Non-heart-beating donors: estimated actual potential.
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Ethics, Medical↗
Biomedical subjects
J Alvarez
Publications and source records attributed to J Alvarez.
Measuring [Ca2+] in the endoplasmic reticulum with aequorin.
The photoprotein aequorin was the first probe used to measure specifically the [Ca(2+)] inside the lumen of the endoplasmic reticulum ([Ca(2+)](ER)) of intact cells and it provides values for the steady-state [Ca(2+)](ER), around 500 microM, that closely match those obtained now by other procedures. Aequorin-based methods to measure [Ca(2+)](ER) offer several advantages: (i) targeting of the probe is extremely precise; (ii) the use of low Ca(2+)-affinity aequorin allows covering a large dynamic range of [Ca(2+)], from 10(-5) to 10(-3)M; (iii) aequorin is nearly insensitive to changes in Mg(2+) or pH, has a high signal-to-noise ratio and calibration of the results in [Ca(2+)] is made straightforward using a simple algorithm; and (iv) the equipment required for luminescence measurements in cell populations is simple and low-cost. On the negative side, this technique has also some disadvantages: (i) the relatively low amount of emitted light makes difficult performing single-cell imaging studies; (ii) reconstitution of aequorin with coelenterazine requires previous complete depletion of Ca(2+) of the ER for 1-2h, a maneuver that may result in deleterious effects in some cells; (iii) because of the high rate of aequorin consumption at steady-state [Ca(2+)](ER), only relatively brief experiments can be performed; and (iv) expression of ER-targeted aequorin requires previous transfection or infection to introduce the appropriate DNA construct, or alternatively the use of stable cell clones. Choosing aequorin or other techniques to measure [Ca(2+)](ER) will depend of the correct balance between these properties in a particular problem.
Aequorin↗
[Toxic peripheral polyneuropathy outbreak in a labour environment].
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Disease Outbreaks↗
Creation of a modified angiography (endovascular) suite for transluminal endograft placement and combined interventional-surgical procedures.
PURPOSE: To describe early experience with an endovascular suite created for procedures requiring surgical access, endograft placement, or combined surgical and interventional radiologic expertise. MATERIALS AND METHODS: After examining the operating room and angiography environments, practice guidelines, state law, and regulatory agency requirements, a multidepartmental task force recommended reconfiguring an angiography suite to serve as an endovascular suite. Forty patients have been treated; 28 underwent vascular endograft placement and 12 underwent other combined procedures. RESULTS: Procedures included 31 femoral and axillary cutdowns; placement of one aortobifemoral graft, two iliofemoral grafts, two femoropopliteal grafts, and two femoral-femoral crossover grafts; two abdominopelvic exposures for aortic access, and five endarterectomies, including one at the carotid bifurcation performed in combination with common carotid stent placement. Three of the abdominopelvic procedures were not planned, including two emergency conversions. No patient had to be moved to an operating room. There was one major infection (2.5%), two minor wound infections (5%), and one wound with delayed healing (2.5%). CONCLUSION: Early experience with a combined surgical-interventional suite has been favorable, but a vigilant approach is warranted.
Angiography↗
Exhaustive generation of organic isomers. 6. Stereoisomers having isolated and spiro cycles and new extended N_tuples.
A new stereoisomer generation system named CAMGEC2 for generation of stereoisomers containing isolated and spiro cycles with one or more descriptors among R, S, Z, E, M, and P is developed using Graph Theory. It includes new approaches for symmetry analysis, cycle detection processes in molecular graphs in a modular way, and also an extension of the N_tuple format for linear representation of molecular graphs that keeps graph topographical information.
Journal Article↗
Algorithm for exhaustive and nonredundant organic stereoisomer generation.
Generation of organic stereoisomers with R/S, Z/E, and/or M/P configurations that may contain heteroatoms, multiple bonds, and any kind of cycle (isolated, spiro, condensed, and nested) is described. Inputs for processing are molecular structures in a N_tuple format resident on an automatic (canonical) or manual (non canonical) generated file which are processed by doing internal molecular graph construction, a weighted bipartite tree construction for all atoms and bonds to detect stereocenters, and symmetrical atom groups (SAG) with some specific SAG parameters that constitute a novel way for redundancy elimination of meso structures. Finally, determination of ligand CIP priorities allows for writing the output N_tuples with stereoisomer description. Several examples showing application of this methology to a wide number of structures are also presented.
Algorithms↗
Cross-sectional growth study of the child and adolescent population of Catalonia (Spain).
A cross-sectional growth study was undertaken on a sample of 5472 school-children aged between 4 and 17. The sample was representative of the Catalan population. Results on height, weight and age at menarche are presented. Cross-sectional centile curves on height and weight were constructed using non-parametric methods. The height of Catalan children was compared with that of children from the United Kingdom (1965 and 1990), France, Greece and the Basque country (Spain). Until puberty Catalan children were similar in height to English (1990) and Greek children, and taller than children in the other studies mentioned. Only differences in final height compared with the English (1990) population were detected. Parents' place of birth and father's profession are associated with height. 'Probit analysis' revealed that the average age of menarche (12.31 years) was similar to that of other Mediterranean countries and lower than in other parts of Spain and northern European countries. There were differences in age at menarche according to the father's occupation. The secular trend of height of the Catalan child population has increased during the twentieth century, rising more than 2 cm per decade.
Adolescent↗
Prepubertal rats are more resistant to ischemic renal injury and recover more rapidly than adult rats.
Bilateral clamping of renal pedicles during 60, 75 or 90 min was used to characterize the evolution of ischemic acute renal failure (ARF) in prepubertal rats. To verify the existence of age-conditioned differences in the evolution of ARF, adult rats were exposed to 40, 60 or 75 min of clamping. After 7 days, survival rate was significantly better in young than adult rats for identical times of clamping (89 vs. 35% for 60 min and 69 vs. 35% for 75 min). Young rats largely died within the first 24 h following ischemia while the risk of death extended until the 4th day after ischemia in adult rats. Peak values of serum urea nitrogen and creatinine were observed on the 1st and 3rd day after ischemia in young and adult rats, respectively. In young rats, these markers of renal function returned to normal on days 5 and 6 whereas they remained elevated at the end of the study in adult animals. Growth curves of young rats paralleled those of sham-operated animals from the 3rd day of clamping whereas adult rats did not even reach the initial weight at the end of the study. Analysis of kidneys obtained 7 days after clamping revealed more severe histopathological lesions in adult rats as well as a higher proliferative activity (10-40 times the value of sham-operated animals versus 2-4 times the control value in young rats). Our findings indicate that kidneys from young rats are more resistant to ischemia and recover more quickly from the ischemic insult. Therefore, the experimental model of ischemic ARF is clearly different in young and adult rats.
Acute Kidney Injury↗
Lack of relationship between the degree of induced gingival hyperplasia and the concentration of diphenylhydantoin in various tissues of ferrets.
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Adrenal Glands↗
[Community participation and appropriate technology in the early diagnosis of human hydatidosis].
The basic strategy for development of hydatid struggle programs is in the actuality: Primary Attention of Health. In the present work and in this instance, it's arm a precocious detection system of hydatid disease, fixed in immunologic diagnostic by means of ELISA technical beginning with blood capillary samples, taken in filter paper by teachers and sanitary agents from official services of Rio Negro Province. 177 teachers and 45 sanitary agents were trained, correspondent to 25 schools, 3 lodging schools and 9 Hospitals all of them from rural area. 890 blood samples during the training were obtained. Lastly, the trained personal armed the system and they obtained 728 samples in the beginning of the Program. It hadn't statistical differences in the reactivity of both samples. The serological prevalence found was 1.32%. The activity displayed by teachers and sanitary agents permitted to detect 21 new cases it was the 20% of new cases diagnosed in this area in the period of work. The viability and the importance of the incorporation of non traditional effectors into the Hydatid Control Programs is discussed.
Community Participation↗
[Leukotriene modifiers in the treatment of asthma].
So far, the inhaled steroids are the most potent topical anti-inflammatories; however, they have disadvantages on their correct administration and possible side effects. The leukotrienes: LTC4, LTD4 and LTE4 are agents that are related with the asthma, because they promote the eosinophils proliferation, the destruction of the bronchial epithelium, bronchial constriction, sanguineous vasodilatation, stimulation of the mucous-producing glands with hypersecretion and decrease of the ciliary motility. The leukotrienes modifiers possess an effect antiinflammatory in the bronchial asthma, demonstrated in diverse clinical studies and they have a beneficial effect in the remodelling of the airways. They can also have clinical applications in the COPD, allergic rhinitis and in the chronic urticaria; however to make wider recommendations of their therapeutic indications more studies they will be made.
Acetates↗
[Continuous renal replacement therapy: management of acute renal insufficiency in critical care units].
Acute renal insufficiency is characterized by a sudden decrease in renal function. Various causes are implicated and the physiopathological mechanisms are quite complex. When kidney failure is associated with other organ or system failure, the patient is usually treated in an intensive care unit. Such "critical status" patients are characterized by severe cardiovascular, respiratory and metabolic unstability that may make conventional methods of dialysis (intermittent hemodialysis and peritoneal dialysis) impossible or inadvisable. Continuous methods of renal replacement include 24-hour extracorporeal blood filtration for an indefinite period of time. Such aspects of renal function as electrolyte regulation of nitrogenated products, inflammatory mediators and so forth are replaced or supplemented by various continuous modes available. In this review we discuss the functions and indications for the continuous renal replacement techniques available. The components of each technique are studied exhaustively with a view to obtaining benefit.
Acute Kidney Injury↗
Temporomandibular arthroscopy: a retrospective clinical study (1995-1999) of 61 cases.
OBJECTIVES: A study was made of the internal derangements of the temporomandibular joint (TMJ) in order to: (a) determine the coincidence between the preoperative clinical diagnosis and imaging findings and the intraoperative arthroscopic observations, (b) establish the efficacy of arthroscopic treatment, and (c) evaluate the complications of the procedure. DESIGN: A descriptive and retrospective clinical study (1995-1999) of 61 TMJ arthroscopies was design. RESULTS: Coincidence was recorded between the clinical diagnosis and arthroscopic findings in 66.6% of cases, and the imaging diagnostic observations (magnetic resonance imaging) in 71.6%. The surgical outcome in terms of movement range was considered excellent (aperture > 40 mm) in 19 patients (42.2%), good (30-40 mm) in 19 (42.2%), and poor (< 30 mm) in 7 patients (15.6%). Postoperative pain assessment was in turn excellent (absence of pain) in 27 patients (60%), good (significant pain remission) in 9 (20%) and poor (persistent or increased pain) in 9 patients (20%). There were 7 complications and all healed without sequelae. CONCLUSIONS: The global results indicate an excellent or good movement range in 84.2%, with either no postoperative pain or only minimum pain in 81.4% of cases. Consequently, if arthroscopy is used for a precise indication in an adequate patient, it can improve the quality of life of individuals with TMJ pathology in situations where conservative procedures have failed.
Adolescent↗
[Postoperative analgesia using the intravenous PCA technique. Results in the first 400 patients treated at a general hospital].
INTRODUCTION: PCA (patient controlled analgesia) has represented a remarkable advance in the treatment of postoperative pain. In this work we describe our experience with this analgesic technique. MATERIAL AND METHODS: One hundred patients undergoing thoracic and abdominal surgery were selected after giving information to the medical and nurse personnel. Pharmacologic agents used in this study were morphine (intravenous PCA) and fentanyl (epidural PCA). Starting of the perfusion pump was done by the anesthesiologist at the Recovery Unit and the treatment was continued by the nurse. Every morning the patients were visited and the degree of analgesia was recorded according to the following score: 1: no pain, and 5: intolerable pain. An anesthesiologist was permanently available. Later on, this study was expanded to 400 patients including other types of surgery. RESULTS: Mean duration of the treatment was 60 hours. The amount of analgesics administered varied among patients and was greater during the first postoperative hours specially in the group of patients treated with fentanyl. The mean degree of pain was 1.5 (grade 1 in 37.5% of cases and grade 5 in 3.5% of patients). Secondary effects were only nausea and vomiting. Inconvenient features of the technique were: patient's difficulties in the management of the technique (3 cases), and spontaneous loss of the program (1 case). Patient's acceptance of the technique was good. CONCLUSIONS: PCA analgesia has been successfully introduced in our hospital since it is effective, safe, easy to manage.
Adolescent↗
[Tracheal rupture during a transhiatal esophagectomy without thoracotomy. Intra- and postoperative treatment].
We report the case of a male patient with a carcinoma of the upper third of the esophagus who presented a tracheal rupture during a transhiatal esophagectomy. The clinical picture was characterized by a severe alteration of the ventilatory function that required selective intubation and, later on, a right thoracotomy for repairing the tracheal lesion. After surgery the patient was treated at the Recovery Unit. He received high-frequency mechanic ventilation (jet ventilation type) during nine days in a attempt to decrease the risk for dehiscence of the tracheal suture and to ensure an adequate oxygenation and hemodynamic control. The clinical course was favourable.
Carcinoma, Squamous Cell↗
[San Juan de la Cruz and nursing care].
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History of Nursing↗
[Experience with 100 anesthetized patients ventilated with laryngeal mask].
We studied 100 adult patients who were anesthetized for different surgical procedures and were ventilated with laryngeal mask either with spontaneous or controlled ventilation. Despite of the inexperience we achieved an appropriate placement of the mask in 99% of cases; 74% at the first attempt, 22% at the second, and 4% at the third. In 87.8% of patients we had an adequate control of the air way. In 12.2% of cases there were problems in relation to the controlled ventilation. In one patient we were unable to correctly place the mask and another anesthetic technique had to be performed. Laryngeal mask is useful in the control of the air way in anesthetized patients with spontaneous ventilation. Some inconvenience may arise when controlled ventilation is used.
Adolescent↗
[Management in clinical nutrition].
Terms such as management, costs, efficacy, efficiency, etc. that are so common in the discourse of managers are now beginning to appear in the vocabulary of clinicians. Management in Clinical Nutrition is an innovative aspect of interest among health-care professionals dealing with the needs of undernourished patients or those at risk of malnutrition. The basic goal of this paper is to show that the tools for clinical management of hospitals are applicable to such a multidisciplinary and complex speciality as clinical nutrition and also to propose the measures needed to improve our information systems and optimize management in this field. The very concept of hospitals has changed, as has their activity, over the years. Hospitals are nowadays no longer just a charitable institution but has become a service company, a public utility for the promotion of good health and they have to be managed in accordance with criteria of efficacy, efficiency, equity and quality. The concepts of Evidence-Based Medicine (EBM) and Cost-Effective Medicine (CEM) are of evident importance in the different ways of managing health-care services. Good clinical practice is the combination of EBM and CEM. This review defines the various cost studies of fundamental importance when taking decisions in hospital management and analyzes such clinical management tools as analytical accounting, Minimum Hospital Database Set (MHDS) and encoding systems, among others, thus facilitating an analysis of the usefulness of data in clinical nutrition management systems. Finally, after reviewing some specific examples, measures are proposed to optimize current information systems. The medical staff and those of us responsible for Nutrition Units operate in hospitals as part of a centralized service transferring information to the various departments where the patient is physically located (Surgery, Internal Medicine, Digestive, ICU, etc.). One of the priority goals in micro-management and middle management is to observe the quality improvement in the discharge reports for the patients admitted, including the nutritional diagnosis within the section for the main diagnosis, and also the administration of artificial nutrition (enteral or parenteral) in the section on procedures. With all of these measures we will improve the quality of the hospitals' information systems and contribute directly to ensuring that our activities in clinical nutrition have an impact on the overall results of the hospital when measured in terms of effectiveness, efficacy or quality.
Food Service, Hospital↗