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Biomedical subjects

J Figueras

Publications and source records attributed to J Figueras.

At least 163 records · Page 9Linked to original sources
PubMed1993

Atrial natriuretic factor in neonatal hypoxic-ischemic encephalopathy.

The influence of perinatal asphyxia in the secretion of atrial natriuretic factor (ANF) during the first 6 days of life, and its renal consequences are discussed. Comparison between 20 healthy term neonates and 19 with first--or second--degree hypoxic-ischemic encephalopathy (HIE) is made. Daily controls were performed on clinical and neurological examinations and administration of sodium and fluids. On the first and sixth days of life, 24 hours urine collection, natremia, natriuresis, fractionated excretion of sodium and creatinine clearance were determined. The ANF was performed at 1, 2, 3 and 6 days old, by R.I.A. The full term newborns with HIE showed a peak in ANF values on day two, as does the control group, thereafter maintaining higher levels, with a significant difference on day three and six. No correlation could be found between the ANF levels and the renal variables analyzed.

Asphyxia Neonatorum↗
PubMed1992

Liver transplantation in hepatocellular carcinoma.

The initial enthusiasm for orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC) soon vanished as early recurrences appeared. OLT in HCC remains a controversial issue. We evaluated the efficacy of preoperative studies to select No-Mo patients and determined whether pT stage and histopathological grade (G) have a prognostic significance. A group of 25 patients, all previously thoroughly studied to rule out extrahepatic disease, underwent OLT for HCC. All patients were pNo after pathological study and none of the six patients who died in the postoperative period showed extrahepatic dissemination at necropsy (pMo). The recurrence rate was 43%. The 2 and 5 years actuarial survival was 62% and 43% respectively. The pT and G were not prognostic factors for long-term survival. We think that HCC is still a good indication for OLT because almost 50% of patients have good survival prospects.

Carcinoma, Hepatocellular↗
PubMed1992

[Long-term results of surgical treatment of soft tissue retroperitoneal sarcomas].

Soft-Tissue Retroperitoneal Sarcomas (STRP) are rare tumors. Late diagnostic and extreme technical difficulties to obtain total resection with margins free of tumor, are associated to a high relapse rate. Eighteen patients with STRP were retrospectively reviewed, evaluating: Clinical onset, histology, treatment-type performed, mortality and survival rate. Total resection was performed in eleven patients (61%), with inclusion of neighbor organs or structures in five of them (45%). In one case partial exeresis associated with left hemicolectomy was done, and only biopsy was performed in six cases. After total exeresis, seven patients showed local relapse (64%) and four of these patients (57%) underwent surgery again. Global surgery mortality was one patient. Survival at five years in resected patients was 57%. In patients with biopsy only, mean survival was 16.6 months, patients with total or partial resection, survival was 79.1 months. An aggressive surgical approach, with tumor total exeresis and a block resection of neighbor affected organs or structures, is the best alternative in the treatment of STRP.

Adult↗
PubMed1992

[Does reperfusion modify the risk of heart rupture? Effects of early reperfusion].

The goal of this study was to evaluate whether early fibrinolytic therapy could reduce in-hospital mortality caused by cardiac rupture in patients with acute myocardial infarction (AMI). Based on the strong correlation between occurrence of left ventricular free wall rupture and development of sudden electromechanical dissociation (EMD) in patients with a first TAMI without relevant heart failure, we compare the incidence of this mechanism of death in patients treated with streptokinase and in those from a control group. The study included 406 patients with a first transmural AMI younger than 71 years who received intravenous streptokinase (SK) with 104 similar patients not treated with fibrinolytic agents. Mortality rate in patients treated with SK was 6% compared to 11% in those from the control group. Patients treated with SK presented a lower incidence of EMD than those from the control group (17% vs 72%; p < 0.002). A necropsy study carried out in 33% of cases, confirmed the existence of left ventricular free wall rupture in each of the 7 cases who presented EMD but in none of the 6 who died in shock. We conclude that left ventricular free wall rupture is the principal cause of mortality in patients admitted to a Coronary Care Unit with a first transmural AMI, and that fibrinolytic treatment reduces mortality mainly by reducing development of cardiac rupture.

Administration, Oral↗
PubMed1991

Metaraminol-induced reversal of acute myocardial ischaemia associated with hypotension and refractory to intravenous nitroglycerin.

In seven patients, acute myocardial ischaemia associated with ST segment elevation (5.7 +/- 1.6 mm, mean +/- SEM) and arterial hypotension (systolic blood pressure 57 +/- 9 mmHg), was reversed within 9 min (mean time to reversal 274 +/- 45 s) by the intravenous administration of metaraminol (1.9 +/- 0.2 mg). This myocardial ischaemia was refractory to nitroglycerin and, in every patient, the increases in blood pressure induced by metaraminol (to a mean systolic blood pressure of 191 +/- 22 mmHg) preceded reversal of the ECG changes. It is suggested that, in some patients, transmural myocardial ischaemia of recent onset associated with hypotension can be reversed by transiently increasing blood pressure with metaraminol.

Aged↗
PubMed1991

Rebound myocardial ischaemia following abrupt interruption of intravenous nitroglycerin infusion in patients with unstable angina at rest.

Isolated observations prompted a prospective study of the possible occurrence of myocardial ischaemia following abrupt discontinuation of intravenous infusion of nitroglycerin in 46 consecutive patients with unstable angina. In 26 (55%, group 1), but not the remainder (45%, group 2), cessation of nitroglycerin produced in 10.3 +/- 5.8 (mean +/- SD) minutes ECG changes comparable with those of spontaneous angina without significant changes in heart rate and blood pressure. Reproducible results were observed in 18/20 patients in whom the test was repeated. In four patients with two positive tests, a third test failed to elicit ischaemia 15 min after sublingual administration of 5 mg isosorbide dinitrate. An ergonovine test performed in four other patients with a positive test produced similar ECG changes. Thus, acute interruption of intravenous nitroglycerin infusion in patients with unstable angina is often associated with acute myocardial ischaemia. The lack of preceding changes in heart rate and blood pressure and the similarities with the spontaneous episodes and with those produced by ergonovine, strongly suggest a rebound coronary vasoconstrictive phenomenon as the underlying mechanism.

Adult↗
PubMed1990

Effect of balanced amino acid solution on protein metabolism after surgery. A clinical study.

The aim of this study was to investigate the nitrogen-sparing effect of hypocaloric parenteral nutrition (HPN) with a balanced amino acid supply compared with that of a standard Rose's formula. Eighteen well-nourished patients with colorectal cancer were randomly distributed into 3 groups: I control, II Study group, III Rose's formula. The amount of non-protein calories was similar in both groups: 8 kcal/kg administered as glucose, and 1.33 g of amino acid/kg was also infused during 5 days. There were no differences in the plasma protein levels of total proteins, albumin, and transferrin, but retinol-binding protein was higher in group II compared with the control. Nitrogen balance was significantly better in group II than in group III during the 3rd and 4th days. There were differences in the concentration of aspartic acid and glycine in the plasmatic aminograms between groups II and III. It was concluded that the balanced amino acid solution does not significantly improve a patient's nutritional state. Nor have we observed that the balanced amino acid solution causes fewer modifications in the plasma aminograms. However, it does achieve a slight improvement in the nitrogen balances and the synthesis of retinol-binding protein.

Amino Acids↗
PubMed1989

[Quality of life after liver transplant].

Hepatic transplant has recently undergone ostensible changes in post operative mortality. The present study investigates whether this improvement in survival is associated with a subjective and objective improvement in quality of life. Nineteen patients were evaluated preoperatively and/or postoperatively with a questionnaire (Nottingham Health Profile). The results showed a remarkable improvement in the quality of life of these patients, which became more marked after three months. The readaptation to work was good, considering the current state of our society. The mean yearly hospital stay was 12 days, distributed in three admissions mainly to perform hepatic biopsy.

Adolescent↗
PubMed1989

Nocturnal angina in patients with fixed coronary stenosis. Increased coronary vasoconstrictive sensitivity with independence of pacing ischaemic threshold.

Atrial pacing and ergonovine tests were performed in 18 consecutive patients with unstable angina at rest and significant coronary artery stenosis (greater than or equal to 90% in greater than or equal to one vessel in 16 patients). 13 of them also had exertional angina. 14 patients presented at least one positive response (greater than or equal to 1.0 mm ST-segment shift) to pacing, with a heart rate (144 +/- 11 vs 75 +/- 13 beats min-1, P less than 0.001) and double product (195 +/- 26 vs 108 +/- 32 x 10(-2), P less than 0.001) significantly higher than during angina at rest. In the ten patients who presented nocturnal angina, the incidence of positive response to pacing and the pacing ischaemic threshold, tested on three different days, were similar to those seen in the remaining patients. In contrast, the ergonovine test was positive in all patients with nocturnal angina (100%), who required a low dose (0.28 +/- 0.2 mg), but it was positive in only four (50%) of those without nocturnal angina, who needed a higher dose (0.55 +/- 0.12 mg, P less than 0.005). Therefore, in patients with severe coronary stenosis and exertional angina, spontaneous episodes, including nocturnal angina, are not related to increases in heart rate. The increased coronary vasoconstrictive sensitivity found in these patients, particularly those with nocturnal angina, was not dependent on the status of the coronary reserve, which strongly suggests that changes in coronary tone, focal or diffuse, are involved in the mechanisms of these ischaemic events.

Aged↗
PubMed1989

Blood volume and right heart haemodynamics in abrupt hypotension following sublingual isosorbide dinitrate in acute myocardial infarction.

Arterial blood pressure and heart rate were measured in 43 patients with acute myocardial infarction and a systolic blood pressure greater than or equal to 120 mmHg during sublingual administration of 5 mg of isosorbide dinitrate. In 25 of them right heart haemodynamics were also measured. Severe (greater than or equal to 25%) hypotension developed in 12 patients (Group 1, systolic blood pressure 158 +/- 28 to 78 +/- 17 mmHg, mean +/- SD) but not in the remaining 31 (Group 2) and was accompanied by a fall in heart rate (82 +/- 20 to 70 +/- 22 beats min-1, P less than 0.05), in cardiac output (4.3 +/- 0.3 to 3.2 +/- 0.41 min-1, P less than 0.02, n = 5) and in systemic vascular resistances (2326 +/- 463 to 1532 +/- 442 dynes sec-1 cm.5, P less than 0.02) not present in Group 2. The reduction in right (Group 1, 8 +/- 3 to 3 +/- 1, vs. Group 2, 10 +/- 3 to 6 +/- 3 mmHg, P less than 0.005) and in left ventricular filling pressures (Group 1, 15 +/- 4 to 8 +/- 2, vs. Group 2, 18 +/- 6 to 13 +/- 5 mmHg, P less than 0.001) was more remarkable in Group 1. In this group there was also a high incidence of anterior infarction (9/12, 75%).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Sublingual↗
PubMed1989

Prognostic value of segmental contractility assessed by cross-sectional echocardiography in first acute myocardial infarction.

We prospectively studied 110 patients with a first acute myocardial infarction with cross-sectional echocardiography, between 7-10 days post-infarction, to assess the value of semiquantitative segmental contractility score for the first year post-AMI risk stratification. 87 patients had acceptable recordings (40 anterior and 47 inferior infarction). Twelve patients had severe complications (severe angina or heart failure, reinfarction or death) and 40 had non-severe complications. The total segmental score was higher in complicated than in non-complicated patients. The score also differentiated angina from heart failure. The score of necrotic area was more discriminating than that of non-necrotic area. Discriminating power was higher in anterior than in inferior acute myocardial infarction. Thus we conclude that the semiquantitative assessment of segmental contractility by cross-sectional echocardiography is useful for risk stratification following acute infarction identifying severe complications, particularly heart failure, with better discrimination in anterior acute myocardial infarction.

Adult↗
PubMed1989

Treatment of an enteric fistula with somatostatin in a premature.

The authors present the case of an extremely premature baby affected by severe Necrotizing Enterocolitis (NEC) needing intestinal resection and ileostomy. An enteric fistula developed 3 days after ostomy closure. The baby was started on Total Parenteral Nutrition (TPN), and 7 days later the fistula output remained constant. Somatostatin (SM) was then given intravenously (3.0 micrograms/Kg/hr) and the fistula closed on the 3rd day of treatment. Since SM was introduced in 1986 as an adjunct treatment to TPN in enteric fistulas, the authors believe that theirs is the first report of a successful SM treatment in a premature.

Enterocolitis, Pseudomembranous↗