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Biomedical subjects

A Vargas

Publications and source records attributed to A Vargas.

At least 73 records · Page 4Linked to original sources
PubMed1981

Childhood thyromegaly: recent developments.

Evaluation of a child with goiter includes historical review, physical examination, and measurement of serum concentrations of PBI, T4 and T3RU, TSH, and titers of antithyroglobulin and antithyroid microsomal antibodies. If there are no indications for more intensive evaluation such as history of cervical irradiation, a palpable abnormality of the thyroid gland or unusual laboratory findings (e.g., a significant PBI-thyroxine iodine discrepancy in the absence of a positive antithyroid antibody titer), a trial of TSH-suppressive therapy with thyroxine is undertake, even if the cause of thyromegaly has not been identified. If thyroid size diminishes in the ensuing six to 12 months, treatment is maintained for approximately two years and then discontinued. If the goiter recurs, or if there is impaired thyroid function, treatment is resumed. Periodically, antithyroid antibody titers and indices of thyroid function are determined. If the goiter does not diminish after a reasonable trial of suppressive therapy with adequate amounts of thyroxine (i.e., those quantities which will inhibit TRH-induced secretion of TSH), subtotal thyroidectomy is recommended to be certain that an underlying neoplasm has not been overlooked. A biopsy of the thyroid is not performed routinely in such children prior to operative therapy. Almost invariably, examination of the surgical specimen reveals CLT. Postoperatively, suppressive doses of thyroxine are maintained indefinitely. Inasmuch as thyroxine suppression of TSH secretion is essential in the management of patients with thyroid neoplasms, a limited medical trial, as described, does not place the patient at undue risk.

Adolescent↗
PubMed1981

[Evolution of the content of gluconeogenic metabolites in rat liver and kidney during exercise (author's transl)].

The evolving concentration of metabolite intermediates for gluconeogenesis in liver and kidney has been studied in rats after varying periods of exercise (swimming in water at 22 degrees C). Lactate consumption by liver, according to the results, does not take place by gluconeogenesis primarily, since the values for malate, aspartate and PEP show a low in vivo activity for phosphoenolpyruvate carboxykinase. The PEP/aspartate ratio, on the contrary, gradually rises in kidney, suggesting a gradual increase in the in vivo activity of phosphoenolpyruvate carboxykinase, which agree quite well with the results of previously obtained in vitro. The prevention of metabolic acidosis by bicarbonate administration affects the metabolite profile in liver during exercise only very slightly. Renal phosphoenol-pyruvate carboxykinase activity in vivo decreases in relation to previously untreated rats, as well as gluconeogenesis, although to a lesser extent.

Animals↗
PubMed1980

Epidermoid cysts of testis.

Six cases of epidermoid cyst of the testis are presented. Conservative surgical treatment of this condition is discussed.

Adolescent↗
PubMed1980

Peripheral temperature monitoring during cardiopulmonary bypass operation.

Almost one-third of 24 adult patients undergoing hypothermic cardiopulmonary bypass (CPB) for elective cardiac operation were found to have upper extremity skin and muscle temperatures of 30.0 degrees C or less at termination of CPB despite the return of nasopharyngeal temperature to normal values. Within 45 minutes, the mean nasopharyngeal temperature of these patients fell spontaneously from 37.1 degrees +/- 0.3 degrees C (+/- standard deviation) to 35.1 degrees +/- 0.4 degrees C, a significantly greater fall (p less than 0.005) than was observed for patients with extremity temperatures greater than 30.0 degrees C. Persistent hypothermia of the upper extremities correlated statistically with large body mass; it appears that these patients incur disproportionately large caloric debts during hypothermic CPB. Inadvertent hypothermia after CPB can be minimized if both core and extremity temperatures are utilized to provide an assessment of the adequacy of warming prior to return to spontaneous circulation.

Adult↗
PubMed1980

Pathologic fracture of the clavicle caused by arteriovenous malformation.

An anusual pathologic fracture of clavicle was caused in a 48-year-old woman by an arteriovenous malformation. The lesion radiologically mimicked a neoplastic process. Arteriography disclosed the vascular cause. Treatment was achieved by interrupting the feeding vessels and resecting the involved bony segment.

Arteriovenous Malformations↗
PubMed1979

Changes in 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D during pregnancy.

Serum concentrations of 25-hydroxyvitamin D (25OHD) and 24,25-dihydroxyvitamin D (24,25(OH)2D) were measured in a cross-sectional study of 94 normal pregnant women at various stages of gestation in order to assess the hormonal regulation of calcium homeostasis during gestation. The 40 week gestational period was divided into four 10 weeks quarters. 25OHD concentration were significantly below control levels (32.2 +/- 3.1 (S.E.) ng/ml) by the second quarter of pregnancy and were even lower at term. Serum levels of 24,25(OH)2D did not decrease until the fourth quarter, when the mean concentration (0.8 +/- 0.1 ng/ml) was approximately one half the control values (1.5 +/- 0.3, p less than 0.025). These data suggest that the metabolic pathways of vitamin D are altered during gestation, perhaps in response to increasing mother-to-fetus transport of calcium. There is decreased 24-hydroxylation and, in view of the lowered 25OHD levels, possibly increased production of 1,25-hydroxyvitamin D (1,25(OH)2D).

Chorionic Gonadotropin↗
PubMed1978

Induction of rat kidney gluconeogenesis during acute liver intoxication by carbon tetrachloride.

1. Glucose production from L-lactate was completely inhibited 24h after carbon tetrachloride treatment in liver from 48h-starved rats. The activities of phosphoenolpyruvate carboxykinase, fructose diphosphatase and glucose 6-phosphatase were decreased by this treatment in fed and starved rats, whereas lactate dehydrogenase activity was only decreased in fed animals. 2. The production of glucose by renal cortical slices from fed rats previously treated with carbon tetrachloride was enhanced when L-lactate, pyruvate and glutamine but not fructose were used as glucose precursors. Renal phosphoenolpyruvate carboxykinase activity was increased in this condition. 3. This increase was counteracted by cycloheximide or actinomycin D, suggesting that the effect was due to the synthesis de novo of the enzyme. 4. The pattern of hepatic gluconeogenic metabolites in treated animals was characterized by an increase in lactate, pyruvate, malate and citrate as well as a decrease in glucose 6-phosphate, suggesting an impairment of liver gluconeogenesis in vivo. 5. In contrast, the profile of renal metabolites suggested that gluconeogenesis was operative in the treated rats, as indicated by the marked increase in the content of phosphoenolpyruvate, 2-phosphoglycerate, 3-phosphoglycerate and glucose 6-phosphate. 6. It is postulated that renal gluconeogenesis could contribute to the maintenance of glycaemia in carbon tetrachloride-treated rats.

Acute Disease↗
PubMed1978

Synthesis of 1,25-dihydroxyvitamin D in the nephrectomized pregnant rat.

Pregnant rats were maintained on diets either adequate or deficient in vitamin D. On the 20th day of gestation, animals were either nephrectomized bilaterally or sham operated. Immediately therafter, four groups of nephrectomized or sham-operated pregnant rats received iv [26,27-3H]25-hydroxyvitamin D3 ([26,27-3H]25OHD3), while two groups received [1,2-3H,4-14C]D3. The animals were sacrificed 10-24 h later. The distribution of the radiolabeled metabolites of vitamin D3 was determined in extracts of maternal plasma, maternal intestinal tract, placentae, and fetuses after Sephadex LH-20 column chromatography. Both vitamin D3 and 25OHD3 crossed the placenta and entered the fetus. In anephric animals receiving [26,27-3H]-25OHD3, 24,25-dihydroxyvitamin D and a polar peak eluting in the position of 1,25-dihydroxyvitamin D [1,25(OH)2D] and 25,26-dihydroxyvitamin D were identified in extracts of maternal plasma and intestinal tracts and of placentae and fetuses. The identities of 24,25-dihydroxyvitamin D and 1,25 (OH)2D were confirmed by high pressure liquid chromatography. In rats receiving [1,2-3H,4-14C]D3, approximately 50% of the polar metabolite consisted of 1,25(OH)2D. We conclude that the anephric pregnant rat is able to synthesize 1,25(OH)2D, that the fetal portion of the feto-placental unit is the most likely site of production of this hormone, and that this metabolite of vitamin D is able to cross the placenta from the fetus to the mother.

Animals↗
PubMed1977

Effects of coronary bypass surgery on the electrical activity of revascularized myocardium. Immediate and early postoperativeobservations.

The effect of myocardial revascularization on bipolar epicardial electrograms was recorded with fixed wire electrodes from revascularized left ventricular sites and from control sites on the right ventricle. Studies were performed during and after surgery in 19 patients undergoing aorta-coronary bypass grafting for occlusive coronary artery disease and in 6 additional patients having aortic valve replacement for isolated aortic valve disease. In the latter 6 patients, neither left nor right ventricular electrogram voltage changed immediately following aortic valve replacement; however, left ventricular electrogram voltage gradually decreased for 5 days postoperatively. In the 19 patients with coronary artery disease, electrogram voltage in the revascularized area increased immediately following coronary bypass grafting (+40 to +300 per cent) in 13 patients (68 per cent) and immediately decreased (-20 to -70 per cent) in 6 patients (32 per cent). In 5 of the patients showing immediate increases, temporary occlusion of the bypass grafts for 3 minutes during surgery resulted in a decrease of electrogram voltage in the distribution of the occluded bypass, followed by return to preocclusion levels after release. Postoperative monitoring of electrogram voltage for 5 days in all patients with coronary artery disease revealed that the electrogram voltage in the revascularized area decreased to or below control levels in 16 patients (84 per cent) and remained increased in 3 patients (16 per cent). These observed changes did not correlate with preoperative hemodynamics, number of grafts, graft flow rate, aortic cross-clamp time, cardiopulmonary bypass time, and the early postoperative course. These preliminary observations suggest that coronary bypass grafting does affect the electrophysiological state of the revascularized myocardium. However, the mechanism by which it occurs and its clinical implications remain to be determined.

Adult↗
PubMed1977

Long-term clinical and hemodynamic studies after ventricular aneurysmectomy and aorta-coronary bypass.

Late clinical and hemodynamic evaluations in 18 patients with ventricular aneurysmectomy and aorta-coronary bypass are presented. Tne patients had significant obstructive lesions in two major vessels (55 per cent), and 6 had extensive three vessel disease (33 per cent). In 13 patients, 21 aorta-coronary saphenous bypass grafts were performed in addition to aneurysmectomy. The operative mortality rate was 11 per cent. One patient died suddenly 5 months after the operation (one year mortality rate 17 per cent). The 15 surviving patients have been followed up for 12 to 41 months (average 24 months). Clinical results were considered excellent in 2 patients who have been asymptomatic (Class I, N.Y.H.A.). Nine others were considered to have good clinical results (Class II). Five patients have continued to have congestive heart failure and angina on minimal effort (Class III or IV). Six of the 11 patients considered to have excellent or good results underwent postoperative hemodynamic studies 6 to 34 months after the operation. A significant increase in cardiac index was documented in all 6 patients. Paradoxic movement was not detected in any of the postoperative ventriculograms. Five of the seven venous grafts inserted were patent. Elevated left ventricular end-diastolic pressure (LVEDP), low cardiac index, and a persistent dyskinetic area in the left ventricle were found in 2 patients considered to have poor clinical results. Clinical and hemodynamic evaluations have shown a significant improvement in most patients surviving ventricular aneurysmectomy. However, postoperative systemic embolism, myocardial infarction, progression of coronary artery disease, transient cerebral ischemic attacks, graft occlusion, arrhythmias, and mitral regurgitation in previously prolapsed mitral valve leaflets account for progressive disability and limited activity after a successful operation.

Adult↗