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Biomedical subjects

J Cosín

Publications and source records attributed to J Cosín.

35 records · Page 2Linked to original sources
PubMed1990

Recurrent pericarditis. Relief with colchicine.

Recurrence is one of the major complications of pericarditis. Treatment of recurrence is often difficult, and immunosuppressive drugs or surgery may be necessary. We conducted an open-label prospective study of nine patients (seven men and two women; age, 18-64 years; mean age, 41.7 +/- 13.7 years). Patients were treated with colchicine (1 mg/day) to prevent recurrences. All patients had suffered at least three relapses despite treatment with acetylsalicylic acid, indomethacin, prednisone, or a combination. Pericarditis was classified as idiopathic in five patients, postpericardiotomy in two, post-myocardial infarction in one, and associated with disseminated lupus erythematosus in one. For statistical analysis, we conducted a paired comparison design (Student's t test). All patients treated with colchicine responded favorably to therapy. Prednisone was discontinued in all patients after 2-6 weeks (mean, 26.33 +/- 10.9 days), and colchicine alone was continued. After a mean follow-up of 24.3 months (minimum, 10 months; maximum, 54 months), no recurrences were observed in any patient; there was a significant difference between the symptom-free periods before and after treatment with colchicine (p less than 0.002). Our study suggests that colchicine may be useful in avoiding recurrence of pericarditis, although these results need to be confirmed in a larger, double-blind study.

Adolescent↗
PubMed1989

[Regional differences in the contractile function of the subendocardium and subepicardium of the left ventricle in the dog].

With the objective to study the regional differences in myocardial function of different left ventricular (LV) segments, twelve pairs of ultrasound crystals were implanted in six open-chest dogs. Six pairs in the subendocardium and six in the subepicardium in three zones of the left ventricle (4 in the apex, 4 in the left anterior descending region and 4 in the circumflex region). In each zone of subendocardium one pair was placed parallel to the epicardial fibers (long axis) and the other following the circumferential plane of the left ventricle (short axis); the same orientation was followed in the subepicardium. Left ventricular pressure, coronary flow (electromagnetic flow-meters), peripheral ECG leads, dp/dt, and segmental shortening were measured. The extent of shortening and the fraction of shortening were considered. The extent of shortening is always higher in the long axis than in the short axis crystals. Similarly, the shortening in the subendocardium is higher than in the subepicardium. The greater extent of shortening and fraction of shortening appeared in the apex, above all in the subendocardium. There are differences in the time-course of fibrillar shortening between subepicardium and subendocardium; the subendocardial contraction was simultaneous with a lengthening of the subepicardial segments. In conclusion, there are differences in myocardial contraction depending on the myocardial region and the layer. Also the shortening of the subendocardium is not synchronous with the subepicardium.

Animals↗
PubMed1988

High prevalence of tuberculosis in AIDS patients in Spain.

A total of 67 cases of tuberculosis was diagnosed in the first 100 cases of AIDS, diagnosed according to the former CDC criteria, at a hospital in Madrid, Spain. This is the highest known prevalence of tuberculosis in AIDS patients both within and outside Spain. The clinical manifestations of tuberculosis were very variable and atypical. The rate of isolation of Mycobacterium tuberculosis from blood was particularly high: of 25 patients in whom blood cultures were performed, 16 were positive. In a third of the patients with proven mycobacteremia, blood was the first or the only positive specimen. In general, therapy resulted in rapid clinical improvement, but in some cases mycobacteria were isolated from clinical or necroscopy specimens months after what was considered adequate therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Electrophysiological mechanisms of the SI SII SIII electrocardiographic morphology.

We studied three groups of individuals by means of spatial-velocity electrocardiograms and thallium-201 myocardial imaging to figure out the electrophysiological explanation of the SI SII SIII electrocardiographic morphology. We studied twelve healthy individuals without SI SII SIII, seven healthy individuals with SI SII SIII and fifteen patients with chronic obstructive pulmonary disease with SI SII SIII. The average values of the QRS-E and QRS-F intervals were higher in the second (P less than 0.05 and P less than 0.005) and third groups (P less than 0.01 and P less than 0.001) than in the first. One patient of the second group and thirteen of the third showed right ventricular enlargement. The slowing down of the right ventricular conduction explained the SI SII SIII morphology in normal individuals in more than half the cases. In patients with chronic obstructive pulmonary disease with SI SII SIII the conduction delay plays an important part in the electrogenesis of the right ventricular enlargement electrocardiographic morphology. We think that these observations can give further data about the electrophysiologic mechanism of the SI SII SIII morphology.

Cardiomegaly↗
PubMed1981

Effects of high-frequency harmonics on cardiac relaxation indices.

This study was designed to determine the degree to which the systematic distortions in the pressure curve due to recording and filtering systems influence the relaxation indices. The purposes are 1) to analyze the dependency on the high frequencies of the relaxation and contractility parameters, 2) to determine the degree to which the catheter recordings modify those parameters, and 3) to test the monoexponential hypothesis in which the T index is based (Weiss, Frederiksen, and Weisfeldt, J. Clin. Invest. 58: 751-760, 1976). In 17 open-chest dogs, the left ventricular pressure (LVP) was recorded in four different ways: 1) with a large-bored metal cannula, 2) with a catheter-tip manometer, 3) with a Cournand catheter, and 4) with a pigtail catheter. The ECG and LVP were digitized by a computer. A Fourier analysis was performed, and the LVP waves were resynthesized with different numbers of harmonics. We conclude that 1) the catheter recordings are not recommended to calculate relaxation indices, 2) relaxation parameters present more sources of errors than contractility parameters, 3) the monoexponential hypothesis of T is fulfilled if the isovolumic relaxation is considered to end at the time the LVP is 10 mmHg more than left ventricular end-diastolic pressure level, 4) the dependency on higher harmonics of T index and +dP/dtmax is similar, and 5) -dP/dtmax is much more high-frequency dependent than T index.

Animals↗
PubMedDate not supplied

Nelfinavir plus nevirapine plus two NRTIS as salvage therapy for HIV-infected patients receiving long-term antiretroviral treatment.

PURPOSE: To evaluate a rescue therapy involving nevirapine plus nelfinavir plus two nucleoside reverse transcriptase inhibitors (NRTIs) in patients with prior extensive antiretroviral therapy (AT) including protease inhibitors (PIs) but not nonnucleoside reverse transcriptase inhibitors (NNRTIs). METHOD: Patients with failing regimens were prospectively enrolled. According to genotypic profile at baseline, two groups were identified: a highly resistant (HR) group, which included strains resistant to PI and NRTI, and a moderate nonresistant group (MR), which showed resistance only to PI or NRTI or no resistance. RESULTS: Twenty-two individuals were included. Average time of AT prior to enrollment was 3.7 years (range 1.4-7.6), median viral load 4.92 log(10) (interquartile range [IQR] 1.63 log(10)), and median CD4 cell count 64 cells/microL (IQR 94). After 16 weeks of treatment, seven patients (31%) achieved virological response, five of them (22.7%) with <500 c/mL (bDNA). Fourteen patients were studied for resistance. The HR group showed a poorer response than the MR group (0 vs. 7 responses; p =.034). CONCLUSION: We found a virological response in 31% of our patients, and mainly in those of the MR group some presented previous intolerance. These two factors probably reflect the number of drugs included in the rescue therapy to which the patient is sensitive. Treatment history as well as genotypic resistance assays are useful in identifying patients with the best chance of responding.

Adult↗
PubMedDate not supplied

[Supraventricular arrhythmia. Potential applications of esmolol].

Atrial fibrillation, atrial flutter, paroxistical supraventricular tachycardias and atrial tachycardias are the main supraventricular arrhythmias. Atrial fibrillation is the most common. In this review we comment their physiopathology, clinical manifestations, and treatments, paying special attention to the possible esmolol applications.

Adrenergic beta-Antagonists↗