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J Bermejo

Publications and source records attributed to J Bermejo.

At least 55 records · Page 3Linked to original sources
PubMed1998

Mechanisms of residual lumen stenosis after high-pressure stent implantation: a quantitative coronary angiography and intravascular ultrasound study.

BACKGROUND: Intravascular ultrasound (IVUS) studies have demonstrated that stents are frequently suboptimally expanded despite the use of high pressures for deployment. The purpose of this study was to identify the mechanisms responsible for such residual lumen stenosis. METHODS AND RESULTS: Fifty-seven lesions from 50 patients treated with high-pressure (median+/-interquartile range, 14+/-2 atm) elective (44 de novo, 13 restenotic lesions) stenting were prospectively studied (29 Wiktor, Medtronic; 28 Palmaz-Schatz, Cordis Corp). Balloon subexpansion was calculated as the difference between maximal and minimal balloon cross-sectional areas at peak pressure measured by automatic edge detection; elastic recoil was calculated as the difference between minimal measured balloon size and IVUS-derived minimal lumen area within the stent. Angiographic residual diameter stenosis was 10+/-13% (reference diameter, 3.1+/-0.7 mm; balloon to artery ratio, 1.12+/-0.23) and IVUS-derived stent expansion was 80+/-28%. However, although balloon nominal size was 9.6+/-1.3 mm2 and maximal balloon size measured inside the coronary lumen was 12.5+/-3.2 mm2, final stent minimal lumen area was only 7.1+/-2.2 mm2. Balloon subexpansion of 4.0+/-1.8 mm2 (33%) and elastic recoil of 1.6+/-2.3 mm2 (20%) (both P<0.0001) were the two mechanisms responsible for residual luminal stenosis. Wiktor stent and peak inflation pressure correlated with balloon subexpansion, whereas Wiktor stent, de novo lesion, and minimal lumen area at baseline correlated with elastic recoil. CONCLUSIONS: Despite high-pressure deployment, lumen dimensions after stenting are only 57% of maximal achievable. Inadequate balloon expansion and elastic recoil are responsible for residual lumen stenosis, suggesting that plaque characteristics and stent resistance deserve further investigation.

Aged↗
PubMed1998

Effect of partial HLA class I match on acute rejection in viral pre-infected human liver allograft recipients.

BACKGROUND: Acute rejection in liver transplants is one of the commonest causes of liver dysfunction in the early postoperative period. However, the factors involved in liver graft rejection are still unknown. Our study was aimed at ascertaining whether the degree of HLA class I and class II compatibility or pretransplant viral infection have any influence on early acute liver graft rejection. METHODS: We reviewed clinical and laboratory data in 190 consecutive patients who underwent a liver transplant. HLA-A, HLA-B, and HLA-DR typing for the establishment of an HLA match score was performed by a standard microcytotoxicity method. The existence of pretransplant viral infection was investigated in sera and biopsy tissue by serologic (hepatitis B virus, hepatitis C virus) and polymerase chain reaction (cytomegalovirus) techniques, respectively. The influence of these two factors in acute rejection and the interaction between them was also analyzed. RESULTS: A strong association between viral infection and acute rejection in the group with partial class I matching was found (odds ratio=7.75; P<0.0009), whereas no correlation was observed in the group with zero class I matching (odds ratio=0.98; P=0.81). The rejection percentage in the group in which partial class I match and viral infections coexisted was 60%, whereas in the partially class I-matched group without pretransplant viral presence it was 16%. CONCLUSIONS: These findings suggest a participation of partial HLA class I compatibility in triggering acute rejection in recipients suffering preoperative viral infections and support the idea that HLA class I antigen matching could play a role as a linking element between the MHC-restricted T cell-mediated response to viral infection and the allogenic response in liver transplantation.

Adolescent↗
PubMed1998

Role of transesophageal echocardiography in the assessment of patients with blunt chest trauma: correlation of echocardiographic findings with the electrocardiogram and creatine kinase monoclonal antibody measurements.

OBJECTIVES: This study was designed to evaluate the usefulness of transesophogeal echocardiography (TEE) for detecting cardiac damage after blunt chest trauma (BCT). BACKGROUND: Multiple methods have been used to detect cardiac damage after a BCT, but none has been demonstrated to be sensitive, specific, and feasible enough. METHODS: This multicenter prospective trial was designed to evaluate the usefulness of TEE in the assessment of patients with BCT and to compare the TEE findings with those provided by the electrocardiogram (ECG) and cardiac isoenzymes assay. One hundred seventeen consecutive patients with a significant BCT were enrolled. A TEE was performed in each patient. Serial ECGs and plasma profiles of creatine kinase (CK) and CK-monoclonal antibody (MB) were obtained. RESULTS: Sixty-six (56%) patients had pathologic findings in the TEE attributed to the BCT (group A). In the remaining 51 (44%) patients the TEE was normal (group B). An abnormal ECG was more frequent in group A (59% vs 24%; p < 0.001), and the serum CK-MB peak level was also higher in group A (174 +/- 30 U/L vs 93 +/- 21 U/L; p = 0.05). Relative to pathologic TEE findings, the sensitivity and specificity of an abnormal ECG were 59% and 73% and of high CK-MB with CK-MB/CK > 5% were 64% and 52%, respectively. CONCLUSIONS: We conclude that TEE can be routinely and safely performed for diagnosing cardiac injuries after a BCT and plays an important role in the evaluation and treatment of these patients. EGG and CK-MB assay are not good methods for detecting cardiac damage in this setting.

Adolescent↗
PubMed1998

Clinical features and investigations in patients with columnar-lined oesophagus.

BACKGROUND: It is unclear why some patients with a columnar-lined oesophagus present with intestinal metaplasia and others do not. The physiopathological and clinical implications of the length of the metaplastic segment are also controversial. The aim of the study was to determine whether the length of the metaplasia and the presence of intestinal epithelium are related to the clinical, manometric and pHmetric data in patients with columnar-lined oesophagus. METHODS: A comparison of clinical, endoscopic, pathological, manometric and pHmetric data was made between patients with columnar-lined oesophagus of 3-5 cm (n=31) and those with a metaplastic segment of 5 cm or more (n=28); the same comparison was made between patients who had specialized intestinal metaplasia (n=37) and those who did not (n=22). RESULTS: No significant difference was found in any of the variables studied except for associated inflammatory lesions above the columnar epithelium which were more frequent in patients with a shorter metaplastic segment (P < 0.05). CONCLUSION: Neither the length of the metaplastic segment nor the presence of intestinal metaplasia was related to a more evolved gastro-oesophageal reflux disease, a poorer oesophageal clearing function or higher acid reflux rates.

Adult↗
PubMed1997

Long-term results of liver transplantation in familial amyloidotic polyneuropathy type I.

BACKGROUND: The aim of this article is to report our experience regarding the survival and the evolution of polyneuropathy of the extremities and autonomic dysfunction in 18 liver transplant patients with familial amyloidotic polyneuropathy type I after a mean follow-up of more than 2.5 years for 13 patients. METHODS: The actuarial survival rate of the 18 patients is 72.2% and 60.1%, respectively, at 12 and 58 months. RESULTS: In all the patients we noted clinical improvement of the polyneuropathy of the extremities and autonomic dysfunction during the first 6 months after transplant. The clinical data due to autonomic nervous system involvement showed an earlier improvement than those due to nervous motor involvement. CONCLUSIONS: In conclusion, our results suggest that liver transplant may be useful in the treatment of certain cases of familial amyloidotic polyneuropathy to stop the neurological deterioration of the patients and to avoid the fatal end of the disease.

Adult↗
PubMed1997

In-hospital outcome of elderly patients with acute inferior myocardial infarction and right ventricular involvement.

BACKGROUND: There are some specific high-risk subgroups of patients with acute inferior myocardial infarction, such as older patients and those with right ventricular involvement. However, the clinical implications of right ventricular infarction in elderly subjects have not been studied previously. METHODS AND RESULTS: To determine the clinical impact of right ventricular involvement in elderly patients with inferior myocardial infarction, we studied the in-hospital outcome of 198 consecutive patients > or = 75 years of age with a first acute inferior myocardial infarction according to the presence of ECG or echocardiographic criteria of right ventricular infarction. In patients with right ventricular involvement (41%), in-hospital case fatality rate was 47% (mainly because of nonreversible low cardiac output cardiogenic shock) compared with 10% in patients without right ventricular involvement (P<.001). Patients with right ventricular involvement also had a significantly higher incidence of cardiogenic shock (32% versus 5%), which was independent of left ventricular ejection fraction, complete AV block (33% versus 9%), and interventricular septal rupture (9% versus 0%). After adjustment for age, sex, diabetes, shock on admission, left ventricular systolic dysfunction, and complete AV block, right ventricular infarction remained a powerful independent predictor of in-hospital death (adjusted odds ratio, 4.0; 95% confidence interval, 1.3 to 14.2). CONCLUSIONS: Elderly patients with acute inferior myocardial infarction have a substantially increased risk of death during hospitalization when right ventricular involvement is present. The poorer outcome is due mainly to the high incidence of cardiogenic shock and its infrequent reversibility.

Acute Disease↗
PubMed1997

[Familial visceral myopathy].

We report a patient with intestinal pseudo-obstruction in which both the histopathological findings and the clinical history strongly suggest a visceral myopathy of familial type. Reviewing the clinicopathological descriptions of the different families appearing in the literature, is evident that both the presentation (severity, distribution of lesions, etc) and the inheritance pattern seem not to be clearly delimitated, and it has been recently suggested that it may be related to the mitochondrial myopathies. The useless of conventional biopsy procedures (due to the almost exclusive affectation of the external muscle layer of the intestinal wall); the frequently patchy distribution of the lesions (which might be overlooked in a routine histological handling of a resection specimen) and the extensive range of symptoms of the disease, support the paramount importance of a high index of suspicion (obviously, the clinical history plays a fundamental role). In this setting, it is also interesting to emphasize the utility of manometric studies for the correct diagnosis and management of these patients; as well their possible application to identify asymptomatic heterozygotes.

Adolescent↗
PubMed1996

Effects of dobutamine on Doppler echocardiographic indexes of aortic stenosis.

OBJECTIVES: This study sought to assess the diagnostic implications of the flow dependence of Doppler echocardiographic indexes of aortic valve stenosis. BACKGROUND: Although valve area has been shown to change with alterations in flow rate, the diagnostic consequences of this phenomenon remain unknown. Valve resistance has been suggested as a more stable index for evaluating aortic stenosis. METHODS: A low dose dobutamine protocol was performed in 35 patients with aortic stenosis. Hemodynamic indexes were obtained by Doppler echocardiography at baseline and at each dobutamine dose. RESULTS: As a result of the shortening of the systolic ejection period, flow increased from (mean +/- SD) 164 +/- 48 to 229 +/- 102 ml/s (p < 0.0001). At peak flow, valve area increased by 28% (from 0.5 +/- 0.2 to 0.6 +/- 0.3 cm2, p < 0.0001), whereas valve resistance decreased by 4% (from 498 +/- 252 to 459 +/- 222 dynes.s.cm-5, p = 0.04). This observed change in resistance was smaller than that for valve area (p < 0.01). The flow dependence of valve area varied among individual patients (p < 0.0001). Multivariate analysis identified calcific degenerative etiology (beta 0.29, p = 0.002), left ventricular velocity of fiber shortening (beta 0.22, p = 0.01), baseline flow (beta -0.28, p = 0.04) and amount of flow increased induced by dobutamine (beta 0.90, p < 0.0001) as factors related to valve area flow dependence. CONCLUSIONS: Although all Doppler echocardiographic indexes of aortic stenosis are affected by flow, valve resistance is more stable than valve area under dobutamine-induced hemodynamic changes. Baseline valve area may be unreliable in patients with calcific degenerative aortic stenosis and low output states.

Adult↗
PubMed1996

Conservative treatment versus antireflux surgery in Barrett's oesophagus: long-term results of a prospective study.

The results obtained for the treatment of 59 patients diagnosed with Barrett's oesophagus, randomized to receive medical treatment (n = 27) or antireflux surgery (n = 32) were assessed prospectively. Median follow-up for the patients undergoing medical treatment was 4 (range 1-11) years and for patients undergoing surgical treatment 5 (range 1-11) years. Satisfactory symptomatic control (excellent to good results) was achieved in 24 patients after medical therapy and in 29 after antireflux surgery. The proportion of patients with persistent inflammatory lesions (54 per cent) and persistent or recurrent stenosis (47 per cent) was significantly higher after conservative treatment than after surgery (5 and 15 per cent, respectively). A decrease in the length of the segment of columnar mucosa was observed in eight of the patients who underwent antireflux surgery, and in only two of those given medical therapy. Conversely, an upward progression of the columnar lining was more frequent in the latter group (11 versus three). Mild dysplasia was observed in five patients, all from the group undergoing medical treatment. Severe dysplasia was detected in two patients, one undergoing medical treatment and the other following surgical therapy, in whom an antireflux procedure had failed previously. Both patients underwent oesophageal resection, with confirmation of a carcinoma in situ. The patients in whom antireflux surgery proved effective showed no dysplastic change or progression to adenocarcinoma. These results, despite the small number of patients and methodological limitations, question the systematic conservative approach in the initial management of patients with Barrett's oesophagus.

Adolescent↗
PubMed1996

[Coronary endoprosthesis (stents) implanted without coumadin administration: one year's experience].

BACKGROUND AND OBJECTIVES: Subacute occlusion and bleeding complications have been the major limitations of coronary stenting. Several authors have suggested the nonessential role of oral anticoagulation to prevent occlusions. METHODS: We treated 121 patients (125 stent procedures with initial angiographic success) with the following regimen: heparin 10-20,000 IU i.v. and ASA 325 mg i.v. during the procedure, followed by ASA 125-325 mg/day/6 months and ticlopidine 250-500 mg/day/3 months. 40 patients were also treated with enoxaparine (14,000 IU/day, median) for 10 days. RESULTS: 172 stents (119 Palmaz-Schatz, 35 Wiktor and 18 of other types) were implanted in 148 lesions (in 45 cases with non-occlusive dissection or suboptimal results and the rest electively). Most of the stents were deployed at high pressure (median 14 atm.). The procedure was ended when the stent expansion was considered as optimal by angiography and/or intravascular ultrasound. No patient developed signs of subacute occlusion at follow-up (30-441 days). 2 patients developed non-Q wave myocardial infarction (occlusion of side branches). The rates of bleeding and vascular complications were 0.8% and 1.6%, respectively. CONCLUSIONS: Coronary stenting with high pressure dilatation and without subsequent anticoagulation seems to be associated with low rates of subacute occlusion and bleeding or vascular complications.

Adult↗
PubMed1996

[Wiktor stent in de novo lesions: immediate results in 100 consecutive patients].

BACKGROUND: Randomized trials which compare different stents are lacking and the studies to test the behavior of the Wiktor stent in de novo lesions have not been substantiated by large numbers and with consistent results. METHODS: The lesions were predilated with a conventional balloon 1/2 mm smaller in diameter than the stent to be used. The overdilation was done with the same balloon in which the stent comes mounted. The quantitative coronary analysis was "off line" by the automatic edge detection method with the CMS system by Medis. The post implantation treatment was aspirin and ticlopidine in most of the patients and they were discharged 24-48 hours after the procedure. RESULTS: In one hundred consecutive patients 112 Wiktor stents were attempted to treat 106 de novo lesions. All stents but one were successfully implanted. The quantitative coronary analysis of the treated lesions showed a pre-procedure minimal luminal diameter of 0.85 +/- 0.65 mm for a reference diameter of 3.18 +/- 0.49 mm. The minimal luminal diameter after stent implantation was 2.97 +/- 0.39 mm for a reference diameter of 3.42 +/- 0.46 mm. The diameter stenosis changed from 73 +/- 18% pre-procedure to 13 +/- 9% after stent implantation. One patient was sent to emergency surgery. Another patient was referred for a semiselective bypass surgery. There was no mortality. One patient suffered a non Q wave myocardial infarction. There were no important bleeding complications. There were no cases of subacute thrombosis. All the patients were contacted by telephone one month after the procedure. CONCLUSIONS: In this study we have demonstrated that Wiktor stent implantation is associated with excellent immediate results. The new model makes stent implantation a rapid, safe and relatively easy procedure. If the angiographic result is good, there is no need for an stringent anticoagulation regimen. We have to wait for long term clinical and angiographic results to determine the role of Wiktor stent in novo lesions.

Coronary Disease↗
PubMed1995

[The mitral valve apparatus in hypertrophic myocardiopathy: observations by transesophageal echocardiography].

INTRODUCTION AND OBJECTIVES: We analyzed the characteristics of mitral valve apparatus by transesophageal echocardiography in a consecutive series of patients with hypertrophic cardiomyopathy. METHODS: We performed a transesophageal study in 60 patients; 35 of them had intraventricular obstruction at basal state. The following measurements and observations were made in the frontal long-axis transesophageal plane: a) length of both mitral leaflets and dimensions of left ventricular outflow tract that were compared with those obtained from 25 normal subjects; b) structure involved in the systolic anterior mitral motion; c) mechanism of mitral regurgitation, and d) sequence of systolic events. RESULTS: Compared with control subjects (anterior mitral leaflet: 2.86 +/- 0.3 cm, posterior mitral leaflet: 1.62 +/- 0.2 and 1.7 +/- 0.2 cm, respectively; the mitral leaflets were longer in patients with and without subaortic obstruction (anterior leaflet: 2.3 +/- 0.1; posterior leaflet: 1.07 both, p < 0.01). Systolic anterior motion was observed in 49 patients, with mitral leaflet-septal contact in 87% of patients with obstruction and in 11% of nonobstructive patients (p < 0.01). Structures participating in this phenomenon were: distal portion of the anterior mitral leaflet (77.5%), of both mitral leaflets (18.4%) and anomalous chordae (4.1%); in 5 patients the obstruction was located at a more distal level. Mitral regurgitation was observed in 43 patients; in 37 of them the jet was posteriorly directed in late systole. Patients with hypertrophic cardiomyopathy have longer mitral leaflets with frequent associated abnormalities suggesting that this disease is not confined to myocardium and that leaflet length is not the sole determinant of the obstruction; 2) in almost 80% of patients the systolic anterior motion was produced by the distal anterior mitral leaflet resulting in incomplete coaptation in mid-systole; 3) the sequence of systolic events was ejection/obstruction/leak.

Adult↗
PubMed1995

[The echocardiographic assessment of wall regurgitant jets in prosthetic mitral valves: the superiority of multiplanar transesophageal sections over standard sections].

OBJECTIVES: The purpose of this study was to determine whether multiplanar (MP) transesophageal echocardiographic views were superior to standard views (ST), in the evaluation of mitral prosthesis regurgitation (MR), particularly in presence of wall regurgitant jets. METHODS: We studied all mitral prostheses (n = 43) in which pathological mitral regurgitation had been detected by multiplanar TEE between January 1993 and March 1994. Regurgitant prostheses were classified in two groups according to the presence of wall regurgitant jets and maximum turbulent color flow areas (Amax.) were measured on standard (0 and 90 degrees) and MP (0 to 180 degrees) views. RESULTS: The Amax. detected on ST views were 5.80 +/- 4.60 cm2 and on MP 7.42 +/- 5.13 cm2. Student's test was used to compare both areas and significant differences were found: 1.61 cm2; 95% confidence interval from 0.94 to 2.28 cm2; p = 0.000025. The sample was divided in two groups, A (n = 33): with wall jets and B (n = 10): without wall jets. The Amax. for group A was 5.64 +/- 4.30 cm2 in ST views, and 7.51 +/- 5.12 cm2 in MP. The difference was statistically significant: 1.86 cm2, 95% c.i. from 1.04 to 2.68 cm2; p = 0.00009. Differences for group B were also statistically significant: 0.68 cm2; p = 0.0172. MP views detected a bigger regurgitant area in 26 of the 43 cases (60%). The difference between ST and MP views was significantly bigger for group A than for group B: mean 1.18 cm2; p = 0.0176. MP views detected a severer degree of MR, classified as mild moderate and severe according to the color flow area, than ST views in 8 patients. All of them had wall regurgitant jets. Three had been considered normal on ST views. CONCLUSION: We conclude that MP transesophageal views are significantly superior to ST in the assessment of regurgitant prosthetic mitral valves, particularly in presence of wall regurgitant jets. Our data strongly suggest that multiplanar TEE is the procedure of choice in the assessment of wall regurgitant mitral prostheses.

Adult↗
PubMed1995

[Accuracy and clinical applicability of the echocardiographic automated endocardial boundary detection system: correlation and bias analysis].

INTRODUCTION AND OBJECTIVES: Automated edge detection of endocardial borders is a new echo system that permits on-line delineation and tracking of blood-tissue interface and offers promise for measuring cyclic changes in cavity area and the assessment of left ventricular function on-line. Its accuracy has only been analyzed by linear regression and its applicability in unselected patients is not clearly established. METHODS: We analyzed the accuracy and clinical applicability of the system in 150 patients. Its accuracy was assessed not only by linear regression but also by bias analysis by comparing the results of the system with those obtained by manual tracing from parasternal short-axis and apical 4 chamber views. RESULTS: We obtained satisfactory studies with this system in at least one of the two echo views in 66% of patients: 47% from 4-chambers view, 43% from parasternal short-axis view and 24.6% from both echo views. A visual semiquantitative assessment of left ventricular function could be performed in 88.6% of patients (p < 0.001). On-line and hand-traced left ventricular areas there well correlated, but fractional area change values from both methods correlated less closely. 95% limits of agreement between both methods were: 2.8 +/- 5.5 cm2 (end-diastolic area), 1 +/- 4.4 cm2 (end-systolic area) and 1.2 +/- 23% (fractional area change) in short-axis parasternal view; in apical 4-chambers view these limits were: 1.16 +/- 6.4 cm2,--1.1 +/- 6 cm2 and 7.3 +/- 16%, respectively. CONCLUSIONS: Although the correlations between left ventricular areas from both methods were close the limits of agreement exceeded our acceptable range of reproducibility. Fractional area change showed only moderate correlations and a lack of agreement with off-line method. Poor image quality of the conventional echo still limits the clinical applicability of the current automated edge detection system.

Adult↗
PubMed1995

[Cardiovascular pharmacology (XIII). The efficacy of different thrombolytic drugs in the treatment of acute myocardial infarct].

In patients with acute myocardial infarction (AMI) thrombolysis reduces the infarct area, preserves ventricular function and improves survival. This effect is more significant in men with age between 65 and 75 years, anterior ST segment elevation or branch block, during the first 6 hours of evolution. In this review the comparative studies with placebo and between different fibrinolytic agents, in different doses or in combination are reviewed, and the drug selection, the actual impact or fibrinolysis and future directions of thrombolysis in patients with AMI are discussed. Reperfusion is highest with the use of double bolus tPA of front-loaded rapid tPA infusion. Reocclusion is more frequent after tPA and minimal after urokinase or the combination of tPA and urokinase. In the GISSI-2 and ISIS-3 studies, the mortality of patients treated with streptokinase, tPA or APSAC was similar. However, in the GUSTO study, with front loaded, rapid infusion of tPA, mortality was lower than with streptokinase, although this effect was only statistically significant in patients with anterior infarction or age < 75 years. Bleeding is more common with tPA, and allergic reactions are more frequent after streptokinase and APSAC than after tPA or urokinase. Symptomatic hypotension and bradycardia are also more frequent after streptokinase or APSAC, specially in patients with right ventricular infarction. Streptokinase and APSAC generate antibodies that may neutralize the effect of a second administration even years after the first dose. On the basis of the current clinical evidence it is not possible to recommend the use of a single fibrinolytic and, due to its lowest cost, streptokinase could be considered the first choice. However, in patients with previous thrombolysis, as well as in those with right ventricular infarction, the drug of choice should be tPA or urokinase; in young patients with anterior infarction tPA is more effective and in patients with difficult controls (mobile CCU, emergency wards, etc.) APSAC or urokinase may be considered the agent of choice because their easier administration. In spite of clear evidence of the efficacy of the thrombolytic therapy, it is only used in 20%-30% of the patients with AMI, and probably there is a selection of low risk patients. For these reasons, the impact of thrombolysis in the whole population of AMI is probably lower than it could be. Future directions for the use of thrombolytic agents include a better selection of the candidates and the drug to be used as well as the early administration of thrombolytics, even before the admission to the CCU.

Aged↗
PubMed1994

Antinociceptive, anti-inflammatory and antipyretic effects of lapidin, a bicyclic sesquiterpene.

Lapidin, a bicyclic sesquiterpene from Ferula linkii Webb, has been evaluated for antinociceptive, anti-inflammatory, and antipyretic activities in mice and rats. Lapidin, vehicle, or the appropriate reference analgesic and anti-inflammatory compounds (acetylsalicylic acid [ASA] and indomethacin) were injected i.p. The more conspicuous effects of lapidin were: 1) a significant protective effect (17-62%; 2.5-20 mg/kg) towards writhings and stretchings induced by acetic acid in mice; 2) a significant antinociceptive effect on jumping responses in the hot-plate test (120 seconds at 15 mg/kg vs. 40 and 85 seconds in vehicle and ASA-treated mice, respectively); 3) a significant dose-dependent (5-15 mg/kg) antinociceptive effect against mechanical noxious stimuli; 4) a dose-dependent anti-inflammatory effect in the carrageenan-induced edema which, at the higher dose (20 mg/kg), was comparable (65% inhibition of paw swelling at 3 hours) to that obtained after indomethacin (10 mg/kg); and 5) a moderate antipyretic effect against yeast-induced hyperthermia. Present results demonstrate that lapidin possesses antinociceptive, anti-inflammatory, and less pronounced antipyretic effects comparable to those of classical non-steroid anti-inflammatory drugs, which make it worthy of further investigations as an antinociceptive and anti-inflammatory drug.

Analgesics↗
PubMed1994

[Transesophageal echocardiography assessment of regurgitant jets of eccentric geometry in mitral valve prosthesis: superiority of multiplanar sections over standard sections].

OBJECTIVE: The purpose of this study was to determine whether multiplanar (MP) transesophageal echocardiographic views were superior to standard views (ST) at 0 degree and 90 degrees in the evaluation of mitral prosthesis regurgitation (MR), particularly in presence of wall regurgitant jets. DESIGN: Comparison between MP and ST views in the evaluation of mitral prosthesis regurgitation. SETTING: Laboratory of Echocardiography of the General Hospital Gregorio Marañon. MATERIAL AND METHODS: Study of all mitral prostheses in which pathological mitral regurgitation had been detected by multiplanar TEE, between January 1993 and March 1994. Regurgitation prosthesis were classified in two groups according to the presence of wall regurgitation jets and maximum turbulent color flow areas (MAX) were measured on standard (0 degree and 90 degrees) and MP (0 degree to 180 degrees) views. The sample was divided in two groups, A (n = 33): with wall jets and B (n = 10): without wall jets. Students' t test was used to compare both areas using a 95% confidence interval (95% c.i.). RESULTS: MAX detected on ST views were of 5.80 +/- 4.60 cm2 and on MP were of 7.42 +/- 5.13 cm2 being the difference statistically significant: 1.61 cm2, 95% c.i. from 0.94 to 2.28 cm2, p = 0.000025. MAX for group A was of 5.64 +/- 4.30 cm2 in ST views and of 7.51 +/- 5.12 cm2 in MP views, being the difference 1.86 cm2, 95% c.i. from 1.04 to 2.68; p = 0.00009. Differences for group B were also statistically significant: 0.68 cm2, p = 0.0176. Mitral regurgitation (MR) was classified as mild, moderate and severe according to the color flow area. MP views detected a severer degree of MR than ST views in 8 patients, all of them with wall regurgitation jets. Three of these cases had been considered normal on ST views. CONCLUSIONS: Multiplanar transesophageal views are significantly superior to standard views in the assessment of regurgitant prosthetic mitral valves, particularly in presence of wall regurgitant jets. Our data strongly suggest that multiplanar TEE is the procedure of choice in the assessment of wall regurgitant mitral prostheses.

Adult↗