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Biomedical subjects

H Torres

Publications and source records attributed to H Torres.

At least 19 recordsLinked to original sources
PubMed1998

[Partial left ventriculectomy for end stage dilated cardiomyopathy. Is it an alternative for heart transplantation?].

We present a case of a 60 year old male with end stage dilated cardiomyopathy in NYHA functional class IV in whom a partial left ventriculectomy was performed, a new surgical procedure developed in Brazil and done for the first time in Chile. Left ventricular size reduction produced an objective improvement on echocardiographic parameters of left ventricular function as well as in patient's NYHA functional class in the early post operative period.

Cardiac Surgical Procedures↗
PubMed1996

[Acute kidney failure in patients with and without sepsis: prognosis and clinical course].

The purpose of this prospective study was to determine whether the course and prognosis of acute renal failure (ARF) in patients with and without sepsis are different. Two hundred fifty-two (8%) of 3086 consecutive patients admitted to a medical-surgical intensive care unit (ICU) developed ARE. One hundred forty-nine (59%) were septic and 103 (41%) were non-septic. No differences were found between groups regarding the incidence of oliguria, hyperkalemia, hypercatabolism, gastrointestinal bleeding, duration of oligria and renal deficit, severity of axotemia, dialysis requirements and duration of stay in the hospital. There were statistically significant differences between septic and non septic patients with respect of hyponatremia (67.8 vs 54.4%, p < 0.04), respiratory failure (68 vs 54%, p < 0.04), and thrombocytopenia (64 vs 48%, p < 0.02). Mortality in septic patients was higher than in non-septics (56 vs 42.7%, p < 0.009). Factors associated with increased mortality in ARF septic patients were respiratory failure, metabolic acidosis and oliguria while in the non-septics they were hepatic dysfunction, hyperkalemia, respiratory failure and infection acquired during the course of renal failure. We conclude that ARF developing in septic patients has a higher mortality than that of non-septic patients, whereas the incidence of hypercatabolism and oliguria was not different between both groups.

Acute Kidney Injury↗
PubMed1995

Reabuse rates in a sample of children followed for 5 years after discharge from a child abuse inpatient assessment program.

Efforts to accurately measure rates of reabuse have been elusive because of problems in definition and methodology. The present study examines reabuse rates across a 5-year follow-up period in a sample of children assessed for child abuse (October 1986-October 1987). Participants consisted of 304 children (7 months-15 years of age), systematically selected from a population of 1,100 children consecutively admitted to a hospital-based, interdisciplinary, child abuse assessment unit. Reabuse was determined by matching sample names against information in a centralized reporting system. Reabuse was studied across demographic and socioeconomic variables, vulnerability days, initial and subsequent type(s) of abuse, and other considerations. At the end of the 61-72 month follow-up period, the sample had a 16.8% incidence of reabuse. The greatest risk of reabuse occurred during the first 2 years following an initial discharge diagnosis of maltreatment. Although no particular initial maltreatment diagnosis was a statistically significant predictor of the likelihood or type of reabuse, neglect was shown to be the most frequent type of reabuse. Children experiencing reabuse were more likely to reside in public housing/apartments, have unmarried and/or unemployed parent(s), and be Medicaid recipients. Opportunities for secondary prevention initiatives and future research are discussed.

Adolescent↗
PubMed1995

Blunt trauma to the carotid arteries.

Carotid artery dissection is a rare occurrence in the trauma patient. Two cases of blunt trauma resulting in carotid artery dissection are reported. Initial recognition by clinicians is often difficult because of the diverse clinical manifestations, the delay in presentation, and the associated multi-organ system injuries that accompany carotid artery dissection. Because the diagnosis of carotid injury is rarely suspected in patients with neurological deficits, the first diagnostic test performed is usually computed tomography (CT) of the head. Angiography should be strongly considered when the following occur: (a) Neurologic deficits are incompatible with CT findings; (b) there is monoparesis or hemiparesis with a normal mental status examination; (c) there is severe cervical trauma with an abnormal neurological exam; or (d) a basilar skull fracture is present in a patient with an abnormal mental status exam. Once diagnosed, the management of carotid artery dissection is complex and no generalized guidelines have been established.

Adult↗
PubMed1993

In vitro activities of ceftriaxone and fusidic acid against 13 isolates of Coxiella burnetii, determined using the shell vial assay.

The susceptibilities of 13 isolates of Coxiella burnetii to fusidic acid and ceftriaxone were determined by use of the recently described shell vial assay (D. Raoult, H. Torres, and M. Drancourt, Antimicrob. Agents Chemother, 35:2070-2077, 1991). At a concentration of 4 micrograms/ml, ceftriaxone was bacteriostatic for four isolates and slowed the multiplication of the other nine. Fusidic acid at a concentration of 2 micrograms/ml was bacteriostatic for six isolates and slowed the multiplication of three others. These results show that these compounds could be effective in the phagolysosome of C. burnetii-infected cells.

Ceftriaxone↗
PubMed1992

Susceptibility of Rickettsia conorii, R. rickettsii, and Coxiella burnetii to PD 127,391, PD 131,628, pefloxacin, ofloxacin, and ciprofloxacin.

Plaque formation and dye uptake assays were used to measure the MICs of PD 127,391 and PD 131,628 against Rickettsia species. The MICs of PD 127,391 were 0.25 microgram/ml for Rickettsia rickettsii and 0.125 to 0.25 microgram/ml for Rickettsia conorii. The MICs of PD 131,628 were 0.25 to 0.5 microgram/ml for R. rickettsii and 0.5 microgram/ml for R. conorii. As determined by the shell vial technique, 15 strains of Coxiella burnetii were susceptible to PD 127,391 and PD 131,628 (MIC, < or = 1 microgram/ml), while one strain of C. burnetii (MP10) was of intermediate susceptibility.

Anti-Infective Agents↗
PubMed1991

Shell-vial assay: evaluation of a new technique for determining antibiotic susceptibility, tested in 13 isolates of Coxiella burnetii.

Coxiella burnetii is a strictly intracellular bacterium. Bacteriostatic effects have been described previously on a few isolates in embryonated eggs (A. J. Spicer, M. G. Peacock, and J. C. Williams, p. 375-383, in W. Burgdorfer and R. L. Anacker, ed., Rickettsiae and rickettsial diseases, 1981). We used the shell-vial technique (D. Raoult, G. Vestris, and M. Enea, J. Clin. Microbiol. 28:2482-2484, 1990) to determine the susceptibility of C. burnetii to amoxicillin, amikacin, erythromycin, co-trimoxazole, pefloxacin, ofloxacin, ciprofloxacin, chloramphenicol, tetracycline, doxycycline, minocycline, and rifampin antibiotics at a single dilution. Human embryonic lung fibroblast monolayers in shell vials were seeded with 13 different C. burnetii isolates, including 3 reference strains (Nine Mile, Q212, and Priscilla) and 10 new isolates, in order to obtain 30% infected cells 6 days later. After inoculation, antibiotics were added, shell vials were incubated for 7 days, and immunofluorescence was revealed and compared with that of the positive controls. Strain Nine Mile was more susceptible than strains Q212 and Priscilla were. The heterogeneity of susceptibility to fluoroquinolones, chloramphenicol, and erythromycin was noted among the strains; all were resistant to amoxicillin and amikacin, and all were susceptible to rifampin, co-trimoxazole, tetracycline, and tetracycline analogs.

Anti-Bacterial Agents↗
PubMed1991

[Cardiac transplantation: economizing cyclosporin A by including ketoconazole in the immunosuppressive schedule].

Use of cyclosporin A has improved survival in patients submitted to cardiac transplantation. However, high cost of cyclosporin poses a problem for many patients in Chile. Ketoconazole is able to reduce hepatic metabolism of cyclosporin and thus prolong therapeutic levels. A 74 to 82% reduction in cyclosporin requirements was obtained in a cardiac transplant patient by adding ketoconazole. No renal damage was detected. Therefore, this drug association may help extend cardiac transplantation programs in Chile.

Adult↗
PubMed1990

[Evaluation of systolic and diastolic left ventricular function in acute myocardial infarction by aortic echogram].

A noninvasive method for the measurement of the cardiac output and diastolic ventricular function was evaluated by aortic echogram in a group of patients with acute myocardial infarction (AMI). The following parameters were employed: average of initial and late aortic cusp separation (ACS), left ventricular ejection time (EP) and amplitude of aortic posterior wall during ejection (AA). The following formula was used: cardiac output (CO) = (ACS x EP) x 100 + AA x HR. Diastolic ventricular function was evaluated by the left auricle emptying index (LAEI) described by Strunk et al. This last relationship X/OA where X is the movement of the aortic posterior wall (AP) at the first third of passive diastole, and OA is the total aortic movement during the passive diastole. All patients were followed by cardiac output measurements by thermodilution and pulmonary capillary pressure (PCP). Twenty measurements were made in fourteen subjects; for CO a good lineal correlation was found (r = 0.81). As for diastolic ventricular function, LAEI reached a value of 0.49 (+/- 0.23); normal value was 0.82 (p less than 0.01); it was significantly diminished showing the stiffness of the chamber. The utilization of aortic echogram and the analysis of movement of APW result in a non invasive reliable procedure that can be repeated to evaluate the hemodynamic situation in AMI.

Aged↗
PubMed1989

[Lactic acidosis in diabetic patients associated with buformin].

We report two diabetic patients who developed lactic acidosis following the use of Buformin. Treatment consisted of mechanical ventilation, massive bicarbonate administration, circulatory support with dopamine and peritoneal dialysis. Despite this, both patients died.

Acidosis, Lactic↗
PubMed1988

Growth response of human myeloid leukemia cells to colony-stimulating factors.

The effects of human recombinant granulocyte and granulocyte-macrophage- (G- and GM-CSF), and of purified macrophage-stimulating factors (CSF-1), were tested on populations of leukemia cells isolated from 18 patients with different types of acute myeloid leukemia. Cell proliferation and differentiation were studied by culturing the cells in suspension for 7 days in the presence of CSF or medium alone. Spontaneous cell proliferation, as assessed by tritiated thymidine uptake, was observed in 9 of the 18 cases. GM-CSF induced proliferation in seven of the nine cases without spontaneous growth and increased spontaneous proliferation in nine cases. G-CSF added alone was also found to strongly stimulate leukemic blast cell proliferation, in which a translocation involving the long arm of chromosome 17 was observed. Low levels of CSF-1 stimulation were also observed in some cases. No clear morphological modification supporting evidence of terminal differentiation was observed, whereas modulation of some cell surface antigens was detected by flow cytometry. Thus, most leukemia cells still depend on growth factors for their proliferation, GM-CSF appearing the most effective. On the other hand these factors were not able to induce terminal differentiation.

Antigens, Surface↗
PubMed1985

Molsidomine in the treatment of acute heart failure.

In this report we present the results of hemodynamic monitoring with a Swan-Ganz balloon catheter in 14 patients with heart failure associated with acute myocardial infarction, before and during 8 hours after a single oral dose of molsidomine (6 mg). Molsidomine induced the following changes: heart rate was reduced between 1.6% and 4.7% (significant at 4 hours, p less than 0.05); systolic blood pressure decreased 8.4% at 1 hour (p less than 0.05); pulmonary capillary pressure decreased approximately 30% (significant and lasting until 8 hours after administration, p less than 0.002); cardiac index did not change significantly, although individual analysis showed an increase in 6 of 12 cases; stroke volume index increased by 6% (significant at 1 hour, p less than 0.025); and left ventricular stroke work index increased from 9.8% to 24.5% (significant at 1 and 4 hours, p less than 0.01 and 0.025). These findings show the beneficial hemodynamic effects of molsidomine in patients with heart failure complicating acute myocardial infarction.

Aged↗
PubMed1984

Haemodynamic effects of oral molsidomine in pump failure complicating myocardial infarction.

Haemodynamic monitoring, using a Swan-Ganz balloon catheter, was done in 14 patients with pump failure associated with acute myocardial infarction, before and for 8 h after single 6 mg oral dose of molsidomine. The following changes effects were found: HR fell by 1.6 to 4.7% (significant at 4th hour; p less than 0.05); SBP was 8.4% lower after 1 h (p less than 0.05); PCP was decreased by approximately 30%, a significant effect that lasted for 8 hours (p less than 0.002). CI did not change significantly, although individual analysis showed it to have increased in 6 out of 12 cases. Stroke volume index was increased by about 6% (significant after 1 h, p less than 0.025). The left ventricular stroke work index also increased from 9.8 to 24.5% (significant after 1 and 4 h, p less than 0.01 and 0.025). These findings show the beneficial haemodynamic effects of molsidomine in pump failure complicating acute myocardial infarction.

Aged↗