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Biomedical subjects

A Barreiro

Publications and source records attributed to A Barreiro.

At least 19 recordsLinked to original sources
PubMed2004

[Combined sciatic and inguinal paravascular nerve block: a valid alternative for arthroscopic knee surgery].

OBJECTIVE: To assess the effectiveness of a combined transgluteal sciatic and inguinal paravascular nerve block for arthroscopic knee surgery. MATERIAL AND METHODS: Prospective descriptive study of 88 patients scheduled for arthroscopic knee surgery. Using a nerve stimulator and a transgluteal approach, we infiltrated the sciatic nerve with 20 mL of 1.5% mepivacaine. Then, with the patient in supine position, we located the femoral nerve and inserted a plastic catheter into the descending inguinal canal, applying pressure near the tip, to inject 20 mL of 1% mepivacaine. We evaluated a) anesthetic effectiveness, b) tolerance of the pressure cuff, c) time in the intensive care recovery unit, and d) time until reversal of the block. RESULTS: Anesthesia was efficacious for 89.77% of the patients: excellent for 54 patients (61.36%), good for 25 (28.41%), and insufficient for 9 (10.23%). The pressure cuff was well tolerated by 70 patients (79.54%) and caused discomfort for 18 (20.45%). Mean postoperative stay in the intensive care recovery unit was 19.05 (SD 8.11) minutes. Reversal took place at a mean 204.09 (SD 22.59) minutes for the sensory nerve block and at 223.45 (SD 20) minutes for the motor block. CONCLUSIONS: The combined sciatic and inguinal paravascular block is effective for arthroscopic knee surgery and offers an alternative when other anesthetic techniques cannot be used. Use of a pressure cuff may require complementary sedation.

Adult↗
PubMed2003

Atypical presentation of long-term ethylene glycol poisoning in a German shepherd dog.

Ethylene glycol is a common cause of poisoning and death in pets by being converted to more toxic metabolites responsible of many toxic effects, mainly renal damage. The present paper describes an atypical case of ethylene glycol poisoning in a dog due to consumption of small amounts of antifreeze solution over a long period of time, and resulting a renal failure.

Animals↗
PubMed2001

Factors increasing the mortality rate for patients with ruptured abdominal aortic aneurysms.

The objective of this report was to analyze the current surgical results of operative treatment in patients suffering ruptured AAA (abdominal aortic aneurysms) and to define those independent predictive factors for mortality. During a period of 2 years, from January 1996 to December 1997, 144 patients operated on for ruptured AAA in 10 hospitals were included in a multicenter retrospective study. Among the collected variables concerning each patient, those with potential relation to surgical mortality were studied: gender, age, diabetes, hypertension, cardiopathy, pulmonary obstructive disease, preoperative renal dysfunction, symptomatic cerebrovascular disease, peripheral vascular disease, hematocrit on admission, preoperative hypotension < 80 mmHg, loss of consciousness, cardiac arrest, aortic aneurysm location (infrarenal versus non-infrarenal), iliac involvement, aneurysm size, type of rupture, left renal vein ligature, ligature of a patent inferior mesenteric artery, place of aortic cross-clamping, type of grafting, exclusion of both hypogastric arteries, venous technical complications, associated surgery, use of cell saver, intraoperative blood loss, and postoperative complications (renal failure, sepsis, coagulopathy, cardiac complications, pulmonary complications, colon ischemia, prosthetic graft complications, and need for reoperation). Those variables with statistical significance in the univariate analysis were introduced into a multivariate logistic regression model to determine the independent predictors of death. From our results we concluded that surgery for ruptured abdominal aortic aneurysms continues to have an excessively high mortality rate. Even though some preoperative variables could be identified as predictors of mortality, an absolute mortality risk has not yet been determined and the decision to negate surgery should be individualized rather than taken on that basis only. Early diagnosis and treatment of symptomatic aneurysms would improve mortality figures and selective screening should be contemplated.

Age Factors↗
PubMed2001

Helicobacter pylori and gastroesophageal reflux disease: lack of influence of infection on twenty-four-hour esophageal pH monitoring and endoscopic findings.

The precise role of Helicobacter pylori infection in gastroesophageal reflux disease (GERD) is a matter of intense debate. Twenty-four-hour esophageal pH monitoring has a higher accuracy than endoscopy for the diagnosis of GERD, but the correlation between H. pylori infection and esophageal pH-metric parameters has almost never been assessed. Therefore, we evaluated the relationship between the infection and the presence of disturbances not only in endoscopy but also in 24-hour esophageal pH monitoring. One hundred consecutive patients undergoing 24-hour esophageal pH monitoring because of symptoms suggestive of GERD were included in the study. Esophageal manometry was carried out to study the position and the pressure of the lower esophageal sphincter (LES). Prevalence of H. pylori infection was evaluated by histology (hematoxylin and eosin stain) and rapid urease test. The mean age of the patients was 50 +/- 15 years; 50% were men and 56% had an abnormal pH-metry (DeMeester score more than 14.7). The prevalence of H. pylori in patients with abnormal pH-metry was 57% (95% CI, 42-70%) and was 52% (95% CI, 39-64%) in those with normal pH-metry (nonsignificant differences [NS]). In the multivariate analysis, H. pylori infection did not correlate with an abnormal pH-metry (odds ratio, 0.8; 95% CI, 0.4-1.8; NS). The proportion of cases with abnormal pH-metry among infected patients was 54% (95% CI, 41-66%) and was 59% (95% CI, 44-72%) among uninfected patients (NS). Mean values of pH-metric parameters (+/-SD), respectively for H. pylori-positive and -negative patients, were total score (30 +/- 33 vs. 36 +/- 38), number of reflux episodes (7 +/- 7 vs. 11 +/- 11), number of episodes more than 5 minutes (3.7 +/- 5 vs. 3.8 +/- 5), longest reflux episode (2.4 +/- 2 minutes vs. 3.1 +/- 3 minutes), and fraction time (%) with pH less than 4 (total, 6 +/- 7 vs. 6.8 +/- 8; upright, 3.9 +/- 4 vs. 4.5 +/- 5; supine, 7.4 +/- 12 vs. 7.2 +/- 10) (all findings were NS). Endoscopic findings, respectively for H. pylori-positive and -negative, were hiatus hernia (41% vs. 41%), endoscopic esophagitis (Savary-Miller) (54% vs. 46%), and Barrett's esophagus (15% vs. 11%) (all findings were NS). Finally, differences were not demonstrated in the pressure of the lower esophageal sphincter (12 +/- 8 mmHg vs. 14 +/- 12 mmHg) among H. pylori-positive and -negative patients. H. pylori infection is not associated with gastroesophageal reflux disease, as evaluated endoscopically and with 24-hour esophageal pH monitoring.

Esophagoscopy↗
PubMed1998

Squamous cell carcinoma in an immature common stork (Ciconia ciconia).

An immature common stork (Ciconia ciconia) was referred from the Wildlife Recovering Center to the Department of Surgery for evaluation. Physical examination revealed a partially ulcerated, necrotic mass on the left surface of the upper beak. The mass was surgically removed and classified histologically as a squamous cell carcinoma. Postsurgically, the bird recovered uneventfully and proceeded to mature normally. During this growth period, no tumor recurrence or metastasis was detected, and no local bone alteration to the beak was found. The stork was ringed and released back into its natural environment.

Animals↗
PubMed1993

Design and integration of a graphic interface for an expert system in oncology.

We describe a graphic user interface for an expert system in oncology. The main objectives of our work has been to facilitate the adaptation of the system to different clinical environments and potentiate the factors which more directly determine the acceptance of the system by its users. We present the design principles derived from the features of the clinical domain chosen and from the objectives of the system. These principles are reflected on the design of the screen and of the interaction and in the style of integration of the interface with the other components of the system. Underlying the application we describe is a graphic user interface management system which provides facilities for the fast prototyping and integration of interfaces. We describe here those features of this tool which make the practical application of the design principles we consider possible.

Clinical Protocols↗
PubMed1993

[Cardiovascular risk factors in peripheral arterial disease. A study of 403 cases].

We studied the prevalence of risk factors and related cardiovascular complications in 403 patients with periferal arterial disease (PAD) arising from atherosclerosis. The control group was made up of 126 patients of the same age and sex and without PAD. The average age was 66.9 +/- 12 years, and the percentage of men was 80%. Among the male subjects, smoking, the presence of diabetes, total cholesterol count, and age were the prevalent risk factors, even after logistic regression analysis. Among women, only smoking and diabetes showed significant differences. Among both sexes, the prevalence of arterial hypertension was similar to that of the controls. Greater prevalence of related cardiovascular complications was found only in men. We conclude that for PAD, smoking and diabetes are the most important cardiovascular risk factors, with total cholesterol level being an important additional factor in men.

Adult↗
PubMed1993

A modular knowledge base for the follow-up of clinical protocols.

From the knowledge engineering point of view, the observation of patients subjected to clinical protocols of therapy constitutes a domain characterized by the existence of strongly structured knowledge. We have approached the problem from the perspective of a homogeneous and modular knowledge representation theory, based on the concept of Generalized Magnitude. This concept arises from identifying and collecting all possible facts of a domain established a priori, and being inspired by the concept of physical magnitudes. The Generalized Magnitudes scheme includes temporal extensions necessary to solve a medical problem for which exists a therapy and a follow-up plan with temporal specifications, and also facilitates the creation of advisory expert systems.

Drug Therapy, Computer-Assisted↗
PubMedDate not supplied

[Percutaneous transluminal angioplasty (PTA), 10 years of experience].

Authors present their experiences during 10 years (1980-89) with the treatment of peripheral arteriopathies with the ATP. Between a total of 455 procedures, an accumulative permeability of 82% in the iliac sector and 71% in the femoro-popliteal sector in elective indications was reached. The total availability of this therapeutic method, the accurate selection of indications and the valious cooperation between Angioradiology and Vascular Surgery Departments should be noted.

Angioplasty, Balloon↗