Generalized virial theorem for compact problems.
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Biomedical subjects
Publications and source records attributed to J Abad.
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We report an apparent solution to nasal dryness for patients with obstructive sleep apnea syndrome treated with nasal continuous positive airway pressure (CPAP) when a hygroscopic condenser humidifier is introduced into the CPAP circuit. Six patients underwent a 5-h test period of nasal CPAP therapy with a mask containing a hygroscopic humidifier. The water vapor showed a statistically significant increase in both inspired and expired gases. The relative humidity of the inspired gases increased significantly. The levels of O2 and CO2 in the respired gases did not change. When patients were asked about nasal dryness at the end of the test, all of them reported marked improvement.
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In February 1989 we began a combined treatment with mebendazole (3 g/day for 30 days) and praziquantel (1.8 g/day for 15 days) with variable rest periods, in a patients with hydatid disease who had been previously unsuccessful treated only with mebendazole. All the patients were monitored with serological techniques and radiography. Generally the treatment was without side-effects. According to radiography results, there was a reduction in the size of the cyst in 5 patients, in 2 there was no change and 1 patient, the cyst continued to increase in size. Results suggest that the combination of mebendazole more praziquantel could be a pharmacological alternative in the medical treatment of hydatid disease.
We prospectively evaluated in 88 inpatients the incidence of fever and bacteremia after fiberoptic bronchoscopy and its predisposing variables. Fever was present in 27% of cases and no bacteremia could be demonstrated neither associated nor intercurrent . Chronic Hepatic Disease, endobronchial pathology and bronchial biopsy practice were predisposing factors for fever development in the univariant analysis.
Transcatheter embolization was performed with stainless steel coils in a patient with bilateral pulmonary arterial aneurysms of unknown etiology. After a successful initial procedure, endobronchial migration of one of the coils was found which required surgical treatment. Indications of embolization and different types of materials are discussed.
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We have evaluated the close contacts of 191 patients diagnosed of tuberculosis in our center between 1984 and 1987. The overall number of evaluated contacts was 666, and the mean number of contacts for each index case was 3.7. In 55% of the evaluated population PPD reaction was positive, and their mean age was 33.3 years. In 132 cases chemoprophylaxis was given during one year (22%). Forty-one new cases of tuberculosis were detected, with a mean age of 25.6 years. In ten new cases the source of infection was familial. When the contacts were distributed according to the bacteriologic status of the index case (direct investigation of tubercle bacilli positive in 103 cases and negative in 167), the rate of disease and infection was significantly higher among those related to positive patients. In the group related to negative patients we discovered 7 new cases of active tuberculosis. Our results confirm the usefulness of the systematic evaluation of the contacts of tuberculous patients in our area, as it permits the identification of an important number of new patients which should be adequately treated. This practice contributes to interrupt the epidemiologic transmission chain of the disease and to facilitate its eradication.
Two orthotopic liver transplant recipients underwent percutaneous transluminal angioplasty (PTA) for stricture of the hepatic arterial anastomosis. In both, arterial revascularization was effected by end-to-end anastomosis between the donor common hepatic artery and the recipient's hepatic artery. Both patients had elevated liver enzyme levels, abnormal results on duplex Doppler images, and severe stricture on angiograms. In one patient, percutaneous biopsy revealed graft ischemia. PTA was performed successfully without complications. PTA produced substantial improvement in biochemical, duplex Doppler, histologic, and angiographic patterns. Both patients were asymptomatic 5 and 6 months after PTA.
Two recipients of orthotopic liver transplants (OLT) underwent intra-arterial thrombolytic treatment for hepatic artery thrombosis. Complete clot lysis was achieved in both using infusion of high-dose urokinase directly into the thrombus for 12 and 3 hours, respectively. Percutaneous transluminal angioplasty (PTA) was later carried out successfully on various strictures. Doppler ultrasonography confirmed arterial permeability one month after treatment. Liver transplantation is now an accepted therapeutic option in some patients with irreversible liver failure. Although the results of this procedure have improved radically since cyclosporine was introduced in 1978, life-threatening postoperative complications still occur. The one with the worst prognosis is hepatic artery thrombosis (HAT), with 64% mortality despite retransplantation. HAT was found in 7.4% of liver transplant recipients in a recent review of the most important group of these patients. Fibrinolytic treatment using an exogenous plasminogen activator, urokinase (UK), is effective and safe in the thrombotic obstruction of acute pulmonary embolism, acute myocardial infarction, and graft or peripheral arterial occlusion. We used intra-arterial thrombolysis in two patients with HAT of the liver graft, to avoid retransplantation and to treat a complication secondary to percutaneous transluminal angioplasty (PTA) of an anastomotic stricture, respectively. To our knowledge, this is the first report of treatment of HAT by direct infusion of urokinase in liver transplantation.
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In order to assess the effect of captopril on bronchial reactivity, 16 consecutive patients with asthma and hypertension were randomized in a double-blind crossover study, with increasing doses of placebo or captopril for 4 week periods. Forced expiratory flow (FEV1) and a dose-response curve with methacholine (PD20) were measured before and after treatment . Effective control of hypertension was achieved in all patients on captopril (P less than 0.05), while no changes in FEV1 and PD20 were observed. We conclude that captopril can be used as a first step in the treatment of asthmatic patients with hypertension.
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In this work, we tried to correlate the usefulness of the Koup nomogram for dosage prediction of continuous theophylline Dm therapy as compared with the usual method of dosification. To do this, a first group of 20 patients (5 with chronic bronchitis and 15 with bronchial asthma) without clinical or biochemical evidence of hepatic or heart disease (3 with smoking habit), were chosen. They were given a loading dose of theophylline 5 mg/kg over 30 min (as aminophylline). A blood sample was then taken after six hours. The result of this value and in accordance with the nomogram determines the individual oral dose of theophylline administered to attain a serum concentration of 10 mg/ml. The oral dose of theophylline, based according to Hendeles was given to another group of 16 asthmatic patients without smoking habit and clinical or biochemical signs of hepatic or heart disease. Two commercial preparations of theophylline were chosen (Theolair or Theodur). We concluded that: 1) Koup's nomogram is useful in estimating the dose requirement of oral theophylline to reach 10 mcg/ml (Css) at steady state, although it could not be useful in greater Css. 2) Among the patients given the dose according to Hendeles, 37.5% showed toxic serum concentrations. 3) Therapeutic serum concentrations could be obtained in the greater number of patients with twice daily doses, independently of the commercial product. 4) A great number of subjects showed the side effects (discomfort of the stomach, irritability, headache) which appeared to have little direct relationship to serum concentration.