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Biomedical subjects

A Montes

Publications and source records attributed to A Montes.

At least 73 records · Page 4Linked to original sources
PubMed1977

Lipid metabolism in pregnancy. IV. C Apoprotein changes in very low and intermediate density lipoproteins.

In vitro studies indicate that relative amounts of apolipoproteins CII and CIII in plasma may alter lipoprotein lipase mediated triglyceride removal from very low density lipoprotein. Therefore, we have determined relative amounts of these peptides in pregnant women in late gestation (mean 36 weeks) and 6 and 20 weeks postpartum. Very low density (d less than 1.006) and intermediate density (d 1.006-1.019) lipoproteins have been examined because they are affected similarly in pregnancy. Triglyceride and cholesterol in these two fractions increased 3 1/2 to 4 1/2-fold in pregnancy in keeping with previous reports. On a relative basis, apo CII was decreased and apo CIII1 and CIII2 increased in both VLDL and IDL at 36 weeks gestation. At 6 and 20 weeks postpartum relative amounts of C peptides returned to identical levels and were unaffected by lactation. It remains to be seen if in vivo triglyceride removal in pregnancy is altered by the reduction in apo CII relative to apo CIII.

Adult↗
PubMedDate not supplied

Mycoplasma hominis infection in three renal transplant patients.

We describe three cases of extragenital infection by Mycoplasma hominis in three patients transplanted with kidneys from cadaver donors. In two patients, the microorganism was isolated in the exudate from the surgical wound after 72 hrs. of culture on blood-agar (Columbia + 5% horse blood) in CO2 and under anaerobic conditions. In the remaining case, M. hominis was isolated in urine from a suprapubic catheter. All three patients responded satisfactorily to treatment with doxycycline. Mycoplasma hominis should be considered as the possible source of infection in patients at risk because of immunosuppressive therapy and manipulation of the urinary tract. Detection and identification of the organism are difficult without the appropriate techniques.

Abscess↗
PubMedDate not supplied

Peripheral blood CD34+ cell immunomagnetic selection in breast cancer patients: effect on hematopoietic progenitor content and hematologic recovery after high-dose chemotherapy and autotransplantation.

BACKGROUND: Tumor cells have been detected in mobilized peripheral blood of breast cancer patients, and they may contribute to tumor recurrence after the transplantation of peripheral blood progenitor cells. One of the most widespread technologies for tumor purging of the graft is immunomagnetic hematopoietic progenitor cell selection. STUDY DESIGN AND METHODS: The study assessed the effectiveness of a magnetic cell-separation system in selecting functional subpopulations of hematopoietic progenitors from 14 blood-derived harvests of 11 patients with high-risk breast cancer after mobilization following cytotoxic chemotherapy supported by granulocyte--colony-stimulating factor, as well as the feasibility of transplanting these selected subpopulations. RESULTS: CD34(+)-enriched cell fractions had a median purity of 93.0 percent (72.7-98.5%). The procedure yielded 52.6 percent of the CD34+ cell input (39.4-116.8%). Median recoveries of colony-forming units (CFUs) (36.87%) and cobblestone area-forming cells (CAFCs) (152.5%) were, respectively, 0.70 and 2.87 times those of CD34+ cells (52.6%). Moreover, CAFC efficiency in the positive cell fraction was 2.57 times that in the starting cell fraction. Peripheral blood neutrophil counts of 0.5 x 10(9) per L and platelet counts of 20 x 10(9) per L were reached after median times of 9 and 11 days, respectively. The number of transfused CAFCs per kg, CD34+ cells per kg, and postthaw CFU-granulocyte-macrophage per kg was correlated, respectively, with the speed of engraftment of neutrophils, platelets, or both. Tumor cells detected in one patient's peripheral blood were not found after CD34+ cell selection. CONCLUSION: Transplantation of immunomagnetically purified peripheral blood CD34+ cells does not increase transplantation-related morbidity. It induces a selective enrichment of more immature hematopoietic progenitors, which makes it suitable for use in cell expansion and gene therapy protocols.

Adult↗
PubMedDate not supplied

Morphology and amplitude values of the electrocardiogram of Spanish-bred horses of different ages in the Dubois leads system.

The aim of this work was to record the modifications of the form and amplitude of the electrocardiographic tracings during growth using the Dubois system and to study its sensibility to these physiological changes. This work was carried out on 179 healthy, young and adult Spanish-bred horses (98 females and 81 males). One electrocardiogram (ECG) was obtained from each horse using the Dubois leads system. The bifid shape deflection of the P wave was generally more frequent than the simple one in animals at 4 months of age or older. Amplitudes of the P2 component and of the simple positive wave presented significant differences (p < 0.01) between the age groups studied: animals up to 3 months in age and older than 2 years of age (highest amplitudes), and the rest of the animals (lowest amplitudes). Significant variations (p < 0.05) were found for the QS amplitude between animals of 1 month of age, and all the other groups. The multiple range analysis did not define a clear distribution of age groups for the amplitude of the T wave. It may therefore be concluded, that in the Spanish-bred horse up to 1 month of age, the form and amplitude of the QRS complex in the Dubois leads system differ from those of older animals. Thus, this study shows the sensibility of the Dubois leads system for detecting the electrocardiographic changes related to the growing process in the Spanish-bred horse. In addition, it provides standard values of electrocardiographic parameters in the Spanish-bred horse at different stages of growth.

Aging↗
PubMedDate not supplied

Physiologic and supraphysiologic increases in lipoprotein lipids and apoproteins in late pregnancy and postpartum. Possible markers for the diagnosis of "prelipemia".

A supraphysiologic (greater than 95th percentile) rise in plasma lipids in pregnancy may serve as a marker for "prelipemia" in the same way that gestational diabetes is a marker for prediabetes. To qualify as prelipemic, subjects with an abnormal lipid rise antepartum must return to normal postpartum but may have other identifying characteristics. This paper describes the antepartum-postpartum changes of lipoprotein lipids and apoproteins at 34 to 38 weeks of gestation and 6 and 20 weeks postpartum in 23 subjects with physiologic and six subjects with supraphysiologic plasma lipid increases during pregnancy. These results are compared to measurements in 23 nonpregnant controls matched for weight, age, and race. In subjects with a physiologic antepartum lipid rise, postpartum total triglyceride and very low density lipoprotein (VLDL) lipids (cholesterol and triglyceride) and apo B returned to baseline within 6 weeks. In contrast, low density lipoprotein (LDL) showed a slow postpartum decline in lipids and apo B with elevations remaining at 20 weeks postpartum. High density lipoprotein (HDL) cholesterol concentrations, elevated in pregnancy, remained elevated at 6 weeks postpartum, but fell to baseline by 20 weeks postpartum. HDL triglyceride and apo A-l concentrations, both elevated in pregnancy, returned to baseline by 6 weeks postpartum. A supraphysiologic triglyceride rise in pregnancy was associated with a slower return of total triglycerides and VLDL to baseline, reduced HDL cholesterol ante- and postpartum, atypical changes in LDL cholesterol during pregnancy and postpartum, and evidence of hyperlipidemia among family members. Two subjects with hypercholesterolemia in the nonpregnant state showed no marked exaggeration of total or LDL cholesterol concentrations in pregnancy. The data support the hypothesis that a supraphysiologic rise in plasma triglyceride concentrations in late pregnancy may serve as a marker of prelipemia. Proof of the hypothesis requires further investigation and longer follow-up.

Adult↗
PubMedDate not supplied

[New treatments for germ cell tumors with poor prognosis].

OBJECTIVE: To discuss briefly the new therapeutic strategies for poor-prognosis testicular germ cell cancer. METHODS: The use of new drugs in first line chemotherapy, intensive alternating and sequential chemotherapy and high dose chemotherapy with autologous bone marrow or stem cell transplantation are briefly discussed. RESULTS/CONCLUSIONS: Despite the current advancements in the treatment of germ cell tumors, approximately 50% of patients with poor-prognosis germ cell tumors according to the IGCCCG classification die from their disease. In order to improve the results in this group of patients, new therapeutic strategies are currently being investigated, such as the introduction of new drugs to the first line chemotherapeutic regimen. However, randomized studies have shown no benefit from the use of ifosfamide. Phase II trials have shown promising results with intensive alternating and sequential chemotherapy, although the only phase III randomized trial that has been conducted comparing BOP-VIP with BEP showed no advantages. Some phase II trials using high-dose chemotherapy with hematopoietic support in first line treatment of poor-prognosis germ cell tumors have shown promising results. Randomized trials are necessary in this group of patients in order to achieve therapeutic advancements.

Antineoplastic Agents↗
PubMedDate not supplied

[Comparative study of vecuronium and atracurium at low doses in minor pediatric surgery under combined anesthesia].

To compare, the time of onset and time of recovery of muscular blockade after use of half doses of vecuronium and atracurium, we studied 18 children ASA I who were proposed for short lasting pediatric surgery and combined anesthesia. Patients were divided into two groups: group V (n = 10) was treated with a single dose of 0.05 mg/kg of vecuronium and group A (n = 8) with 0.25 mg/kg of atracurium. Assessment of muscular relaxation was performed by measuring the electromyographic responses to a train of four stimuli applied to the cubital nerve at the level of the hypothenar eminence. We administered 0.02 mg/kg of atropine, 5 to 10 mg/kg of thiopental, and the muscular relaxing dose together with orotracheal intubation when the first stimulus of the train of four stimuli was blocked at 90% of its initial value (T90). Maintenance of the anesthetic level was performed with 50% of N2O-O2 without inhalational anesthetics. A caudal blockade was induced by 1 ml/kg of bupivacaine at 0.25%. We measured the following parameters of muscular relaxation: T90, T10 (time at which the 10% of the first stimulus reappears), T25 (time of clinical efficacy) and IR (index of recovery). Only 60% of patients (6 out of the 10 patients of vecuronium group and 5 out of the 8 subjects of atracurium group) achieved the T90. This occurred 2.5 +/- 0.7 min after vecuronium and 3.2 +/- 0.6 min after atracurium. T10 was 13.7 +/- 4.1 min for vecuronium and 13.3 +/- 4.1 min from atracurium. T25 occurred 18.2 +/- 6.5 min after vecuronium and 19.4 +/- 2.1 min for atracurium.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Caudal↗
PubMedDate not supplied

[Experience with the Du Pen epidural catheter in chronic cancer pain].

We evaluate the results obtained with the use of Du Pen's epidural catheter in a series of patients with chronic oncologic pain. There were 27 patients with neoplasms of different etiologies who received a total number of 30 catheters. Inclusion criteria were established. All patients received bolus of morphine chloride free of conservers. Follow-up controls were carried out at least every week and consisted on the evaluation the dosage efficacy, dose adjustments, catheter condition, physical activity, neurologic state, and requirements of adjuvant medication. The documented use of the 30 catheters implanted in this study lasted up to 1452 days with a mean of 48.5 days. There were no complications related to catheter insertion. However we observed complications related to the use of the catheter: reflow at the site of catheter implantation in 4 cases, infection of the external (one case) and internal (one case) catheter route without antibiotic resolution, and infection of the epidural space responding to antibiotherapy without catheter withdrawal in one patient. Twenty patients died. Mortality was not attributed to catheter complications in any case. The present study confirms that placement of the catheter is technically easy and provides an efficacious opiate analgesia with minimal complications.

Adult↗
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

[Bilateral interpleural analgesia in a patient with multiple myeloma].

The case of one patient with multiple myeloma and thoracic pain during myeloptysis is described. Bilateral interpleural analgesia was accomplished with 10 ml of 0.375% bupivacaine with adrenaline (5 micrograms/ml) in both hemithorax and bilateral infusion at a rate of 3 ml/h started immediately and maintained during 24 hours. Analgesia was then obtained by means of a bolus pattern 10 ml/6 h until myeloptysis finished. Analgesic effectiveness was evaluated through visual analogue scale (VAS). Plasmatic levels of bupivacaine were found below toxic levels; maximum concentration was (1.12 microgram/ml) at the steady state (5 x t 1/2). Difficulty in treatment of pain and utility of interpleural analgesia is suggested.

Aged↗
PubMedDate not supplied

[Thoracic trauma].

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Anesthesia↗