveolar i peritoneal en pacients amb quadre abdominal agut més síndrom de distress respiratori agut (SDRA). Es va concloure que el sTREM-1 és útil per diagnosticar infeccions abdominals i pulmonars en aquests pacients i que la relació sTREM-1 alveolar/peritoneal podria ser útil per determinar el focus infecciós.

Utilidad de la ecografía abdominal con contraste en la valoración de la recurrencia quirúrgica en la enfermedad de Crohn.

En aquest estudi, s'ha intentat determinar si l'aplicació de contrast intravenós augmenta la rendibilitat de l'ecografia abdominal en l'estudi de la recurrència postquirúrgica de la malaltia de Crohn (EC). Per a això vam estudiar 40 pacients que complien uns determinats criteris d'inclusió, als quals se'ls va realitzar una colonoscopia (gold standar) i una ecografia abdominal (EA) amb contrast intravenós. Després d'analitzar els resultats, podem concloure, que l'ocupació de contrast durant la realització de l'ecografia abdominal permet augmentar la capacitat diagnòstica de la recurrència endoscópica en pacients amb EC i resecció intestinal, no obstant això la seva utilitat és menor per a valorar la gravetat de la recurrència

Schistosomiasis mansoni in low transmission areas: abdominal ultrasound

In endemic areas with low prevalence and low intensity of infection, the diagnosis of hepatic pathology due to the Schistosoma mansoni infection is very difficult. In order to establish the hepatic morbidity, a double-blind study was achieved in Venezuelan endemic areas, with one group of patients with schistosomiasis and the other one of non-infected people, that were evaluated clinically and by abdominal ultrasound using the Cairo classification. Schistosomiasis diagnosis was established based on parasitologic and serological tests. The increase of the hepatic size at midclavicular and midsternal lines (in hepatometry) and the hard liver consistency were the clinical parameters able to differentiate infected persons from non infected ones, as well as the presence of left lobe hepatomegaly detected by abdominal ultrasound. The periportal thickening, especially the mild form, was frequent in all age groups in both infected and uninfected patients. There was not correlation between the intensity of infection and ultrasound under the current circumstances. Our data suggest that in Venezuela, a low endemic area of transmission of schistosomiasis, the hepatic morbidity is mild and uncommon. The Cairo classification seems to overestimate the prevalence of periportal pathology. The specificity of the method must be improved, especially for the recognition of precocious pathology. Other causes of hepatopathies must be investigated.

Effect of blood components, abdominal distension, and ecdysone therapy on the ultrastructural organization of posterior midgut epithelial cells and perimicrovillar membranes in Rhodnius prolixus

The effects of blood components, nerve-cord severance, and ecdysone therapy on the posterior midgut epithelial cells of 5th-instar Rhodnius prolixus nymphs 10 days after feeding were analyzed by transmission electron microscopy. Cutting the nerve-cord of the blood-fed insects partially reduced the development of microvilli and perimicrovillar membranes (PMM), and produced large vacuoles and small electrondense granules; insects fed on Ringer's saline diet exhibited well developed microvilli and low PMM production; swolled rough endoplasmatic reticulum and electrondense granules; Ringer's saline meal with ecdysone led to PMM development, glycogen particles, and several mitochondria in the cytoplasm; epithelial cells of the insects fed on Ringer's saline meal whose nerve-cord was severed showed heterogeneously distributed microvilli with reduced PMM production and a great quantity of mitochondria and glycogen in the cytoplasm; well developed microvilli and PMM were observed in nerve-cord severed insects fed on Ringer's saline meal with ecdysone; Ringer's saline diet containing hemoglobin recovered the release of PMM; and insects fed on human plasma showed slightly reduced PMM production, although the addition of ecdysone in the plasma led to a normal midgut ultrastructural organization. We suggest that the full development of microvilli and PMM in the epithelial cells depends on the abdominal distension in addition to ingestion of hemoglobin, and the release of ecdysone.

General and Abdominal Adiposity and Risk of Death in Europe

Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death. This study examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). A Cox regression analysis was used, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height.

Your result shows a small abdominal aortic aneurysm (AAA)

This leaflet is given to all men who have attended screening through the Northern Ireland Abdominal Aortic Aneurysm (AAA) Screening Programme and been diagnosed with a small AAA.The leaflet provides: �background information on the AAA screening programme; details on what a small AAA is; information on the monitoring process to regularly check the size of the AAA;lifestyle advice that may help those men diagnosed with an AAA. �Men who have been diagnosed with a small AAA will be invited to a monitoring scan once a year, unless their AAA increases in size to a medium AAA, at which point they will be invited to a monitoring scan once every three months.

Your result shows a medium abdominal aortic aneurysm (AAA)

This leaflet is given to all men who have attended screening through the Northern Ireland Abdominal Aortic Aneurysm (AAA) Screening Programme and been diagnosed with a medium AAA.The leaflet provides: background information on the AAA screening programme; details on what a medium AAA is; information on the monitoring process to regularly check the size of the AAA;lifestyle advice that may help those men diagnosed with an AAA. Men who have been diagnosed with a medium AAA will be invited to a monitoring scan once every three months, unless their AAA increases in size to a large AAA, at which point they will be referred to a team of vascular specialists for further assessment and the possible offer of surgery.

Your result shows a large abdominal aortic aneurysm (AAA) that may need surgery

This leaflet is given to all men who have attended screening through the Northern Ireland Abdominal Aortic Aneurysm (AAA) Screening Programme and been diagnosed with a large AAA.The leaflet provides: background information on the AAA screening programme; details on what a large AAA is; information on the process of referral to a team of vascular specialists;details on the operation to treat a large AAA;important information on the symptoms of a ruptured AAA;lifestyle advice that may help those men diagnosed with an AAA. Men who have been diagnosed with a large AAA will be invited to meet a team of vascular specialists for further assessment within two or three weeks of their scan. Following additional medical tests, the patient may be offered surgery to treat the large AAA. Those men assessed as unsuitable for an operation will continue to be monitored within the vascular service.

Abdominal Aortic Aneurysm (AAA) Screening Programme annual report

This inaugural annual report for the Northern Ireland Abdominal Aortic Aneurysm (AAA) Screening Programme (produced jointly by the Public Health Agency and the Belfast Health and Social Care Trust) looks back on a successful first year for the programme. The Public Health Agency (PHA) is responsible for commissioning and quality assuring the programme. The Belfast Health and Social Care Trust is responsible for providing and managing the programme.Following significant planning, AAA screening was introduced on time in June 2012, as required by the Government's 'Priorities for Action' target. There is no doubt that this was due to sustained partnership working across a wide range of health and social care services within Northern Ireland.

Abdominal aortic aneurysm (AAA) screening: Things you need to know (English and translations)

This information leaflet is for all men invited to take part in the Northern Ireland Abdominal Aortic Aneurysm (AAA) Screening Programme. Men will automatically be invited for screening in their 65th year, while men aged over 65 can request a scan through the central screening office.

Perioperative nutrition in abdominal surgery: recommendations and reality.

Introduction. Preoperative malnutrition is a major risk factor for increased postoperative morbidity and mortality. Definition and diagnosis of malnutrition and its treatment is still subject for controversy. Furthermore, practical implementation of nutrition-related guidelines is unknown. Methods. A review of the available literature and of current guidelines on perioperative nutrition was conducted. We focused on nutritional screening and perioperative nutrition in patients undergoing digestive surgery, and we assessed translation of recent guidelines in clinical practice. Results and Conclusions. Malnutrition is a well-recognized risk factor for poor postoperative outcome. The prevalence of malnutrition depends largely on its definition; about 40% of patients undergoing major surgery fulfil current diagnostic criteria of being at nutritional risk. The Nutritional Risk Score is a pragmatic and validated tool to identify patients who should benefit from nutritional support. Adequate nutritional intervention entails reduced (infectious) complications, hospital stay, and costs. Preoperative oral supplementation of a minimum of five days is preferable; depending on the patient and the type of surgery, immune-enhancing formulas are recommended. However, surgeons' compliance with evidence-based guidelines remains poor and efforts are necessary to implement routine nutritional screening and nutritional support.