Search PubMed⌕ Search

Biomedical subjects

E Rubio

Publications and source records attributed to E Rubio.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

[Arteriovenous malformations of the posterior fossa. Clinical features, treatment and results].

OBJECTIVES: We present our experience of 20 cases of arteriovenous malformations (MAV) of the posterior fossa. PATIENTS AND METHODS: During the period 1991 1999 we prospectively collected radiological and therapeutic clinical data and the results obtained in all cases of adults whose arterio venous malformations were treated. We selected 20 of those who had MAV of the posterior fossa. RESULTS: The average age was 39.6 years (15 64). Thirteen (65%) were men. Most patients, 16 cases (80%) presented clinically with cerebellar haemorrhage, subarachnoid and/or intraventricular haemorrhage and 6 (30%) of the patients were admitted in coma. On the Spetzler and Martin scale: grade 1, 1 patient (5%); grade 11, 8 patients (40%); grade 111, 8 patients (40%) and grade 1V, 3 patients (15%). One patient had an associated pedicular aneurysm, another a supratentorial MAV and another patient had several cavernomas. Nine patients required external ventricular drainage, which in 4 cases became a permanent CSF drainage system. Endovascular treatment was used in 8 patients, radiosurgery in 2 and surgery in 9. Complete resection of the MAV was only possible in the patients treated by surgery (two patients had been treated previously by embolizations and radiosurgery). In this series there was a mortality of 20%, in all four cases due to recurrence of bleeding. Good results were obtained in 11 (55%) of the patients, but in the other 5 (25%) there were sequelas. CONCLUSION: The high percentage with haemorrhages as the form of presentation, with a much higher mortality than that of supratentorial MAVs makes more aggressive treatment necessary.

Adolescent↗
PubMedDate not supplied

[Epidemiology of head traumas. "Barcelona" data base. Objectives, design and analysis of 584 cases].

INTRODUCTION: Descriptive analysis of some features in patients with cranio-encephalic traumatisms (CET) admitted to our hospital and collected in a data base, in order to establish the prognosis of the lesions and apply the most appropriate diagnostic and therapeutic procedures. MATERIAL AND METHODS: Since July 1987 to June 1989 we collected data on 584 patients with CET who presented the following selection criteria: consciousness level lower than 13 points in the Glasgow scale and/or pathologic computerized tomography. According to the consciousness level (Glasgow scale) on admission, patients were classified into three groups: slight CET (Glasgow 15-13), moderate CET (Glasgow 12-9), and severe CET (Glasgow < 9). The traumatic mechanisms were divided into 8 categories (occupant, pedestrian, motorbike, aggression, labor, drop, sporting, cyclist). According to the main lesion we considered the following diagnoses: subdural hematoma, epidural hematoma, cerebral contusion (s), diffuse lesion with normal computerized tomography and/or subarachnoid hemorrhage, cerebral congestion, and diffuse axonal lesion. Results were evaluated six months after using the Glasgow scale. RESULTS: The mean age of patients with slight CET was 37.7 +/- 22.1 years, those with moderate CET 31.7 +/- 22.6 years, and those with severe CET 30.8 +/- 21.6 years. Four hundred and forty-two were men (75.6%). The time period between the accident and hospital admission could be determined in 512 cases (87.6%). Severe CET arrived to the hospital (4.8 +/- 7.3 hours) earlier than the other groups (6.6 +/- 11.9 hours in moderate CET and 14.2 +/- 23 hours in slight CET). Most of patients, 488 (83.5%), were referred from another hospital, whereas the remaining cases came directly from the accident place. Traumatic mechanisms according to the previous categories were: occupant 145 (25%), pedestrian 112 (20%), motorbike 104 (18%), cyclist 2 (0.003%), labor 39 (7%), drop 154 (27%), sporting 7 (1%), aggression 10 (2%). Percentage of traffic accident was higher in patients with severe CET (74.6, 64, and 47% in severe moderate, and slight CET, respectively). The main lesions were: acute subdural hematoma, 72 (12.3%); cerebral contusion, 207 (35.4%); epidural hematoma, 88 (15%); normal computerized tomography/subarachnoid hemorrhage, 87 (14.8%); swelling, 17 (2.9%); diffuse axonal injury, 74 (12.6%); and the remaining, 39 (6.6%) had other lesions such as hydrocephalus fracture-sinking, etc. Mortality was 44.2, 12.2, and 3.7% respectively in severe, moderate, and slight CET. CONCLUSIONS: Data base may contribute to establish the prognosis of CET and to determine the efficacy of therapeutic procedures as well as that of diagnostic and investigational methods.

Adolescent↗
PubMedDate not supplied

[Adverse reactions to medications in patients in ambulatory otorhinolaryngology].

A 12 months prospective study to detect adverse drug reactions (ADR) was carried out in an ORL outpatients clinic. 52 patients (1.8%) out of 2891 examined suffered one or more ADRs. The incidence was higher in women and in older patients. 94% of the ADRs were mild to moderate and 3 patients suffered irreversible lesions. Reactions were most commonly located in the nervous system (50%) and gastrointestinal tract (21%). The most common drugs involved were cardiovascular (40%) and central nervous system (25%) active drugs. Papers concerning ADRs published from 1976 to 1985 in spanish otorhinolaringologic journals have also been analyzed. 0.88% of 1357 published papers described ADRs. The incidence of ADRs observed in our study is higher than expected from the low number of papers published on this subject.

Adolescent↗
PubMedDate not supplied

[Reduction of the mortality from acute subdural hematoma. Comparison of 2 series (1979-1982 and 1987-1989) of patients operated on at the Hospital de la Vall d'Hebron].

Several clinical variables from a series of 101 patients with acute subdural hematoma (ASDH) operated on during the period 1979-1989 were compared with those from another group of 43 patients who were operated on during the period 1987-1989. Twenty-seven patients (26.7%) in the earlier period and 15 (34.8%) in the later one were younger than 40 years. The difference was not significant. There was a higher proportion of patients, 41 (40.5%), in the earlier period (1979-1982) who had traffic accidents than in the 1987-1989 period, where trauma was the mechanism in 15 patients (38.8%). However, the difference was not significant. Seven patients (6.9%) from the earlier group and 18 (41.9%) from the later group had a lucid interval. This difference was significant (p less than 0.001). During the 1979-1982 period 80 patients (79.2%) were comatose on admission as compared with 27 (62.7%) during 1987-1989. The difference was significant (p less than 0.05). A small group of 11 patients (10.8%) from the earlier series were operated on by means of craniotomy or trephine; by contrast, this approach was used in 35 (81.3%) patients from the later series. The difference was significant (p less than 0.001). Seventy-nine (78.2%) and 26 (60.4%) patients died in the periods 1979-1982 and 1987-1989, respectively. The difference between the mortality rates of both groups were significant (p less than 0.05). Our data suggest that the earlier diagnosis and the use of wider surgical procedures have contributed to the reduction in mortality.

Accidents, Traffic↗
PubMedDate not supplied

[The diagnosis of perioperative myocardial infarction in heart surgery].

Fifty three consecutive patients undergoing open heart surgery were prospectively studied to assess current techniques for diagnosing perioperative myocardial infarction (PMI). All patients had preoperative and postoperative electrocardiograms, serial determinations of serum creatine phosphokinase (CK), myocardial fraction of CK (CK-MB) and scintigraphy with technetium-99m labeled pyrophosphate. Seven patients (13.2%) sustained perioperative myocardial infarction. Four of these patients exhibited abnormal Q waves, and one poor R wave progression. Three of them had a positive scintigram. Two patients with a non-Q-wave infarction had a abnormal radioisotopic imaging. The CK and CK-MB were higher in patients with infarction (818.1 U) than in those without this complication (349 U) p less than 0.05. The relative sensitivity and relative specificity of given variables in the diagnosis of PMI were as follows: electrocardiogram 71.4% and 97.5% respectively; scintigraphy 71.4% and 94.1%; and serum enzymes 100% and 71.8%. Age, incidence of prior myocardial infarction, unstable angina, elevated left ventricular filling pressure, number of diseased coronary arteries, and number of grafts per patient did not correlate with PMI. Duration of extracorporeal circulation and number of electric shocks during surgery were slightly higher in the infarction group, but the difference was not significant. These results indicate that the combination of these three diagnostic procedures is the best way to evaluate myocardial damage after open heart surgery.

Adult↗
PubMedDate not supplied

[Treatment of cerebrospinal fluid shunt infections using the Perrin and McLaurin technique. Analysis of 11 cases].

Eleven patients with shunt infection (SI) of the cerebrospinal fluid in whom the SI was withdrawn and replaced by a new SI system with reservoir and intraventricular and parenteral antibiotic treatment were reported. The diagnosis was made by culture of the components of the SI and, or, the cerebrospinal fluid. In 9 cases the agent was a staphylococcus. The different therapeutic trials to treat SI infections can be summarized as follows: a) replacement of the SI by an external drainage, antibiotics, and reinsertion of the SI when the cerebrospinal fluid was sterilized; b) withdrawal of the SI and placement of a new SI in the same surgical procedure associated with intraventricular and systemic antibiotic treatment; and c) treatment with intraventricular and, or, systemic antibiotics. It has been demonstrated that the surgical approach (a and b) is more effective. In our series the procedure indicated in B was followed by the control of the infection in all cases. The follow-up of the surgical treatment was 1-3 years. The most currently used SI was the ventriculoperitoneal bypass. Their main complications are pseudocysts which are easily recognized by of abdominal echography and frequently revealed SI infection. Diagnosis and treatment of SI infections should take into account the type of complications and the most appropriate collaboration with other clinical departments.

Adolescent↗
PubMedDate not supplied

[Importance and characteristics of burns in a pediatric emergency service].

The purpose of this study was to describe the magnitude and some relevant aspects of children with burn injuries as seen at the emergency room of a metropolitan hospital at Santiago, Chile, from a random sample of 22,430 consultations from a total of 137,220. Two hundred and thirty seven burn injuries were detected corresponding to 5.2% of all surgical consultations and 1.1% from the whole sample, 56.5% occurring in males, 73.4% of the affected patients were under 5 years of age, 72% of lesions were caused by hot liquids, 51.6% affected the upper limbs and 4.5% were considered to require admission to hospital wards. Consultations most frequent in july (winter) the lesser incidence occurring in february (summer). Preventive programs addressed to burn injuries should cover children under 5 years of age and should be specially focussed on winter and safe handling of hot liquids.

Adolescent↗
PubMedDate not supplied

[Evaluation of post-traumatic coma using evoked potentials].

In 130 cases of post-traumatic coma a study of multimodality evoked potentials (MEP) was carried out shortly after the traumatism (within 72 h). According to the morphology of the records they were classified in grades (I-IV) in agreement with Greenberg et al. The worst grade of EP in the different types was related to the outcome at 6 months, distinguishing between focal lesions and diffuse lesions. Only a group (22.9%) of the 109 patients in which the auditory brain-stem evoked potentials (ABEP) could be studied, showed severe disorders (grade III-IV). There was a significant correlation between the ABEP grades and the outcome in the focal lesions (p less than 0.001). In the diffuse lesions the ABEP grades did not show significant differences with the outcome. A 22.4% of the patients with diffuse lesions had some visual evoked potentials (VEP) in grades III-IV against almost the double (41.6%) in the focal lesions. The grades of the VEP in the focal lesions did not have differences with outcome and in the diffuse lesions they did (p less than 0.05). Approximately half of the cases with focal lesions and one third of the diffuse lesions showed severe disorders (grades III-IV) of the somatosensory evoked potentials (SEP). In the two types of lesions there were significant differences with the outcome (p less than 0.001) and (p less than 0.01). The multimodality evoked potentials (MEP) are useful for predicting the outcome, especially in the patients where the neurological examination is impossible. Among the different modalities, the SEP were shown to be more predictive.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Injuries↗
PubMedDate not supplied

[Inhibitory action of histamine on the isolated rat uterus].

1. The present work investigates in vitro the inhibitory dose-response curves to histamine, 4-methyl-histamine and 2-pyridylethylamine in depolarized (KCl 37 mM) uterus from estrogenous sensitized rats. 2. Dose-response curves for the various agonists were obtained in the absence and presence of selective histaminergic (clemizole and cimetidine) and adrenergic (propranolol and reserpine) blocking drugs. 3. Histamine and 4-methyl-histamine, but not 2-pyridylethylamine, produced dose-dependent relaxations of the uterus. 4. Neither clemizole nor propranolol displaced the inhibitory dose-response curves for histamine. 5. After adrenergic blockade with either propranolol or reserpine, cimetidine produced a rightward displacement of the dose-response curves to histamine. 6. Theses results suggest that the inhibitory effect of histamine is mediated through activation of H2 histamine uterine receptors.

Animals↗
PubMedDate not supplied

[Double-outlet left ventricle].

Two cases of double-outlet left ventricle with ventricular septal defects and pulmonic stenosis are described. Both had atrial situs solitus, one with concordant and another with discordant atrioventricular connections. Considering the clinical behaviour of the malformation, the diagnosis is difficult. Although the echocardiographic findings suggest the abnormality, angiocardiography is the best procedure for the accurate diagnosis.

Angiocardiography↗