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Biomedical subjects

A Cabrera

Publications and source records attributed to A Cabrera.

At least 127 records · Page 7Linked to original sources
PubMed1988

Definite and sustained improvement with pimozide of two patients with severe trigeminal neuralgia. Some neurochemical, neurophysiological and neuroendocrinological findings.

In the present study we report two typical cases of trigeminal neuralgia in whom all conventional drug treatments were attempted without success, and in whom low doses of pimozide, a dopaminergic blocking agent, provoked a definite and sustained improvement. All biological markers used in these cases provided indirect evidence that a central serotonergic hypoactivity is an underlying mechanism in this disease. A low intestinal tone, raised levels of norepinephrine, dopamine, platelet serotonin and non-platelet plasma serotonin were registered during relapses and normalized during improvement periods. Pimozide was not able to improve the depressive state diagnosed in these two cases, nor in 13 other trigeminal neuralgia patients (not reported in this study).

Aged↗
PubMed1987

Heterogeneity of chronic T-cell lymphocytosis: immunological and clinical aspects.

The clinical and laboratory findings as well as the immunological cell phenotype of nine patients with chronic T-cell lymphocytosis (T-CL) are presented. The clinical course was stable in most patients and only one patient died. Splenic enlargement was the main clinical finding and in contrast to B-CLL the age at presentation was lower; T-CL predominated in females and lymphadenopathy was rare. The lymphocyte count was moderate (range 4.1-23.8 X 10(9)/L). Six patients displayed neutropenia; in contrast, anaemia was only observed in one patient and thrombopenia in another. The immunological cell phenotype was heterogeneous: four cases exhibited a cytotoxic/suppressor phenotype, two a helper phenotype and in the remaining three cases mixed OKT4+ and OKT8+ lymphocytes were observed; these results suggest that T-CL may originate from different T-cell subsets. Although the question of the benign or neoplastic nature of the T-CL remains open, some of the characteristics of the immunological phenotype could provide additional evidence to demonstrate the malignant condition of the process: in contrast to normal lymphocytes (CD5+, CD7+) the lymphocytes in T-CL were generally CD5 +/-, CD7-, and one patient showed an aberrant phenotype (OKT3+, OKT6+), an occasional finding in other T lymphoproliferative disorders.

Aged↗
PubMed1987

[Prostaglandins in newborn infants with severe cardiopathy].

Between February 1983 and December 1985 authors have studied 26 newborn infants with severe congenital heart disease who received prostaglandin E1 infusion as therapy. Onset of therapy was before 5 days of age in 15 patients, between 5 and 7 days of age in 7 cases and after 14 days of age in the remaining ones. Initial dose was 0.05 mcg/kg/minutes and mean duration of infusion was 131.9 +/- 19.0 hours. Patients were divided into 3 groups according to pulmonary and systemic blood flows: Group I, with cyanosis and diminished pulmonary blood flow (12 cases); Group II, with diminished systemic blood flow (10 cases); and group III, with cyanosis and normal or increased pulmonary blood flow (4 cases). Most patients of groups I (10/12) and II (9/10) improved levels of blood PO2: mean increments of 17.8 +/- 7.4 and 17.5 +/- 13.3 torr respectively. Peripheral pulses also improved in four extremities in patients from group II; systolic and diastolic pressures increased 16 +/- 9.6 and 5 +/- 2.2 mmHg, respectively. No improvement was observed in patients from group III, with exception of patients with transposition of great vessels. Most frequent complication of prostaglandin infusion was hyperthermia, which was observed in 16 cases but disappeared in all with moderate reduction of doses. Appropriate surgery was performed in 19 patients, with an overall survival of 52.6%. In conclusion, prostaglandin infusion appears to be a very valued tool to improve the hemodynamic condition in newborn infants with severe congenital heart disease and thus allow the practice of corrective surgery during first month of life.

Blood Pressure↗
PubMed1987

[Treatment with intravenous indomethacin of symptomatic ductus arteriosus in premature newborn infants].

Sixty-four preterm infants (birth weight 1,393 +/- 483 g g and gestational age 30.1 +/- 2.7 weeks) developed a symptomatic ductus arteriosus, and were treated with intravenous indomethacin. Mechanical ventilation was needed by all of them, and 98% had IRDS. Pharmacologic ductus closure rate was 87%. Sixty-four per cent of patients had a permanent closure after first trial, and 74% after a second course of the drug. Ductus closure rate was found to be greater in patients with higher birth weight and gestational age. It was also higher in patients treated in the first week of life. Closure rate was higher in this group of patients treated with intravenous indomethacin, than in a previous group of a similar birth weight and gestational age, who received the drug by oral route (87% versus 64%). Incidence of necrotizing enterocolitis was found to be similar in both groups. Follow-up data showed that four infants (8.5%) had severe neurological sequelae, and another three cases (6.4%) developed severe respiratory problems.

Ductus Arteriosus, Patent↗
PubMed1986

Post-traumatic diffuse axonal brain injury. Analysis of 78 patients studied with computed tomography.

A group of 78 severe head injury patients showing computerized tomography (CT) findings of the so-called "diffuse axonal injury" is analyzed. These patients represent 20% of the authors' series of severe head injury. Twenty-three patients showed small intraparenchymal haemorrhages in the CT scan study, 15 intraventricular haemorrhage and 40 patients had both intraparenchymal and intraventricular haemorrhages. Signs of brainstem haemorrhagic contusion were seen in 29 (38%) patients. Generalized brain swelling superimposed on the above findings was present in 75% of the cases. Raised intracranial pressure, which was found in 50% of the patients, correlated with the presence of ventriculocisternal collapse in the CT scan and an unfavourable outcome. Only 4 patients in this series made a good recovery, 13 developed a moderate disability, 11 a severe disability, 12 became vegetative and 38 (49%) died. The prognosis with this post-traumatic lesion is the worst in the authors' severe head injury series after excluding cases with subdural haematoma.

Adolescent↗
PubMed1986

Normal computerized tomography scans in severe head injury. Prognostic and clinical management implications.

The authors analyze the clinical course of 46 severely head-injured patients who had completely normal computerized tomography (CT) scans through the immediate posttraumatic period (1 to 7 days after trauma). These patients represent 10.2% of a consecutive series of 448 cases of severe head injuries and two-thirds of the cases showing a normal CT scan on admission (the other one-third of the cases developed new pathology). The usual course in these 46 patients after the initial coma was toward progressive neurological improvement, and 35 patients (76%) achieved a functional level of survival. Nine patients (19.5%) remained comatose for several weeks and developed severe disability. There were two fatalities due to medical complications. The final outcome was more closely related to the duration of coma (the longer the duration the worse the result) than to the initial Glasgow Coma Scale (GCS) score. In fact, 26% of the patients in the lower GCS score ranges (3 to 4 points) made a good recovery and 46% developed moderate disability only. These findings indicate that the grim prognostic significance of deep posttraumatic coma is tempered in the presence of a normal scan. However, the absence of CT abnormalities in severely head-injured patients cannot be equated with a good prognosis because in one-fifth of the cases serious permanent disability develops. Sustained elevation of the intracranial pressure (ICP) was not seen in these patients, indicating that ICP monitoring may be omitted in cases with a normal scan. However, since one-third of the patients with a normal admission scan developed new pathology within the first few days of injury, a strategy for control scanning is recommended. Control CT scans performed more than 6 months after injury showed a significantly higher incidence of brain atrophy in patients developing permanent disability than in those who made a good recovery.

Adult↗
PubMed1986

[Mitral atresia. Anatomical study and surgical implications].

We present the pathological study of 17 cases of mitral atresia with patent aortic valve and their surgical implications. The study is based on the type of atrioventricular connection, presence or absence of ventricular septum, size of the left ventricle and relation of the aorta with the aforementioned ventricle. We have classified mitral atresia into two groups by assessing these data. Group A) Both ventricles and atrioventricular connections are present and there is ventricular septal defect. The aorta may connect with an either normal or hypoplastic left ventricle or it may emerge in double outlet from the right ventricle. Group B) Absent left ventricle and atrioventricular connection. The aorta emerges from the single ventricle or the rudimentary chamber. Thirteen cases belonged to group A and four to group B. The pathological structure of mitral atresia requires the decompression of the left atrium by atrioseptostomy during the neonatal period to enable survival. On a second stage a palliative correction should be carried out, which; depending on ventricular size and outlet of the vessels, will be a valvular prosthesis left atrium-left ventricle or the modified atriopulmonary technique connecting the new left atrium with the systemic ventricle and aorta after resecting the auricular septum and connecting the right atrium with the pulmonary artery.

Female↗