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Background and objectives

A prompt and effective management of trauma patient is necessary. The aim of this case report is to highlight the importance of intraoperative echocardiography as a useful tool in patients suffering from refractory hemodynamic instability no otherwise explained.

Case report

A 41 year‐old woman suffered a car accident. At the emergency department, no abnormalities were found in ECG or chest X‐ray. Abdominal ultrasound revealed the presence of abdominal free liquid and the patient was submitted to urgent exploratory laparotomy. Nevertheless, she persisted suffering arterial hypotension and metabolic acidosis. Looking for the reason of her hemodynamic instability, intraoperative transthoracic echocardiography was performed, finding out the presence of pericardial effusion. Once the cardiac surgeon extracted pericardial clots, patient's situation improved clinically and analytically.

Conclusion

Every anesthesiologist should be able to use the intraoperative echocardiography as an effective tool in order to establish the appropriate measures to promote the survival of patients suffering severe trauma.  相似文献   
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The current situation in which the humanities are disparaged affects all university disciplines, including nursing, in whose historical evolution the humanities have always been present in one form or another. Looking beyond this disrepute, this study proposes that nursing renew its attention to classical philosophy. Specifically, it invites a close reading of Xenophon's Anabasis and Plato's Meno, to get three related goals: to show how the use of ancient texts are very valuable tools for the philosophical initiation of nursing students and can help them reflect on their choice of nursing as a practical activity; to reflect on the problem of virtue and the nature of the good life; and to show how the interaction with ancient texts allows students to reflect on questions and issues of life, theirs and others, that are not open to investigation through a purely scientific method. Consequently, both Anabasis and Meno readings strengthen the intellectual relationship between philosophy and nursing, enabling the latter to delve deeper into the key questions of its own thought as a discipline.  相似文献   
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目的 探究高糖饮食对小鼠真菌性角膜炎的影响。方法 选取健康无眼疾的雄性C57BL/6J小鼠78只,随机分为高糖饮食组和模型对照组,每组36只,模型对照组给予正常饮用水,高糖饮食组给予含体积分数10%果糖溶液,每2 d测量两组小鼠体质量及血糖,10 d后建立真菌性角膜炎模型。造模后24 h、36 h、48 h、72 h、96 h、120 h、168 h裂隙灯显微镜下对角膜进行临床评分并拍照。处死小鼠后,取角膜组织进行HE染色和PAS染色;测定角膜内中性粒细胞和巨噬细胞浸润体积。利用酶联免疫吸附实验对小鼠角膜内的白细胞介素-1β含量进行测定。结果 造模后 0~14 d,两组小鼠体质量与血糖差异均无统计学意义(均为P>0.05)。造模后24 h、36 h、48 h、120 h、168 h,高糖饮食组小鼠角膜临床评分均明显高于模型对照组,差异均有统计学意义(均为P<0.05)。高糖饮食组小鼠角膜穿孔率79.5%,高于模型对照组的40.9%,差异有统计学意义(P=0.000)。造模后各时间点,高糖饮食组中性粒细胞浸润体积均高于模型对照组,差异均有统计学意义(均为P=0.000)。造模后72 h、96 h、120 h、168 h,高糖饮食组巨噬细胞浸润体积均高于模型对照组(均为P=0.000)。角膜组织病理学检查结果示,高糖饮食组炎症反应更重,角膜组织破坏更早且更为严重。造模后24 h、48 h高糖饮食组白细胞介素-1β含量均明显高于模型对照组(均为P<0.05)。结论 高糖饮食加重了真菌性角膜炎感染的严重程度,增强了中性粒细胞、巨噬细胞的趋化,促进了IL-1β的分泌。  相似文献   
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The present study aimed at measuring seropositivities for infection by Ascaris suum and Toxocara canis using the excretory/secretory (E/S) antigens from Ascaris suum (AES) and Toxocara canis (TES) within an indigenous population. In addition, quantification of cytokine expressions in peripheral blood cells was determined. A total of 50 Warao indigenous were included; of which 43 were adults and seven children. In adults, 44.1% were seropositive for both parasites; whereas children had only seropositivity to one or the other helminth. For ascariosis, the percentage of AES seropositivity in adults and children was high; 23.3% and 57.1%, respectively. While that for toxocariosis, the percentage of TES seropositivity in adults and children was low; 9.3% and 14.3%, respectively. The percentage of seronegativity was comparable for AES and TES antigens in adults (27.9%) and children (28.6%). When positive sera were analyzed by Western blotting technique using AES antigens; three bands of 97.2, 193.6 and 200.2 kDas were mostly recognized. When the TES antigens were used, nine major bands were mostly identified; 47.4, 52.2, 84.9, 98.2, 119.1, 131.3, 175.6, 184.4 and 193.6 kDas. Stool examinations showed that Blastocystis hominis, Hymenolepis nana and Entamoeba coli were the most commonly observed intestinal parasites. Quantification of cytokines IFN-γ, IL-2, IL-6, TGF-β, TNF-α, IL-10 and IL-4 expressions showed that there was only a significant increased expression of IL-4 in indigenous with TES seropositivity (p < 0.002). Ascaris and Toxocara seropositivity was prevalent among Warao indigenous.  相似文献   
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