Candida albicans blastoconidia in peripheral blood smears from non-neutropenic surgical patients

An 80 year old woman developed fever 11 days after volvulus surgery. A peripheral blood smear showed numerous yeast cells--both extraleucocytic and intraleucocytic--as well as leucoagglutination. The fungal elements included blastospores, pseudohyphae, and germ tubes. Two days later, blood cultures yielded Candida albicans, Enterobacter aerogenes, and Staphlococcus aureus. The patient had no medical history of immunodeficiency. Several reports indicate that fungal elements may be detected in peripheral blood smears from patients who have a severe intestinal disease.     

Cardiovascular effects of ozone exposure in human volunteers

We hypothesized that ozone (O3) exposure acutely affects cardiovascular hemodynamics in humans and, in particular, in subjects with essential hypertension. We studied 10 nonmedicated hypertensive and six healthy male adults. Each subject, after catheterization of the right heart and a radial artery, was exposed in an environmentally controlled chamber to filtered air (FA) on one day and to 0.3 ppm O3 on the following day for 3 h with intermittent exercise. Relative to FA exposure, O3 exposure induced no statistically significant changes in cardiac index, ventricular performance, pulmonary artery pressure, pulmonary and systemic vascular resistances, ECG, serum cardiac enzymes, plasma catecholamines and atrial natriuretic factor, and SaO2. The overall results did not indicate major acute cardiovascular effects of O3 in either the hypertensive or the control subjects. However, mean preexposure to postexposure changes were significantly (p < 0.02) larger with O3 than with FA for rate-pressure product (1,353 beats/min/mm Hg) and for heart rate (8 beats/min); these responses were not significantly different between the hypertensive and the control subjects. Significant O3 effects were also observed for mean FEV1 (-6%), and AaPO2 (> 10 mm Hg increase), which were not significantly different between the two groups. These results suggest that O3 exposure can increase myocardial work and impair pulmonary gas exchange to a degree that might be clinically important in persons with significant preexisting cardiovascular impairment, with or without concomitant lung disease.     

Flow-cytometric characterization of hematopoietic cells in non-pregnant human endometrium

Musculoskeletal disorders (MSD) in industrialized and industrializing countries are situated and discussed. Considerations are made on the registration of MSD cases, on the consequences for humans, industry and society, on scientific methodology and prevention strategies. These considerations are used to develop proposals for future actions. These concern the development of structures, some ideas about training and education as well as a common method for applied field research enabling the use of data in all industries.     

Management of gynecologic oncology patients with a preoperative deep vein thrombosis

Study of the effect of a tricyclic antidepressant amitriptyline on an isolated papillary muscle of the rat left ventricle showed a decrease of the contractility due to depression of the potential of action and the slow calcium channels, as well as decreased rate and prolongation of contraction caused by impairment of calcium reabsorption from the sarcoplasma. Injection of dobutrex after amitriptyline has a positive inotropic effect by completely removing the disorders in the time parameters of contraction.     

Is postmenopausal estrogen therapy associated with neuromuscular function or falling in elderly women? Study of Osteoporotic Fractures Research Group

Thirty-one cases of endoprosthetic proximal femoral reconstruction after resection for bone tumors are reported. The minimum follow-up period was 2 years (average, 63 months). There were two local recurrences, two deaths from pulmonary metastases, two postoperative infections (1 superficial and 1 deep), both responding to therapy, one postoperative dislocation of a bipolar endoprosthesis, and two cases of loosening of acetabular cups on the same patient. Clinical results (Enneking grade) showed 27% E, 56% G, 14% F, and 3% P. Diaphyseal remodeling results (Rizzoli grade) were 29% A, 6% B, 49% C, 10% D, and 6% E. Anchorage (International Society of Limb Salvage grade) was assessed as 97% E and 3% F, whereas interface (International Society of Limb Salvage grade) was 100% E. Hip (bipolar) articulation was graded as 30% E, 56% G, 11% F, and 3% P. Initial rigid stabilization of the stem with cross-fixation screws allows for excellent bone ingrowth, but presents the problem of proximal cortical atrophy. Bipolar hip components are easy to insert and offer greater inherent stability and so are to be recommended for use in tumor surgery. The results suggest good medium- to long-term results with respect to wear. A new radiographic grading system is presented for bipolar arthroplasty. Survivorship of the femoral component in this series is 100% at a maximum follow-up period of 8 years.     

The analgesic potency of dexmedetomidine is enhanced after nerve injury: a possible role for peripheral alpha2-adrenoceptors

This study investigated the analgesic potency and site of action of systemic dexmedetomidine, a selective alpha2-adrenoceptor (alpha2AR) agonist, in normal and neuropathic rats. Ligation of the L5-6 spinal nerves produced a chronic mechanical and thermal neuropathic hyperalgesia in rats. von Frey fibers and a thermoelectric Peltier device were used to measure mechanical and heat withdrawal thresholds over the hindpaw. Systemic dexmedetomidine dose-dependently increased the mechanical and thermal thresholds in the control animals (50% effective dose [ED50] 144 and 180 microg/kg intraperitoneally [i.p.], respectively). Neuropathic animals responded to much smaller doses of dexmedetomidine with mechanical and thermal ED50 values of 52 and 29 microg/kg i.p., respectively. There was no difference between the control and neuropathic animals with respect to dexmedetomidine-evoked sedation, as determined by decreased grid crossings in an open-field activity chamber (ED50 12 and 9 microg/kg i.p., respectively). Atipamezole, a selective alpha2AR antagonist, blocked the analgesic and sedative actions of dexmedetomidine inboth the neuropathic and control animals. However, L-659,066, a peripherally restricted alpha2AR antagonist, could only block the analgesic actions of dexmedetomidine in the neuropathic rats, with no effect in control animals. In conclusion, nerve injury enhanced the analgesic but not the sedative potency of systemic dexmedetomidine and may have shifted the site of alpha2 analgesic action to outside the blood-brain barrier. IMPLICATIONS: We tested the analgesic efficacy of the alpha2 agonist dexmedetomidine in normal and nerve-injured rats. The analgesic potency of dexmedetomidine was enhanced after nerve injury with a site of action outside the central nervous system. Peripherally restricted alpha2 agonists may be useful in the management of neuropathic pain.