Kirugija glave in vratu med pandemijo covida-19 Zore, Sara Bitenc; Šifrer, Robert; Mavrič, Ajda ...
Zdravniški vestnik (Ljubljana, Slovenia : 1992),
02/2022, Volume:
91, Issue:
1-2
Journal Article
Peer reviewed
Open access
Kirurgija glave in vratu med pandemijo covida-19 je za zdravstveni sistem velik izziv. Pred kirurškimi posegi je potrebna ustrezna priprava in poznavanje vseh možnosti zdravljenja, da bolnik in ...zdravstveni delavci ne tvegajo okužbe. Treba je odložiti vse posege, katerih odložitev ne ogroža bolnikovega zdravja. Operacijske posege glede na nujnost delimo v tri skupine – v prvo skupino sodijo urgentni, neodložljivi posegi, v drugo skupino posegi, ki jih lahko odložimo za največ štiri tedne, in v tretjo skupino posegi, katerih odložitev za šest do osem tednov ne vpliva na izid zdravljenja. Pred predvideno operacijo je treba ugotoviti status okužbe bolnika z virusom SARS-CoV-2, razen ob urgentnih posegih, ki jih opravimo ne glede na status okužbe bolnika. Kirurški posegi glave in vratu se med seboj razlikujejo glede na možnost prenosa okužbe z virusom SARS-CoV-2 s pozitivnega bolnika na zdravstvenega delavca; pri tem upoštevamo predvsem verjetnost tvorbe aerosola med posegom. Med posege največjega tveganja sodijo endoskopske preiskave zgornjih dihal in prebavil ter žlez slinavk in operacije v tem področju, ki prekinejo sluznice. Te so: traheotomija, laringektomija, faringektomija, operacija raka ustne votline, transoralna laserska mikrokirurgija, transoralna robotska kirurgija. V skrbi za zdravje zdravstvenega osebja in bolnikov je med kirurškimi posegi nujna dosledna uporaba osebne varovalne opreme ne glede na okuženost bolnika.
Progesterone in sublethal concentrations temporarily inhibits growth of
Hortaea werneckii. This study investigates some of the compensatory mechanisms which are activated in the presence of ...progesterone and are most probably contributing to escape from growth inhibition. These mechanisms lead on the one hand to progesterone biotransformation/detoxification but, on the other, are suggested to increase the resistance of
H. werneckii to the steroid. Biotransformation can detoxify progesterone efficiently in the early logarithmic phase, with mostly inducible steroid transforming enzymes, while progesterone biotransformation/detoxification in the late logarithmic and stationary phases of growth is not very efficient. The relative contribution of constitutive steroid transforming enzymes to progesterone biotransformation is increased in these latter phases of growth. In the presence of progesterone, activation of the cell wall integrity pathway is suggested by the overexpression of Pck2 which was detected in the stationary as well as the logarithmic phase of growth of the yeast. Progesterone treated
H. werneckii cells were found to be more resistant to cell lysis than mock treated cells, indicating for the first time changes in the yeast cell wall as a result of treatment with progesterone.
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