Search PubMed⌕ Search

Biomedical subjects

J Gener

Publications and source records attributed to J Gener.

At least 19 recordsLinked to original sources
PubMed2000

Evaluating the outcome of severe head injury with transcranial Doppler ultrasonography.

The authors conducted a study to determine the value of transcranial Doppler (TCD) ultrasonography in evaluating the outcome of severely head injured patients and to correlate the TCD values with those obtained from intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring. The authors conducted a prospective study of 125 patients with severe head injury (Glascow Coma Scale scores of less than 9) who underwent TCD ultrasonography according to the standard technique of insonating the middle cerebral artery (MCA) and measuring the mean blood flow velocity and pulsatility index within the first 24 hours of admission. The ICP and CPP values, as well as other clinical, analytical, and neuroimaging data, were also recorded. After 6 months, outcome was evaluated using the Glasgow Outcome Scale. Moderate disability and complete recovery were considered "good" outcome; death, vegetative state, and severe disability were considered "poor." In 67 patients (54%) good outcome was demonstrated whereas in 58 (46%) it was poor. The mean blood flow velocity of the MCA in patients with good outcome was 44 cm/second; in those with poor outcomes it was 36 cm/second (p < 0.003). The mean PI in cases of good outcome was 1 whereas in poor outcome was 1.56 (p < 0.0001). The correlations of ICP and CPP to PI were statistically significant (r2 = 0.6; p < 0.0001). When performed in the first 24 hours of severe head injury, TCD ultrasonography is valid in predicting the patient's outcome at 6 months and correlates significantly with ICP and CPP values.

Adolescent↗
PubMed1999

Specific prognostic factors for secondary pancreatic infection in severe acute pancreatitis.

BACKGROUND/AIMS: The aim of the present study was to investigate whether there are specific prognostic factors to predict the development of secondary pancreatic infection (SPI) in severe acute pancreatitis in order to perform a computed tomography-fine needle aspiration with bacteriological sampling at the right moment and confirm the diagnosis. METHODS: Twenty-five clinical and laboratory parameters were determined sequentially in 150 patients with severe acute pancreatitis (SAP) and univariate, and multivariate regression analyses were done looking for correlation with the development of SPI. RESULTS: Only APACHE II score and C-reactive protein levels were related to the development of SPI in the multivariate analysis. A regression equation was designed using these two parameters, and empiric cut-off points defined the subgroup of patients at high risk of developing secondary pancreatic infection. CONCLUSION: The results showed that it is possible to predict SPI during SAP allowing bacteriological confirmation and early treatment of this severe condition.

APACHE↗
PubMed1994

Acute necrotizing pancreatitis: a multicenter study.

A multicenter study of acute necrotizing pancreatitis (ANP) classified in accordance with the Balthazar criteria (grades D and E), has been performed in 12 teaching hospitals. A total of 233 patients were reviewed, and the mortality rate was 26.6%. The most common etiology was biliary pancreatitis (45.5%). Among the complications, shock, renal insufficiency, pulmonary insufficiency and hemorrhagic gastritis were associated with a mortality rate of 51-66%. Diffuse fluid collections were associated with a higher mortality rate (26.8%) than localized fluid collections (14.5%). In 106 patients with gallstone pancreatitis, early surgery was performed in 17, and 5 patients (29.4%) died. No mortality was observed in 32 patients with delayed surgery. Sphincterotomy was performed in 13 patients, and 4 (30.7%) died. Early surgery (necrosectomy and closed peritoneal lavage) was undertaken in 75 patients, with a mortality rate of 39%. In conclusion, the morbidity and mortality rates of ANP can be improved with proper monitoring, adequate supportive care and the judicious use of surgery based on clinical and morphological findings.

Acute Disease↗
PubMed1992

[Antithrombin III: its prognostic value in acute pancreatitis].

PURPOSE: Antithrombin III (AT-III) activity was studied in relation to the seriousness of a series of patients with acute pancreatitis (AP). The aim of this study was to determine whether AT-III can be a prognostic factor for early detection of negative evolution on these patients. MATERIAL AND METHODS: AT-III was determined on days 1, 3, 5, 7, 10, 15 and 21 after admission and weekly until discharge in 28 consecutive patients with AP, admitted in our hospital during a period of six months. The patients were 13 males and 15 females, with a mean age of 57 years (range 32 to 82). Fifteen AP were serious and 13 were not. RESULTS: AT-III levels under 80% of activity were found up to the 10th day in serious AP, turning back to normality from this day. In nonserious AP, AT-III remained within normal levels. This different evolution between both kinds of AP was statistically significant (p less than 0.05) during the first seven days, and became more evident in patients with fatal evolution (p less than 0.001). After grouping the lower levels of AT-III observed during the first 48 hours with those detected at the end of the first week, and introducing a cut off value of AT-III under 70% of activity, serious and nonserious AP presented predictive indexes of 67 and 70% respectively. Every deceased patients had, at admission and at the end of the first week, average levels of AT-III under 70%. CONCLUSION: We conclude that determination of AT-III levels is a good prognostic factor to differentiate between serious and nonserious AP, especially during the first week of illness.

Acute Disease↗
PubMed1990

[Development of resistance to antibiotic therapy at a polyvalent intensive care unit during 3 years].

The antibiotherapy resistance evolution and the appearance of new enterobacter in our ICU's flora have been studied. A total of 638 bacterial samples were studied. The most frequent isolated pathogens were: Pseudomonas aeruginosa (182 strands), Escherichia coli (108 strands), Staphylococcus epidermidis (99 strands) and Staphylococcus aureus (41 strands). These four types of bacteria have been used to evaluate the antibiotic resistance variations over a period of time, which have only been significant for Pseudomonas with an increased number of amikamicine's resistant strands after the second year (p less than 0.001) and the of one multiresistant strand to piperaciline and amikamicine this second year, and four (8%) the year after. There are not significant differences in the resistance of E. Coli, Staphylococcus aureus and Staphylococcus epidermidis over this period of time. We have not observed new enterobacter strands over the time this study was performed although a higher incidence of Serratia (p less than 0.05) and Enterobacter (p less than 0.05) have been detected between the first and the third year, respectively.

Bacterial Infections↗
PubMed1989

[Immediate and 1-year survival after cardiopulmonary resuscitation at an intensive care unit].

Eighty consecutive patients requiring cardiopulmonary resuscitation (CPR) for cardiorespiratory arrest (CRA) were prospectively studied. The immediate survival rate and the survival rates after 48 hours, at the time of hospital discharge and one year later were evaluated. Forty-one patients (51%) initially recovered from CRA, 20 died in the hospital and 17 (21% of the initial group) survived after one year. Survival was related to: 1) the mechanism of CRA. Ventricular tachycardia-fibrillation (VT-VF) had a better prognosis than asystole (AS) and electromechanical dissociation (EMD) (p less than 0.005). 2) Duration of CPR. The survival was higher when CPR lasted for less than 15 minutes (p less than 0.001). 3) Underlying disease. The classification of the patients in three categories depending on the underlying condition permitted an approach to the prognosis of CPR. Group A: patients who did not benefit from CPR, without survivors at the time of hospital discharge. Group B: patients who had a benefit from CPR, with a 37% survival at the time of hospital discharge and 33% after one year, with a good quality of life and a good neurological status. Group C: patients in whom the benefit of CPR was variable, with a similar survival rate as group B at the time of discharge, but with a reduction to 20% in the subsequent year.

Adolescent↗
PubMed1989

[Correlation of etiology and severity in a series of 506 cases of acute pancreatitis].

We present a retrospective study on 506 patients with acute pancreatitis (AP), admitted in our hospital in the last five years (1984-1988). The goal of the paper is to establish a possible correlation between the severity and the etiology of the AP. Depending on the severity of the acute attack, and according to the Ranson's prognostic signs and the findings of the abdominal CAT, we have classified AP in three grades: mild, moderate and severe. 52% of AP were of biliary etiology, 25.7% alcoholic, and in 17.0% of the cases the responsible agent was not demonstrated. In relation with severity, the distribution was as follows: mild, 184 (36.4%), moderate, 254 (50.2%) and severe, 68 (13.4%). Among the cases of biliary and alcoholic etiology, 14.7% and 9.2%, respectively, were severe. Postoperative AP were severe in 71.4% of the cases. Systemic complications were more frequent in the severe forms, particularly of biliary etiology. Pancreatic abscesses and fistulas were also more frequent in biliary pancreatitis; on the other hand, pseudocysts and ascites were more common in alcoholic pancreatitis. Overall mortality was 2.8% (14 patients). Mortality was 19.1% in the severe forms. In relation to etiology the mortality was as follows: 3.7% in biliary AP; 0.8% in alcoholic AP; 14.3% in postoperative AP; and 2.3% in the idiopathic AP.

Acute Disease↗
PubMed1981

Colorimetry of diaphorase in commercial preparations and clinical chemical reagents by use of tetrazolium salts.

We describe a procedure for assay of diaphorase activity in commercial purified preparations and in clinical chemical reagents by use of iodonitrotetrazolium chloride or other tetrazolium salts. The method is based on measurement of the formazan produced by enzymic reduction of tetrazolium salts in the presence of NADH. The assay procedure has been optimized for linear kinetics, simplicity of operation, nondetectable blank rates, and extended activity/enzyme concentration proportionality. The proposed method has several advantages over the older assay by use of dichlorophenolindophenol.

Colorimetry↗
PubMed1979

Red cell antibody screening with the Groupamatic system. I. Bromelin methyl-cellulose and saline techniques: evaluation of five years' routine use.

These data comprise 1,231,024 routine tests carried out over a 5-year period on voluntary blood donors. The percentage of positive results on the machines varies from 1 to 3% of the total number of samples tested. Antibodies identified either by manual or automated techniques make up 15--20% of the positive screening reactions. Rhesus, Luewis and P systems prevail, whilst Duffy, Kidd and Ltheran systems are absent. This screening has three main advantages: the supply of plasma for our production of test sera, or therapeutic immunoglobulins; protection of the recipient; partial information on the donor's immunohaematological state, especially for the risk of giving him incompatible blood sometimes in the future.

Antibody Specificity↗
PubMed1977

Inorganic phosphorus measurement: an improved method.

An improved micromethod for the determination of inorganic phosphorus in serum and urine is outlined. The procedure requires no deproteinization and yields a stable colour. The new formulation proposed avoids the pitfalls of other techniques. The method is both accurate (recovery 99-100.4 percent) and precise (C.V. 2.19 percent).

Drug Interactions↗
PubMed1977

Screening of HBs antigen and detection of corresponding antibodies on groupamatic equipment.

The widespread utilization of Groupamatic equipment for routine immunohaematological tests has increased the demand for serological procedures that can be performed with this machine. We describe the test method which was developed and with which the detection of HBs antigen has now been carried out routinely for 1 year. It is an automated haemagglutination inhibition reaction which is called GIPHA (Groupamatic inhibition of passive haemagglutination). The sensitivity corresponds to 2 CNTS units, the antigen weight for 1 unit being from 1 to 4 ng. The reproducibility is good; the percentage of false positive reactions is about 0.5% and that of technical problems 0.7%. The additional advantages of the machines are numerous, among which we have the possibility of 11 other simultaneous reactions. One of them is the detection of antibodies against HBs antigen, which is a passive haemagglutination test called PHAG (passive haemagglutination on Groupamatic).

Antibodies↗