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Biomedical subjects

C Gomez

Publications and source records attributed to C Gomez.

At least 55 records · Page 3Linked to original sources
PubMed1996

Assessing health status in the elderly: the nutrition screening initiative.

The recent dramatic growth in the population aged 65 and over is projected to continue well into the 21st century. While improved health status of most aging Americans is also expected, such is not the case in certain vulnerable subgroups at risk for poor health. This includes older women; minority groups; those aged 85 and above; older persons with limited economic resources, those isolated from family and friends; and older persons with impaired physical, cognitive, or emotional status. These factors, plus the cost implications of caring for a rapidly aging population, provided the impetus for the development of the Nutrition Screening Initiative (NSI). Established in 1990, the goal of the NSI is to promote the incorporation of routine nutrition screening and nutritional care into America's health services delivery system. The NSI has devoted its activities toward increasing the awareness of nutritional factors as they relate to the older population.

Aged↗
PubMed1996

[Imaging of Erdheim-Chester disease].

Erdheim-Chester disease is a form of Histiocytosis which involves the adults and is distinct from Histiocytosis X. It is characterized by a constant diaphyseal and metaphyseal bone involvement predominating in the lower links. The diagnosis can readily be envisaged when the typical radiological findings are present. Bone involvement may be isolated and well tolerated, or can be associated with systemic involvement and a severe prognosis. We describe three cases of women aged 46, 50 and 73 years. One patient presented with isolated bone lesions, while the two others had a multiorgan localization. From the three cases and from an extensive review of the literature, we describe the spectrum of bone and visceral lesions that can be seen by imaging. The emphasis is put on lesions of the skeletal system, the retroperitoneum, the nervous system, and the pericardium. Furthermore, the relationships between Erdheim-Chester disease and Histiocytosis X are discussed.

Aged↗
PubMed1995

Peritoneal migration of an abdominally implanted epicardial pacemaker: a cause of intestinal obstruction.

We report the case of a 10-year-old child with an abdominally implanted epicardial pacemaker that eroded through the peritoneum and migrated to an intraperitoneal location, resulting in partial and then complete intestinal obstruction. This potentially life-threatening complication should be considered when a patient with an abdominally implanted pacemaker presents with abdominal pain.

Child↗
PubMed1995

Spinocerebellar ataxia type 1 and Machado-Joseph disease: incidence of CAG expansions among adult-onset ataxia patients from 311 families with dominant, recessive, or sporadic ataxia.

The ataxias are a complex group of diseases with both environmental and genetic causes. Among the autosomal dominant forms of ataxia the genes for two, spinocerebellar ataxia type 1 (SCA1) and Machado-Joseph disease (MJD), have been isolated. In both of these disorders the molecular basis of disease is the expansion of an unstable CAG trinucleotide repeat. To assess the frequency of the SCA1 and MJD trinucleotide repeat expansions among individuals diagnosed with ataxia we have collected DNA from individuals representing 311 families with adult-onset ataxia of unknown etiology and screened these samples for trinucleotide repeat expansions within the SCA1 and MJD genes. Within this group there are 149 families with dominantly inherited ataxia. Of these, 3% had SCA1 trinucleotide repeat expansions, whereas 21% were positive for the MJD trinucleotide expansion. Thus, together SCA1 and MJD represent 24% of the autosomal dominant ataxias in our group, and the frequency of MJD is substantially greater than that of SCA1. For the 57 patients with MJD trinucleotide repeat expansions, a strong inverse correlation between CAG repeat size and age at onset was observed (r = -.838). Among the MJD patients, the normal and affected ranges of CAG repeat size are 14-40 and 68-82 repeats, respectively. For SCA1 the normal and affected ranges are much closer, containing 19-38 and 40-81 CAG repeats, respectively.

Adult↗
PubMed1994

Effect of hyperosmolarity on extracellular acidification associated with catecholamine secretion evoked by barium in perfused bovine adrenal medulla.

1. The effects of the increase of osmotic strength on extracellular pH modifications produced during buffer-free, 5 mM Ba2+ stimulation was studied in decorticated perfused bovine adrenal glands. 2. A pronounced and reversible attenuation of the extracellular pH drop as well as of the release of catecholamines induced by Ba2+ was detected in glands exposed to a hyperosmotic (750 mOsm) perfusion fluid made up by the addition of NaCl. 3. Similar results were observed using sucrose as osmoticant instead of NaCl. 4. A progressive decline in both external acidification and secretory response to Ba2+ was found on gradually increasing the osmotic strength of the perfusion fluid. 5. These results provide additional evidence in favour of the existence of a close association between extracellular acidification and adrenomedullary secretion induced by buffer-free Ba2+.

Adrenal Medulla↗
PubMed1994

Influence of chronic angiotensin-converting enzyme inhibition on anesthetic induction.

BACKGROUND: Several cases of hypotension have been reported in patients who received angiotensin-converting enzyme inhibitors (ACEIs) before a surgical procedure, suggesting that interactions between ACEIs and anesthesia may be neither beneficial nor predictable. To determine if continuation of ACEI therapy until the morning of surgery leads to an unacceptable decrease in blood pressure on induction, we investigated 51 vascular surgical patients that were chronically treated for hypertension with either captopril or enalapril. METHODS: After randomization, ACEI therapy was either continued until the morning of surgery or stopped at the time of the preanesthetic visit, at least 12 h (captopril) or 24 h (enalapril) before surgery. Each patient received a standardized anesthetic induction. If systolic blood pressure (monitored using a radial artery cannula) decreased to less than 90 mmHg in response to induction, ephedrine was administered. RESULTS: A marked decrease in plasma converting-enzyme activity was found in patients who received enalapril until the morning of the surgical procedure, and 100% of them required ephedrine after induction. In patients who received their usual dose of captopril on the morning of surgery, plasma converting-enzyme activity was reduced to a lesser extent (when compared with patients who received enalapril). Finally, in the patients in whom ACEI therapy, either enalapril or captopril, was stopped of the evening before surgery, the incidence of induction-induced hypotension was significantly less when enalapril or captopril therapy has been discontinued. CONCLUSIONS: These data indicate that in hypertensive patients chronically treated with ACEIs, maintenance of therapy until the day of surgery may increase the probability of hypotension at induction.

Anesthesia↗
PubMed1994

Hepatitis C in liver transplantation: preliminary study of prognostic factors.

At the University of Miami liver transplantation for chronic liver disease in HCV-positive patients has shown good results, with a 92% patients survival rate (follow up 8 to 57 months, median 21). None the less, we found that a large number of patients are expected to develop serious histological graft damage and may need retransplantation, which may place a further strain on the already scarce donor resources. We have conducted a preliminary investigation on the importance of parameters which may correlate with the prognosis of HCV grafts. We found no impact of HLA match or typing. An interesting hypothesis, which deserves further investigation, is that some HCV strains could be more virulent than others and play a role as an independent risk factor. We have identified six strains among our patients and the BK serotype shows a trend to be associated with a worse outcome. We have found that patients developing and maintaining higher liver enzyme levels (ALT and GGT) after transplant and those with higher levels of viremia may be at risk to develop serious damage to their grafts.

Adolescent↗
PubMed1994

In vitro demineralization-remineralization of enamel caries at restoration margins utilizing fluoride-releasing composite resin.

The release of fluoride from a composite resin has been shown to inhibit enamel demineralization. The purpose of this study was to examine the remineralization effects of a fluoride-releasing resin. Twenty extracted molars were painted with an acid-protective varnish, excluding a 2 x 6-mm window. Artificial carieslike lesions were created in the exposed enamel with an acidified gel. A Class II preparation was restored with a fluoride-releasing or a non-fluoride-releasing composite resin. The teeth were sectioned longitudinally and photographed with polarized light microscopy in water and Thoulet's imbibition media. The sections were then painted with an acid-protective varnish, so that only the natural external surface of the lesion was exposed, and placed in separate closed environments of a nonfluoridated artificial saliva. Sections were removed after 2 weeks and 3 months and photographed under polarized light as before. A sonic digitizer was used to measure the area of the body of the lesion. Results demonstrated a statistically significant area reduction in the body of the lesions exposed to the fluoridated composite resin at 2-week and 3-month intervals.

Acrylic Resins↗
PubMed1993

Decrease of extracellular pH associated with the secretion of catecholamines induced by barium in perfused bovine adrenal medulla.

1. The possible modifications of extracellular pH produced during buffer-free 5 mM Ba2+ stimulation was studied in decorticated perfused bovine adrenal glands. 2. A significant and reversible drop of pH accompanied the release of catecholamines each time the tissue was exposed to a buffer-free 5 mM Ba2+ solution. 3. A progressive declination of the magnitude of this acidification associated with a gradual attenuation of the secretory response was observed consecutive to successive periods of Ba(2+)-stimulation. 4. D-600 (methoxyverapamil), in a concentration of 3 x 10(-4) M, markedly antagonized both Ba(2+)-induced secretory response and extracellular pH drop. 5. Perfusion of adrenal medulla for 4 min period with Locke solution buffered at pH 6.9, significantly and reversibly reduced the secretory response to 5 mM Ba2+ (pH 6.9) compared to a first control response obtained 35 min before at pH 7.4. 6. These results are compatible with the view that Ba(2+)-induced secretory activity is accompanied by the release of protons which could be involved in a local negative automodulatory mechanism of adrenomedullary secretion.

Adrenal Medulla↗