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Biomedical subjects

A Montero

Publications and source records attributed to A Montero.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

[Effect of the diet on the nutritional status of ballerinas: immunologic markers].

UNLABELLED: Athletes have special nutritional needs that will vary with sex, age, body composition and most importantly by the type, intensity, frequency and duration of the physical exercise. However the diet of certain groups of athletes such as ballet dancers is inadequate due to overly restrictive habits as a consequence of their obsession with losing or maintaining a low body weight that reflects an aesthetic preference for thinness. Physical exercise implies energy expenditure and thus, an increase in the energy intake is required to avoid possible situations of malnutrition. Both a negative energy balance and physical exertion have been shown to induce immunological changes which have been implicated as a possible explanation for increased susceptibility to illness and infections. OBJECTIVE: To find out the influence of a restricted energy intake on the immune system of 14 ballet dancers (20-25 h/w) in comparison with a control sedentary group (n = 23) by evaluating dietetic, anthropometric and some immunological parameters. RESULTS: Ballet dancers consumed a hypocaloric diet (mean: 1555 kcal), the energy intake being significantly lower than in the control group. None of both groups showed a similar calorie profile to the recommended intake for Spanish population, especially fat percentage was higher than it should. Regarding weight, ideal body weight and BMI values, no significant differences were shown between both groups. However, all the skinfolds thickness and the sum of skinfolds were significantly lower in ballet dancers than in controls. Leukocytes, lymphocytes and all lymphocyte subset counts were lower in ballet dancers in comparison with controls. CONCLUSIONS: In view of these results, ballet dancers may suffer from an impaired nutritional status, determined by a depletion of anthropometric and immunological parameters. The nutritional requirements for this population should be increased in order to compensate their high-energy expenditure, avoid a negative energy balance and lessen the nutritional damage.

Adolescent↗
PubMedDate not supplied

[Model to predict staffing for anesthesiology and post-anesthesia intensive care units and pain clinics].

Human resources account for a large part of the budgets of anesthesia and post-anesthesia intensive care units and pain clinics (A-PICU-PC). Adequate staffing is a key factor in providing for both effective care and professional staff development. Changes in professional responsibilities have rendered obsolete the concept of one anesthesiologist per operating room. Duties must be analyzed objectively to facilitate understanding between hospital administrators and A-PICU-PC chiefs of service when assigning human resources. The Catalan Society of Anesthesiology, Post-anesthesia Intensive Care and Pain Therapy has developed a model for estimating requirements for A-PICU-PC staffing based on three factors: 1) Definition of staff positions that must be filled and criteria for assigning human resources; 2) Estimation of non-care-related time required by the department for training, teaching, research and internal management, and 3) Estimation of staff required to cover absences from work for vacations, personal leave or illness. The model revealed that the ratio of number of staff positions to number of persons employed by an A-PICU-PC is approximately 1.3. Differences in the nature of services managed by an A-PICU-PC or the type of hospital might change the ratio slightly. The model can be applied universally, independently of differences that might exist among departments. Widespread application would allow adoption of a common language to be used by health care managers and A-PICU-PC departments when discussing a basis for consensus about our specialty.

Anesthesiology↗
PubMedDate not supplied

Chronic cutaneous lupus erythematosus and subsequent infection with HIV1.

Since the beginning of the pandemia caused by the Human Immunodeficiency Virus several reports have described cases of infection by HIV1 in patients bearing rheumatic diseases. The infection by HIV 1 in patients with Systemic Lupus Erythematosus (SLE) and Chronic Cutaneous Lupus Erythematosus (CCLE), however, seems to be elusive. As far as we know, only 3 cases of HIV infection associated with SLE have been published. Furthermore, we have not been able to find out any report concerning HIV infection in patients bearing CCLE. The aim of the present article is to present a case of a female patient with CCLE that subsequently developed an infection with human immunodeficiency virus.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Plasma bupivacaine levels after pleural block: the effect of epinephrine after unilateral or bilateral bupivacaine administration.

BACKGROUND AND OBJECTIVES: To determine the effect of adding epinephrine (5 micrograms/ml) to bupivacaine during continuous spinal infusion and the effect of the administration of the same total dose of bupivacaine, in a bilateral or unilateral way, on its consequent plasma levels. METHODS: Sixteen cholecystectomized patients were studied prospectively. In ten patients with midline incision, bilateral pleural infusion (half total unilateral dose in each hemithorax) was administered, and in six patients with subcostal incision, unilateral pleural infusion. The unilateral group received a loading dose of 20 ml 0.375% bupivacaine immediately followed by an infusion at a rate of 6 ml/hour. Three patients randomly received epinephrine (5 micrograms/ml) added to bupivacaine, whereas the other three remaining patients did not receive it. The bilateral group received 10 ml 0.375% bupivacaine followed by an infusion at a rate of 3 ml/hour in each hemithorax. Five patients randomly received epinephrine; five others did not. The plasma levels of bupivacaine were determined at 5, 15, 30, and 60 minutes and at 6 and 18 hours. RESULTS: Plasma levels of bupivacaine were significantly lower (p less than 0.05) during the whole study in patients receiving epinephrine. For the same total dose, there were no statistical differences in the plasma levels of bupivacaine between unilateral and bilateral pleural groups. CONCLUSIONS: The addition of epinephrine (5 micrograms/ml) to a continuous pleural infusion of bupivacaine diminishes the plasma levels of the local anesthetic. For the same total dose of bupivacaine, there are no differences in the plasma levels obtained between unilateral and bilateral administration.

Adult↗
PubMedDate not supplied

Continuous pleural infusion of bupivacaine offers better postoperative pain relief than does bolus administration.

BACKGROUND AND OBJECTIVES: To determine whether continuous pleural analgesia offers better postoperative pain relief than does bolus administration in postcholecystectomy patients. METHODS: Eighty postcholecystectomy patients with a subcostal incision were randomly allocated to receive pleural analgesia with either a bolus regime of 20 ml 0.375% bupivacaine with 1:200,000 epinephrine at four-hour intervals (bolus group), or a loading dose of 20 ml 0.375% bupivacaine with 1:200,000 epinephrine immediately followed by a continuous infusion at a rate of 6 ml/hour during the first 24 hours postoperatively (infusion group). A 10-cm linear visual analog scale was used and recorded before performing pleural analgesia and at 1,6,12,18, and 24 hours subsequently. Plasma levels of bupivacaine were determined in eight patients of the infusion group. Samples were taken at 5,15,30, and 60 minutes and at 6 and 18 hours after the start of infusion. RESULTS: Mean visual analog scale values were significantly lower (p less than 0.001) at 6, 12, 18, and 24 hours in the infusion group. PaCO2 decreased significantly (p less than 0.001) after the block in both groups, with no difference between the groups. Plasma levels were well below toxic levels in the infusion group. CONCLUSIONS: Continuous pleural analgesia offers better postoperative pain relief than does bolus administration. Pneumothorax was observed in two patients during the study.

Adult↗
PubMedDate not supplied

Pulmonary valve endocarditis during puerperal sepsis.

A case of pulmonary valve endocarditis caused by Staphylococcus aureus during puerperal sepsis in a female patient is reported. The M-mode and two dimensional echocardiographic finding are described. A review of the literature shows that this entity is rare. A large vegetation in the leaflet of the pulmonary valve was excised and the patient recovered after a full course of antibiotics.

Adult↗
PubMedDate not supplied

Noninvasive radioisotopic diagnosis of acute heart rejection.

In a prospective protocol for noninvasive diagnosis and follow-up of acute heart rejection 162 examinations were performed in 36 patients who underwent heart transplantation. The follow-up period ranged from 15 days to 44 months. The protocol comprised multiple gated acquisition ventriculography with albumin labeled with 99mTc (740 MBq), acquired using a forward/backward by thirds framing mode, 32 frames/cycle, and 10 million total counts. Parameters of left ventricular diastolic function were analyzed. Antimyosin antibody labeled with indium 111 (74 MBq) was injected, and myocardium/lung uptake ratios were obtained at 48 hours in counts per pixel. Endomyocardial biopsy was performed in all patients within 48 hours. The results were evaluated by comparison of mean values of each parameter and global and individual correlation analysis in relation to the presence or absence of rejection and treatable (moderate or severe) or nontreatable (mild or absent) rejection. Antimyosin and diastolic function parameters showed significant differences (p less than 0.001) between patients with and without rejection and between patients with treatable and nontreatable rejection. Global correlation with biopsy existed (p less than 0.05) for antimyosin (r = 0.75), average filling rate (r = 0.61), and peak filling rate (r = 0.56). Individual correlation exhibited significance in all patients only for antimyosin (r = 0.78 to 0.98). In eight patients average filling rate also showed significant correlation (r = 0.65 to 0.88). In conclusion, these results provide a noninvasive diagnosis of cardiac allograft rejection episodes and allow an accurate selection between treatable and nontreatable rejection. Individual patient follow-up is possible with antimyosin. The study of diastolic function is also useful in this setting.

Antibodies, Monoclonal↗
PubMedDate not supplied

[Survey of nursing roles in anesthesiology, postoperative recovery care and pain management in Catalonia, Spain: analysis of the current situation].

OBJECTIVE: To determine nursing functions in anesthesiology, postoperative recovery care, and pain management in Catalan hospitals and to analyze the roles of nurses in this specialty. METHODS: Development of a mail questionnaire sent to 70 public and private hospitals in Catalonia, to be filled in and returned separately by the nursing supervisor and by the anesthesiology department of each hospital. The survey included questions on whether tasks were or were not carried out by nurses. RESULTS: Responses were received from 31% of nursing supervisors and 45% of anesthesiology departments. Only 22% of the hospitals employed nursing staff with duties exclusively in the anesthesiology department. Nurses took on more responsibilities in major outpatient surgery services and postanesthetic recovery care units than in other areas. Significant discrepancies were found between answers given by nursing supervisors and those returned by anesthesiology departments regarding tasks of nurses in this specialty. Items with the greatest agreement were those related to maintenance of material. Those with the lowest agreement were related to drug management. CONCLUSIONS: Although responses came from only a third of the target population, the information obtained suggests a lack of definition in Spain of nursing tasks in the field of anesthesiology. This situation is different from that of most European countries and of the United States of America.

Anesthesia↗
PubMedDate not supplied

Bilateral interpleural injection of local anesthetics.

Two cases of bilateral interpleural analgesia using bupivacaine are presented. This technique was selected due to relative or absolute contraindications to continuous thoracic epidural analgesia in both cases. Emphasis is placed on the safeguards that need to be employed to avoid the very serious potential complications when this method is employed bilaterally.

Adult↗
PubMedDate not supplied

Preliminary experience with deflazacort, a new synthetic steroid with fewer undesirable side effects, in heart transplant patients.

Prednisone is widely used by most heart transplant units, despite its frequent side effects. Deflazacort, a new oral synthetic steroid with fewer side effects, has not been studied in heart transplant patients. Our initial experience with 26 heart transplant patients in whom prednisone was replaced by deflazacort at 11 +/- 11 months after transplantation is reported. After the switch to deflazacort, a significant decreased was noted in glycemia, total cholesterol, and LDL-cholesterol (p < 0.001). No difference was noted in severity or frequency of rejection and infection between patients being treated with deflazacort and another 26 patients who continued to be treated with prednisone over a comparable period of time after transplantation.

Adult↗