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Biomedical subjects

A Reina

Publications and source records attributed to A Reina.

At least 19 recordsLinked to original sources
PubMed1997

Mortality discrimination in acute myocardial infarction: comparison between APACHE III and SAPS II prognosis systems. PAEEC Group.

OBJECTIVE: To compare the Acute Physiology, Age and Chronic Health Evaluation (APACHE) III with the Simplified Acute Physiology Score (SAPS II) in discriminating in-hospital mortality for intensive care unit (ICU) patients with acute myocardial infarction (AMI). DESIGN: Prospective, observational, multicenter study. SETTING: 70 Spanish ICUs. PATIENTS AND PARTICIPANTS: 1711 patients with AMI and representative of Spanish ICUs. MEASUREMENTS AND RESULTS: APACHE III score, APACHE III system probability of death (APACHE III probability), SAPS II score and in-hospital mortality were noted for each patient. Two hundred and twenty three (13.0 %) patients died in the hospital. The sensitivity (+/- SE), specificity (+/- SE), and accuracy (+/- SE) for the APACHE III score were, respectively, 75.8 +/- 2.9, 75.9 +/- 1.1, and 75.9 +/- 1.0. The corresponding figures for APACHE III probability were 75.3 +/- 2.9, 79.2 +/- 1.1, and 78.7 +/- 1.0, and for SAPS II 72.2 +/- 3.0, 75.9 +/- 1.1, and 75.4 +/- 1.0. CONCLUSIONS: The results indicate good discrimination by the three tests. APACHE III probability shows a statistically significant improvement in accuracy and specificity when compared with the two scores.

APACHE↗
PubMed1993

Circulating alpha-actin in angina pectoris.

We used Western blot, a highly sensitive technique that detects amounts of protein as low as 0.1 to 1.0 ng, to investigate the possible presence in the blood stream of the contractile protein alpha-actin in 29 patients diagnosed with angina pectoris (Braunwald's classification). Circulating protein was identified with a monoclonal antibody specific for cardiac alpha-actin. Of the 20 control samples of blood, the immunoblot results were negative for alpha-actin in 19. Of the 30 patients with skeletal muscle damage caused by surgery, 27 were negative for circulating alpha-actin. Of the 29 patients with angina pectoris, circulating alpha-actin was found in 19 as a 43 kDa band in immunoblots. Of the four patients with anterior acute myocardial infarction, mean concentration of circulating alpha-actin was 58 mg/l. Among the patients with angina pectoris, the highest circulating concentrations (mean 40 mg/l) was found in those with prolonged angina (class III B, according to Braunwald's classification). In the entire group of individuals with angina pectoris alpha-actin was detectable in serum for up to 175 h after the onset of pain, and showed two peaks, one at 1 h (112 mg/l) and one at 50 h (82 mg/l) after the onset of pain. These findings reinforce the notion that unstable angina should be considered a serious condition.

Actins↗
PubMed1993

Circulating alpha-actin protein in acute myocardial infarction.

We used Western-blot analysis to investigate the possible presence in the bloodstream of the contractile protein alpha-actin in 70 patients diagnosed with acute myocardial infarction on the basis of clinical, electrocardiographic and laboratory (creatine kinase and lactate dehydrogenase) criteria. Circulating protein was identified with a monoclonal antibody specific for cardiac alpha-actin. Of the 70 control samples of blood, the immunoblot results were negative for alpha-actin in 98% of the cases. Of the 30 patients with skeletal muscle damage caused by surgery, 26 were negative for circulating alpha-actin. Of the 70 patients with acute myocardial infarction, circulating alpha-actin was found in 67 (95%) as a 43 kDa band in immunoblots; the highest circulating concentrations (0.0580 micrograms/microliters) were found in those with anterior acute myocardial infarction. Circulating alpha-actin was detected in samples taken between 1 and 180 h after the onset of pain, and showed a biphasic pattern of appearance. Our findings for serum alpha-actin, together with the relationship between serum concentrations of this protein and sex (p = 0.001), tobacco use (p = 0.007) and postepisode complications (p = 0.002), should make it possible to gain a deeper understanding of acute myocardial infarction as a clinical entity.

Actins↗
PubMed1990

Definitive management of acute pilonidal abscess by loop diathermy excision.

A simple technique of definitive management of acute pilonidal abscess is described. The procedure consists of incision with drainage of pus followed by controlled excision of diseased tissue and lateral sinuses, using a loop diathermy. It allows one-stage definitive management of both acute pilonidal abscess and chronic pilonidal sinuses.

Acute Disease↗
PubMed1990

Cecal diverticulitis presented as a cecal tumor.

Seven patients diagnosed as having acute appendicitis were operated on and a cecal wall mass due to cecal diverticulitis was found. In two patients the mass could not be separated from the cecal wall and right colectomy was performed. In five patients, in whom the mass could be separated from the cecum, conservative operations (three diverticulectomies and two wedge resections) were performed, thus avoiding needless, more extensive surgery.

Acute Disease↗
PubMed1989

Mediastinal, left, and right atrial pressure variations with different modes of mechanical and spontaneous ventilation.

Variations in mediastinal, left, and right atrial pressures (MedP, LAP, RAP, respectively) were measured by means of catheters and tubes positioned in ten patients with nonvalvular cardiac surgery. For each pressure, a maximum, minimum, and mean value was determined in relation to its oscillations during the respiratory cycle. Thus, we compared the variations in MedP, LAP, and RAP in controlled mechanical ventilation (CMV), CMV with 5 cm H2O PEEP, synchronous intermittent mandatory ventilation (SIMV), SIMV with 5 cm H2O PEEP, continuous positive airway pressure (CPAP), and spontaneous respiration (SR). We built an experimental model to compare the measurements obtained by air-filled tubes inserted at surgery with those obtained by esophageal balloons filled with water. The maximum MedP did not vary significantly in these patients except when SIMV and SR were compared; however, the minimum MedP diminished significantly (p less than .001) in SIMV, SIMV-PEEP, CPAP, and SR, with negative inspiratory values reaching significant proportions. The mean values of MedP, LAP, and RAP showed a similar tendency although to a lesser degree. The experimental model revealed a strong linear relation between the values obtained with air-filled tubes and those obtained with water-filled esophageal balloons (r = .99, p less than .001). These results suggest that the mean values of MedP, LAP, and RAP do not reflect the dynamic variations in ventricular filling pressure accurately, nor the important negative inspiratory peaks that appear in different types of ventilation using spontaneous cycles with and without PEEP. These inspiratory peaks can overload the left ventricle by hydrostatic gradients, and lead to pulmonary edema in susceptible patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Sarcoidosis of oculo-parotid onset. Differential diagnostic considerations].

Two cases of sarcoidosis, presenting with parotid gland enlargement and keratoconjunctivitis sicca, are here described. The difficulty encountered in making correct diagnosis is then stressed. The diagnostic value of invasive and non invasive techniques in the study of parotid gland pathology and function in sarcoidosis is then reviewed.

Adult↗
PubMed1985

Torsion of a wandering spleen.

We present an unusual case of torsion of a wandering spleen in a 14 year old boy. Wandering spleen is an entity which has rarely been reported in infants and children. Although patients may be asymptomatic, some may present as an acute surgical emergency if trauma or torsion of the vascular pedicle occurs, as in our case. The treatment of this condition is splenectomy.

Adolescent↗
PubMed1976

[Value and limitations of telethermography in the diagnosis of peripheral arterial diseases (clinical contribution)].

Using a diagnostic technique allowing thermal variations of the body surface to be translated into pictures by remote recordings (telethermography), the Authors studied a group of patients suffering from peripheral arteriopathies. The patients were also subjected to other tests (oscillography, pletysmography, electrothermometry, arteriography). The diagnostic reliability of the telethermographic procedure in the cases studied was 80% (8 cases out of 10), with 20% of false negatives. Even in the two falsely negative cases, however, the investigation proved useful, since it allowed the improvement obtained with medical and surgical therapy to be evaluated. The Authors therefore conclude by asserting that telethermography is an effective diagnostic means because of the reliability of the results and its simplicity in use, as well as being non-traumatic and hence easily repeatable.

Adult↗
PubMed1975

Tuberculous epidural granuloma simulating a herniated lumbar disc.

A case of tuberculous epidural granuloma producing L5 root compression in a 37-year-old Negro male is presented. Excision of the granuloma and the administration of anti-tuberculous therapy was followed by complete recovery. Tuberculous epidural granuloma simulating a radicular syndrome is rarely seen. A search of the literature revealed only five previously reported cases.

Diagnostic Errors↗
PubMed1975

[Echinococcic cyst of the thyroid].

The Authors, starting from observation of a hydatid cyst of the thyroid, make an examination of this very rare pathological occurrence. They then put forward and evaluate the fundamental problem linked to this localisation of hydatidosis, a problem which can be summed up as the lack of pathological identification of the clinical pattern and the consequent ease of making a diagnostic error. They conclude by stating that the sole differential diagnostic criterion in relation to other diseases that may be considered (cystic uninodular goitre, adenoma, epithelial cyst, haematic pseudocyst) consists in the simple recollection of the possible existence of this very rare localisation of the echinococcus.

Adult↗