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Biomedical subjects

C Gomez

Publications and source records attributed to C Gomez.

107 records · Page 6Linked to original sources
PubMedDate not supplied

Large fetal pulmonary arteriovenous fistula: impact on pulmonary development.

A case report of a patient with a large pulmonary arteriovenous fistula and valvar pulmonary stenosis is presented. The fistula was diagnosed prenatally and its effect on in utero cardiovascular growth and development documented. Due to concerns about massive intrapulmonary shunting potentially causing profound cyanosis after delivery, an EXIT (EX-utero Intrapartum Treatment) procedure was used to transfer the infant from placental to extracorporeal membrane oxygenation (ECMO) support. Severe pulmonary microvascular disease resulted in prohibitive pulmonary hypertension despite surgical ligation of the fistula. Prenatal and postnatal hemodynamic assessments of the fistula are presented and are compared to the pathologic findings.

Arteriovenous Fistula↗
PubMedDate not supplied

In vitro evaluation of lomefloxacin activity in Colombia.

As part of the worldwide in vitro program to determine the antimicrobial activity of lomefloxacin, our study tested susceptibility of bacterial isolates from hospitals in Medellin, Colombia. A total of 504 bacterial isolates were obtained from patients at three different centers. For Enterobacteriaceae, 0.5 micrograms/ml inhibited 100% of the indole-positive Proteus and Salmonella spp.; 1 microgram/ml inhibited 100% of Shigella and Citrobacter, 2 microgram/ml inhibited 100% of Enterobacter spp., E. coli, Proteus mirabilis, and Serratia marcescens isolates tested. The MIC90 for Klebsiella spp. and Pseudomonas spp. was 4 micrograms/ml. The MIC90 was 4 micrograms/ml for S. aureus and 2 micrograms/ml for S. epidermidis and S. saprophyticus. The MIC90 of Streptococcus spp. were less than or equal to 4 micrograms/ml for all isolates tested. Considering that 97.8% were susceptible to concentrations of less than or equal to 4 micrograms/ml of lomefloxacin, this new quinolone offers potential in the therapy of a variety of systemic infections, especially in patients with multiply resistant pathogens.

4-Quinolones↗
PubMedDate not supplied

Lung transplant at the Favaloro Foundation: a 13-year experience.

BACKGROUND: The outcomes of lung transplantation (LT) are well known in developed countries, but not in Latin America. Our objective was to report the LT experience at a single center in Argentina. METHODS: From June 1994 to February 2003, the 54 LT that were performed included 36 single-lung transplants SLT (45.5%) and 18 double-lung transplants (DSLT) (22.7%). Indications for SLT (n = 36) were emphysema (n = 23) and pulmonary fibrosis (n = 13); for DSLT (n = 18), bronchiectasis (n = 8), cystic fibrosis (n = 8), pulmonary emphysema (n = 1), and bronchiolitis obliterans syndrome caused by graft-versus-host disease after bone-marrow transplantation (n = 1). A univariate analysis, chi-square test with Yates' correction was used for qualitative variables; Wilcoxon-Mann-Whitney test, for quantitative and ordinal variables. Survivals were estimated by the Kaplan-Meier method. RESULTS: In-hospital mortality (HM) was 21.1%. Among SLT, early death was due to sepsis in six patients and by ischemia-reperfusion injury (IRI) and acute rejection in other two. In DSLT, two patients died due to IRI and one, sepsis. The overall estimated survival rates at 1, 2, and 4 years were 70.1% +/- 6.5%, 54.3% +/- 7.2%, and 44.3% +/- 7.9%, respectively. The median overall survival was 26.5 (10 to 34) months. When HM was excluded, survival at 4 years was 51.3% +/- 8.7%. The estimated survival at 3 years was 43.3% +/- 9.3% for SLT and 58.7% +/- 13% for DSLT (P = 6). Survival differences according to the baseline diagnosis were not significant (P =.6). Median follow-up time (percentiles 25 to 75) was 16 (2 to 27) months. CONCLUSIONS: Our LT program shows similar results to those reported by the International Society for Heart and Lung Transplantation for developed countries.

Argentina↗
PubMedDate not supplied

Orthotopic heart transplantation in elderly patients: a 10-year experience at a single center.

INTRODUCTION: A consensus has not yet been reached regarding the indications for orthotopic heart transplantation (OHT) in elderly patients or the age limit contraindicating the procedure. The objective of this study was to assess OHT outcomes to determine whether elderly patients benefit from the procedure. METHODS: From February 1993 to February 2003, 178 OHTs were performed on recipients of mean age 47.4 +/- 15 years (range, 4 to 74) including 80.3% men. The population was divided into two groups: group A included patients >/= 60 years, and group B those younger than that age. Survival was analyzed for the overall population and for both age groups during a 10-year follow-up period. RESULTS: Group A included 36 patients (20.8%) and group B 142 patients (79.2%). Mean age was 63.7 +/- 2.9 years (60 to 74) in A, and 43 +/- 13.9 years (4 to 59) in B. In-hospital mortality was significantly higher among group A (n = 11, 31.4%) compared to B (n = 17, 12.1%, P =.008). Survival at 1, 5, and 10 years was 61.5% +/- 8%, 58.1% +/- 8.3%, and 49.8% +/- 10.5% group A; and 84.2% +/- 3%, 73.7% +/- 4.1%, and 69.9% +/- 4.7 for group B. Elderly patients showed a lower survival rate (49.8%) compared with the younger group (69.9%) at 10-year follow-up (P =.007). Conditional survival at 9 years failed to show significant differences (A 72.2% vs B 79.6%, P =.4). CONCLUSION: In our population, elderly recipients showed a higher in-hospital mortality. However, when the first post-OHT year was excluded, we found similar survival rates for both age groups.

Adult↗
PubMedDate not supplied

Significance of microvascular density (MVD) in cervical cancer recurrence.

The purpose of this retrospective study of 118 patients with squamous cell cervical cancer from January 1990 to December 1993 was to evaluate angiogenesis as predictive factor of recurrence in cervical cancer stages II-III treated with standard radiotherapy. Microvessel density (MVD) was evaluated and correlated with other prognostic factors. MVD was greater than 20 in 67.8% of patients with recurrence (P = 0.002) in comparison to 39% of patients without. Disease-free survival was shorter in stage IIA and MVD >20 (P = 0.0193) as well as for stage IIB (P < 0.05 ), but not for IIIB (P = 0.1613 ). Global survival was significantly shorter when MVD was >20 (P = 0.0316). For stage IIA and MVD >20 survival was shorter (P = 0.0008) for stage IIB (P < 0.05) but not for IIIB (P = 0.14). Patients younger than 40 years and MVD >20 had poorer disease-free interval and survival (P = 0.0029). MVD in patients with squamous cell cervical cancer stage II and age younger than 40 may play a role in predicting recurrence and survival.

Adult↗
PubMedDate not supplied

Characterization of extracellular pH drop due to the activation of the secretory process by acetylcholine in the bovine adrenal medulla.

A progressive and reversible decrease of external pH accompanied the catecholamine release elicited by acetylcholine in decorticated bovine adrenal glands perfused with buffer-free Locke solution adjusted to an initial pH of 7.4. Both the secretory response as well as the extracellular acid shift promoted by the cholinergic agonist were antagonized by hexamethonium plus atropine, Mg2+ and verapamil. Experiments performed to assess the effects of the reduction of external pH on acetylcholine-induced release of catecholamines revealed that increasing the extracellular concentration of H+ significantly and reversibly reduced this secretory response. These findings are consistent with the idea that adrenomedullary activation of secretion by acetylcholine could be associated with a transient acidification of the extracellular fluid. This release of protons, arising mainly from the chromaffin granules, may be involved in a local automodulatory mechanism of the regulated secretory process.

Acetylcholine↗