المؤلفون: Alicia Pérez-Blanco, María Acevedo, María Padilla, Aroa Gómez, Luis Zapata, María Barber, Adolfo Martínez, Verónica Calleja, María C. Rivero, Esperanza Fernández, Julio Velasco, Eva M. Flores, Brígida Quindós, Sergio T. Rodríguez, Beatriz Virgós, Juan C. Robles, Agustín C. Nebra, José Moya, Josep Trenado, Nieves García, Ana Vallejo, Eugenio Herrero, Álvaro García, Maria L. Rodríguez, Fernando García, Ramón Lara, Lucas Lage, Francisco J. Gil, Francisco J. Guerrero, Ángela Meilán, Nayade Del Prado, Cristina Fernández, Elisabeth Coll, Beatriz Domínguez-Gil

المصدر: Transplant International, Vol 37 (2024)

مصطلحات موضوعية: transplantation, deceased organ donation, death by neurologic criteria, devastating brain injury, intensive care to facilitate organ donation, Specialties of internal medicine, RC581-951

الوصف: Intensive Care to facilitate Organ Donation (ICOD) consists of the initiation or continuation of intensive care measures in patients with a devastating brain injury (DBI) in whom curative treatment is deemed futile and death by neurological criteria (DNC) is foreseen, to incorporate organ donation into their end-of-life plans. In this study we evaluate the outcomes of patients subject to ICOD and identify radiological and clinical factors associated with progression to DNC. In this first prospective multicenter study we tested by multivariate regression the association of clinical and radiological severity features with progression to DNC. Of the 194 patients, 144 (74.2%) patients fulfilled DNC after a median of 25 h (95% IQR: 17–44) from ICOD onset. Two patients (1%) shifted from ICOD to curative treatment, both were alive at discharge. Factors associated with progression to DNC included: age below 70 years, clinical score consistent with severe brain injury, instability, intracranial hemorrhage, midline shift ≥5 mm and certain types of brain herniation. Overall 151 (77.8%) patients progressed to organ donation. Based on these results, we conclude that ICOD is a beneficial and efficient practice that can contribute to the pool of deceased donors.

وصف الملف: electronic resource

العلاقة: https://www.frontierspartnerships.org/articles/10.3389/ti.2024.12791/fullTest; https://doaj.org/toc/1432-2277Test

الوصول الحر: https://doaj.org/article/d59dcd5b764d4511be1e5ecf5f6c5c39Test

المؤلفون: Eva M. Flores, Flavia V. Gouveia, Marcio Matsumoto, Tomás H. F. S. Bonacif, Mayra A. Kuroki, Geiza Fernanda Antunes, Ana Carolina P. Campos, Pedro P. Kimachi, Diego O. Campos, Claudia M. Simões, Marcelo M. C. Sampaio, Felipe E. M. Andrade, João Valverde, Alfredo C. S. D. Barros, Rosana L. Pagano, Raquel C. R. Martinez

المصدر: Scientific Reports, Vol 13, Iss 1, Pp 1-12 (2023)

مصطلحات موضوعية: Medicine, Science

الوصف: Abstract Breast cancer is the second most common diagnosed type of cancer in women. Chronic neuropathic pain after mastectomy occurs frequently and is a serious health problem. In our previous single-center, prospective, randomized controlled clinical study, we demonstrated that the combination of serratus anterior plane block (SAM) and pectoral nerve block type I (PECS I) with general anesthesia reduced acute postoperative pain. The present report describes a prospective follow-up study of this published study to investigate the development of chronic neuropathic pain 12 months after mastectomy by comparing the use of general anesthesia alone and general anesthesia with SAM + PECS I. Additionally, the use of analgesic medication, quality of life, depressive symptoms, and possible correlations between plasma levels of interleukin (IL)-1 beta, IL-6, and IL-10 collected before and 24 h after surgery as predictors of pain and depression were evaluated. The results showed that the use of SAM + PECS I with general anesthesia reduced numbness, hypoesthesia to touch, the incidence of patients with chronic pain in other body regions and depressive symptoms, however, did not significantly reduce the incidence of chronic neuropathic pain after mastectomy. Additionally, there was no difference in the consumption of analgesic medication and quality of life. Furthermore, no correlation was observed between IL-1 beta, IL-6, and IL-10 levels and pain and depression. The combination of general anesthesia with SAM + PECS I reduced the occurrence of specific neuropathic pain descriptors and depressive symptoms. These results could promote the use of SAM + PECS I blocks for the prevention of specific neuropathic pain symptoms after mastectomy. Registration of clinical trial: The Research Ethics Board of the Hospital Sirio-Libanes/Brazil approved the study (CAAE 48721715.0.0000.5461). This study is registered at Registro Brasileiro de Ensaios Clinicos (ReBEC), and ClinicalTrials.gov, Identifier: NCT02647385.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2045-2322Test

الوصول الحر: https://doaj.org/article/7ed4d69b8b624e1d96e74bb8a3f33b53Test

المؤلفون: Eva M. Flores Ruiz, Juan David Luna Rodríguez

المصدر: Revista de Literatura, Vol 67, Iss 133, Pp 49-75 (2005)

مصطلحات موضوعية: pérez galdós, el doctor centeno, novelas españolas contemporáneas, romanticismo, tuberculosis, fiebre creativa, French literature - Italian literature - Spanish literature - Portuguese literature, PQ1-3999

الوصف: En El Doctor Centeno (1883), Pérez Galdós perfila un cuadro clínico-literario del ocaso del romanticismo en la España de mediados del siglo XIX, arrollado por el positivismo que abanderaba la nueva sociedad burguesa. Este artículo explora la forma en que Galdós, a tal fin, se sirve de Alejandro Miquis, personaje consumido a lo largo de la narración por un doble proceso febril de naturaleza y origen románticos. En el Madrid de 1863 y, mientras agoniza de la misma enfermedad que el romanticismo elevara a categoría mítica —la tuberculosis—, Miquis se empeña en renovar el teatro de su época, creando y ofreciendo a la naciente sociedad un drama histórico de clara filiación romántica, tan anacrónico y moribundo como él. Así, mediante su muerte y posterior profanación de su obra, y valiéndose de una estructura plagada de guiños médico-literarios, Galdós acierta a extender el acta de defunción de la cultura romántica.

وصف الملف: electronic resource

العلاقة: http://revistadeliteratura.revistas.csic.es/index.php/revistadeliteratura/article/view/113Test; https://doaj.org/toc/0034-849XTest; https://doaj.org/toc/1988-4192Test

الوصول الحر: https://doaj.org/article/f6857a99962c4a64861e8adf3f6ed6e3Test

المؤلفون: Felipe Andrade, Alfredo Carlos Simões Dornellas de Barros, Eva M. Flores, Marcio Matsumoto, Rosana L. Pagano, Eduardo F. Abrantes, Claudia Marquez Simões, Mayra A. Kuroki, Marcelo Sampaio, João Valverde, Raquel Chacon Ruiz Martinez, Pedro Paulo Kimachi, Flavia Venetucci Gouveia

المصدر: Scientific Reports, Vol 8, Iss 1, Pp 1-9 (2018)
Scientific Reports

مصطلحات موضوعية: Adult, medicine.medical_treatment, Sedation, Mammaplasty, Interleukin-1beta, lcsh:Medicine, Breast Neoplasms, Anesthesia, General, Article, Fentanyl, law.invention, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Mastectomy, Modified Radical, Randomized controlled trial, 030202 anesthesiology, law, medicine, Humans, Prospective Studies, lcsh:Science, Radical mastectomy, Aged, Pain Measurement, Pain, Postoperative, Multidisciplinary, business.industry, Interleukin-6, lcsh:R, Nerve Block, Middle Aged, medicine.disease, Interleukin-10, Analgesics, Opioid, Treatment Outcome, 030220 oncology & carcinogenesis, Anesthesia, Anesthetic, Nerve block, Female, lcsh:Q, medicine.symptom, business, Mastectomy, medicine.drug

الوصف: Surgery is the first-line treatment for early, localized, or operable breast cancer. Regional anesthesia during mastectomy may offer the prevention of postoperative pain. One potential protocol is the combination of serratus anterior plane block (SAM block) with pectoral nerve block I (PECS I), but the results and potential benefits are limited. Our study compared general anesthesia with or without SAM block + PECS I during radical mastectomy with axillary node dissection and breast reconstruction using evaluations of pain, opioid consumption, side effects and serum levels of interleukin (IL)-1beta, IL-6 and IL-10. This is a prospective, randomized controlled trial. Fifty patients were randomized to general anesthesia only or general anesthesia associated with SAM block + PECS I (25 per group). The association of SAM block + PECS I with general anesthesia reduced intraoperative fentanyl consumption, morphine use and visual analog pain scale scores in the post-anesthetic care unit (PACU) and at 24 h after surgery. In addition, the anesthetic protocol decreased side effects and sedation 24 h after surgery compared to patients who underwent general anesthesia only. IL-6 levels increased after the surgery compared to baseline levels in both groups, and no differences in IL-10 and IL-1 beta levels were observed. Our protocol improved the outcomes of mastectomy, which highlight the importance of improving mastectomy protocols and focusing on the benefits of regional anesthesia.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c3f065d5f1c7b2485bd8bc9c4f6a1a51Test
http://link.springer.com/article/10.1038/s41598-018-26273-zTest