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Biomedical subjects

F Aguirre

Publications and source records attributed to F Aguirre.

At least 73 records · Page 4Linked to original sources
PubMed1990

Early ambulation after 5 French diagnostic cardiac catheterization: results of a multicenter trial.

Because earlier ambulation and discharge after cardiac catheterization may result in the increased utilization of outpatient facilities, a prospective five center clinical pilot trial assessing the safety and outcome of early ambulation after routine left heart catheterization was performed in 287 patients. Catheterization routines at each clinical center were unchanged throughout the study. After the diagnostic catheterization using 5 French (F), preformed, large lumen catheters and arterial puncture compression (mean 15 min, range 5 to 52), 260 patients were ambulated by a physician at a mean time of 2.6 h (range 1.8 to 3.1) after catheterization. Follow-up examination or a phone call 24 to 72 h later was performed to assess late results. The mean age of the patients was 58 years (range 25 to 91); 166 (58%) were men. Left ventricular ejection fraction was 54 +/- 15%. One hundred twenty-seven patients (44%) received intravenous heparin (1,500 to 5,000 U as an intravenous bolus) and 136 (47%) received aspirin. Major complications included transient ischemic attack (one patient) and ventricular tachycardia requiring cardioversion during ventriculography (two patients). A small hematoma (less than 5.0 cm) after ambulation occurred early (from compression to standing) in 14 patients (5%; 9 received heparin, 8 were taking aspirin) and later (after standing to 72 h) in 9 patients (3%; 2 receiving heparin, 2 taking aspirin). Five patients with a hematoma had studies with a 6F sheath. No patient required surgical intervention for early or late hematoma. Only three patients (1%) needed a 7F or 8F catheter because of suboptimal 5F coronary angiography.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Use of coronary arteriography in the preoperative management of patients undergoing urgent repair of the thoracic aorta.

Noninvasive innovations have advanced the timing and precision of diagnosis of acute dissection or enlarging aortic aneurysm. However, the need to perform coronary arteriography prior to surgical repair in these patients remains a question for many clinicians. This retrospective 10-year (1978 to 1988) review examined data of 54 patients undergoing urgent surgical repair of thoracic aortic tear, aneurysm, or dissection in our institution. Results of coronary arteriography and clinical variables (history of coronary artery disease, electrocardiographic abnormalities, surgical procedures, and in-hospital mortality) were tabulated. Twenty-seven patients had type A aortic dissection and 27 patients had type B. Twenty-four patients had aortic dissection or tear (type A or B) due to motor vehicle trauma. In patients with type A, a history and/or electrocardiogram suggestive of coronary artery disease was present in 16, in whom cardiac catheterization was performed in five. None required coronary bypass surgery or died. In the 11 patients with no clinical history of coronary artery disease or electrocardiographic abnormalities, six had cardiac catheterization, none had coronary artery disease, two had coronary reimplantation, and six died. Only 1 of the 27 patients with type A dissection had a perioperative myocardial infarction (a patient with a clinical history of coronary artery disease who did not undergo cardiac catheterization). In patients undergoing type B aortic repair, 10 had a clinical history or electrocardiogram consistent with coronary artery disease but only one underwent cardiac catheterization and subsequent coronary artery bypass graft surgery for coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Perioperative and long-term prognostic value of intravenous dipyridamole thallium scintigraphy in patients with peripheral vascular disease.

The prognostic value of long-term risk stratification of patients with peripheral vascular disease who undergo intravenous dipyridamole thallium scintigraphy has not been well studied. We screened 131 patients with peripheral vascular disease who underwent intravenous dipyridamole thallium testing to determine cardiac event rates over an average follow-up of 18 +/- 10 months. Of the 131 patients, 111 subsequently had peripheral vascular surgery. The patients with abnormal thallium scans after dipyridamole had a significantly higher risk of death or myocardial infarction, both in the perioperative phase (7% versus 0%; p less than 0.001) and at late follow-up (17% versus 6%; p less than 0.01). The risk of a cardiac event was two-fold greater when a reversible as compared to a fixed thallium defect was present. Multivariate analysis selected the number of thallium segments with perfusion defects, prior history of angina pectoris, and chest pain during dipyridamole testing as perioperative predictors of a cardiac event. A reversible thallium defect was the only predictor of death or nonfatal myocardial infarction during late follow-up. Thus intravenous dipyridamole thallium scintigraphy is a useful noninvasive test for risk stratification of patients before peripheral vascular surgery and provides prognostic information as to the risk of a cardiac event in the 2-year period after the test. A reversible thallium defect is associated with a significant increased risk and would indicate that coronary angiography should be considered and preoperative coronary revascularization.

Aged↗
PubMed1990

Effect of abruptly increased intrathoracic pressure on coronary blood flow velocity in patients.

To assess the effects of abruptly increased intrathoracic pressure on coronary blood flow, arterial pressure, heart rate, and intracoronary Doppler blood flow velocity were measured continuously during cough(s) and again during the four phases of the Valsalva maneuver in 14 patients. Coughing significantly increased the systolic pressure (137 +/- 25 to 176 +/- 30 mm Hg), diastolic pressure (72 +/- 10 to 84 +/- 18 mm Hg), and arterial pulse pressure (65 +/- 27 to 92 +/- 35 mm Hg), with no change in heart rate. The mean coronary flow velocity decreased (17 +/- 10 to 14 +/- 12 cm/sec, p less than 0.03). During the Valsalva maneuver, despite marked reduction in the mean arterial pressure during phase III (96 +/- 12 to 68 +/- 14 mm Hg, p less than 0.05), the reduction of coronary blood flow velocity did not achieve statistical significance. These data demonstrate that neither type of abrupt physiologic increase in intrathoracic pressure enhances coronary blood flow. Coughing does not improve coronary perfusion pressures or flow velocity, despite marked increases in arterial diastolic pressure. The Valsalva maneuver, for the most part, does not significantly alter coronary blood flow velocity.

Blood Flow Velocity↗
PubMed1987

Treatment of bone, joint, and soft-tissue infections with oral ciprofloxacin.

We treated 52 patients with orally administered ciprofloxacin. In this study of 34 men and 18 women who completed therapy and who could be evaluated, there were 29 patients with nonhematogenous osteomyelitis, 20 patients with skin or soft-tissue infections, and 3 patients with joint infections. During the study, 92 isolates of pathogenic facultative aerobic bacteria, including 37 members of the family Enterobacteriaceae, 30 Staphylococcus aureus isolates, and 21 Pseudomonas aeruginosa isolates, were recovered, and 88 (96%) of the isolates were found to be susceptible to ciprofloxacin. Of the 29 patients with osteomyelitis, 14 have not experienced relapse after a follow-up of at least 1 year. Overall, 61% of infections were resolved, as judged by both clinical and microbiological criteria, during therapy. One patient developed Streptococcus salivarius sepsis during ciprofloxacin therapy, and one patient developed a rash which required discontinuation of ciprofloxacin. Otherwise, there were no serious reactions or complications.

Administration, Oral↗
PubMedDate not supplied

Abnormal coronary flow velocity reserve after coronary artery stenting in patients: role of relative coronary reserve to assess potential mechanisms.

BACKGROUND: Absolute coronary flow velocity reserve (CVR) after stenting may remain abnormal as a result of several different mechanisms. Relative CVR (rCVR=CVR(target)/CVR(reference)) theoretically normalizes for global microcirculatory disturbances and facilitates interpretation of abnormal CVR. METHODS AND RESULTS: To characterize potential mechanisms of poststent physiology, CVR was measured using a Doppler-tipped angioplasty guidewire in 55 patients before and after angioplasty, after stenting, and in an angiographically normal reference vessel. For the group, the percent diameter stenosis decreased from 75+/-13% to 40+/-18% after angioplasty and to 10+/-9% (all P<0.05) after stent placement. After angioplasty, CVR increased from 1.63+/-0.71 to 1.89+/-0.55 (P<0.05) and after stent placement, to 2.48+/-0.75 (P<0.05 versus pre- and postangioplasty). After angioplasty, rCVR increased from 0.64+/-0.26 to 0.75+/-0.23 and after stent placement to 1.00+/-0.34. In 17 patients with CVR(stent) < or = 2.0, increased basal coronary flow, rather than attenuated hyperemia, was responsible in large part for the lower CVR(stent) compared with patients having CVR(stent) >2.0. In 8 patients with CVR(stent) <2.0, a normal rCVR supported global microvascular disease. The subgroup of 9 patients with CVR(stent) <2.0 and abnormal rCVR (16% of the studied patients) may require a pressure-derived fractional flow reserve to differentiate persistent obstruction from diffuse atherosclerotic disease or microvascular stunning. CONCLUSIONS: Although a majority of patients after stenting normalize CVR for the individual circulation (ie, normal CVR or normal rCVR), in those with impaired CVR(stent), the analysis of coronary flow dynamics suggests several different physiological mechanisms. Additional assessment may be required to fully characterize the physiological result for such patients to exclude remediable luminal abnormalities.

Aged↗
PubMedDate not supplied

Glucocorticoid response and adrenal lipid peroxidation in rats submitted to chronic hypobaric hypoxia.

The well known physiological changes that occur in adaptation to chronic hypobaric hypoxia (CHH) prevent the fall in arterial blood oxygen pressure below normal limits but neither the ventilatory nor the circulatory adaptation are able to maintain a normal capillary blood pO2. We report here our findings on adrenal histology, function, and lipid peroxidation in intact and castrated rats of both sexes submitted to twelve weeks of adaptation to 4,400 m simulated altitude. In the CHH rats hematocrit was increased; adrenal weight was increased in males and decreased in castrated females. Adrenal histology and histochemistry were normal. Corticosterone level and uric acid were unchanged except in castrated animals: corticosterone was decreased in males and increased in females. Uric acid was increased in castrated males, the only group in which adrenal lipid peroxidation was unaffected by castration. In the remaining groups, it was diminished compared to their intact controls. Intact normoxic males showed a significant direct correlation between plasmatic lipoperoxidation products (TBA-reactive substances) and uric acid (r = 0.961), which disappeared under hypoxia or with castration. Sex related differences were found in hematocrit and adrenal weight responses. The presence of androgens was involved in the adaptative response of cortical and reticular histometry, lipid peroxidation, and corticosterone level. These results do not support Selye's hypothesis of exhausted adrenal glands in chronic stages of adaptation and suggest that a proper relation between adrenal and gonadal steroids hormones is essential for systemic and tissular responses to diminished oxygen supply.

Adaptation, Physiological↗
PubMedDate not supplied

Changes in the renin-angiotensin-aldosterone system in 2 kidney -2 clip Goldblatt hypertensive rats of both sexes submitted to chronic hypobaric hypoxia.

The effect of chronic hypobaric hypoxia (CHH) on the development of 2k-2c Goldblatt renovascular hypertension has been analyzed in rats of both sexes. Results have shown lower values of blood pressure (BP) in all the animals exposed to CHH compared with their normoxic control (P < 0.001). Haematocrit was increased by adaptation to CHH (P < 0.001), and was larger in male than in female hypoxic rats, both normotensive (P < 0.05) and hypertensive (P < 0.01). Plasma renin activity was higher in normoxic and hypoxic hypertensive female rats than in their normotensive controls (P < 0.05). Plasma angiotensinogen concentration was higher in normoxic control male rats than in all the other groups. This difference disappeared after adaptation to CHH or development of hypertension. Plasma aldosterone concentration was lowest in normoxic control male rats and the difference also disappeared after CHH or renal ischemia. Present data indicate that CHH blunts the hypertensive response to bilateral renal ischemia in male and female rats. Sexual differences related to the mechanisms that could be involved in hypertension development have been observed. The renin-angiotensin-aldosterone system might be modulated by gonadal hormones during the development of hypertension.

Aldosterone↗
PubMedDate not supplied

[Purulent urethritis secondary to intraurethral foreign body].

Due to the rarity of the cases presented in this paper, the prolonged time of residence in the urethra and the limited functional repercussion produced by the foreign bodies lodged in the urethra, we consider convenient the exposition of the mentioned cases.

Adult↗
PubMedDate not supplied

[Giant urethral lithiasis].

We present a case of giant urethral lithiasis, housed in the penile urethra. Owing to the scant incidence of this pathology and its rarity, as well as the small number of bibliographic references found, we believe it of interest to offer this fresh case.

Aged↗