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Biomedical subjects

F Jimenez

Publications and source records attributed to F Jimenez.

18 recordsLinked to original sources

Could CAPD modulate the hemodynamic changes induced by rHuEPO treatment?

Hemodynamic response to treatment with erythropoietin has been analyzed on two different groups of patients. The first group of 25 patients was treated with hemodialysis. The second group of 27 was treated with peritoneal dialysis. Both groups were studied before starting the treatment with erythropoietin, after reaching the hemoglobin target point, and after one year of treatment. The following parameters were recorded: basal and hemoglobin target point, time and dosage of response, incidence of arterial hypertension, diastolic and systolic left ventricular diameters, interventricular septum and posterior wall thickness, ejection fraction, fractional fiber shortening, left ventricular mass index, cardiac output index and peripheral resistance index. The incidence of hypertension was 28.8% and, in both techniques, stabilization of left ventricular mass index occurred a year later. When the hemoglobin target point was reached, a decrease in cardiac output and an increase in peripheral resistance was found. These changes were more evident in the group of patients treated with HD. After a year of treatment, both peripheral resistance and cardiac output were similar to basal values in both groups of patients.

Adult

Topographic maps of brain electrical activity in primary degenerative dementia of the Alzheimer type and multiinfarct dementia.

The topography of the electroencephalographic (EEG) pattern of ten patients with primary degenerative dementia of the Alzheimer type, ten multiinfarct dementia patients, and ten age-matched controls was compared during three different behavioral conditions: resting condition with eyes open (EO), memorizing a list of words (M), and recalling the same list of words (R). Results indicate that the alpha frequency band does not show significant changes. On the other hand, the theta band could be considered an important factor in the differential diagnosis of the primary degenerative dementia of the Alzheimer type, showing a higher power over right posterior regions in this group of patients compared with the multiinfarct dementia patients under different behavioral conditions.

Aged

Balloon valvuloplasty for mild mitral stenosis.

Of a total number of 288 patients with mitral stenosis treated by percutaneous balloon valvuloplasty, 21 patients had a basal mitral area equal to or greater than 1.5 cm2, as measured hemodynamically. The immediate hemodynamic results of this particular group of patients with mild mitral stenosis are described, as well as the clinical and echo doppler findings at follow-up (22 +/- 12 mo). Patients with mild mitral stenosis (group I) had more pliable valves (p less than 0.01), as assessed by echo, and higher incidence of sinus rhythm (p less than 0.02) than that observed in the remaining 267 patients (group II). After valvuloplasty the valve area increased in group I from 1.7 +/- 0.2 to 3.1 +/- 0.7 cm2 (p less than 0.0001). This mean final area was significantly different (p less than 0.0001) than that observed in group II (1.98 +/- 0.6 cm2). No patients with mild mitral stenosis developed progression of mitral regurgitation, and none had any other major complications. Most of them reached a grade I final functional status. At echo doppler follow-up studies we did not observe significant changes in the mean mitral gradient as compared with the immediate hemodynamic results. These findings suggest that early mitral balloon valvuloplasty could be an alternative in trying to favorably influence the natural course of the rheumatic mitral disease in selected patients.

Adult

False tendon rupture simulating chordal rupture after percutaneous mitral balloon dilation. A report of two cases.

We describe two cases of ruptured false tendons following percutaneous balloon dilation of the mitral valve in one case, and combined mitral and aortic balloon valvotomy in the other, using in both the retrograde approach. The echocardiographic characteristics of this previously unreported complication of the procedure are presented with special emphasis on the differentiation with true chordal rupture. No short or mid term adverse effects were noted following this complication.

Adult

Electroencephalographic activity and serum and cerebrospinal fluid pentobarbital levels in determining the therapeutic end point during barbiturate coma.

Controversy exists regarding the optimal means for monitoring the patient receiving pentobarbital therapy during medical coma. Serum pentobarbital levels have been used traditionally to gauge cerebral penetration and efficacy of the drug. These peripheral levels have been assumed to reflect pentobarbital concentrations in the cerebrospinal fluid (CSF) and, therefore, the physiological effect on the central nervous system. To determine the relative accuracy of serum versus CSF pentobarbital levels, continuous electroencephalographic (EEG) monitoring in 10 consecutive patients was studied prospectively. Each patient received pentobarbital therapy for cerebral protection in the face of a traumatic injury. Simultaneous serum and CSF pentobarbital levels were obtained 1) before and after the initial barbiturate bolus, 2) every 12 hours during constant infusion therapy, and 3) before and after subsequent boluses necessary because of elevated intracranial pressure (ICP) (ICP greater than 15 mm Hg) or loss of burst suppression by continuous EEG monitoring (defined as greater than five bursts per minute). ICP and relevant clinical events were recorded hourly. Serum and CSF levels ranged from 33 to 74 mg/L and 4 to 54 mg/L, respectively. There was poor correlation between serum and CSF pentobarbital levels at any given time, although patients remained in burst suppression 73% of the time during their therapy. The EEG monitoring not only provided dynamic physiological monitoring, but it also permitted the lowest pentobarbital dose to maintain burst suppression for a specific patient's metabolism, reducing the likelihood of toxicity. In conclusion, CSF pentobarbital levels are of no greater accuracy than serum pentobarbital levels in predicting physiological effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease

Balloon valvuloplasty for mitral restenosis after previous surgery: a comparative study.

We studied 203 patients with mitral stenosis treated by transarterial valvuloplasty. Forty two (group A) had undergone closed (n = 30) or open n = 12) surgical commissurotomy 15 +/- 5 years before. The remaining 161 had not undergone previous surgery (group B). There were no significant differences between both groups in terms of age, sex, functional class, left atrial size, two-dimensional anatomic features of the valve, incidence of mild basal mitral regurgitation, or ejection fraction. A comparative analysis of both groups showed no significant differences in terms of changes in the mean gradient, mitral valve area, and incidence of severe postvalvuloplasty mitral regurgitation (9.5% versus 5.5%). Echo-Doppler follow-up studies (11 +/- 7 months) showed persistent gradient relief in either group. We conclude that the immediate and short-term results of balloon valvuloplasty in patients who had undergone previous surgery are similar to those observed in patients who had not had commissurotomy.

Catheterization

Sertoli cell types in the Sertoli-cell-only syndrome: relationships between Sertoli cell morphology and aetiology.

Histological study of testicular biopsies from infertile men showing Sertoli-cell-only tubules due to hypogonadotropic hypogonadism, cryptorchidism, oestrogen treatment, chemotherapy or Del Castillo's syndrome, revealed four types of Sertoli cells: (1) normal adult mature cells showing an indented nucleus, grossly triangular in shape with a prominent tripartite nucleolus; (2) immature cells with round regularly outlined nuclei and immature cytoplasm; (3) dysgenetic cells showing immature nuclei and a nearly mature cytoplasm with less developed cytoplasmic organelles; and (4) involuting cells with very irregularly outlined nuclei and a mature cytoplasm containing abundant lipid droplets and residual bodies and atypical inter-Sertoli junctional specializations. Testes from men with hypogonadotropic hypogonadism showed only immature Sertoli cells; cryptorchid testes showed dysgenetic cells and occasional normal cells; and after treatment with oestrogens or chemotherapy the testes showed involuting cells and normal cells. The testes of men with Del Castillo's syndrome could be classified into three groups, according to the Sertoli cell type present: mature, dysgenetic and involuting cells. This finding suggests that Del Castillo's syndrome may be due to at least three different aetiologies.

Adult

Combined percutaneous mitral and aortic balloon valvuloplasty.

Between August 1987 and November 1988, combined mitral and aortic balloon valvuloplasty was performed in 10 patients (mean age 42 +/- 9 years), all of whom had symptomatic mitral and aortic stenosis. The procedure was performed using a transarterial approach with a multiballoon catheter and an exteriorized intracardiac long guidewire circuit. The procedure could be considered successful in 9 patients where significant increases in the mean mitral (0.97 +/- 0.19 to 1.80 +/- 0.26 cm2) and aortic (0.63 +/- 0.18 to 1.15 +/- 0.32 cm2) areas were achieved. Severe mitral regurgitation that required surgery developed in 1 patient in the following 24 hours. Femoral vascular surgery was necessary in 1 patient. Mid-term follow-up was available in 8 patients for a period averaging 8 +/- 3 months. The 9 patients in whom the procedure was successful showed persistent clinical improvement in functional class, Doppler echocardiography showed 2 cases of aortic restenosis and none of mitral restenosis. Combined mitral and aortic balloon valvuloplasty could be a valid alternative treatment in selected patients with both mitral and aortic rheumatic stenosis. Further experience and long-term hemodynamic follow-up are necessary to define the role of this mode of treatment.

Adult

Spontaneous healing of Kaposi's angiosarcoma of the penis.

We report a case of Kaposi's angiosarcoma of the penis. Few cases have been reported of the initial and exclusive involvement of Kaposi's angiosarcoma of the glans penis and prepuce. Our case is unique because of the number of lesions and the spontaneous remission.

Aged

Popliteal artery and venous aneurysm as a complication of arthroscopic meniscectomy.

A 29-year-old man presented a 2-week history of right popliteal fossa and leg swelling following an arthroscopic meniscectomy. Roentgenographic evaluation showed an arterial and venous aneurysm at the popliteal level, with an associated arteriovenous fistula. Popliteal aneurysm in young men is very rare and generally related to open surgical techniques; incidence with arthroscopic techniques is extremely infrequent.

Adult

Autogenous rib graft-hydroxylapatite augmentation of the severely atrophic mandible: preliminary report.

Traditional transoral rib grafts were combined with particulate hydroxylapatite (HA) for augmentation in four patients who had advanced alveolar atrophy or cortical resection of the mandible. Follow-up evaluation for up to 18 months revealed restoration of mandibular morphology, with good prosthetic function and insignificant resorption. No infection or graft loss was observed, in spite of wound dehiscence in two of the four patients, possibly due to the placement of the HA lateral and superior to the rib grafts.

Aged

[Polyorchism].

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Child

Intraoperative balloon valvuloplasty in pulmonary valve stenosis.

Balloon valvuloplasty was used in the operating room on 7 patients to visually assess the valvular changes induced by inflation of a balloon catheter. All patients had typical pulmonary valve stenosis and an associated cardiac condition which necessitated surgery. Of 23 fused commissures present, 21 were successfully opened with a single balloon inflation. In 2 patients, damage to the leaflets was observed. In 1 patient there was partial detachment and in the other a small tear was noted at the margin of one leaflet. These intraoperative results may be similar to the results obtained with percutaneous balloon valvuloplasty.

Adolescent

A new type of adjustable vascular introducer for balloon valvuloplasty: technical note.

To minimize vascular damage in percutaneous balloon valvuloplasty, a new type of dynamic adjustable vascular introducer has been developed which is capable of both expanding and contracting on the passage of a balloon catheter. This ability greatly reduces damage to the vessel and limits blood loss at the site of entry during the procedure. It has been used in both mitral and aortic balloon valvuloplasty.

Catheterization