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Biomedical subjects

A Franco

Publications and source records attributed to A Franco.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

[Pneuropsychological disorders after occupational exposure to mercury vapors in El Bagre (Antioquia, Colombia)].

INTRODUCTION: The department of Antioquia in Columbia is the main producer of gold in Columbia. In the gold-producing regions the population is exposed to high levels of mercury used in the processes of extraction and purification. Studies done in Columbia on neurotoxicity underline the hazards of mercury from the environmental and occupational-health point of view, but the effect of long-term exposure on cognitive function has not been studied. OBJECTIVE: To determine whether the miners of El Bagre (Antioquia, Columbia) have neuropsychological and/or behavior disorders as a result of occupational exposure to toxic mercury vapor. PATIENTS AND METHODS: The sample was made up of 22 right-handed men, residents of El Bagre, aged between 20 and 45 years old who had been exposed to mercury vapor for at least three years. The control group consisted of 22 men who lived in the non-mining regions of the department and had not been exposed to mercury, paired with the cases considered for age and educational status. Neuropsychological assessment, a medical examination and behavioral performance tests were applied to all the men (in both groups). RESULTS: In the study group alterations were seen and classified as: intellectual damage (mainly alteration of executive function and constructional praxis); emotional changes (symptoms of depression and anxiety) and neurological changes (amnesia, insomnia and tremor of the tongue). No changes were found in the control group. CONCLUSION: Exposure to mercury causes specific neuropsychological and behavior disorders in the absence of clinically detectable physical or physiological damage.

Adult↗
PubMedDate not supplied

[Fluctuation in bilateral thalamic infarction: diffusion study using magnetic resonance].

INTRODUCTION: Bilateral paramedian thalamic infarcts are uncommon. The most frequent clinical manifestations are acute impairment of consciousness, oculomotor abnormalities and cognitive disturbances. A fluctuating course has not been previously reported. CLINICAL CASE: A 66 year-old woman with a past history of arterial hypertension and diabetes was admitted to our hospital presenting four episodes of decreased consciousness and vertical gaze paresis. Neurological examination between episodes was unremarkable. Diffusion-weighted magnetic resonance imaging revealed high-signal lesions in both paramedian thalamic areas. CONCLUSIONS: Fluctuating impairment of consciousness may be a clinical presentation of bilateral paramedian thalamic infarction. Atheromatous occlusion of the mouth of the paramedian thalamic penetrating artery is the most common cause. Neurological findings and diffusion-weighted images may help to define the extension and the underlying pathophysiological mechanism.

Aged↗
PubMedDate not supplied

[Hematoma of the anterior rectus abdominis muscle as the first manifestation of lymphoproliferative disease after renal transplantation].

Rectus sheath hematoma results from the rupture of rectus muscle vessels by trauma, coagulation disorders or anticoagulant therapy, but it can occur spontaneously too. Its prognosis is good. On the other hand, posttransplant lymphoproliferative disorders (PTLD) are serious and potentially fatal complications in transplant recipients. Patients with PTLD have a mononucleosis-like syndrome or develop extranodal masses which involve various organs. We report the case of a renal transplant recipient who develop a rectus sheath hematoma as the first clinical feature of PTLD.

Hematoma↗
PubMedDate not supplied

[Changes in renal function in renal transplantation. Predictive factors for functional deterioration].

Renal transplants may undergo changes secondary to the decrease of the renal mass, the effects of rejection, and various other risk factors that contribute to the progression of renal insufficiency. We have performed a prospective study of 285 cadaveric renal transplants recipients, that were receiving various maintenance immunosuppressives regimens, to study the evolution of their renal function and to evaluate the influence of various factors in the progression of renal insufficiency. All variables were analysed in a regression model of multivariate analysis. We found a progressive increase of the serum creatinine in the studied population. The mean initial creatinine was 1.70 +/- 0.84 mg/dl and final creatinine in the study 2.17 +/- 2.06 mg/dl, difference statistically significant (p = 0.000). We calculated the increase of creatinine in each patient. We observed that 113 patients (42.2%), had stable serum creatinine but the remaining 155 patients (57.8%) had a mean increase of 0.04 +/- 0.8 mg/dl/month. We analysed the patients according to various variables. Although in most the final creatinine is significantly greater than the initial, this increase of creatinine level was not present in patients with delayed graft function, in patients with no acute rejection, in the extreme age groups, in the grafts from younger donors and in those patients without initial proteinuria. The patients transplanted from younger donor had the best renal function, without any decrease in their function during the study. The advanced age of the donor has a great negative impact in the evolution of the renal transplant. According to our study, proteinuria and its quantity is a major predictor of progressive renal insufficiency. The multivariate analysis confirms that the age of the donor and initial proteinuria predict decrease of renal function. It is important to identify the factors that they could predict a greater progression to the failure of the graft. We have the possibility of acting on them, establishing immunosuppressive strategies that reduce the deleterious effects of the calcineurin inhibitors in the recipients of grafts from older donors' and to encourage the use of drugs which reduce proteinuria.

Adult↗
PubMedDate not supplied

[The introduction of chloroform anesthesia in Madrid. Notes for studying its history].

Until present, the introduction of chloroform anesthesia in Madrid has not been specifically studied by any author. Therefore, knowledge of the events related to this happening is lacking. We have studied this chapter of our history by analyzing primary documents and articles published at the daily press, political press, and scientific journals of Madrid during 1847 to 1848. This investigation allowed us to follow the most relevant news dealing with the discovery of the drug and with its first experimental and clinical applications in Madrid. Based on the present bibliographic material we could establish a chronologic report of all surgical interventions using chloroform that were performed in Madrid. We conclude that albeit surgeons in Madrid were not the first to use chloroform in Spain, they were, however, the ones who most extensively used it. Their contribution was of relevance in the settlement of the new anesthetic agent in Spain.

Anesthesia, General↗
PubMedDate not supplied

[Enteral nutrition in burn patients].

UNLABELLED: Nutritional support plays an important role in the treatment of patients with burns. Due to the severe hypercatabolism that develops in these patients, oral support is insufficient in most cases, and this makes it essential to initiate artificial nutritional support (either enteral or parenteral). Enteral nutrition is more physiological than parenteral, and data exist which show that in patients with burns, enteral nutrition exercises a protective effect on the intestine and may even reduce the hypermetabolic response in these patients. The purpose of the study was to evaluate the effectiveness and tolerance of enteral nutritional support with a hypercaloric, hyperproteic diet with a high content of branched amino acids in the nutritional support of patients suffering from burns. MATERIAL: The study included 12 patients (8 males and 4 females), admitted to the Burns Unit. Average age was 35 +/- 17 years (range: 21-85 years). The percentage of body surface affected by the burns was 10% in two cases, between 10-30% in three cases, between 30-50% in five cases and over 50% in two cases. Initiation of the enteral nutrition was between twenty-four hours and seven days after the burn. The patients were kept in the unit until they were discharged, and the average time spent in the unit was 31.5 days (range: 17-63 days). Total energetic requirements were calculated based on Harris-Benedict, with a variable aggression factor depending on the body surface burned, which varied from 2,000 and 4,000 cal day. Nitrogenous balance was determined on a daily basis, and plasmatic levels of total proteins, albumin and prealbumin on a weekly basis. RESULTS: There was a significant difference between the prealbumin values at the initiation and finalization of the enteral nutrition (9.6 +/- 2.24 mg/dl compared with 19.75 +/- 5.48 mg/dl; p < 0.001). The nitrogenous balance improved, changing from -5.4 in the second week to positive values by the fourth and fifth weeks of treatment. Tolerance to the enteral diet was very good, and only mild complications such as diarrhoea developed in two patients. CONCLUSIONS: Enteral nutrition is a suitable nutritional support method for patients with burns, which maintains the nitrogenous balance positive and improves the visceral protein parameters in these patients at an early stage, with very few complications.

Adult↗
PubMedDate not supplied

[Experience with 100 anesthetized patients ventilated with laryngeal mask].

We studied 100 adult patients who were anesthetized for different surgical procedures and were ventilated with laryngeal mask either with spontaneous or controlled ventilation. Despite of the inexperience we achieved an appropriate placement of the mask in 99% of cases; 74% at the first attempt, 22% at the second, and 4% at the third. In 87.8% of patients we had an adequate control of the air way. In 12.2% of cases there were problems in relation to the controlled ventilation. In one patient we were unable to correctly place the mask and another anesthetic technique had to be performed. Laryngeal mask is useful in the control of the air way in anesthetized patients with spontaneous ventilation. Some inconvenience may arise when controlled ventilation is used.

Adolescent↗
PubMedDate not supplied

[Doctoral theses and memoirs about anesthesia. Documents for a history of Spanish anesthesia].

Based on the importance of document files and first-hand bibliographic sources for studying the history, we have recently investigated the chapter of Doctoral Thesis and Reports on anesthetic topics since we believe that these are fundamental to gain insight into the knowledge of our history. This investigation was planned to find such documents by reviewing the data of several Spanish archives and libraries. We collected 80 works: 14 Reports and 66 Doctoral Theses performed during a period of 95 years (heuristic limits 1847-1942). These papers were classified in several subgroups according to the subjects they deal with: 21 works on inhalation anesthesia, 7 on intravenous general anesthesia, 20 on spinal anesthesia, 10 on locoregional, 7 on anesthesia and metabolism, 12 on obstetric anesthesia, and 3 works on varied anesthesia issues. Analysis of these documents revealed that the authors (physicians and Spanish medical corporations) undertook an accurate consideration of the more relevant scientific subjects at the time of their investigation. We conclude that the works analyzed in the present study represented the beginning of the Spanish investigation on anesthesia. Further investigations may contribute to enrich our historiography.

Academic Dissertations as Topic↗