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Biomedical subjects

F Pérez

Publications and source records attributed to F Pérez.

At least 19 recordsLinked to original sources
PubMed2002

Is prosthetic umbilical hernia repair bound to replace primary herniorrhaphy in the adult patient?

Given the outstanding outcome that prosthetic repair has recently achieved in the repair of inguinal hernia, we wonder whether it should be implemented as the gold-standard technique for umbilical hernia repair. We report on 213 adult patients who underwent surgery for umbilical hernia at our Day Surgery Unit from June 1992 to January 1998. Criteria for exclusion included problematic social and family environment and ASA IV status. A polypropylene plug was placed in small umbilical defects, whereas large defects (> 3 cm in diameter) were repaired with a polypropylene mesh. The mean follow-up was 64 months. The mean age was 57.1 years, with females accounting for the majority (57.8%). Most patients (88.3%) were classified as ASA I-II. With regard to the hernia size, 143 patients (67.1%) presented with small defects (< 3 cm). The anaesthetic technique of choice was local plus sedation. Reported complications included seroma (5.6%), haematoma (2.3%), wound infection (1.4%), and intolerance to prosthesis (0.95%), the last causing recurrence. The overall recurrence rate at a mean follow-up of 64 months was 0.95%. Prosthetic umbilical hernia repair can safely be performed in adults, and the rate of recurrence in this study is low in comparison to primary tissue repair.

Adolescent↗
PubMed2002

Placental transfer of albendazole sulphoxide enantiomers in sheep.

Albendazole sulphoxide (ABZSO) is an anthelmintic drug used in veterinary practice. Its molecule has a chiral centre in the sulphur atom and racemic formulations are always used. The kinetics of the ABZSO enantiomers in the last third of pregnancy in ewes, and the placental transfer to the fetus, were studied after a single-dose oral administration (7.5 mg/kg) of a racemic formulation. In mothers, the area under the plasma concentration-time curve (AUC) and C(max) values of (+)-ABZSO (42.4+/-10.5 microg/mL and 1.9+/-0.4 microg/mL, respectively) were higher than those of (-)-ABZSO (15.3+/-5.1 microg/mL and 1.0+/-0.3 microg/mL). The MRT values were 17.0+/-1.6 h for (+)-ABZSO and 13.1+/-1.8 h for (-)-ABZSO. Similar kinetic parameters were obtained in the fetus for both enantiomers, but the fetal concentrations were lower compared with values for the dam. The AUC ratio between (-)-ABZSO/(+)-ABZSO in the dam was 0.36 and in the fetuses 0.64, indicating a higher impairment for the (+)-enantiomer in its placental transfer to the fetus.

Administration, Oral↗
PubMed2001

[HELLP syndrome].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed2001

[Postsurgical meningitis caused by Acinetobacter baumannii: study of 22 cases and review of the literature].

BACKGROUND: Postsurgical Acinetobacter baumannii meningitis is associated with relevant morbidity and mortality. It has been related to neurosurgery, intraventricular catheters (IC) or CSF fistula. Thus, features, epidemiology and clinical course of this infection were studied. METHODS: Retrospective analysis of 22 episodes of nosocomial postsurgical Acinetobacter baumannii meningitis. Twenty episodes occurred in males. The mean age of patients was 46 years (range: 16-83 years). RESULTS: All patients were admitted to the ICU. In 50% of patients a history of intraventricular hemorrhage was recorded, 36% had had a skull fracture and the remaining patients had a brain tumor. In 18 cases the portal of entry was considered to be IC, in two an epidural catheter, and in two a CSF fistula. Patients showed a clinical picture indistinguishable from other types of meningitis, fever being the most common symptom (100%). CSF findings were consistent with bacterial meningitis. In one case the microorganism was recovered from blood. Fifteen patients recovered, three died as a direct result of the infection, and the remaining patients relapsed. Non recovery of patients was significantly associated with non removal of catheter (p < 0.05). CONCLUSIONS: Postsurgical Acinetobacter baumannii meningitis occurs frequently in patients previously colonized with this microorganism in other sites and is enhanced by the presence of an IC. Catheter removal is essential for recovery of patients.

Acinetobacter Infections↗
PubMed2001

Bovine immunodeficiency virus in experimentally infected rabbit: tropism for lymphoid and nonlymphoid tissues.

The bovine immunodeficiency virus (BIV)/New Zealand (Oryctolagus cuniculus) rabbit model was used to study events that underlie the early and chronic stages of viral replication, routes and time course of viral dissemination and the distribution of the virus in the lymphoid. nonlymphoid and mucosa associated tissues. The results indicated that BIV, a lentivirus with genetic relatedness to the HIV, induced changes of clinical (anorexia, weight loss, muscular wasting, diarrhea, hypoalgesia, torticollis), immunological (recurrent T- and B-cell dysfunctions) and histopathological (lymphadenopathy, splenomegaly) nature that closely parallels those described for cat (Fly), monkey (SIV) and human (HIV) lentiviral diseases. These findings showing that BIV induces both splenomegaly and lymphadenopathy syndromes with associated fatal immune dysfunctions and the ability of the virus to replicate productively at the mucosal surfaces in rabbits, emphasize the importance of the BIV/rabbit system as a good small-animal model for the study of retrovirus-induced AIDS and offers the opportunity to evaluate prophylactic and therapeutic anti-retroviral agents of relevance to HIV-1 as well as the opportunity to study mechanisms of drug resistance phenomena.

Animals↗
PubMed2001

Hernia surgery for the third millennium. Does classical herniorraphy still play a role?

The steadily increasing use of prosthetic grafts in hernia repairs can be said to play down the classical approach for repairing groin hernia. We retrospectively report on 894 patients operated on for groin hernia at our out-patient surgery clinic from June 1992 to May 1998. Herniorraphy was widely performed (96.3%). The recurrence rate was of 1.6% (overall). For patients younger than 45 yr with no systemic concurrent disease, as few as 0.1% relapsed after a 58-month average follow-up. According to our results, ambulatory herniorraphy can provide an excellent degree of efficiency in selected young patients suffering from indirect unilateral primary groin hernia. Likewise, we regard the prosthetic repair as the gold standard technique in those patients with a weakened posterior inguinal wall.

Journal Article↗
PubMed2001

Influence of killer strains of Saccharomyces cerevisiae on wine fermentation.

The effect of killer strains of Saccharomyces cerevisiae on the growth of sensitive strains during must fermentation was studied by using a new method to monitor yeast populations. The capability of killer yeast strains to eliminate sensitive strains depends on the initial proportion of killer yeasts, the susceptibility of sensitive strains, and the treatment of the must. In sterile filtered must, an initial proportion of 2-6% of killer yeasts was responsible for protracted fermentation and suppression of isogenic sensitive strains. A more variable initial proportion was needed to get the same effect with non-isogenic strains. The suspended solids that remain in the must after cold-settling decreased killer toxin effect. The addition of bentonite to the must avoided protracted fermentation and the suppression of sensitive strains; however, the addition of yeast dietary nutrients with yeast cell walls did not, although it decreased fermentation lag.

Culture Media↗
PubMed2001

Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults.

BACKGROUND: Prosthetic repair has become the standard method for inguinal hernia and has excellent results. The question remains of whether the mesh technique could also improve results for umbilical defects. METHODS: The study was a randomized clinical trial comparing herniorrhaphy (primary suture) with hernioplasty (polypropylene mesh or plug) in 200 adult patients with a primary umbilical hernia. Patients at high anaesthetic risk (American Society of Anesthesiologists (ASA) grade IV) or those who needed emergency surgery were excluded. The mean postoperative follow-up was 64 months. The population studied included 118 women and 82 men with a mean age at presentation of 57 years. Some 173 patients were ASA grade I-II and 27 were ASA III. The anaesthetic technique of choice was local anaesthetic infiltration plus sedation (98 per cent). RESULTS: There were no significant anaesthetic complications or surgical deaths. The mean duration of surgery was greater for mesh than for suture repair (45 versus 38 min). Rates of early complications such as seroma, haematoma or wound infection were similar in the two groups. The hernia recurrence rate was higher after suture repair (11 per cent) than after mesh repair (1 per cent) (P = 0.0015). CONCLUSION: Prosthetic repair could become the standard treatment for primary umbilical hernia in adults.

Adolescent↗
PubMed2001

Successful treatment of severe intra-abdominal bleeding associated with disseminated intravascular coagulation using recombinant activated factor VII.

Recombinant activated factor VII (rFVIIa) is indicated mainly for the treatment of patients with haemophilia and inhibitors. However, little information is available on the use of rFVIIa in the treatment of the severe bleeding associated with disseminated intravascular coagulation (DIC). We report a pregnant woman with DIC, who developed severe intra-abdominal bleeding after caesarean section. Despite treatment with fresh-frozen plasma, fibrinogen, platelet transfusions and surgery, the abdominal bleeding persisted and intravenous treatment with rFVIIa was initiated. The response to treatment was rapid, with control of the bleeding and resolution of the coagulopathy. No side-effects related to rFVIIa were noted. This case suggests a potential role for rFVIIa in the treatment of severe and refractory bleeding associated with DIC.

Acute Disease↗
PubMed2001

Effect of calcium hydroxide form and placement on root dentine pH.

AIM: The aim of this study was to measure variations in dentinal pH following the placement of various forms of calcium hydroxide in either the root canal or the pulp chamber. METHODOLOGY: Extracted single-rooted human teeth were prepared, and the root canals instrumented using a conventional technique. Three cavities were drilled through the root dentine to within 1 mm of the canal wall at the cervical, middle and apical thirds. A total of 125 teeth were randomly divided into five groups; group 1: pure aqueous calcium hydroxide paste (calcium hydroxide/distilled water solution) was placed in the root canal; group 2: the same aqueous calcium hydroxide paste was placed in the pulp chamber; group 3: Hycal, a new form of calcium hydroxide paste, was placed in the pulp chamber; group 4: calcium hydroxide gutta-percha points were placed in the root canal; group 5: control group, wet canal (distilled water) without medication. The access cavities and apical ends were sealed, and the teeth were placed in individual vials containing phosphate-buffered saline, and stored at 37 degrees C. The pH was measured in the dentinal cavities at 8 h and at 1, 2, 3, 7, 14, and 21 days using a calibrated microelectrode. RESULTS: At 8 h and 1, 2, and 3 days, the highest pH values were obtained when the aqueous calcium hydroxide paste was placed in the pulp chamber. At 7 days, the pH had increased in the Hycal group without being significantly different from the aqueous calcium hydroxide paste placed either in the root canal or in the pulp chamber. At 14 days, Hycal( had the highest pH values (pH 10.65); however, at 21 days no significant difference was noted amongst these first three groups. Control group values ranged from 7.88 to 8.60; the pH created by the calcium hydroxide gutta-percha points was lower than for the control group. Whatever the product or placement location, cervical pH was similar to middle pH, and greater than apical. However, there was no significant difference between the three when all groups were combined. Overall, aqueous calcium hydroxide paste placed in the pulp chamber provided the highest pH values during the experiment, except at day 14. The aqueous calcium hydroxide paste placed in the root canal or Hycal had similar values at days 7 and 21. CONCLUSIONS: Under the conditions of this study, an aqueous calcium hydroxide paste placed in the pulp chamber increased dentinal pH more than the other techniques. The pH of dentine is affected by the form of calcium hydroxide used.

Calcium Hydroxide↗
PubMed2001

Allometric analysis of thiamphenicol disposition among seven mammalian species.

The pharmacokinetics of thiamphenicol (TAP), a broad-spectrum antibiotic, was determined in male mice, rats, rabbits, dogs, pigs, sheep and calves. The relationship between the main pharmacokinetic parameters of TAP and body weight (W) was studied across these seven mammalian species, using double-logarithmic plots. The experimental values of volume of distribution (Vss), clearance (Cl) and elimination half-life (t(1/2)beta) were plotted, and extrapolated values were determined from corresponding allometric equations. These parameters were fitted to the following equations: Vss=0.98W0.92, Cl=15.80W0.76 and t(1/2)beta=0.94W0.20, and present good correlation (Vss: r2=0.997, P < 0.001; Cl: r2=0.976, P < 0.001, t(1/2)beta: r2=0.852, P < 0.005), that is expected of a drug eliminated primarily by renal glomerular filtration, with insignificant hepatic metabolism. For the t(1/2)beta, the extrapolated and observed values were similar. The extrapolated values of Cl were close to the experimental values, except for the mouse and pig mean percent error [(M.E.) equal to 62 and 119%, respectively], while the extrapolated and observed values for the Vss were very similar. The comparison between experimental and extrapolated values suggests that it could be possible to extrapolate, with good prediction, the kinetic parameters of this drug for mammalian species, using allometric scaling, except for the species that eliminate the drug by a combination of renal excretion and hepatic metabolism.

Animals↗
PubMed2001

Anetoderma associated with antiphospholipid antibodies: case report and review of the literature.

The association of primary anetoderma (PA) with antiphospholipid antibodies (APAs; with or without criteria of primary antiphospholipid syndrome) has been observed repeatedly and a possible pathogenic significance of this asssociation has been hypothesized. We report the case of a 21-year-old-woman who developed anetodermic lesions on her upper trunk and arms. The presence of APAs was demonstrated, but no diagnostic criteria of systemic lupus erythematosus were present. A review of the literature disclosed 20 previously reported patients presenting this peculiar association. Thrombotic phenomena, represented by spontaneous abortions or venous thrombosis, are a frequent complication in this setting. Taking these observations into account a systematic search for APAs in patients with PA seems advisable.

Adult↗
PubMed2001

Oral microemulsion cyclosporine in the treatment of steroid-refractory attacks of ulcerative and indeterminate colitis.

BACKGROUND: To assess the efficacy of oral microemulsion cyclosporine (CyA Neoral) in the treatment of steroid-refractory attacks of ulcerative an indeterminate colitis. METHODS: In this non-randomized study on the use of oral microemulsion cyclosporine in steroid refractory ulcerative colitis, we used CyA Neoral in 10 patients suffering from ulcerative colitis and in 1 patient suffering from indeterminate colitis with a steroid-refractory attack. The initial dose was 7-7.5 mg kg-1 day-1 adjusted to maintain whole blood cyclosporine levels between 250 and 350 ng/mL, as measured by RIA using monoclonal antibodies. RESULTS: Nine patients presented a favourable response in a mean time of 3.6 days, that is, 81.8% of cases. One initial responder developed megacolon on the 11th day and another did not respond; surgical treatment was performed in both cases. The remaining nine patients, followed for a mean period of 14.6 months (2-36 months). Nine patients presented side effects, the most frequent being slight hand tremor with hypomagnesaemia, followed by hypertension, slight increase in creatinine and hirsutism. No one needed to withdraw from treatment, but the dose was lowered in three cases. CONCLUSIONS: Oral microemulsion cyclosporine is an effective drug in the initial management of patients suffering from a steroid-refractory attack of ulcerative and indeterminate colitis. Additional controlled studies with the new oral formulation are required to confirm these results.

Administration, Oral↗
PubMed2001

[A model of primary prevention of sexually transmitted diseases and HIV/AIDS in adolescents].

OBJECTIVE: To develop, apply, and evaluate an educational model for the primary prevention of sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS) that was based on the sexual knowledge, attitudes, and practices (KAPs) of adolescents and on their perceptions and behaviors in this area, with the ultimate goal of helping develop educational tools to prevent infection with STDs and the human immunodeficiency virus (HIV). METHODS: An STD/HIV/AIDS primary prevention model was applied with adolescent schoolchildren (12 to 15 years old) in the canton of Santo Domingo de los Colorados, Ecuador. Two groups with similar characteristics were formed: the experimental group, with 358 students, and the control group, with 288 students. Schools were selected according to inclusion criteria, and adolescents at each school were chosen at random. A discussion guide was applied with 16 focus groups, and the resulting information was used to prepare a KAP survey. After being validated, the KAP survey was applied to the experimental group and to the control group. A prevention education program geared to students and teachers was implemented with the experimental group. Eight months later a second KAP survey was done with the experimental group and the control group. The differences in KAPs before and after the intervention were evaluated using the chi-square test. RESULTS: There were no statistically significant differences between the two groups before the intervention, but afterwards the differences were statistically significant (P = 0.012), with an increase in the knowledge of sexuality and STDs/AIDS in the experimental group, even though the long-term behavior changes have not been evaluated. CONCLUSIONS: This study validated a multifactorial STD/AIDS prevention model adapted to the reality of adolescents, and it suggests the possibility of extrapolating this experience more broadly to contexts similar to those of this Ecuador population.

Adolescent↗