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Biomedical subjects

C Rodrigo

Publications and source records attributed to C Rodrigo.

At least 73 records · Page 4Linked to original sources
PubMed1995

Prospective study of drug-resistant tuberculosis in a Spanish urban population including patients at risk for HIV infection.

From January 1988 to October 1992, the primary resistance to first-line antituberculous drugs in 501 tuberculous patients was evaluated prospectively. Three-hundred and seventeen patients were HIV-negative and 184 were HIV-positive; these patients had several different clinical forms of tuberculosis. Moreover, the acquired resistance to antituberculous drugs was studied in 295 non-AIDS patients and in 42 AIDS patients with evidence of antecedent tuberculosis treatment. The data indicated that during these five years there was no consistent and clear-cut trend toward greater frequency of primary drug resistance to any of the first-line antituberculous drugs. Primary drug resistance in HIV-positive patients (7.1%) did not differ significantly (p > 0.05) from that found in HIV-negative patients (8.2%). Among HIV-positive patients, the acquired drug resistance pattern was similar to that detected in HIV-negative patients although the frequency of resistance in the former (69%) was significantly higher (p < 0.01). During the study, resistance to isoniazid was almost constant in the acquired-resistance cases and was frequently associated with resistance to other drugs. Furthermore, the acquired resistance to isoniazid was often of a higher level (1 to 10 mg/l) than the primary resistance (0.2 mg/l), and those strains were usually catalase and peroxidase negative.

AIDS-Related Opportunistic Infections↗
PubMed1995

A comparison of 1- and 3-minute lockout periods during patient-controlled sedation with midazolam.

PURPOSE: The maximum effect of midazolam injected intravenously occurs in about 3 minutes. Patient-controlled sedation carried out with 1-mg increments of midazolam at 3-minute intervals provides comparable conditions to that of doctor-controlled sedation carried out with 1-mg increments at 1-minute intervals, except for the longer duration taken for the patients to achieve satisfactory sedation prior to surgery. The purpose of this study was to find out how safe it would be to shorten the interval of increments of midazolam to 1 minute in patient-controlled sedation. PATIENTS AND METHODS: In a randomized crossover study, 26 patients undergoing bilateral lower third molar surgery at two visits had patient-controlled sedation with 1 mg midazolam increments at 1-minute or 3-minute intervals at one visit and the alternative at the other visit. RESULTS: The time taken for patients to achieve a degree of sedation that they thought was sufficient to tolerate the surgery was significantly longer when the increment interval was 3 minutes (t = -4.8; P < .05). Both techniques provided good operating conditions, stable vital signs, mild to moderate sedation, without loss of verbal contact. CONCLUSION: A significant majority preferred the sedation technique with 1-minute increment intervals (chi 2 = 4.6; P < .05).

Adolescent↗
PubMed1995

High-dose MDI salbutamol treatment of asthma in the ED.

Beta-adrenergics have long been under special scrutiny because of their potential for cardiotoxicity. To assess the safety of high doses of salbutamol delivered by metered dose inhaler (MDI) with spacer in the emergency department (ED) setting, 11 patients (mean age 33 +/- 12.2 years) with severe acute asthma were studied. All patients were treated with 400 micrograms of salbutamol at 10-minute intervals for 3 hours (1,200 micrograms each 30 minutes or 7,200 micrograms at 180 minutes. There were dose-related significant increases in forced expiratory volume in the first second (FEV1) and peak expiratory flow (PEF) (P < .01), with a net mean increase of 90.4% and 80.1%, respectively. A significant (P < .01) reduction of heart rate was observed with treatment. At the end of protocol, reductions ranged from 7 beats/min to 35 beats/min (mean decrease 10.6 +/- 10.5 beats/min). There was no prolongation in the QTc interval. Mean baseline serum potassium was 4.23 +/- 0.53 mmol/L and decreased nonsignificantly after treatment to 3.99 +/- 0.62 mmol/L. Only 4 patients showed net decreases. There were no significant changes in oxygen saturation and plasma glucose. The mean end-treatment salbutamol level was 10.0 +/- 1.67 ng/mL. These data support the notion that treatment of acute asthma patients in the ED with 2.4 mg salbutamol per hour delivered by MDI and spacer produce satisfactory bronchodilation, low serum concentration, and minimal extrapulmonary effects.

Acute Disease↗
PubMed1995

Inhibitory effect of sodium dodecyl sulfate in detection of Mycobacterium tuberculosis by amplification of rRNA.

The concentrations of sodium dodecyl (lauryl) sulfate (SDS) found in the sediments of the respiratory samples pretreated with SDS-NaOH varied between 3.36 and 12.42 mg/ml. These concentrations of SDS were higher than the level considered critical (> or = 0.16 mg/ml) to obtain negative results with the Gen-Probe Amplified Mycobacterium Tuberculosis Direct Test. Extensive washing, after neutralization of sediment, is sufficient to remove all traces of detergent which interfere with the enzymes used by the Mycobacterium Tuberculosis Direct Test assay.

Bronchoalveolar Lavage Fluid↗
PubMed1995

Induced hypotension during anesthesia with special reference to orthognathic surgery.

Since Gardner first used arteriotomy during anesthesia to improve visibility in the surgical field, various techniques and pharmacological agents have been tried for the same purpose. With reports documenting the spread of acquired immune deficiency syndrome through blood transfusions, prevention of homologous blood transfusions during surgery has also become a major concern. Induced hypotension has been used to reduce blood loss and thereby address both issues. In orthognathic surgery, induced hypotension during anesthesia has been used for similar reasons. It is recommended that hypotensive anesthesia be adjusted in relation to the patient's preoperative blood pressure rather than to a specific target pressure and be limited to that level necessary to reduce bleeding in the surgical field and in duration to that part of the surgical procedure deemed to benefit by it. A mean arterial blood pressure (MAP) 30% below a patient's usual MAP, with a minimum MAP of 50 mm Hg in ASA Class I patients and a MAP not less than 80 mm Hg in the elderly, is suggested to be clinically acceptable. Various pharmacological agents have been used for induced hypotension during orthognathic surgery. In addition, there are many drugs that have been used in other types of surgery that could be used in orthognathic surgery to induce hypotension. Recent reports using control groups do not show significant differences in morbidity and mortality attributable to induced hypotension during anesthesia. Appropriate patient evaluation and selection, proper positioning and monitoring, and adequate fluid therapy are stressed as important considerations in patients undergoing induced hypotension during orthognathic surgery.

Anesthesia, Dental↗
PubMed1995

Anesthesia for maxillary and mandibular osteotomies in osteogenesis imperfecta.

A 21-yr-old female suffering from osteogenesis imperfecta was anesthetized for correction of maxillary and mandibular deformities that had restricted her chewing. Preoperative assessment revealed a difficult intubation, restrictive lung disease secondary to bony deformities, and multiple repairs of fractures. Management of anesthesia for this operation--which is very rarely carried out in this disorder--is described along with a review of the problems of anesthesia associated with osteogenesis imperfecta.

Adult↗
PubMed1994

Early administration of hydrocortisone in the emergency room treatment of acute asthma: a controlled clinical trial.

STUDY OBJECTIVE: To determine whether early administration of a single dose of intravenous hydrocortisone (500 mg) modified the need for hospitalization and duration of treatment, and improve pulmonary function assessed by subjective and objective criteria of acute asthma patients. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: The emergency room (ER) of a large, urban hospital with primary and referral care responsibilities. PATIENTS: Ninety-eight patients from 18 to 50 years of age with acute bronchial asthma, with a PEFR and FEV1 in the first second below 50% of predicted value (FEV1 mean % of predicted = 27.8 +/- 10.0) and without history of chronic cough or other medical disease. INTERVENTIONS: The corticosteroid group received 500 mg of intravenous hydrocortisone whereas the control group received intravenous normal saline immediately after arrival to the ER. Additional treatment included salbutamol delivered with metered-dose inhaler into a spacer device (Volumatic), in four puffs actuated in rapid succession (100 micrograms per actuation), at 10-min intervals. The final mean dose was 5.7 mg for the steroid group and 5.6 mg for the control one (P = 0.86). Hospitalization was mandatory if total treatment time was greater than 6 h. MEASUREMENTS AND RESULTS: Age, sex, PEFR, FEV1, FVC, symptom index, and corticosteroids use were similar in both groups. FEV1 expressed as mean % of predicted was 54.6 +/- 17.3% in the control group and 54.6 +/- 17.4% in the steroid group (P = 0.75). Duration of ER treatment was 2.22 +/- 1.75 h in the corticosteroid group and 2.24 +/- 1.70 h in the control group (P = 0.81). The hospital admission rate was 10.2% for the corticosteroid group and 8.16% for the control group. There were no differences between the groups when patients admitted or discharged were examined separately. CONCLUSIONS: Early administration of corticosteroids does not modify outcome of ER treatment of asthma, and does not improve pulmonary function in the first 6 h of treatment. In accord with this, administration of corticosteroids to these patients could be delayed by several hours without modifying clinical outcome. When an aggressive beta-agonist bronchodilator regimen is used, it obviates the need for steroids in this early stage of treatment.

Acute Disease↗
PubMed1994

Treatment of acute asthma. Lack of therapeutic benefit and increase of the toxicity from aminophylline given in addition to high doses of salbutamol delivered by metered-dose inhaler with a spacer.

We conducted a randomized, double-blind, placebo-controlled study to determine if intravenous aminophylline adds any benefit to high doses of inhaled salbutamol in patients who presented for treatment of acute asthma. We studied 94 patients (mean age, 35.6 +/- 11.2 years) with moderate to severe acute asthma. All patients received therapy with salbutamol delivered with metered-dose inhaler (MDI) into a spacer device (Volumatic) in four puffs (400 micrograms) at 10-min interval, and intravenous hydrocortisone (500 mg). Patients were randomly assigned to receive either a loading dose of intravenous aminophylline followed by a routine infusion (n = 45) or an equal volume of placebo as a loading dose and infusion (n = 49). The two groups showed no differences in measurements of peak expiratory flow, FEV1, and FVC at baseline and at the end of treatment. However, the patients treated with aminophylline had significantly more adverse effects (p < 0.05). There were no differences in the final mean dose of salbutamol (6.3 +/- 44.5 mg for the placebo group and 5.8 +/- 4.2 mg for the aminophylline group), hospital admission rate (10.2 percent for the placebo group and 9.0 percent for the aminophylline group), and mean duration of Emergency Department treatment (2.5 +/- 1.83 h for the placebo group and 2.37 +/- 1.75 h for the aminophylline group). The results were similar when the patients were divided in accord with the degree of respiratory obstruction (baseline FEV1 < 30 percent of predicted) and theophylline level at 30 min of treatment (placebo group patients with theophylline level < 10 mg/L vs aminophylline group patients with theophylline level > or = 10 mg/L). We conclude that intravenous aminophylline adds to the toxicity but not the efficacy of inhaled salbutamol in the treatment of acute exacerbations of asthma.

Acute Disease↗
PubMed1993

Assessment of the patient with acute asthma in the emergency department. A factor analytic study.

Acute asthma is a very common medical emergency. Thus, a variety of measures are currently used to assess severity; most are logical and seem reasonably effective but have never been scientifically tested in a comprehensive manner. Additionally, simple brief measures are needed for greater specificity in describing variables and in assessing different aspects of asthma. The purpose of this study was to examine the most common clinical and objective measures utilized in the assessment of acute asthma in the emergency department for determining whether these variables comprise separate or distinct dimensions. To carry out the above purpose, we used the multivariate statistical technique of factor analysis. Measures of age, duration of attack, heart rate, respiratory rate, peak expiratory flow (PEF), FVC, FEV1 percent of predicted, accessory-muscle use, dyspnea, wheezing, steroid use, and early response to treatment in 194 patients with acute asthma (mean age = 32.8 +/- 11.9 years) were factor analyzed through the method of principal components. Factors extracted with this method were then rotated orthogonally through the Varimax procedure. The first factor contained the three measures of lung function (PEF, FVC, and FEV1 percent of predicted) and early response of treatment. The second factor extracted contained respiratory rate, accessory-muscle use, and dyspnea. Factor 3 contained heart rate and wheezing, and factor 4 contained age, duration of attack, and steroid use. Exploratory analysis of subgroups (by randomization, by severity of airflow obstruction, and by use of steroids) confirmed the results of the primary analysis. The coefficients of congruence obtained were above 0.90. Early response of treatment measured by the percent variation of FEV1 at 30 min over baseline value significantly correlated with a broad variety of asthma characteristics (PEF, FVC, FEV1 percent of predicted, accessory-muscle use, and duration of attack), resulting in a rather general measure, and suggesting that its measure can be a reliable assessment of acute adult asthma. Finally, early response to treatment was the most important predictor of the patient outcome (r = 0.48, p < 0.00). In summary, the results of this study support the hypothesis that most of the subjective and objective measures utilized in the assessment of patients with acute adult asthma represent separate and nonoverlapping dimensions and provided a useful summary of acute asthma. Early response to treatment in combination with measures of the four identified factors could be included in other acute adult asthma research protocols promoting greater comparable among studies.

Acute Disease↗
PubMed1992

Tenoxicam for pain relief following third molar surgery.

Tenoxicam is a long-acting nonsteroidal anti-inflammatory agent that appears to have the ability to control pain of musculoskeletal origin. A double-blind randomized crossover study was designed to determine the efficacy of tenoxicam for pain relief following third molar surgery by comparing it with paracetamol. Immediately before surgery, 30 Chinese patients with bilateral symmetrically impacted mandibular third molars were given 40 mg of tenoxicam for surgery on one side and 1,000 mg of paracetamol for surgery on the other. Both paracetamol and tenoxicam were efficient as pain relievers after third molar surgery. Tenoxicam had comparable efficacy to paracetamol, but did not provide any advantage in terms of duration of action. The discrepancy between the clinical observation and pharmacokinetic prediction may be related to the strong serum binding property of tenoxicam.

Acetaminophen↗
PubMed1989

A comparison of paracetamol and diflunisal for pain control following 3rd molar surgery.

A double-blind randomised cross-over study to compare 2 regimes of paracetamol and diflunisal for postoperative pain relief following 3rd molar surgery was designed. 35 patients received one of the regimes at one visit and the alternative at the other visit. Both drugs, namely a single dose of 500 mg of diflunisal given preoperatively or 2 doses of 1000 mg of paracetamol, given preoperatively and 4 h postoperatively, produced adequate pain relief, without the need for supplementary analgesics during the 10-h test period. The differences in the mean overall pain scores in the 2 regimes were not statistically significant.

Acetaminophen↗
PubMed1989

[Knowledge and treatment of hypertension in La Plata, Argentina].

Hypertensive subjects, aged 15-75 years, detected by the survey of Prevalence of Hypertension in La Plata, were evaluated to settle the rates of awareness, treatment, control status and the efficacy of pharmacologic therapy (EPT). The survey was composed of 2,090 subjects when the threshold of hypertension was equal to blood pressure (BP) greater than or equal to 140-90 mm Hg and of 1,203 subjects with a BP threshold greater than or equal to 160-95 mm Hg (Table I). The rates of awareness, treatment and control for the 140-90 mm Hg threshold were 43.97%, 33.06%, 4.9%, respectively, and the EPT was 15.03%. For the 160-95 mm Hg threshold the rates were 69.41%, 54.44% and 27.76% and the EPT was 48.32% (Table 2 and Fig. 1). The awareness and treatment rates for women were greater than those for men (p less than 0.0005) (Table 2). The EPT was similar in both sexes when the 140-90 mm Hg threshold was used while it was greater in women than in men with the 160-95 threshold (p less than 0.014) (Table 2). The rates of awareness and treatment increased with age and with the severity of the disease (Table 3-5). The EPT decreased from 85.71% in the 15-24 yr. age group to 10.56% in the 65-75 yr. age group (Table 4). Although the rates of awareness and treatment of hypertension found in La Plata were similar to those found in USA, the control of the disease was lower.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗