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Biomedical subjects

C Ruiz

Publications and source records attributed to C Ruiz.

At least 163 records · Page 9Linked to original sources
PubMed1980

[Short-term therapy of atrial fibrillation with an association of digitalis and amiodarone (author's transl)].

Forty patients with organic cardiopathies and permanent atrial fibrillation were divided at random into two similar groups in relation to their diagnoses and ages. Twenty patients were treated with digoxine alone, and the other 20 with digoxine plus amiodarone hydrochloride. Comparison of results from each group showed statistical significant differences (p less than 0.0005) regarding total digoxine dosage and length of treatment. Mechanism of action of this synergia is discussed, and the association of digitalis and amiodarone is recommended to reduce digitalization time in patients with paroxysmal auricular tachycardia.

Adult↗
PubMed1974

Biliary tract excretion of cefazolin, cephalothin, and cephaloridine in the presence of biliary tract disease.

The biliary tract excretion of three cephalosporins, cefazolin, cephaloridine, and cephalothin, was compared in patients with biliary tract disease. In the absence of obstruction, mean antibiotic levels in bile from gall bladder and common duct in patients undergoing cholecystectomy were highest for cefazolin (17 and 31 mug/ml, respectively) than either cephaloridine (7 and 9 mug/ml) or cephalothin (1 and 4 mug/ml). Biliary tract levels generally paralleled serum levels. In no patient with cystic duct obstruction were any of the cephalosporins detectable in appreciable amounts in gall bladder bile. In patients with T-tube drainage given each of the three different cephalosporins on separate days, concentrations of cefazolin in bile were many-fold higher than either cephaloridine or cephalothin. Peak levels of cefazolin in T-tube bile averaged 51 mug/ml after intravenous and 26 mug/ml after intramuscular administration, whereas mean peak levels of cephalothin and cephaloridine were only 6 and 16 mug/ml, respectively. Here, too, T-tube levels reflected serum concentrations and obstruction to biliary flow impaired excretion of each of the drugs.

Biliary Tract↗
PubMedDate not supplied

Transcatheter intracavitary fibrinolysis of loculated pleural effusions: experience in 102 patients.

PURPOSE: To assess the efficacy of intrapleural urokinase instillation through small-caliber catheters for the treatment of loculate and/or septate effusions. METHODS: We inserted small-caliber catheters (8.2 Fr) in 102 patients with septate and/or loculate pleural effusions using ultrasonographic guidance. Urokinase (100,000 IU/2 hr, 3 times a day) was instilled through the catheter until the effusion resolved and D-dimer levels were <500 ng/ml. Patients were enrolled regardless of the etiology of the pleural effusion provided there were no contraindications for the use of urokinase. D-dimer levels were determined before and after treatment. Follow-up was performed by chest radiograph and sonography at 1 day, 7 days, and every 30 days thereafter for 6 months. RESULTS: Successful catheter placement was achieved in all cases. The mean time catheters stayed in place was 5.7 days and the mean dose of drug instilled was 690,000 IU. Pleural effusion drainage was complete at the first assessment in all patients. Failure of the treatment, with recurrent effusion at 30 days, occurred in six patients (5.8%). Complete resolution without sequelae was observed in 19 patients (19.6%). In 75 cases (73.5%) resolution was partial, with pleural thickening (>2 mm). Two patients died from unrelated causes within 30 days after catheter placement. Complications were seen in 13 patients (12.74%): hydropneumothorax, nine cases (8.82%); infection of the puncture point, three cases (2.94%); and adverse reaction, one case (0.98%). No further treatment was required. CONCLUSION: The use of intrapleural fibrinolytic agents delivered through small-caliber catheters for the treatment of loculate and/or septate pleural effusion is a simple, effective, minimally invasive and inexpensive procedure that can prevent sequelae and shorten drainage time.

Adolescent↗
PubMedDate not supplied

[Coronary angioplasty with a rotary atherotome].

Several new coronary dilatation systems, including those using laser energy, atherectomy devices and stent implantation, are being developed as alternative or complementary procedures to coronary artery balloon angioplasty. We report our initial experience performing coronary angioplasty with a new rotational atherectomy device, the transluminal extraction catheter, which simultaneously cut and aspirate fragments from the atherosclerotic plaque. The components of the whole system are a special guidewire to cross the stenosis, the atherectomy catheter and the conduction-control unit. This unit, connected when the atherectomy catheter is positioned across the lesion, produces rotation of the conical bladder located in the catheter distal tip and simultaneous aspiration of residual particles. The procedure was performed in 11 patients in whom 13 lesions were dilated. All patients were male (mean age 55 +/- 23 years, range 45-77). The reason for the angioplasty was stable angina in 2 patients and unstable angina in the remaining seven. Initial success (residual stenosis less than 50% of vessel diameter) was obtained in 10 of 13 lesions. In two, conventional balloon angioplasty was required to improve atherectomy result. The only unsuccessful procedure was in a proximal right coronary artery venous graft, in which a large dissection occurred. Patient had angina but no myocardial infarction. Pathologic examination of aspirated material revealed fibrous tissue in 12 cases and cholesterol crystals in four. We conclude, with the limitation of a preliminary study, that rotational atherectomy with the transluminal extraction catheter is a useful procedure to relief coronary stenosis of the coronary arteries.

Aged↗
PubMedDate not supplied

[Infiltrating transitional cancer of the bladder (2). Prognostic value of the stage. Its influence on the therapeutic decision)].

The only reliable sign to give a prognosis is the anatomopathological stage (P or pT) obtained from the study of the cystectomy surgical piece: partial or total. Tumourless (P0) bladders conceal the inability to reach any certainty over the tumour's inexistance. Removal should not be considered as a success but an error. The fact that no tumour is found in the removed bladder does not guarantee that the patient will not eventually die of metastasis. A pT2 stage has a better prognosis than pT3a and both evolve better that either pT3b or pT4a and, therefore, their treatment and management may be different. Clinical stage (T) is not a reliable sign: the possibilities of over and undervaluation are very high. Subtraction of P from T cannot be maintained as an adequate sign to assess the action of the adjuvant therapy to surgery and should be excluded in order to delimit the action of the neo-adjuvant chemotherapy. Also, patients with pT2 and pT3a tumours should be excluded from these protocols since the possibilities that they may be removed during the evaluation R.T.U. are high.

Carcinoma, Transitional Cell↗
PubMedDate not supplied

[Urologic symptoms as first clinical manifestation of tumors of the nervous system. Apropos of 2 cases].

Neurological tumor processes when involving urinary bladder organs or innervation, may give rise to urological symptoms. Depending on the organ or nerve tract affected, and whether such involvement leads to disturbances in the storing or emptying capacity of the bladder, the clinical signs manifested may be extremely varied, simulating different pathological entities that may lead to unnecessary treatment. Two such cases are presented. The symptoms produced and the difficulty in pinning down their origin are discussed. The relevance of urodynamic tests and a permanent attitude of suspicion are highlighted as a key approach to correct diagnosis.

Adult↗
PubMedDate not supplied

Orthotopic transplantation for total anomalous pulmonary venous connection associated with complex congenital heart disease.

BACKGROUND: When total anomalous pulmonary venous connection is associated with other complex cardiac malformations, early and late postsurgical morbidity and mortality are excessive. METHODS: In an attempt to modify this outcome, twelve children (4 days to 6.8 years of age) with total anomalous pulmonary venous connection and various congenital cardiac defects were treated with orthotopic heart transplantation. Associated cardiac diagnoses included the following: hypoplastic left heart syndrome (n = 2), unbalanced atrioventricular canal with pulmonary atresia (n = 2), and single ventricle with severe pulmonary stenosis (n = 3) or atresia (n = 5). Two patients had situs inversus, and two had dextrocardia with situs ambiguous. Eight patients had asplenia and one had polysplenia. Palliative pretransplantation procedures in five patients included the following: systemic to pulmonary artery shunt (n = 5), atrioventricular valve annuloplasty (n = 1) and classical Glenn shunt (n = 1). The donor left atrium was anastomosed directly to a common pulmonary venous pool in nine patients; whereas three children required complex reconstruction to baffle the pulmonary venous flow to the donor left atrium. RESULTS: There was one operative death related to an oversized heart and vena caval thrombosis. Follow-up ranged from 16 months to 4.5 years (average 3 years). In two patients (18%) pulmonary venous obstruction developed 3 and 4 months after transplantation. Reoperation to relieve the obstruction was successful in one patient. The second patient underwent three such reoperations and died of sepsis 10 months after orthotopic heart transplantation. CONCLUSION: Orthotopic transplantation is a viable option for children with complex total anomalous pulmonary venous connection that precludes a biventricular repair. Transplantation may improve the dismal prognosis of those children, but it does not eliminate the potential for late pulmonary venous obstruction.

Child↗
PubMedDate not supplied

[Right upper lobar mass of the lung caused by subclavian artery aneurysm].

Subclavian artery aneurysm is a rare condition. The main causes are degenerative disease and, less often, trauma. We report the case of a sawmill worker with a large mass in the upper right lobe found in a routine X-ray. Imaging studies revealed the aneurysm to be 12.2 x 13.1 cm, partially thrombosed and located in the right subclavian artery. Our experience suggests that this cause of lung mass should be considered early in the diagnostic process, before undertaking invasive diagnostic (puncture-biopsy) or therapeutic procedures that might place the patient at risk.

Aneurysm↗