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Biomedical subjects

E Ruiz

Publications and source records attributed to E Ruiz.

At least 109 records · Page 6Linked to original sources
PubMed1991

[Continuous ambulatory peritoneal dialysis (CAPD): an alternative for the treatment of children with terminal chronic renal insufficiency in Argentina].

Twenty three children aged 0.4 to 15 years, (x 7.5 years) with end-stage renal disease were treated with continuous ambulatory peritoneal dialysis (CAPD) over 46 months. The mean time of treatment for the group was 13 months (range 1.0 to 31 months). Sixty five percent of the patients had readmission after catheter placement; 53% were for peritonitis. Nine out of 23 patients (39%), presented 20 episodes of peritonitis, an incidence of one episode per 15 patient months. Gram positive organisms were culture in 60% of these episodes. A total of 26 peritoneal catheters were placed in 23 patients. Of the five catheters that required replacement, three were for peritonitis. Seven out of 23 patients had nephrotic syndrome when admitted to CAPD, four of which develop peritonitis. Although no difference was seen between nephrotic and non nephrotic patients in relation to CAPD initiation and peritonitis development, nephrotic patients without peritonitis and non nephrotic had significantly higher initial growth index for height and iron binding capacity than those with nephrotic syndrome and peritonitis (-1.71 +/- 0.90 vs -2.29 +/- 0.27, P less than 0.05, and 265 +/- 50.5 vs 175 +/- 5.0 mg/dL, P less than 0.0005, respectively). No difference in mean plasma gamma globulin concentration was seen between patients with and without peritonitis. In 14 patients followed for a period greater than to 6 months, the delta growth index for weight and height and was: -0.13 +/- 0.31 and -0.31 +/- 0.46, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Activity of the hypothalamo-pituitary ovarian axis in hypothyroid rats with or without triiodothyronine replacement.

The hypothalamic pituitary ovarian axis in adult female rats with 131-I induced hypothyroidism was studied before and after triiodothyronine (T3) replacement. Forty days after 131-I, hypothyroid (H) rats showed irregular cycles with predominantly diestrous vaginal smears, atrophied and underweight ovaries, and decreased serum T3, T4, LH and estradiol (E2). T3 replacement restored normal cycles and ovary weight and increased serum E2 levels above control values, while LH levels remained below the limit of detection of the RIA. The GnRH stimulation test performed on the day that the rats exhibited diestrous vaginal smears elicited a greater increase in FSH than in LH in H rats and a greater increase in LH than in FSH in both H-T3 treated and control rats. The data suggest that the lack of thyroid hormones in adult female rats seems to produce a reversion of sexual hormones to a prepubertal pattern, while T3 treatment restored normal estrous cycles and ovarian function.

Animals↗
PubMed1990

Fiberoptic intubation in the emergency department.

Fiberoptic-aided endotracheal intubation has been shown to be effective in difficult intubation secondary to anatomic abnormalities and traumatic conditions. A retrospective review of emergency airway management in an emergency department during a 30-month period found 35 patients who underwent fiberoptic-aided endotracheal intubation; 31 were treated for medical conditions, and four were trauma patients. Indications in the medical group included failed nasotracheal intubation (ten), anatomic abnormalities (six), and the initial airway maneuver attempted (15). Indications in the trauma group with suspected cervical-spine injury included failed nasotracheal intubation (one) and initial airway maneuver attempted (three). In the medical subgroup, 25 of 31 patients were intubated successfully fiberoptically. All four trauma patients were intubated successfully, and all attempts were done nasally. The limitations of the technique were varied. Twenty of the 25 successful intubations had times recorded for completion (mean time, 1.8 +/- 1.4 minutes [SD]). Four of the six failed attempts had recorded times of 7.8 +/- 1.4 minutes. The mean time of the four trauma cases was 3 +/- 2.2 minutes. The presence of secretions, blood, or vomitus was the cause in five of the six failed intubations. The sixth patient kept swallowing the distal end of the scope. Fiscal restraints may also limit its use. At our institution, the financial commitment has been approximately +17,000 during the past nine years. Repair or replacement of broken equipment appears to be necessary every two or three years. Immediate airway control is often difficult with fiberoptic-aided endotracheal intubation and should be used only in selected patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Costs and Cost Analysis↗
PubMed1989

An analysis of time delays preceding thrombolysis for acute myocardial infarction.

For a patient to derive maximal benefit from intravenous thrombolytic therapy for acute myocardial infarction, early treatment is essential. As part of the Thrombolysis in Myocardial Infarction II trial, this study investigated the time delays that preceded treatment of 236 consecutive patients with intravenous tissue-plasminogen activator (TPA) during acute myocardial infarction. The average (+/- SD) time from the onset of symptoms to treatment with TPA was 153 +/- 54 minutes. After arrival in the emergency department, patients waited an average of 19.9 +/- 17.8 minutes for the initial electrocardiogram. Following the diagnosis of acute myocardial infarction by electrocardiogram, an additional 70 +/- 40 minutes elapsed before thrombolytic therapy began. The interval between the initial electrocardiogram and initiation of treatment with TPA was less when the drug was first administered in the emergency department (46.8 +/- 23.4 minutes) rather than after transfer to the coronary care unit (82.1 +/- 34.7 minutes). In-hospital delays at the two academic and two private hospitals accounted for more than half of the total time from the onset of symptoms to initiation of thrombolytic therapy. We conclude that significant in-hospital delays are likely to occur before a patient receives thrombolytic therapy for acute myocardial infarction. Various factors conspire to create these delays, but a well-organized team approach to treatment will help to minimize delays in the implementation of this new form of therapy.

Adult↗
PubMed1989

A comparison of open peritoneal lavage with modified closed peritoneal lavage in blunt abdominal trauma.

A randomized prospective study compared open peritoneal lavage using a peritoneal dialysis catheter with modified closed lavage using either the Lazarus-Nelson or Cook lavage catheter. The time required to perform the lavage, technical difficulties, complications, and accuracy were assessed in 63 adult victims of blunt abdominal trauma. The average time to perform lavage was 21.1 minutes for open lavage, 14.7 minutes for Lazarus-Nelson closed lavage, and 9.8 minutes for Cook closed lavage. The closed technique using the Cook catheter was significantly faster than open lavage. Technical difficulties were significantly less frequent with Cook catheter closed lavage than with Lazarus-Nelson catheter closed lavage. The overall complication rate was 1.8%, and the overall accuracy was 98.1%, without apparent difference among techniques. It is concluded that, when no contraindications to closed lavage exist, and when time is of importance, closed lavage with the Cook catheter is the preferred technique.

Abdominal Injuries↗
PubMed1989

Comparison of single-dose meperidine, butorphanol, and dihydroergotamine in the treatment of vascular headache.

We treated 64 emergency room patients with a primary vascular headache with dihydroergotamine (DHE), meperidine, or butorphanol. Post-treatment pain scores were lowest in the DHE group (p less than 0.01). Eight of 21 patients receiving DHE had greater than 90% reduction in pain compared with three of 19 patients receiving butorphanol and none of 22 receiving meperidine.

Adult↗
PubMed1989

Incidence and diagnosis of C7-T1 fractures and subluxations in multiple-trauma patients: evaluation of the advanced trauma life support guidelines.

A 5-year retrospective review was done to evaluate C-7 and C7-T1 cervical spine injuries and to assess the advanced trauma life support guidelines for cervical spine evaluation. Eighteen fractures of C-7 and four fracture-dislocation at C7-T1 were identified. Nineteen of the patients had neck pain, tenderness, or neurologic findings on initial examination. Three patients were awake and asymptomatic. The initial diagnosis could be made from lateral cervical spine x-ray film in only three of the 22 patients. In the remaining patients, the diagnosis was made by either swimmer's view (7 of 8 positive), oblique views (1 of 1 positive), flexion-extension views (2 of 3 positive), or computed tomography (CT) scan (7 of 7 positive). In two patients, the diagnosis was not made in the first 24 hours. Follow-up x-ray films were positive in 3 of 22 lateral cervical spine films, 10 of 14 swimmer's views, 2 of 3 oblique views, 2 of 3 flexion-extension views, and 14 of 20 CT scans. The data support the advanced trauma life support recommendation for liberal use of cervical spine radiologic screening. We recommend that the screening examination consist of a lateral cervical spine film, and a swimmer's view, if necessary, to visualize C-7 and the C7-T1 interspace. We further recommend that strong consideration be given to the use of a five-view trauma series. CT scan should be viewed as complementary to conventional film techniques.

Adolescent↗
PubMed1988

Influence of intracerebroventricular (ICV) injection of ACTH (1-24) on plasma gonadotropin in female rats: dose-response study.

The intracerebroventricular (ICV) injection of ACTH (1-24) (0.1, 1.0 and 2.5 micrograms) to adult conscious ovariectomized (OVX) rats caused a dose-related inhibition of plasma LH at 10 min postinjection. The ICV injection of ACTH (1-24) (2.5 micrograms) to OVX rats in the absence or presence of a single dose of estradiol benzoate (OVX + EB): a) Decreased significantly plasma LH levels in OVX rats at 10 and 30 min postinjection. b) Decreased significantly plasma LH levels in (OVX + EB) rats at 10 min but not at 30 min postinjection. c) Did not change plasma FSH levels at 10 or 30 min postinjection in both (OVX) or (OVX + EB) rats. d) Did not change plasma ACTH levels at 10 or 30 min postinjection in (OVX) rats. Our observation suggest that ACTH (1-24) inhibited plasma LH, possibly through brain sites of action.

Adrenocorticotropic Hormone↗
PubMed1988

Balance of production and consumption of ATP in ammonium-starved Saccharomyces cerevisiae.

To establish a balance between the ATP produced in catabolism and the ATP consumed in net biosynthesis of cellular components the energy metabolism of Saccharomyces cerevisiae utilizing glucose in the absence of a nitrogen source (resting cells) was studied. The following results were obtained. (i) Cell number and biomass increased 2- and 2.5-fold, respectively, during the first 8 h of ammonium starvation. After this period, both values remained constant. (ii) The rate of sugar consumption and ATP production decreased with the duration of starvation to about 20% of the original in 24 h. (iii) About 60% of the sugar consumed was fermented to ethanol and about 10% assimilated as cellular material. Of the assimilated sugar, as much as 80% was accumulated as carbohydrate. (iv) Only 15% of the total ATP produced in catabolism seems to be consumed in net biosynthesis and maintenance of intracellular pH. The fate of the remaining 85% is unknown.

Adenosine Triphosphate↗
PubMed1988

[Effects of age and obesity on the conversion of androstenedione to estrone in postmenopausal women].

The effects of aging as well as body weight on conversion of circulating Androstendione (A) to Estrone (E1) in 21 postmenopausal women of different ages and body weights have been studied. Serum concentration of A and E1 were measured by RIA. The E1/A ratio was correlated with total body weight, body mass index, excessive body weight, age and years after cessation of menstruation. The results show that the E1/A ratio was significantly correlated with total body weight, body mass index and excessive body weight. In contrast the E1/A ratio is not significantly correlated with age or years after cessation of menstruation.

Aging↗
PubMed1987

Frequency of hypokalemia after successfully resuscitated out-of-hospital cardiac arrest compared with that in transmural acute myocardial infarction.

To evaluate the prevalence of hypokalemia in out-of-hospital cardiac arrest, the initial serum potassium and arterial pH values were reviewed from 138 consecutive patients resuscitated from cardiac arrest. For comparison, the same variables were reviewed for 62 consecutive patients who had transmural acute myocardial infarction (AMI) without cardiac arrest. The mean serum potassium level was lower after resuscitation from cardiac arrest (3.6 +/- 0.6 mEq/liter) than during AMI (3.9 +/- 0.5 mEq/liter) (p less than 0.005). The incidence of hypokalemia (potassium less than 3.5 mEq/liter) was greater in patients sustaining cardiac arrest (41%) than in patients who had AMI without cardiac arrest (11%) (p less than 0.001). Hypokalemia was common after cardiac arrest regardless of the occurrence of AMI at the time of arrest. Hypokalemia after cardiac arrest was independent of arterial pH, epinephrine or bicarbonate therapy during resuscitation, or prior therapy with diuretic drugs, digoxin or propranolol. In 10 patients with marked hypokalemia, the serum potassium level returned to normal rapidly (16 hours) during the hospitalization even though only 29% of the predicted potassium requirement was infused before its normalization. Thus, hypokalemia is prevalent immediately after out-of-hospital cardiac arrest, whereas it is uncommon in AMI in the absence of cardiac arrest. The cause and electrophysiologic consequences of this hypokalemia are unknown; in most cases, it is apparently caused by a shift of potassium from the intravascular compartment rather than a total body depletion of potassium.

Acute Disease↗
PubMed1987

Testosterone implants into the lateral septum of male rats, a positive effect on LH and FSH secretion.

After two days, testosterone implanted into the lateral septum increased serum levels of LH and FSH in male Wistar rats. As measured by RIA, LH in animals with testosterone implanted in them in comparison to those with an empty cannula was 0.220 +/- 0.015 vs. 0.111 +/- 0.019 ng/ml; p less than 0.001 and FSH was 3.20 + 0.21 vs. 1.50 + 0.21 ng/ml; p less than 0.001. Serum testosterone was not increased to a statistically significant extent by the implants (4.12 +/- 0.54 vs. 2.87 +/- 0.42 ng/ml; ns). It was concluded that testosterone or possibly one of its metabolites acting in the lateral septum facilitates the release of LH and FSH.

Animals↗
PubMed1987

A trial of povidone-iodine in the prevention of infection in sutured lacerations.

A prospective, randomized study of 500 consecutive emergency department patients with traumatic lacerations requiring sutures was performed comparing use of topical 1% povidone-iodine (Betadine) and scrubbing with wound management by irrigation with normal saline without scrubbing. A 60-second wound irrigation and scrub with a 1% povidone-iodine solution was the only difference in treatment between the two groups. Data relating to risk factors such as age; degree of contamination; type of closure; ethanol intoxication; mechanism of injury; and bone, joint, or tendon involvement were analyzed. Wounds were classified as clean, infected, or purulent at follow-up examination. One hundred five patients were lost to follow-up. Of the 395 remaining patients, 122 were contacted by phone and were classified based on their description of the wound; 273 were classified at reexamination in the ED. Of 201 povidone-iodine group wounds, 11 became infected; two of them (5.4%) were purulent. Of 194 control wounds, 30 became infected, of which 12 (15.46%) were purulent (P less than .01). These data suggest that use of a topical 1% povidone-iodine solution in traumatic lacerations prior to suturing reduces the incidence of wound infections.

Adult↗
PubMed1987

Haloperidol for sedation of disruptive emergency patients.

Agitated, threatening, or violent behavior often jeopardizes the patient with self-inflicted injury or delays medical evaluation and treatment. Patient cooperation with therapy can be achieved using haloperidol by the IM, IV, or oral route. The safety and efficacy of haloperidol in the emergency department setting was examined. Haloperidol was administered to 136 patients to control behavior. Eighty-eight received the drug in the ED; 18 of these 88 were critical patients receiving the drug during resuscitation. Forty-eight of the 136 were crisis intervention center patients. Ninety patients were acutely intoxicated with ethanol. Twenty-three patients had head trauma; 20 of these also were inebriated. Various other drugs were responsible for the behavior of 15 patients. Acute psychosis was involved in 40 cases. Thirty-one patients were thought to have a personality disorder. The route of administration of haloperidol was intramuscular in 110, IV in 19, and oral in seven patients. Disruptive behavior was alleviated within 30 minutes in 113 of 136 (83%) patients. Effect was judged suboptimal in 20 of 136 (15%), and no effect was noted in three of 136 (2%) patients. Four complications (3%) were noted, three minor and one more serious episode of hypotension in a critical patient. Haloperidol is a safe and efficacious drug for use with disruptive patients in the emergency setting. It is a useful tool for management of agitation of diverse etiologies.

Administration, Oral↗
PubMed1987

Comparison of gastric lavage and thoracic cavity lavage in the treatment of severe hypothermia in dogs.

A study was undertaken to compare warm gastric (Group 1) and closed thoracic cavity (Group 2) lavage for rewarming severely hypothermic dogs. Adult mongrel dogs were monitored by intra-arterial catheter, central venous catheter, and ECG, and by central venous, esophageal, and rectal temperature probes. Animals were externally cooled to an average of 21.2 C using ice bags. Eight Group 1 and eight Group 2 animals underwent continuous warm saline gastric or closed thoracic cavity lavage, respectively, using afferent and efferent nasogastric and thoracostomy tubes. No animal suffered ventricular fibrillation during tube placement. The closed lavage system consisted of a high-efficiency heat exchanger, a roller pump infusion device, and a heat exchange fluid bath. The lavage fluid circulated at a flow rate of 550 mL/min and a temperature of 39 C. Thoracic lavage animals were followed clinically for 24 hours for evidence of complications, then euthanized and autopsied. The mean time required to rewarm the animals 10 C by central venous temperature probe was 210.9 +/- 18.6 minutes for the gastric group and 99.3 +/- 23.0 minutes for the thoracic group (P less than .001). Rectal temperature consistently lagged behind central venous temperature during both the cooling and rewarming phases in both treatment groups. All of the thoracic lavage animals made an uneventful recovery. Continuous warm saline thoracic cavity lavage for core rewarming of severely hypothermic dogs is more effective than gastric lavage, and appears to be safe.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗