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Biomedical subjects

J Alvarez

Publications and source records attributed to J Alvarez.

At least 397 records · Page 22Linked to original sources
PubMedDate not supplied

[Hemodynamic effects of levosimendan following cardiac surgery].

The hemodynamic effect of levosimendan was compared to that of dobutamine in a trial enrolling 30 adults undergoing scheduled cardiac surgery with cardiopulmonary bypass. Fifteen patients were randomly assigned to receive levosimendan in a single dose of 18 microg x kg(-1) followed in 15 to 20 minutes by start of infusion at a rate of 0.2 microg x kg(-1) min(-1) for 24 hours (levosimendan group). Another 15 randomized patients received dobutamine infused at a rate of 7.5 microg x kg(-1) min(-1). Hemodynamic parameters were measured before starting infusion of the drug and after 24 hours of treatment. Changes in the main hemodynamic parameters were as follows. In the levosimendan group heart rate (beats/min) was 87.15 (SD 10.22) at baseline and 87.91 (6.00) at 24 hours; mean arterial pressure (mm Hg) was 83.96 (10.57) at baseline and 86.41 (13.29) after 24 hours; cardiac index (L/min/m2) was 2.21 (0.23) at baseline and 2.53 (0.35) at 24 hours; systemic vascular resistance (dyn/sec(-1)/cm(-5)) was 1436.74 (311.48) at baseline and 1378.35 (320.68) at 24 hours. In the dobutamine group heart rate (beats/min) was 84.28 (2.18) at baseline and 96.02 (9.10) after 24 hours; mean arterial pressure (mm Hg) was 83.59 (9.05) at baseline and 74.29 (6.33) at 24 hours; cardiac index (L/min/m2) was 2.16 (0.28) at baseline and) 3.02 (0.34) at 24 hours; systemic vascular resistance (dyn/sec(-1)/cm(-5)) was 1578.93 (334.88) at baseline and 1136.68 (158.60) at 24 hours. We found that mean arterial pressure and both systemic and pulmonary vascular resistance decreased significantly in the levosimendan group (P < 0.05), but not in the dobutamine group. On the other hand, both heart rate and cardiac index increased in the levosimendan group only (P < 0.05). We conclude that levosimendan improves hemodynamic stability in patients who have undergone cardiac surgery and that it is a good alternative for treating postoperative low cardiac output syndrome.

Adult↗
PubMedDate not supplied

[Control of hydatidosis in the Province of Rio Negro, Argentina: epidemiology].

In this paper we attempt to present a general view of the situation of hydatidosis in the Province of Rio Negro, Argentina, considering the magnitude of infection in man and dog. Because of its seriousness a 10 year program for the control of hydatidosis has been carried out, which included veterinary and medical care. The number of human cases with hydatidosis in the period 1981-1988 was determined by a retrospective study of the registers of Public Health. From 1188 cases registered in the period, the annual numbers varied between 152 in 1981 and 104 in 1988. This implies an incidence rate of 40 x 100,000. The most frequent localization observed was in the liver. The average days of hospitalization has decreased to 15.8 per patient. Screening seroepidemiological surveys using DD5 allowed us to determine that the prevalence rate was in some departments of 2330 x 100,000. Also included are the results, up to now, of 10 years of field work done in the program area.

Adolescent↗
PubMedDate not supplied

[Family studies in the fragile X syndrome].

A family study and detection of bearer individuals has been carried out in five families suffering from the fragile X syndrome by means of clinical and cytogenetical examination, as well as by DNA recombination techniques in one of them. In 14 males the X marker chromosome was found. In 45 females studied in order to find bearer features, 23 heterozygote individuals have been detected. Out of those 23 cases, 11 were fragile X positive and in the remaining 22 a previous risk of 25-50% was estimated. In this group we used the Bayes theorem considering as conditional probabilities to bear a healthy male and to be fragile negative and the risk of being a bearer person decreased in all the cases. The significance and difficulties of the genetical prevention in families suffering from this syndrome because of the great number of young female with risk at the reproductive age are debated. The DNA study with the St14 sound (DXS52 Locus) in a family was concordant with the cytogenetical studies. A possible recombination in an individual suffering from fixation, atypical phenotype and low percentage of the maker expression.

Female↗
PubMedDate not supplied

[Isoflurane in pulmonary hypertension and failure of the right ventricle].

We evaluated the effects of the use of 1.2% isoflurane (group A) in a group of patients (n = 13) referred for mitral valve surgery, with pulmonary hypertension and right ventricular failure. We evaluated the hemodynamic status in baseline conditions, after isoflurane ++ administration and in relative hyper- and hypovolemia. We compared the results with those in 17 patients (group B) in identical clinical state who did not receive isoflurane during anesthesia. The evaluated parameters were: mixed venous Hb saturation (SvO2), heart rate (HR), pulmonary capillary pressure (PCP), central venous pressure (CVP), mean blood pressure (mBP), mean pulmonary arterial pressure (mPAP), cardiac index (CI), arteriolar pulmonary resistances (APR), peripheral vascular resistances (SVR), stroke index (SI), left ventricular work (LVW), right ventricular work (RVW), and O2 consumption (VO2). In group A, after isoflurane ++ administration, CI was 107.05% and 80% of baseline values in relative hypervolemia and hypovolemia, respectively. In group B (control), CI was 121.48% and 88.28% of basal values in relative hypervolemia and hypovolemia, respectively. In group A, SVR were 73.59% and 76.72% in hypervolemia and hypovolemia, respectively, while in group B they were 86.21% and 106.80%. In group A, APR were 90.85% and 89.96% in hypervolemia and hypovolemia, while they were 80.72% and 102.34% in group B. We found that isoflurane results in a greater peripheral than pulmonary vasodilation with a greater impairment in right ventricular function.

Adult↗
PubMedDate not supplied

[Allergic reactions to local anesthetics].

We studied 35 patients which had been sent by various specialists to the Allergy department of a general hospital because they had an adverse reaction to some type of local anesthetic. The subjects underwent three types of tests: a prick test, an intradermoreaction test and a provocation test using three local anesthetics: procaine 2%, lidocaine 2%, mepivacaine 1% with no vasoconstrictors or parabens in order to rule out the possibility that the reaction was due to these substances rather than the local anaesthetic being tested. The results indicated that both the prick test and the provocation test of the local anesthetics included in the study were negative for all of the patients. One patient who had an adverse reaction to Hostacain was tested with that same anesthetic. The patient tested positive in the intradermoreaction test with a 1/10 solution but was not able to be tested with a solution free of parabens due to lack of availability. The results of our study coincide with the bibliographic research done in that real allergic reactions to local anesthetics are infrequent. The methodology used effectively distinguishes those patients with a risk of real allergic reactions there by indicating to the physician the safest local anesthetic for the patient.

Adolescent↗