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Biomedical subjects

E Acosta

Publications and source records attributed to E Acosta.

45 records · Page 3Linked to original sources
PubMed1982

On the use of clonidine and thioproperazine in a woman with Gilles de la Tourette's disease.

A 25-year-old woman with Gilles de la Tourette's disease was successfully treated with clonidine (an inhibitor of noradrenaline release). However, the drug was stopped because of side effects. Thioproperazine, a phenothiazine derivative which blocks subcortical dopaminergic receptors, suppressed Gilles de la Tourette's symptoms totally. The patient has tolerated the drug well for over a year since its introduction. The pharmacomanometric investigation performed in this patient showed hyperactivity of her noradrenergic system.

Adult↗
PubMedDate not supplied

Pharmacomanometric studies of colonic motility as a guide to the chemotherapy of schizophrenia.

Distal colon motility studies performed in 41 psychotic subjects demonstrated that 32 of them had hyperactivity of the noradrenergic system at this peripheral level, while the remaining nine cases showed hyperactivity of the dopaminergic system. The noradrenergic-hyperactive patients fulfilled the Research Diagnostic Criteria of schizophrenia, whereas the dopaminergic-hyperactive patients were diagnosed as having schizoaffective disorders. Noradrenergic-hyperactive subjects were successfully treated with clonidine, a drug which inhibits release of noradrenaline, while dopaminergic-hyperactive subjects were successfully treated with clonazepam, a drug which inhibits release of dopamine. The addition of sulpiride (a postsynaptic dopaminergic blocking agent) and of phentolamine (a postsynaptic noradrenergic blocking agent) to clonidine and clonazepam, respectively, induced further significant improvements in both types of psychotic patients.

Adult↗
PubMedDate not supplied

Small-diameter mesocaval shunts: a 10-year evaluation.

The use of small-diameter portosystemic shunts for the treatment of bleeding esophageal varices caused by portal hypertension has emerged as an outgrowth of the development of polytetrafluoroethylene vascular grafts, which allow the use of a narrow lumen. We report our experience with this type of graft over a 10-year period. Thirty-three patients with good liver function (Child-Pugh class A) were electively operated. The average age of these patients was 45 years (range 17 to 71 years). Twenty-nine patients had liver cirrhosis, one had portal fibrosis, and three had idiopathic portal hypertension. Operative mortality was 3%, and the rebleeding rate was 15%. Postoperative encephalopathy was observed in 14 patients (11%), three of whom had grade III to IV encephalopathy. The remaining 11 patients, had mild encephalopathy that was easily controlled. Postoperative angiography showed shunt patency in 81% of the patients, reduction in portal vein diameter in 33% of the patients, and portal vein thrombosis in 6%. Good postoperative quality of life was observed in 63% of the patients. Survival according to the Kaplan-Meier actuarial method was 81% at 12 months, 56% at 60 months, and 36% at 10 years. These shunts are a good alternative for patients being considered for surgery in whom other portal blood flow preserving procedures (i.e., elective shunts, devascularization with esophageal transection) are not feasible.

Adolescent↗
PubMedDate not supplied

HIV disease and pregnancy. Part 2. Antepartum and intrapartum care.

The spread of human immunodeficiency virus (HIV) disease among childbearing women presents a unique nursing challenge in the delivery of specialized antepartum and intrapartum care. The nurse must be competent in the delivery of psychosocial and physical care to these women, as well as assume a pivotal role as a member of the multidisciplinary health-care team. Aspects of care, from the diagnosis of pregnancy through delivery of the neonate, that are unique to women with HIV disease are described.

Antiviral Agents↗
PubMedDate not supplied

Modified technique for fine needle aspiration biopsy that eliminates needle manipulation.

OBJECTIVE: To evaluate a modified technique of fine needle aspiration biopsy that eliminates needle manipulation after aspiration. STUDY DESIGN: Fine needle aspiration biopsy of 112 palpable lesions was performed using both the conventional and modified techniques. Cellularity, cell preservation and diagnostic yield of the new procedure were compared to those of the conventional technique. RESULTS: Cytologic smears prepared from each method were comparable in quality, quantity and diagnostic yield. CONCLUSION: The modified approach eliminates the hazard of needle manipulation without diminishing the diagnostic efficacy of fine needle aspiration biopsy.

Biopsy, Needle↗
PubMedDate not supplied

[Metastatic disease of the liver: surgical perspective].

Approximately half of patients with colorectal cancer will develop hepatic metastases and it is estimated that up to 10% of that group will have resectable liver disease. Surgical resection remains the first line treatment option of metastatic liver tumors and has yielded a 20 to 40% five year survival rate. Selection of appropriate patients for resection is critical to a successful outcome. The best results are obtained in patients with isolated metastases. Factors that are associated with a poorer results are the presence of four or more lesions or a surgical margin less than 1 cm. Endocrine metastases can be resected in a palliative fashion but each case has to be individualized. This is also true for non colorectal-nonendocrine metastases. For this tumors the experience is anecdotal and confined to limited reported series. Adjuvant treatment (infusional chemotherapy and chemoembolization) can also have a role in treatment as well as cryotherapy.

Antimetabolites, Antineoplastic↗