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Biomedical subjects

E Rubio

Publications and source records attributed to E Rubio.

At least 73 records · Page 4Linked to original sources

Reappraisal of the intracranial pressure and cerebrospinal fluid dynamics in patients with the so-called "normal pressure hydrocephalus" syndrome.

Fifty-four shunt-responsive patients were selected from a prospective protocol directed to study patients with suspected normal pressure hydrocephalus (NPH). Patients with gait disturbances, dementia, non-responsive L-Dopa Parkinsonism, urinary or faecal incontinence and an Evans ratio greater or equal to 0.30 on the CT scan were included in the study. As a part of their work-up all patients underwent intracranial pressure monitoring and hydrodynamic studies using Marmarou's bolus test. According to mean intracranial pressure (ICP) and the percentage of high amplitude B-waves, patients were subdivided in the following categories: 1) Active hydrocephalus (mean ICP above 15 mmHg), which is in fact no tone normal pressure hydrocephalus; 2) Compensated unstable hydrocephalus, when mean ICP was below 15 mmHg and B-waves were present in more than 25% of the total recording time and 3) Compensated stable hydrocephalus when ICP was lower or equal to 15 mmHg and beta waves were present in less than 25% of the total recording time. The majority of the patients in this study (70%) presented continuous high or intermittently raised ICP (active or unstable compensated hydrocephalus group). Mean resistance to outflow of CSF (Rout) was 38.8 mm Hg/ml/min in active hydrocephalus and 23.5 mm Hg/ml/min in the compensated group (Students t-test, p less than 0.05). Higher resistance to outflow was found in patients with obliterated cortical sulci and obliterated Sylvian cisterns in the CT scan. No statistically significant correlation was found when plotting the percentage of beta waves against pressure volume index (PVI), compliance or Rout. An exponential correlation was found when plotting beta waves against the sum of conductance to outflow and compliance calculated by PVI method (r = 0.79). Patients with the so-called normal pressure hydrocephalus syndrome have different ICP and CSF dynamic profiles. Additional studies taking into consideration these differences are necessary before defining the sensitivity, specificity and predictive value of ICP monitoring and CSF studies in selecting appropriate candidates for shunting.

Adult↗

[Symptomatic chronic subdural hematoma. Analysis of 68 cases treated surgically with small craniotomy and placement of a closed drainage system].

Sixty eight cases of chronic subdural hematoma (CSDH) surgically treated (December 1984-December 1988) with twist drill craniostomy (3-4 mm) and application of a closed drainage system (CDS) are reviewed. The patients were distributed in four groups depending on the density of the hematoma: hypodense (36 cases), isodense (6 cases), of mixed density (22 cases) and hyperdense (4 cases). In about one third of patients (25 cases) the duration of symptoms was shorter than one week, in 21 cases it was between one week and one month, and in 22 patients it was longer than one month. 77.95% of cases had a preceding head injury. Headache and motor deficits were the leading symptoms, being present in 43 (63.2%) and 42 (61.7%) cases, respectively. Twelve patients (17.6%) were comatose on admission. Twelve patients required reoperation. Six patients died (8.8%). The preoperative neurological status and associated systemic diseases influenced the outcome. We think that limited craniostomy with CDS is the therapy of choice for symptomatic CSDH.

Aged↗

[Effect of atmospheric factors on the presentation of cerebrovascular accidents].

The concept of meteoropathy implicates the atmospheric properties as determining or at least provoking causes of different disease conditions. Thus, we know that changes in temperature, atmospheric pressure and humidity rate are associated with a higher incidence of stroke presentation. Considered as a whole, these three atmospheric factors have been associated with the several clinical diagnoses of stroke. A higher presentation rate of stroke has been found when the three following facts concurred: a reduction of 10 degrees (C) in the temperature of the preceding day, an increase of the atmospheric humidity rate from 20% to 60% on the day of stroke, and an increase in atmospheric pressure of 6 mlbs from the preceding day (s = 0.0000). In addition, a higher rate of presentation of stroke was found when the difference in atmospheric pressure was 16 mlbs between the day of stroke and the preceding one (s = 0.049). Also, when the atmosphere humidity rate increased from 20% to 60%, the difference in mean temperature between the day of stroke and the preceding one was 3 degrees (C), and the atmospheric pressure increased in 6 mlbs, the incidence of stroke was higher (s = 0.007). We compare these findings with those from other authors.

Atmospheric Pressure↗

[Cerebral contusions. Study of 182 cases].

Clinical cases were selected in which cerebral contusions were the only visible lesions in CT scan on admission over the period from January 1983 and December 1985. The following characteristics were evaluated: Age, sex, conscience level (Glasgow) at admission, early post-traumatic epilepsy, focal signs, lesion mechanism, cranial fracture, as well as CT scan in which specific signs of bad prognosis were analyzed. According to the evolution of conscience level 3 groups of patients were established: Group 1 "no coma", group 2 "coma with lucid interval", group 3 "coma without lucid interval" and were correlated with the previously mentioned characteristics. The highest mean age (59.2 years) appeared in group 2. In 75% of patients in group 3 a traffic accident was the lesion mechanism. Admission CT scan showed that the severity is related to bad prognosis signs (displacement of middle line, lack of 3rd ventricle, and basal cisterns and multiple lesions). Mortality was approximately 70, 80 and 90% whether they had one, two, or three bad prognosis signs at admission CT scan.

Adult↗

Surgery of the parotid region: a new approach.

Many disorders of the parotid gland require treatment by subtotal or total parotidectomy. In such situations functional and esthetic complications may arise due to the location of the incisions or from permanent or temporary injuries to the facial nerve. This report describes a modified revision that gives good esthetic and functional results. A review of a similar series of cases treated surgically by the same surgeons using Yoel and Bilesio's technique showed no differences in morbility associated with parotidectomy performed using the proposed incision.

Adolescent↗

Studies of the spontaneous motility and the effect of histamine on isolated myometrial strips of the nonpregnant human uterus: the influence of various uterine abnormalities.

We investigated the spontaneous uterine activity of isolated corpus uteri myometrial strips from 30 patients with nonpathologic myometrium, 26 patients with uterine myoma, 23 patients with uterine adenomyosis, and three patients with uterine malignancy. We also investigated the influence of these conditions on the response of the uterus to histamine. The results show the same qualitative cyclic changes of the spontaneous motility of isolated myometrial strips throughout the menstrual cycle in all the abnormalities studied. These changes are characterized by a low amplitude and high frequency of spontaneous contractions in the proliferative phase and lower frequency with higher amplitude of contractions in the secretory phase. The isolated strips from patients with myomas present the highest spontaneous activity in reproductive age and preclimacteric women, but not in menopausal women. Histamine produced concentration-related contractions that are not significantly different in all the myometrial strips studied.

Female↗

Study on the histamine-like activity of guanfacine.

The effects of guanfacine have been studied on guinea-pig isolated atria and diethylstilboestrol-treated rat isolated uterus to determine whether it possesses histamine-like activity. Guanfacine produced a concentration-dependent negative chronotropic effect which was not modified by ranitidine (0.1 microM). In rat isolated uterus contracted by KCl, clonidine (5-5000 microM) produced concentration-dependent relaxation which was blocked by ranitidine (0.1 microM), but guanfacine only produced relaxation at high concentrations (100-1000 microM), and this was not affected by ranitidine (0.1 microM). It is concluded that guanfacine, unlike clonidine, does not produce effects due to activation of H2-receptors in either guinea-pig atria or rat uterus.

Adrenergic alpha-Agonists↗

Diffuse axonal injury after severe head trauma. A clinico-pathological study.

Diffuse Axonal Injury (DAI) is a well known entity that affects many patients with severe head trauma. Classically DAI has been considered the pathological substrate of those cases rendered unconscious at the moment of impact and in which the CT scan does not show mass lesions. Diffuse axonal damage is almost always related to mechanisms of injury in which the rotational acceleration produces shear and tensile strains of high magnitude. In this paper we present a group of 24 patients with a severe head injury in whom the postmortem examination demonstrated unequivocal signs of DAI. Widespread axonal retraction balls, located preferentially in the centrum semiovale and internal capsule were the most constant histological finding. We divided the entire series into two subgroups. One group (15 cases), included all the patients in whom the CT scan did not demonstrate mass lesions. In the second group (9 patients) we considered patients with a diffuse axonal injury in whom the CT scan additionally demonstrated a mass lesion (6 acute subdural haematomas, 2 intracerebral and 1 extradural haematoma). The mean age of the entire group was 26 years. Twenty two patients were injured in a road traffic accident, the remaining two fell from a considerable height. All were rendered immediately unconscious on impact. Diffuse brain damage is a common finding in patients with a severe head injury and immediate coma in whom the CT scan does not show mass lesions. Diffuse axonal injury can also appear in connection with a wide spectrum of focal lesions (acute subdural haematoma, basal ganglia haematoma etc.).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

The susceptibility to amoxycillin/clavulanate of Enterobacteriaceae with plasmid-mediated ampicillin resistance: a twelve-year study of strains in one Spanish hospital.

We studied the antibacterial activity of amoxycillin, clavulanic acid and the combination, against 1210 clinical isolates with plasmid-mediated ampicillin resistance, isolated at the Zaragoza Clinical University Hospital during 12 years. MICs were determined by an agar dilution technique with an inoculum of 10(4) cfu per spot. MIC50 values of amoxycillin/clavulanate ranged from 8 to 16 mg/l. The antibacterial activity of amoxycillin/clavulanate did not show any statistically significant variation during the 12-year period.

Amoxicillin↗

Relaxant effect of dopamine on the isolated rat uterus.

The effect of dopamine was studied on the isolated uterus of diethylstilboestrol-treated rats. Dopamine, at concentrations (10(7)-10(-4) M) produced a concentration-dependent relaxation in the K+-depolarized rat uterus. On a molar basis, dopamine was about 500 times less potent than adrenaline in relaxing the uterus, the maximum degree of relaxation obtained with both drugs was the same. Pretreatment of the rats with reserpine (5 mg/kg) did not produce any modification of the dose-response curve to dopamine. Similarly, cocaine (3 x 10(-6) M) failed to modify the relaxant effect of dopamine. The dopamine induced relaxation was inhibited by propranolol (10(-9)-10(-7) M) in a dose-dependent manner. Prazosin (10(-7) M), SCH 23390 (10(-7) M) and sulpiride (10(-7) M) did not affect the dopamine dose-response curve. In the isolated rat uterus which was not preconstricted by KCl neither dopamine nor adrenaline produced any effect when added to the organ bath. This lack of response to both catecholamines was present even in tissues pretreated with propranolol or sulpiride. It is concluded that dopamine produced a concentration-dependent relaxation of the uterus from diethylstilboestrol-treated rats by direct activation of beta-adrenoceptors. There was no evidence for indirect action (catecholamine release and neuronal uptake mechanisms) and specific dopamine receptor mediated relaxation and alpha-adrenoceptor mediated contractions have not been found in this preparation.

Animals↗

Antihistaminic and anticholinergic activities of mequitazine in comparison with clemizole.

The antihistamine and anticholinergic properties of mequitazine have been investigated and compared with those of clemizole. Both mequitazine and clemizole antagonized the effect of histamine in guinea-pig ileum competitively, the pA2 values calculated by Schild plot were 9.95 +/- 0.44 for mequitazine and 10.54 +/- 0.44 for clemizole. Mequitazine at 10(-7) M produced a parallel shift of the dose-response curve to acetylcholine in the rat duodenum, clemizole and the lower doses of mequitazine failed to modify the effect of acetylcholine. The potency of mequitazine and clemizole as H1-histamine blockers is similar, but only mequitazine at highest concentration used showed anticholinergic activity.

Acetylcholine↗

[Spontaneous cerebellar hematoma. Analysis of 23 cases].

A series of 23 patients with spontaneous cerebellar hematoma is analysed retrospectively. Several degrees of consciousness impairment, and headache occurred in all; 12 patients presented motor deficits among the more important clinical signs. Arterial hypertension (69.5%) and diabetes (34%) stand out in the pathological background, and their association was frequent (30%). Computerized tomography (CT) disclosing severe ventricular dilatation (69.5%) associated or not with intraventricular presence of blood is considered as an unsatisfactory prognosis sign, and indicative for emergency therapy. Emergency external ventricular draining is the best indication for the majority of these cases. Posterior fossa craniectomy for emptying the hematoma may be the indication in severe cases. Death and morbidity in this pathology are high as yet. However, CT contribution for diagnosis is quicker and better than benefits obtained through other methods. Results observed in the present series are illustrative on this statement, when compared to data of other series diagnosed through other methods.

Adult↗