Biomedical subjects
Publications and source records attributed to C Villanueva.
When disodium cromoglycate, an inhibitor of histamine release, was instilled into the uterine lumen on Days 5 or 6 of pregnancy, the number of blastocysts implanting was significantly (P less than 0.002) reduced. Simultaneous instillation of histamine and disodium cromoglycate prevented the effect.
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Clinical experience with the latex and new estane balloons and a short and flexible guide is described. The extraovular balloon as an intrauterine pressure sensor is compared to the open-ended transcervical intraamniotic catheter, and the balloon is considered superior in many respects. The transcervical extraovular water-filled 0.8-ml estane balloon is recommended for use in place of the open-ended transcervical catheter in all clinical situations in obstetrics in which there is a need for monitoring intrauterine pressure.
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The prevalence of asymptomatic cardiac valve anomalies was determined in 82 patients (69 females and 13 males) diagnosed as having idiopathic scoliosis and scheduled for corrective surgery (mean age at surgery 16.3 years). The preoperative study in each patient included echocardiography and ultrasound Doppler. Twenty-three valvular anomalies were found in 20 patients (24.4%). The most frequent was mitral valve prolapse. The occurrence of valvular anomalies did not correlate with sex, curve magnitude, or age at diagnosis. Eighteen patients presented a total of 20 comorbid conditions: positive family history of scoliosis (five cases), isthmic spondylolisthesis (five cases), nervous anorexia (two cases), hereditary exostosis, cystic fibrosis, ureteral stenosis, mammary hypoplasia, slipped capital femoral epiphysis, psoriasis, celiac disease, and lactose intolerance. A significant relationship was found between valvular anomalies and comorbidity. Valvular anomalies were detected in 11 out of 64 patients (17.2%) with no comorbidity and in nine out of 18 patients (50%) with a comorbid condition (Chi-square 8.2, p = 0.004). In this latter group of patients, routine echocardiographic study seems advisable in the preoperative evaluation.
A prospective and randomized trial involving 104 patients was performed to assess whether second-look endoscopy could improve the efficacy of injection therapy for bleeding ulcers. The inclusion criteria were the presence of active arterial bleeding or a non-bleeding visible vessel at emergency endoscopy. All the patients received emergency injection of 1:10,000 adrenaline and were subsequently randomized (52 patients in each group) according to whether or not they would receive a second elective endoscopy within the first 24 hours with repeated injection if a visible vessel was still identified. Both groups were well matched for clinical and endoscopic data. A tendency towards better results was noted in the group that received a second-look endoscopy; the two groups were compared in regard to further bleeding (21% versus 29%, 95% confidence interval of the difference = -24.3 to 8.5), need for emergency surgery (8% versus 15%, 95% confidence interval of the difference = -19.9 to 4.5), transfusion requirements (1.7 +/- 1.9 versus 2.5 +/- 2.5 units, 95% confidence interval of the difference = -1.6 to 0.07), length of hospital stay (9.3 +/- 8.6 versus 11.8 +/- 10.8 days, 95% confidence interval of the difference = -6.2 to 1.4), and mortality rate (2% versus 4%). Although these trends did not achieve statistical significance, a type II error cannot be ruled out. However, according to our results, several hundred patients would be required to demonstrate statistically these relatively small differences.(ABSTRACT TRUNCATED AT 250 WORDS)
This paper presents clinical experience with the use of total parenteral nutrition (TPN) in patients undergoing major spinal surgery, as well as the identification of possible risk factors involved in the extended duration of TPN. Although TPN is an expensive therapy, it may even represent a cost saving in patients with a high risk of developing malnutrition. Therefore, it is necessary to identify those patients with the greatest likelihood of presenting nutritional deterioration in order to select those who would benefit from post-operative TPN. During the period under analysis (1995-1998), 137 patients were operated on and could be analyzed retrospectively. The variable considered were: age, sex, weight, body mass index, height, diagnosis, type and time of surgery involved, bleeding, duration of TPN and number of days admitted. The statistical analysis was carried out using the SPSS 6.1 for Windows software package. It comprised a descriptive univariate study, a bivariate comparative means analysis using Student's t test and multi-variant analysis using multiple regression. In the bivariate analysis, a greater duration of TPN was found in those patients subjected to circumferential arthrodesis (p = 0.0001), as well as in patients diagnosed as having kyphoscoliosis following neuromuscular disease (p = 0.0041). The multi-variant analysis gave a correlation statistically significant duration of TPN and surgery time (p = 0.00001), intra-operative bleeding (p = 0.01) and weight (p = 0.0002). No link was found between the duration of TPN and age, nor with the number of days spent in hospital.
The mechanism of estrogen induced eosinophilia is not well understood. It has been proposed that type II estrogen receptors, present both in eosinophils and uterine tissues, can act as anchorage mechanism for the attachment of eosinophils within the uterus. However an explanation based on the existence of chemotactic mediators is more likely. We studied the effects of the lipoxygenase inhibitor BW755 and two different doses of indomethacin in a model of acute uterine eosinophilia promoted by 17-beta-estradiol in young rats; simultaneously estrogen receptors were studied with immunocytochemical methods using monoclonal antibodies. BW755 and a high dose of indomethacin sharply reduced the estrogen induced eosinophilia, whereas a low dose of indomethacin enhanced the steroid effect. No estrogen receptors were found with immunohistochemical methods neither in eosinophils nor in endothelial cells in any of the groups. A role for the lipoxygenase products of arachidonic acid, mainly leukotrine B4 as the chemical mediators responsible of eosinophil chemotaxis in be estrogen primed uterus is suggested.
A 24 year old female with amenorrhea-galactorrhea due to a pituitary macroprolactinoma that eventually responded to bromocriptine with improvement of visual fields and intracranial hypertension syndrome is presented. After 2 years of treatment with bromocriptine her symptoms relapsed and she underwent transphenoidal hypophysectomy. The high serum prolactin levels detected initially decreased under bromocriptine to ward normal levels and was not modified after surgery, while gonadotropin production remain scarce. Growth hormone (GH) serum levels despite its normal concentration decreased significantly (p = less than 0.5) after pituitary ablation. We assume that the lack of response to bromocriptine in this case could have been due to a mixed hormonal nature of the tumor without overproduction or clinical expression of GH activity.
Malignant cells have the ability to invade and metastasize in great part because they secrete proteolytic enzymes. In order to investigate if the abnormal proteinase/antiproteinase balance of cancer bearing patients changes when the malignant tumor is destroyed, we studied 50 patients with invasive carcinoma of the cervix and 33 healthy women as a control group. Patients with cancer were treated with radiation according to the protocols of our hospital. The following serum determinations were performed: plasminogen activators (PA), cathepsin B (CB), antiproteinase alpha-1-antitrypsin (A1AT), trypsin inhibitory capacity (TIC) and antiproteolitic activity ratio (AAR), all of them before and after treatment. Serum proteolytic activity was elevated manyfold in all patients with invasive tumor as well A1AT. The antiproteolytic activity however, was significantly reduced to about 50% of its normal value in the same group of patients. In patients with good response to radiotherapy (tumor necrosis) a great reduction of proteinase activity as well as a recovery to normal of the AAR was observed. Contrary, in those with a poor response after radiation, proteolytic activity remained elevated and AAR diminished. It is concluded that serum PA, CB, A1AT and AAR values can be precise indicators of the presence of malignancy. These tests might be also of help for improving follow-up studies and for better prognostic estimates.
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