Pituitary deficiency after aneurysmal subarachnoid hemorrhage

OBJECTIVE: Aneurysmal subarachnoid hemorrhage puts patients at high risk for the development of pituitary insufficiency. We evaluated the incidence of pituitary dysfunction in these patients and its correlation with clinical outcome. METHODS: Pituitary function was tested in 66 consecutive patients in the first 15 days after aneurysmal subarachnoid hemorrhage. The following were measured in all patients: thyroid-stimulating hormone, free thyroxine, triiodothyronine, luteinizing hormone, follicle-stimulating hormone, total testosterone (in males), estradiol (in females), prolactin, serum cortisol, plasma adrenocorticotropic hormone, growth hormone and insulin growth factor. RESULTS: The endocrine assessment was made at a mean of 7.4 days (standard deviation ±6.6) after subarachnoid hemorrhage. Forty-four (66.7%) female and 22 (33.3%) male patients were evaluated. Thirty-nine patients (59.1%) had some type of pituitary dysfunction. Follicle-stimulating hormone/luteinizing hormone deficiency was the most frequent disorder (34.8%), followed by growth hormone/insulin growth factor (28.7%), adrenocorticotropic hormone (18.1%) and thyroid-stimulating hormone (9%). Seventeen (25.7%) patients showed deficiencies in more than one axis. A greater incidence of hormone deficiency was observed in patients with a Glasgow Coma Scale score ≤13 (t test, p = 0.008), Hunt-Hess grade ≥4 (t test, p;0.05) with increased hospitalization or clinical outcome. CONCLUSION: Pituitary dysfunction was identified in a substantial portion of patients with previous aneurysmal subarachnoid hemorrhage, but no association was found between this dysfunction and poor clinical outcome

HEAT TRANSFER IN A FIXED BED AND MASS TRANSFER IN A COUNTER-CURRENT MOVING BED

The behavior of gas-solid reactors known as compact-fixed and moving beds, is analyzed from a theoretical viewpoint. For a compact fixed-bed the solution of the energy balance equations is obtained for the cases of a uniform temperature inside the solid pellets (i.e., the Biot number is zero) and for the case in which there are temperature gradients within the pellets (Bi > 0). For short contact times, beds with Bi > 0 have gas- and solid- temperatures which are greater than the temperatures within beds with Bi = 0. For long times, the situation is reversed. For a compact-moving bed the solution of the mass balance equations is obtained for the cases of a feed-solid with constant concentration and a feed solid with an oscillating concentration. In both cases the steady states obtained are unique, and internal recycling is observed only for a feed-solid with an oscillating concentration. Recycling is that situation when the concentration of the solid falls below that of the gas for a bed in which the feed-solid is greater than the feed-gas. This occurred when the period of oscillation was smaller than the residence time of the solid provided that the residence time of the solid was not very short (i.e., provided that B(,s) > 0.1). For both types of beds there is an equivalence between mass transfer and energy transfer so that the solutions can be interchanged with suitable definitions of dimensionless variables

Accuracy Comparison between Frameless Biopsy and Frame-Based Biopsy: A Retrospective Study of a Case Series

Objective To compare the efficacy and safety of frameless and frame-based techniques for biopsies of intracranial lesions in an exclusive assistance service at a public health center in Brazil (SUS)

Use of Native Lactococci as Vehicles for Delivery of DNA into Mammalian Epithelial Cells

The use of the food-grade bacterium Lactococcus lactis as a DNA delivery vehicle at the mucosal level is an attractive DNA vaccination strategy. Previous experiments showed that recombinant L. lactis expressing the Listeria monocytogenes inlA gene can deliver a functional gene into mammalian cells. Here, we explored the potential use of noninvasive L. lactis strains as a DNA delivery vehicle. We constructed two Escherichia coli-L. lactis shuttle plasmids, pLIG:BLG1 and pLIG:BLG2, containing a eukaryotic expression cassette with the cDNA of bovine β-lactoglobulin (BLG). The greatest BLG expression after transfection of Cos-7 cells was obtained with pLIG:BLG1, which was then used to transform L. lactis MG1363. The resulting L. lactis strain MG1363(pLIG:BLG1) was not able to express BLG. The potential of L. lactis as a DNA delivery vehicle was analyzed by detection of BLG in Caco-2 human colon carcinoma cells after 3 h of coincubation with (i) purified pLIG:BLG1, (ii) MG1363(pLIG:BLG1), (iii) a mix of MG1363(pLIG) and purified pLIG:BLG1, and (iv) MG1363. Both BLG cDNA and BLG expression were detected only in Caco-2 cells coincubated with MG1363(pLIG:BLG1). There was a decrease in the BLG cDNA level in Caco-2 cells between 24 and 48 h after coincubation. BLG expression by Caco-2 cells started at 24 h and increased between 24 and 72 h. BLG secretion by Caco-2 cells started 48 h after coincubation with MG1363(pLIG:BLG1). We conclude that lactococci can deliver BLG cDNA into mammalian epithelial cells, demonstrating their potential to deliver in vivo a DNA vaccine

Spontaneous complete regression of cerebral arteriovenous malformation

Cilj: utvrditi jesu li pacijenti zadovoljni perioperativnom zdravstvenom njegom te je li iskustvo s radom medicinskih sestara bilo pozitivno, utvrditi utječe li razina obrazovanja, dob i spol s jedne strane te profesionalni pristup medicinaskih sestara/tehničara s druge na pozitivno iskustvo i zadovoljstvo perioperativnom zdravstvenom njegom. Nacrt studije: presječno istraživanje provedeno na odjelima Službe za kirurške djelatnosti Županijske bolnice Čakovec. Ispitanici i metode: u istraživanju je sudjelovalo 100 ispitanika hospitaliziranih i operiranih na odjelima Službe za kirurške djelatnosti. Kao instrument istraživanja korišten je anonimni izvorni upitnik pomoću kojeg se ispitalo iskustvo i zadovoljstvo pacijenata perioperativnom zdravstvenom njegom. Kategorijski podatci su predstavljeni apsolutnim i relativnim frekvencijama. Numerički podatci opisani su medijanom i granicama interkvartilnog raspona. Razina značajnosti je postavljena na Alpha = 0,05. Rezultati: središnja vrijednost (medijan) sveukupne skale zadovoljstva perioperativnom zdravstvenom njegom je 4,8 (interkvartilnog raspona od 4,6 do 4,9). 51% ispitanika je ponašanje medicinskih sestara/tehničara ocijenilo kao izuzetno ljubazno, a 88% da je iskustvo s njihovim radom bilo pozitivno. Što su ispitanici stariji značajno je manje zadovoljstvo i obratno (Spearmanov koeficijent korelacije ρ = -0,204; P = 0,04). Ispitanici koji su dulje ležali u bolnici također su manje zadovoljni (Spearmanov koeficijent korelacije, ρ = -0,237; P = 0,02). 94% ispitanika bi preporučilo liječenje na Odjelima službe za kirurške djelatnosti. Zaključak: istraživanjem se potvrdila izvrsnost perioperativne zdravstvene njege, kvaliteta rada medicinskih sestara/tehničara u Županijskoj bolnici Čakovec te pozitivno iskustvo i zadovoljstvo pacijenata.Aim: to determine whether patients are satisfied with perioperative care and whether they have positive experiences with nurses; to determine whether the nurses’ level of education, age, and sex as well as their professional approach have positive effects on patients experiences and satisfaction with perioperative care. Study plan: a cross-sectional study conducted across various departments within Surgical Services of County Hospital Čakovec. Subjects and methods: 100 subjects who were hospitalized and underwent surgeries at various departments within Surgical Services participated in the study. An anonymous questionnaire, which measured patients’ experiences and satisfaction with perioperative care, was used as the research instrument. Results: the middle value (median) rating of overall perioperative care satisfaction was 4.8 (of the interquartile range value from 4.6 to 4.9). 51% of subjects found the nurses’ behaviour to be extremely kind and 88% stated that they had a positive experience with the nurses’ overall work. The patients’ age was inversely correlated with satisfaction (Spearman correlation coefficient, ρ = -0.204; P = 0.04). Subjects who were hospitalized for longer periods of time were also less satisfied (Spearman correlation coefficient, ρ = -0.237; P = 0.02). 56% of subjects were partially familiar or not at all familiar with the names of the nurses at departments or in operating rooms. 94% of subjects would recommend getting treatment at the departments of Surgical Services. Conclusion: this study has confirmed the excellence of perioperative care, the work quality of the nurses, as well as positive patient experiences and patient satisfaction at County Hospital Čakovec