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E Molina

Publications and source records attributed to E Molina.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Obstructive sleep apnea syndrome in childhood: study of three cases].

We report three children with obstructive sleep apnea syndrome, two secondary to pharyngeal obstruction and the third secondary to laryngomalacia. All patients presented important respiratory efforts with inspiratory stridor during sleep, frequent obstructive apneas with important hipoxemia, sweating, and arousal episodes. Two patients suffered excessive daytime sleepiness, behavioral disturbances and development delay, and the third, intelligence in the borderline retardation range, and important heart arritmias (bradycardia with ventricular extrasystoles) during obstructive apneas. In two children the Obstructive Sleep Apnea Syndrome and the secondary symptoms disappeared after adenotonsillectomy. The patient with laryngomalacia required tracheostomy.

Adenoidectomy↗
PubMed1990

Noninvasive evaluation of sympathetic nervous system in human heart by positron emission tomography.

The noninvasive functional characterization of the cardiac sympathetic nervous system by imaging techniques may provide important pathophysiological information in various cardiac disease states. Hydroxyephedrine labeled with carbon 11 has been developed as a new catecholamine analogue to be used in the in vivo evaluation of presynaptic adrenergic nerve terminals by positron emission tomography (PET). To determine the feasibility of this imaging approach in the human heart, six normal volunteers and five patients with recent cardiac transplants underwent dynamic PET imaging after intravenous injection of 20 mCi [11C]hydroxyephedrine. Blood and myocardial tracer kinetics were assessed using a regions-of-interest approach. In normal volunteers, blood 11C activity cleared rapidly, whereas myocardium retained 11C activity with a long tissue half-life. Relative tracer retention in the myocardium averaged 79 +/- 31% of peak activity at 60 minutes after tracer injection. The heart-to-blood 11C activity ratio exceeded 6:1 as soon as 30 minutes after tracer injection, yielding excellent image quality. Little regional variation of tracer retention was observed, indicating homogeneous sympathetic innervation throughout the left ventricle. In the transplant recipients, myocardial [11C]hydroxyephedrine retention at 60 minutes was significantly less (-82%) than that of normal volunteers, indicating only little non-neuronal binding of the tracer in the denervated human heart. Thus, [11C]hydroxyephedrine, in combination with dynamic PET imaging, allows the noninvasive delineation of myocardial adrenergic nerve terminals. Tracer kinetic modeling may permit quantitative assessment of myocardial catecholamine uptake, which will in turn provide insights into the effects of various disease processes on the neuronal integrity of the heart.

Adult↗
PubMed1990

[Complicated hepatic hydatid cyst and acute pancreatitis. Value of ERCP and treatment with endoscopic sphincterotomy].

We present the case of a 29 year-old cholecystectomized woman with hepatic hydatid cysts who was admitted for acute pancreatitis. Echography and abdominal CAT revealed three thydatid cysts-the one in the right liver lobe being complicated-as well as pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) confirmed the suspected diagnosis of intrabiliary hydatid cyst rupture. An endoscopic sphincterotomy was performed, posterior evolution being asymptomatic, thus permitting the postponing of surgery.

Adult↗
PubMed1990

[Haemophilus influenzae carriers among child care personnel: its prevalence and the efficacy of enoxacin in its elimination].

In a previous study we observed that 6% of adult and 18% of children contacts of H. influenzae infected patients became carriers of the bacillus. We studied 1296 adults involved in children care, 398 from day care centers and 898 from hospitals in Santiago. A pharyngeal sample was cultured in chocolate agar plus bacitracin (300 mg/ml) and incubated at 37 degrees C in a 5-10% CO2 atmosphere for 18-24 h. Isolates of H influenzae were biotypified and serogrouped according to international recommendations. We observed that 2.4% of subjects were H influenzae carriers. Thirty carriers were treated with 2 doses of enoxacin, 440 mg. All became free of H influenzae at a 30-day follow-up.

Adult↗
PubMed1990

Three-dimensional assessment of myocardial oxidative metabolism: a new approach for regional determination of PET-derived carbon-11-acetate kinetics.

We have developed a new analysis algorithm which generates polar coordinate maps of myocardial carbon-11-(11C) acetate kinetics. In 10 normal subjects (n = 20 studies), myocardial 11C clearance rate constants (k) averaged 0.057 +/- 0.009 (per minute). Regional k-values varied only 10.6 +/- 2.4% in the normal left ventricle. However, there was a small but significant segmental variation with increased 11C clearance in the septal, anterior, and basal regions (p less than 0.05). Since 11C clearance rates reflect tri-carboxylic acid cycle flux, these results suggest that myocardial oxidative metabolism is relatively homogeneous in the normal human heart at rest with minor regional variations, which possibly reflect varying regional wall stresses or substrate utilization. The proposed approach provides three-dimensional evaluation of regional oxidative metabolism which will permit characterization of the location, extent, and severity of myocardial disease.

Acetates↗
PubMed1990

McCune-Albright syndrome: the patterns of scintigraphic abnormalities.

This study of 22 patients with the McCune-Albright syndrome examined the scintigraphic distribution of fibrous dysplasia. The most frequently affected areas were the base of the skull (82% of patients), mandible (50%), facial bones (45%), femora (59%), and legs (64%). The least frequently affected areas included the hands (none), wrists (none), ankles (none), feet (5%), sacrum (5%), and vertebrae (9%). The distribution varied somewhat from idiopathic fibrous dysplasia but generally agreed with the distributions reported in radiographic studies of patients with the McCune-Albright Syndrome. The serum alkaline phosphatase was not an accurate predictor of the extent of fibrous dysplasia.

Bone and Bones↗
PubMed1989

An office-based exercise protocol for predicting chronotropic response of activity-triggered, rate-variable pacemakers.

Activity-triggered, rate-variable pacing systems offer a wide range of pacemaker patients the benefits of an appropriate paced chronotropic response. However, optimizing settings for these devices often entails treadmill exercise testing. To assess simpler procedures for predicting appropriate settings, pacing rates of "strapped-on" and implanted Activitrax pacemakers were evaluated during arm exercise, walk-in-place exercise and treadmill exercise (0% slope at 1.5, 2.0 and 3.0 mph). For exercise of similar duration, steady-state pacing rates of implanted devices during arm and walk-in-place exercise were lower than those achieved during treadmill exercise. Linear regression analysis resulted in the slope of these relations most closely approaching 1.0 for arm exercise at "low" activity threshold, while walk-in-place tended to result in slopes approaching 1.0 at all activity thresholds. Similarly, although strapped-on devices underestimated rates obtained with implanted devices, differences fell within a narrow range (-6 to -14%). Thus, in patients with implanted or strapped-on Activitrax pacemakers, relatively simple exercise procedures suitable for office or clinic environment may be useful to provide an estimate of pacing rates during physical activity, and may thereby facilitate selection of appropriate programmable settings.

Adult↗
PubMed1989

[Conservative treatment of urethral stenosis in childhood].

During a 19 years period (1969-March 1988) 22 children presented for treatment of urethral strictures. The patients ranged in age from neonatal period to 13 years old, 20 of them were boys and 2 girls. We have found 3 congenital cases, 5 traumatic cases, 9 inflammatory (versus infections) cases and 5 iatrogenic cases. Diagnosis can be suspected from the history and physical examination (voided stream), and confirmed radiographically and endoscopically; we have employed urodynamics studies in 2 cases, and those have seem of much important the follow-up. Treatment is controversial between different authors. In ours series progressive dilatation procedure have been elective (retrograde swelling catheter versus anterograde swelling catheter with cytostomy), with 86.3% of good results.

Adolescent↗
PubMed1989

[Hernial strangulation of Meckel's diverticulum: Littre's hernia. Apropos of 4 cases].

Hernial strangulation of Meckel's diverticulum (Littre's hernia) is a rare anatomoclinical form. It represents 10% of all complications of Meckel's diverticulum (8.8% of our cases), and complications like hemorrhage, perforation and diverticulitis are fairly frequent. Four cases of Littre's hernia are presented: two males and two females, with an average age of 67 years (range 50-83 years), representing 0.08% of all the inguinal-crural hernias operated in the department. The clinical manifestations were those of intestinal obstruction because a mixed type Littre's hernia was involved, with compromise of the diverticulum and its intestinal loop. Preoperative diagnosis is unlikely in strangulation without disturbances in the intestinal transit and, in fact, is even less likely if it is accompanied by obstruction. The diagnosis is thus almost always intraoperative. The correct treatment is surgery after restoring the patient's hemodynamic equilibrium. Simple and/or loop diverticulectomy via herniotomy, herniolaparotomy or laparotomy are debated. We think that this disorder can generally be resolved using the inguinal approach, as in any strangled hernia, with the technical option of using a larger, more comfortable and safer approach in cases of important obesity and/or deterioration of the loop (necrosis, perforation). In elderly patients with uncomplicated Littre's hernia and Meckel's diverticulum, abstention from diverticular exeresis may be justifiable. Of the four patients, the first two died from cardiogenic shock and pulmonary embolism, respectively; the last two evolved well (except for a wound abscess).

Aged↗
PubMed1988

The renal functional reserve in health and renal disease in school age children.

The capacity to increase the glomerular filtration rate (GFR) in response to stimuli is a characteristic of the healthy kidney. To establish normal limits of this functional reserve is of clinical relevance because its loss may be the earliest indication of renal damage. For this purpose we have used a method applicable in clinical practice: one-hour clearances of creatinine (CCr) done under water diuresis, before (unstimulated) and two hours after (stimulated) a test meat meal, taking a single postmeal blood sample. Urine collection was done by voluntary voiding under direct supervision. In studies done in 14 control subjects, inulin clearance (CIn)/CCr ratios were (mean +/- SEM) 1.04 +/- 0.05 and 0.96 +/- 0.03, in unstimulated and stimulated clearances, respectively. In studies repeated at three to nine week intervals, we found a variation coefficient (mean +/- SEM) of 24.5 +/- 3.11% and 9.25 +/- 1.43% (P less than 0.001) for the unstimulated and stimulated CCr, respectively. The corresponding values for CIn were 19.3 +/- 2.36% and 9.17 +/- 1.19% (P less than 0.001), suggesting that stimulated GFR values are more stable. Unstimulated and stimulated GFR and renal functional reserve (stimulated CCr - unstimulated CCr) were studied in 260 school aged children, ages 6 to 16 years (140 boys and 120 girls). The distribution of the renal functional reserve was approximately Gaussian but the distribution of the urinary creatinine excretion, unstimulated and stimulated GFR had considerable positive skewness.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1987

Single-chamber cardiac pacing with activity-initiated chronotropic response: evaluation by cardiopulmonary exercise testing.

In this study, sequential cardiopulmonary exercise testing was used to assess the physiologic benefits of a single-chamber ventricular pacing system that utilizes a piezoceramic sensor to adjust heart rate by detecting "physical activity." An initial exercise test was conducted with the pacemaker programmed (based on a randomization table) to either the fixed rate (VVI, 70 beats/min) or rate-variable (VVI-Act) mode, and the results were compared with those obtained during a second exercise test in which the pacemaker was programmed to the alternate pacing mode. A 1.5 to 2 hr rest period was permitted between exercise tests, each of which consisted of a symptom-limited constant speed (3.0 mph) Balke protocol with 2 min stages commencing at 0.0% grade with increments of 2.5% at end of each stage. Compared with findings during fixed-rate VVI pacing, VVI-Act pacing was associated with greater exercise-induced positive chronotropic response (mean maximum heart rate VVI-Act 128 +/- 15.3 beats/min vs VVI 90 +/- 28.4 beats/min; p less than .01), prolongation of exercise duration (VVI-Act 10.2 +/- 3.8 min vs VVI 7.7 +/- 2.5 min; p less than .01), increased peak oxygen consumption (VVI-Act 1617 +/- 656 ml O2/min vs VVI 1325 +/- 451 ml O2/min; p less than .01), and onset of anaerobic threshold at a higher oxygen consumption (VVI-Act 1208 +/- 343 ml O2/min vs VVI 1064 +/- 377 ml O2/min: p less than .01). Additionally, of 44 comparable exercise stages tested in the two pacing modes, perceived exertion (assessed by a numerical grading system) was lower in 38 of 44 instances during VVI-Act compared with VVI pacing.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗