[Individual plaque of acrylic resin for cranioplasty].
Explore the source record for details and available documents.
Acrylic Resins↗
Biomedical subjects
A Varela
Publications and source records attributed to A Varela.
[Hospital discharge letter --Clinical information for the family physician].
INTRODUCTION: There are aspects related with the proportion and quality of discharge letters which may influence the management of shared health care after hospital discharge; we describe them taking into consideration that no changes regarding the usual way of giving hospital discharge took place. AIMS: To determine the proportion of cases in which the hospital discharge of inpatients was accompanied with a discharge letter and to measure its quality. METHODS: A descriptive and transverse observation study referring to the year of 1996. The authors observed, in the clinical files of this Department, the total cases of discharge of inpatients with ischaemic heart disease (123 cases). Besides measuring the variable "discharge letter existence", we studied the composed variable discharge letter quality (existence of clinical history data, objective observation data, complementary test results, diagnosis, therapeutic procedures, and also the readability of the clinical information and the existence of the legible name of the specialist). RESULTS: From the study of 121 cases of discharge of inpatients with ischaemic heart disease, 90.2% presented discharge letters. When studied, their quality was considered sufficient in 57.7% and insufficient in the rest of the cases. We point out that 29.7% of the discharge letters did not present objective observation data. DISCUSSION: The clinical information provided in this Department, at the time of hospital discharge, presents a higher proportion and quality than that observed in other studies.
Family Practice↗
[Craniopharyngiomas. Clinicopathological aspects in different age groups].
Craniopharyngiomas are rare brain tumors of the hypothalamo-pituitary region, developing from embryonic remnants of Rathke's pouch and sac. Their overall incidence is 0.13 per 100,000 person years. Most frequently, they are suprasellar, start growing in childhood and originate neurological and hormonal symptoms. We retrospectively studied patients treated in our institution for craniopharyngioma in the last 10 years, in order to evaluate their clinical, imaging and pathological characteristics. Of the 32 patients analysed, 18 were females and 14 males with ages ranging between 6 and 81 years (early onset group--EOG aged 5-14 years: 7 patients; middle age onset group--MAOG aged 15-49 years: 15 patients; late age onset group--LOG aged > or = 50 years: 10 patients). Visual impairment was the most frequent presenting clinical feature in EOG (71.4%) and MAOG (86.6%), while in the LOG personality and cognitive changes including memory loss predominated (60%). Headaches were very frequent in all groups (EOG 42.8%, MAOG 60%, LOG 40%). Meningitis and seizures were presenting features, each in one patient. Regarding endocrine symptoms and signs, growth failure was present in 57.2% of the EOG. Amenorrhea was present in 5 of 10 female patients of the MAOG. Preoperatively, TSH was deficient in 25%, ACTH in 15.6% and gonadotropin in 25% of the patients. There were no cases of diabetes insipidus. Preoperative CT and MR revealed a calcified mass in 12 (37.5%), a partially cystic mass in 20 (62.5%) and a lesion involving or extending into the third ventricle in 7 (21.9%) patients. Twenty seven (84.4%) patients were treated primarily by surgery. In 4 (12.5%) cases the tumour was considered inoperable and 1 (3.1%) patient refused surgery; all were in the LOG. Surgical approach was transsphenoidal in 2/27 (7.4%) (all of them in the LAOG) and by craniotomy in the others. The tumour removable was considered complete in 10 (37%--EOG 2/7, MAOG 6/15, LOG 2/5) and subtotal in 17 (62.9%) patients. Eight (29.6%) patients were reoperated for recurrent tumour. Postoperative radiotherapy was administered in 12 cases with residual tumor, and 3 inoperable tumors were treated primarily by conventional external radiotherapy. Pathological study revealed the adamantinomatous type in 25 (92.6%) and the papillary type in 2 (7.4%--all men in the MAOG) tumors. The average follow-up was longer in the EOG (82.6 +/- 40.7 months) than in MAOG (57.2 +/- 48.5 months) and in LOG (48 +/- 92 months). Four (12.5%) patients died, 1 during the follow-up period due to a radiation-induced astrocytoma and 3 in the postoperative period because of cerebral hemorrhage and hydrocephalus (1 in the EOG and 2 in the LOG). In summary, we found the clinical presentation to be different in the 3 age groups, with a large number of patients in the MAOG. In this group were the only examples of the papillary form. Better prognosis was associated with a total resection at initial surgery.
Adolescent↗
[Evaluation of 2 techniques for ventilation support during single-lung ventilation].
In a group of 22 patients undergoing thoracotomy we compared two techniques of ventilatory assistance to the nondependent lung during single lung ventilation. We simultaneously administered a 0.5% FiO2 to the dependent lung. We used a CPAP system with continuous O2 flow limited by an underwater valve at a pressure of +5 cmH2O. We performed 33 ventilatory assistances: in 15 cases to the nondependent lung (CPAP group) and in 18 patients to the lower lobe of the nondependent lung (lobar CPAP group). Evaluation of both techniques was performed by means of arterial blood gas measurement and the mean values were compared using the student's t test. During single lung ventilation the PaO2 in CPAP group increased from 85.86 +/- 22.28 mmHg to 155.52 +/- 59.54 mmHg (p less than 0.001) and in the lobar CPAP series it increased from 88.75 +/- 24.34 mmHg to 122.36 +/- 43.21 mmHg (p less than 0.01). In 11 out of the 22 patients we firstly applied the lobar CPAP and thereafter the CPAP to the whole lung in order to compare the efficacy of both techniques in the same patient. The PaO2 during single lung ventilation was 86.9 +/- 22.7 mmHg and it increased to 111.1 +/- 37.9 mmHg after lobar CPAP (p less than 0.01) ant to 163.3 +/- 64 mmHg after total lung CPAP ventilation (p less than 0.001). Our results confirm the usefulness of both techniques and they indicate that CPAP to the whole nondependent lung is the most effective.
Adult↗
Characterization of postsynaptic alpha-adrenoceptors in the isolated rat tail artery.
The main purpose was to assess the existence of alpha 2-adrenoceptors in isolated segments of the proximal portion of the rat tail artery. Adrenaline and phenylephrine evoked strong contractile responses, whereas in 22 out of 49 arteries, 10-100 microM clonidine evoked weak contractions. Guanabenz, idazoxan and yohimbine lacked contractile effects. Reserpine pretreatment did not modify the percentage of responsive arteries to clonidine nor the ineffectiveness of guanabenz. Raising the Ca2+ concentration to 2.5 mM did not alter the responsiveness to adrenaline and phenylephrine but enhanced the amplitude of the responses to clonidine. The exposure to 0.1 or 1.0 microM angiotensin did not affect the responsiveness to clonidine. Responses to clonidine were abolished by 10 nM prazosin and not affected by 1 microM idazoxan or yohimbine. Adrenaline and phenylephrine concentration-response curves were shifted rightward by prazosin and phentolamine (pA2 within 7.3-9.0) and by clonidine, guanabenz, idazoxan and yohimbine (pA2 lower than 6.5). These data suggest that the tail artery lacks postsynaptic alpha 2-adrenoceptors, that clonidine exerts partial alpha 1-agonist/antagonist effects and that guanabenz, idazoxan and yohimbine act as partial alpha 1-antagonists.
Adrenergic alpha-Agonists↗
[Functional evaluation of the corneal endothelium using anterior segment fluorophotometry].
The AA have studied the permeability of the corneal endothelium by anterior segment fluorophotometry using instillation of fluorescein. The Fluorotron Master TM has been modified with the introduction of a new slit (58.4 microns) and of the voltage output (6.5 v) has also been increased. The resolution has been improved from 2.39 mm to 0.59 mm. Of this study, we have examined 20 patients submitted to extracapsular cataract extraction with intraocular lens implantation (ECCE + IOL). The patients have been divided in two groups, according to the surgical technic used: "can-open" and intracapsular. Each patient have been submitted before surgery and 1 week after to an ophthalmologic examination, paquimetry and anterior segment fluorophotometry. The permeability coefficient (PAC) increases with the duration of surgery and when using "can-opener" instead of endocapsular.
Aged↗
Rhodococcus equi: first case in a heart transplant recipient.
Rhodococcus equi is a gram-positive diphtheroid that occasionally affects immunocompromised patients, usually causing a chronic respiratory infection with cavitating pulmonary opacities on chest radiograph that resemble mycobacterial or fungal disease. Etiologic diagnosis presents a number of pitfalls, because Rhodococcus equi isolates mimic many of the characteristics of other microorganisms more familiar to the laboratory staff. The treatment of choice for this disease has not yet been established, and its mortality rate is greater than 50% in individuals with human immunodeficiency virus and 20% to 25% among the remaining patients. We describe here the first case of Rhodococcus equi infection in a heart transplant recipient. Clinical presentation was typical, and treatment with a sensitivity-based combination of antibiotics resulted in resolution of both the clinical and radiologic picture.
Adult↗