255 research outputs found

    Coping with the problems of diagnosis of acute colitis

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    AbstractAcute colitis is an acute condition of the colon. For the radiologist, it is mainly diagnosed during differential diagnosis of acute abdominal conditions. There are many causes of colitis and the degree of its severity varies. A CT scan is the best imaging examination for diagnosing it and also for analysing and characterising colitis. The topography, type of lesion and associated factors can often suggest a precise diagnosis but it is nevertheless essential to integrate these findings into the clinical context and take laboratory values into account. The use of endoscopy is still the rule where a doubt remains, or to obtain necessary histological evidence

    Implantes estrechos como alternativa para la restauración del sector estético anterior

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    Existen determinadas situaciones donde los implantes, considerados estándar, no se pueden colocar o suponen un riesgo para el mantenimiento de la cresta marginal. Los implantes de diámetro estrecho se han empleado para numerosas indicaciones, estableciéndose protocolos de tratamiento, científicamente fundamentados, con excelentes resultados a largo plazo. En el presente trabajo presentamos una revisión histórica de los implantes estrechos, destacando sus indicaciones y limitaciones y presentamos un caso clínico en el que se han mostrado útiles. CASO CLÍNICO. Se presenta el caso de una mujer de 59 años de edad, con antecedentes de cáncer de mama en el 2008, que precisa la extracción de los cuatro incisivos supriores. El caso se resuelve con dos implantes estrechos postextracción y prótesis inmediata para preservar el aspecto estético. Conclusiones. En el caso que presentamos se evidencia que los implantes estrechos son una alternativa cuando rehabilitamos espacios edéntulos con poca disponibilidad ósea en el sentido horizontal o espacios mesio-distales reducidos en zonas estéticas

    Efficacy and safety of recruitment maneuvers in acute respiratory distress syndrome

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    Recruitment maneuvers (RM) consist of a ventilatory strategy that increases the transpulmonary pressure transiently to reopen the recruitable lung units in acute respiratory distress syndrome (ARDS). The rationales to use RM in ARDS are that there is a massive loss of aerated lung and that once the end-inspiratory pressure surpasses the regional critical opening pressure of the lung units, those units are likely to reopen. There are different methods to perform RM when using the conventional ICU ventilator. The three RM methods that are mostly used and investigated are sighs, sustained inflation, and extended sigh. There is no standardization of any of the above RM. Meta-analysis recommended not to use RM in routine in stable ARDS patients but to run them in case of life-threatening hypoxemia. There are some concerns regarding the safety of RM in terms of hemodynamics preservation and lung injury as well. The rapid rising in pressure can be a factor that explains the potential harmful effects of the RM. In this review, we describe the balance between the beneficial effects and the harmful consequences of RM. Recent animal studies are discussed

    IGL-1 solution reduces endoplasmic reticulum stress and apoptosis in rat liver transplantation

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    Injury due to cold ischemia reperfusion (I/R) is a major cause of primary graft non-function following liver transplantation. We postulated that I/R-induced cellular damage during liver transplantation might affect the secretory pathway, particularly at the endoplasmic reticulum (ER). We examined the involvement of ER stress in organ preservation, and compared cold storage in University of Wisconsin (UW) solution and in Institute Georges Lopez-1 (IGL-1) solution. In one group of rats, livers were preserved in UW solution for 8 h at 4 °C, and then orthotopic liver transplantation was performed according to Kamada's cuff technique. In another group, livers were preserved in IGL-1 solution. The effect of each preservation solution on the induction of ER stress, hepatic injury, mitochondrial damage and cell death was evaluated. As expected, we found increased ER stress after liver transplantation. IGL-1 solution significantly attenuated ER damage by reducing the activation of three pathways of unfolded protein response and their effector molecules caspase-12, C/EBP homologous protein-10, X-box-binding protein 1, tumor necrosis factor-associated factor 2 and eukaryotic translation initiation factor 2. This attenuation of ER stress was associated with a reduction in hepatic injury and cell death. Our results show that IGL-1 solution may be a useful means to circumvent excessive ER stress reactions associated with liver transplantation, and may optimize graft quality

    Growth inhibition of oral mutans streptococci and candida by commercial probiotic lactobacilli - an in vitro study

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    <p>Abstract</p> <p>Background</p> <p>Probiotic bacteria are suggested to play a role in the maintenance of oral health. Such health promoting bacteria are added to different commercial probiotic products. The aim of the study was to investigate the ability of a selection of lactobacilli strains, used in commercially available probiotic products, to inhibit growth of oral mutans streptococci and <it>C. albicans in vitro</it>.</p> <p>Methods</p> <p>Eight probiotic lactobacilli strains were tested for growth inhibition on three reference strains and two clinical isolates of mutans streptococci as well as two reference strains and three clinical isolates of <it>Candida albicans </it>with an agar overlay method.</p> <p>Results</p> <p>At concentrations ranging from 10<sup>9 </sup>to 10<sup>5 </sup>CFU/ml, all lactobacilli strains inhibited the growth of the mutans streptococci completely with the exception of <it>L. acidophilus </it>La5 that executed only a slight inhibition of some strains at concentrations corresponding to 10<sup>7 </sup>and 10<sup>5 </sup>CFU/ml. At the lowest cell concentration (10<sup>3 </sup>CFU/ml), only <it>L. plantarum </it>299v and <it>L. plantarum </it>931 displayed a total growth inhibition while a slight inhibition was seen for all five mutans streptococci strains by <it>L. rhamnosus </it>LB21, <it>L. paracasei </it>F19, <it>L. reuteri </it>PTA 5289 and <it>L. reuteri </it>ATCC 55730. All the tested lactobacilli strains reduced candida growth but the effect was generally weaker than for mutans streptococci. The two <it>L. plantarum </it>strains and <it>L. reuteri </it>ATCC 55730 displayed the strongest inhibition on <it>Candida albicans</it>. No significant differences were observed between the reference strains and the clinical isolates.</p> <p>Conclusion</p> <p>The selected probiotic strains showed a significant but somewhat varying ability to inhibit growth of oral mutans streptococci and <it>Candida albicans in vitro</it>.</p

    Post-traumatic glenohumeral cartilage lesions: a systematic review

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    <p>Abstract</p> <p>Background</p> <p>Any cartilage damage to the glenohumeral joint should be avoided, as these damages may result in osteoarthritis of the shoulder. To understand the pathomechanism leading to shoulder cartilage damage, we conducted a systematic review on the subject of articular cartilage lesions caused by traumas where non impression fracture of the subchondral bone is present.</p> <p>Methods</p> <p>PubMed (MEDLINE), ScienceDirect (EMBASE, BIOBASE, BIOSIS Previews) and the COCHRANE database of systematic reviews were systematically scanned using a defined search strategy to identify relevant articles in this field of research. First selection was done based on abstracts according to specific criteria, where the methodological quality in selected full text articles was assessed by two reviewers. Agreement between raters was investigated using percentage agreement and Cohen's Kappa statistic. The traumatic events were divided into two categories: 1) acute trauma which refers to any single impact situation which directly damages the articular cartilage, and 2) chronic trauma which means cartilage lesions due to overuse or disuse of the shoulder joint.</p> <p>Results</p> <p>The agreement on data quality between the two reviewers was 93% with a Kappa value of 0.79 indicating an agreement considered to be 'substantial'. It was found that acute trauma on the shoulder causes humeral articular cartilage to disrupt from the underlying bone. The pathomechanism is said to be due to compression or shearing, which can be caused by a sudden subluxation or dislocation. However, such impact lesions are rarely reported. In the case of chronic trauma glenohumeral cartilage degeneration is a result of overuse and is associated to other shoulder joint pathologies. In these latter cases it is the rotator cuff which is injured first. This can result in instability and consequent impingement which may progress to glenohumeral cartilage damage.</p> <p>Conclusion</p> <p>The great majority of glenohumeral cartilage lesions without any bony lesions are the results of overuse. Glenohumeral cartilage lesions with an intact subchondral bone and caused by an acute trauma are either rare or overlooked. And at increased risk for such cartilage lesions are active sportsmen with high shoulder demand or athletes prone to shoulder injury.</p
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