59 research outputs found
De chirurgische ervaringen in de hollandsche ambulance te Versailles
No full textDE CHIRURGISCHE ERVARINGEN IN DE HOLLANDSCHE AMBULANCE TE VERSAILLES
De chirurgische ervaringen in de hollandsche ambulance te Versailles ([1])
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I. Algemeen Gedeelte (8)
A. Huidwonden (8)
B. Spierwonden, vaat- en zenuwwonden (9)
C. Beenwonden (14)
D. Gewrichtswonden (16)
E. Wonden der organgen (18)
II. Specieel Gedeelte (18)
A. Wonden aan het hoofd (18)
B. Wonden aan den hals (24)
C. Wonden aan de borst (24)
D. De wonden aan den buik (29)
E. Wonden aan de bovenste extremiteiten (32)
F. Wonden der onderste extremiteiten (42
Effect of early tirofiban administration on N-terminal pro-B-type natriuretic peptide level in patients treated with primary percutaneous coronary intervention
No full textOBJECTIVES:
To investigate the potential association between early tirofiban treatment and N-terminal pro-B-type natriuretic peptide (NT-proBNP) level after primary percutaneous coronary intervention (PCI).
BACKGROUND:
Whether the use of adjunctive early glycoprotein IIb/IIIa inhibitors (GPIs) therapy, may affect the level of NT-proBNP after primary PCI is poorly studied.
METHODS:
Nine hundred and eighty four ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI were randomized to either pre-hospital tirofiban administration or placebo. NT-proBNP levels were evaluated on admission before angiography (baseline) and 18-96 hr after PCI.
RESULTS:
There were 918 (93.3%) patients with NT-proBNP values available at baseline and 865 (87.9%) post-PCI. Post-PCI NT-proBNP level dichotomized with median value as cut-off (968.8 pg/mL, IQR 430.9-1970.0) was significantly lower in patients treated with early tirofiban as compared to placebo (45.5% vs. 54.2% P = 0.011). At multivariate logistic regression analysis, independent predictors of post-PCI NT-proBNP level above the median were: NT-proBNP baseline level (OR 5.19; 95% CI, 2.92-9.25, P I (OR 4.07; 95% CI 1.24-13.36, P = 0.021), anterior infarct location (OR 2.61; 95% CI 1.84-3.70, P < 0.001), age (years) (OR 1.04; 95% CI 1.03-1.06, P < 0.001), male gender (OR 0.38; 95% CI 0.26-0.57, P < 0.001), prior PCI (OR 0.49; 95% CI 0.27-0.90, P = 0.021) and tirofiban administration (OR 0.71; 95% CI 0.51-0.99; P = 0.045).
CONCLUSIONS:
In a large cohort of STEMI patients, pre-hospital tirofiban administration was independently associate with a lower risk of high NT-proBNP level after primary PCI, supporting the potential benefit of early antithrombotic treatment administration in STEMI patients. The trial is registered under No. ISRCTN06195297
Oral Susceptibility: AHSV Serotypes and Isolates, and Geographic Populations
No full textResumen en inglès, ver archivo PD
Hyperglycemia, hypoglycemia, and glycemic complexity are associated with worse outcomes after surgery
No full textPurpose: The purpose of this study was to determine if glycemic complexity, along with hypoglycemia and hyperglycemia, was associated with worse outcomes after cardiac surgery. Materials and methods: We conducted a retrospective analysis of 970 patients who had insulin infusions designed to keep blood glucose levels between 80 and 110 mg-dL. Glycemic complexity was calculated using jackknifed approximate entropy. Logistic regression was used to adjust for confounders. Results: A total of 495 patients (51percent) developed complications, and 32 patients (3.3percent) died. Along with older age, comorbidities, and complicated surgeries, any hypoglycemia (glucose 71 mg-dL) and the number of glucose values greater than 140 mg-dL were independent predictors of complications. Increased risk of mortality, after adjusting for other risk factors, was associated with older age, longer perfusion time, receiving intraoperative transfusions, and greater jackknifed approximate entropy of the glucose time series. Conclusion: We found that hypoglycemia (glucose 71 mg-dL) and hyperglycemia (glucose 140 mg-dL) were associated with increased risk of complications, whereas greater complexity of the glucose time series was associated with mortality. © 2014 Elsevier Inc.Amir J, 2011, CELL IMMUNOL, V272, P45, DOI 10.1016-j.cellimm.2011.09.008; Bagshaw SM, 2009, CRIT CARE, V13, DOI 10.1186-cc7921; Cochran WG, 1967, SAMPLING TECHNIQUES, P154; Cueni-Villoz N, 2011, CRIT CARE MED, V39, P2225, DOI 10.1097-CCM.0b013e31822572c9; D'Ancona G, 2011, EUR J CARDIO-THORAC, V40, P360, DOI 10.1016-j.ejcts.2010.11.065; Egi M, 2010, MAYO CLIN PROC, V85, P217, DOI 10.4065-mcp.2009.0394; Engoren M, 2009, J APPL PHYSIOL, V106, P766, DOI 10.1152-japplphysiol.90575.2008; Finfer S, 2009, NEW ENGL J MED, V360, P1283, DOI 10.1056-NEJMoa0810625; Finney SJ, 2003, JAMA-J AM MED ASSOC, V290, P2041, DOI 10.1001-jama.290.15.2041; Hermanides J, 2010, CRIT CARE MED, V38, P838, DOI 10.1097-CCM.0b013e3181cc4be9; Hermanides J, 2010, CRIT CARE MED, V38, P1430, DOI 10.1097-CCM.0b013e3181de562c; Hollingdal M, 2000, DIABETES, V49, P1334, DOI 10.2337-diabetes.49.8.1334; Kemeny SF, 2011, J BIOMECH, V44, P1927, DOI 10.1016-j.jbiomech.2011.04.026; Krinsley JS, 2004, MAYO CLIN PROC, V79, P992; Krinsley James Stephen, 2009, J Diabetes Sci Technol, V3, P1292; Lazar HL, 2009, ANN THORAC SURG, V87, P663, DOI 10.1016-j.athoracsur.2008.11.011; Li J, 2006, PHYS REV E, V73, DOI 10.1103-PhysRevE.73.052902; Mackenzie IMJ, 2011, INTENS CARE MED, V37, P435, DOI 10.1007-s00134-010-2103-2; Meyfroidt G, 2011, INTENS CARE MED, V37, P1151, DOI 10.1007-s00134-011-2159-7; Meyfroidt G, 2010, CRIT CARE MED, V38, P1021, DOI 10.1097-CCM.0b013e3181cf710e; Pappada SM, 2011, DIABETES TECHNOL THE, V13, P135, DOI 10.1089-dia.2010.0104; Pincus SM, 2008, J PSYCHIATR RES, V42, P337, DOI 10.1016-j.jpsychires.2007.01.001; Suh SW, 2007, GLIA, V55, P1280, DOI 10.1002-glia.20440; Van den Berghe G, 2006, NEW ENGL J MED, V354, P449, DOI 10.1056-NEJMoa052521; Van den Berghe G, 2001, NEW ENGL J MED, V345, P1359, DOI 10.1056-NEJMoa011300; Wang X, 2009, THESIS U VIRGINIA; Wessel N, 2000, PHYS REV E, V61, P733, DOI 10.1103-PhysRevE.61.7330
Optimizing Chronic HIV Care in the Dutch Caribbean:A Questionnaire Based Study on Experience and Perception of Healthcare Workers
No full textObjective: Human immunodeficiency virus (HIV) infection has become a chronic disorder for which adaptation of current healthcare practices is needed. In Curacao, a new organization of chronic HIV care is being set up based on task shifting in which healthcare workers (HCWs) will deliver HIV care more prominently within the primary healthcare system. In preparation for implementation of the proposed task-shifting model, we investigated the perception of HCWs regarding existing HIV care in Curacao and the need for training in HIV/AIDS among HCWs.Subjects and Methods: An in-depth questionnaire based study was used. Nineteen HCWs of seven different cadres were interviewed. The questionnaire constituted four sections: quality of existing HIV care, respondents own knowledge and willingness to be trained, need for training in HIV/AIDS and preferred educational approaches.Results: Quality of existing HIV services in Curacao is considered acceptable but needs improvement mainly to facilitate integration of chronic HIV care. All respondents indicated that training in HIV/AIDS is needed among HCWs in Curacao, especially for nurses and general practitioners. All were willing to participate in training with varying amounts of time to be spent. Training should be tailored to the level of expertise of HCWs and to the role a HCW is expected to have in the new healthcare delivery frameworkConclusion: There is need for training to ensure the effective integration of chronic HIV care into the existing healthcare delivery system in Curacao. There is a willingness and need in all cadres for training with e-learning as a preferred educational tool.</p
Optimizing Chronic HIV Care in the Dutch Caribbean: A Questionnaire Based Study on Experience and Perception of Healthcare Workers
No full textObjective: Human immunodeficiency virus (HIV) infection has become a chronic disorder for which adaptation of current healthcare practices is needed. In Curacao, a new organization of chronic HIV care is being set up based on task shifting in which healthcare workers (HCWs) will deliver HIV care more prominently within the primary healthcare system. In preparation for implementation of the proposed task-shifting model, we investigated the perception of HCWs regarding existing HIV care in Curacao and the need for training in HIV/AIDS among HCWs. Subjects and Methods: An in-depth questionnaire based study was used. Nineteen HCWs of seven different cadres were interviewed. The questionnaire constituted four sections: quality of existing HIV care, respondents own knowledge and willingness to be trained, need for training in HIV/AIDS and preferred educational approaches. Results: Quality of existing HIV services in Curacao is considered acceptable but needs improvement mainly to facilitate integration of chronic HIV care. All respondents indicated that training in HIV/AIDS is needed among HCWs in Curacao, especially for nurses and general practitioners. All were willing to participate in training with varying amounts of time to be spent. Training should be tailored to the level of expertise of HCWs and to the role a HCW is expected to have in the new healthcare delivery framework Conclusion: There is need for training to ensure the effective integration of chronic HIV care into the existing healthcare delivery system in Curacao. There is a willingness and need in all cadres for training with e-learning as a preferred educational tool
High incidence of intermittent care in HIV-1-infected patients in Curaçao before and after starting cART
No full textNo Apparent Local Effect of Insulin on Microdialysis Continuous Glucose- Monitoring Measurements
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