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Biomedical subjects

J Ortiz

Publications and source records attributed to J Ortiz.

At least 163 records · Page 9Linked to original sources

[Factors associated with hospitalization for ambulatory care sensitive conditions in municipalities].

OBJECTIVES: To describe variability in admission rates for ambulatory care sensitive conditions (ASSC) in municipalities in the catchment area of a tertiary hospital and to determine the influence of primary care characteristics, socioeconomic factors, health of the population, and geographical accessibility to the hospital on this variability. METHODS: An ecological study was carried out in 34 municipalities in the area served by the Hospital Virgen de las Nieves in Granada (Spain) including all admissions for ASSC from 1997 to 1999. The admission rates for men and women were calculated separately and were age-standardized by the indirect method. The following factors were analyzed as independent variables: characteristics of primary care (type of healthcare model and type of center), socioeconomic factors (unemployment rate, income per capita, number of business establishments, size of municipality), health (mortality rate), and accessibility (time in minutes from the municipality to the hospital). A multiple lineal regression model was estimated. RESULTS: A total of 9.8% of all hospital admissions were due to ASSC. The mean annual admission rate was 10 admissions per 1.000 inhabitants. This rate was higher for men and for persons aged more than 74 years. The standardized admission ratios were not statistically different from 1 in 56% of the municipalities and were higher than 1 in 26% and lower than 1 in 18%. Sixty-two percent of the variability in rates for men was associated with time taken to reach the hospital, size of municipality, the interaction between both variables, and mortality. Eighteen percent of the variability in rates for women was associated with time taken to reach the hospital and the unemployment rate. CONCLUSIONS: Variability in admission rates for ASSC was not associated with primary care characteristics in the geographical area analyzed. Accessibility (measured as time to the hospital) was the only variable associated with higher rates in both men and women. Admission rates for ASSC among women were higher when unemployment rates were higher, and rates among men were higher in larger municipalities and in those with higher mortality.

Adult↗

The effect of age, speed, and arm dominance on shoulder function in untrained men.

Bilateral shoulder motor output measurements were obtained in 40 subjects with a Biodex dynamometer. The subjects included two groups, a younger group (20 to 30 years) and an older group (50 to 60 years). They were engaged in low to moderate levels of occupational and spare-time physical activity. Each subject performed three maximum effort shoulder movements in flexion/extension, abduction/adduction, and internal/external rotation at 60 degrees/sec and 120 degrees/sec. Side tested, axis, and speed were randomly selected. The findings indicate that a significant decline occurred in peak torque, work, and power for all axes of movement at both speeds when the older group was compared with the younger group. A decline in peak torque and work and a corresponding increase in power resulting from an increase in speed occurred in both age groups. The effect of age was the same at 60 degrees/sec and at 120 degrees/sec. Overall, no difference in dominant and nondominant motor function was seen in either the younger or older untrained men.

Adult↗

Reliability of serum magnesium values during diabetic ketoacidosis in children.

OBJECTIVE: To determine the prevalence of hypomagnesemia in diabetic children during diabetic ketoacidosis and following restitution of acid-base balance. METHODS: Eight consecutive diabetic children, ranging in age from 8 to 16 years, hospitalized in the pediatric intensive care unit with diabetic ketoacidosis from October 1st. through December 31st, 1995. A control group of 33 metabolically stable diabetic children, and a control group of 30 healthy children. Both control groups were similar in composition regarding age and sex to the study group. None of the patients in the study group and none of the controls had Magnesium supplementation given to them during the study period. MEASUREMENTS: Total serum Magnesium concentrations were measured from peripheral venous blood in all 71 patients. For the study group serum Magnesium was determined in a serial fashion: 1. upon admission in diabetic ketoacidosis 2. 24 hours after admission 3. 72 hours after admission RESULTS: The prevalence of hypomagnesemia was 62.4% in patients with diabetic ketoacidosis, (Group 1), 25% in patients after partial correction of ketoacidosis, (Group 2), and none in patients after resolution of ketoacidosis, (Group 3). The prevalence of hypomagnesemia was 6% for the chronic, metabolically stable diabetic control group, (Group 4), but 0% for the non-diabetic control group, (Group 5). Average serum Magnesium levels were significantly lower (p less than 0.05), in patients admitted in diabetic ketoacidosis compared to those of both the diabetic and the non-diabetic control groups. Also average serum Magnesium levels were significantly lower (p less than 0.05), in patients with corrected diabetic ketoacidosis than those of the healthy control group. But there were no significant differences (p = 0.59263) in average serum Magnesium levels between the diabetic control group and the diabetic patients after resolution of ketoacidosis. CONCLUSIONS: In this study the prevalence of hypomagnesemia was documented to be higher than the average described elsewhere for pediatric, adult, and coronary intensive care units. As hypomagnesemia is an indication of Magnesium depletion, we speculate that the transient hypomagnesemia detected in our study group is an expression of a state of Magnesium depletion that is masked by correction of acidosis and the Magnesium shifts associated with it. Consequently serum Magnesium values ought to be considered most reliable during and not after correction of diabetic ketoacidosis. Since Magnesium was not supplemented to any of our patients, the normalization of their serum values must be the result of: a. decreased glycosuria-related urinary losses b. cessation of acidosis-related urinary losses c. Magnesium shifts from intra to extracellular space The high prevalence of hypomagnesemia and the significant lower average serum Magnesium levels in children with diabetic ketoacidosis reveals the magnitude of the problem and the potential for Magnesium depletion that occurs in diabetic children.

Adolescent↗

[Zinc deficiency caused by postgastrectomy fistula with high flow in a patient undergoing prolonged parenteral nutrition].

A case is presented of a 57-year-old male patient who underwent total gastrectomy due to gastric adenocarcinoma. During the postoperative period the patient required long-term parenteral nutrition due to a high-debit GI fistula (over 700 ml/day) and sepsis. Two months after parenteral nutrition was started, the patients presented irritability, mucocutaneous lesions and progressive bolding. Serum alkaline phosphatase and zinc levels were lower than normal, although a supplemental 0.03 mg/k/day of zinc was administered. Faced with this zinc deficiency picture, 10 mg zinc sulfate was administered parenterally on a daily basis. The deficiency picture improved markedly over a week's period, and serum zinc and alkaline phosphatase levels returned to normal. The importance of zinc balance control in patients under long-term parenteral nutrition and high fluid debit through GI fistulas is highlighted.

Colonic Diseases↗

Effects of different doses of acetylsalicylic acid on platelet aggregation: an experimental study of prosthetic materials in dogs.

Laminar flow is the condition best suited to the study of platelet thrombi. This type of thrombus is predominant in arteries, in the tubes of cannulas used in artificial circulatory systems, in cardiac valve prostheses and in prosthetic arterial implants. Antiplatelet drugs could, in these cases, reduce the extent of thrombus formation. At present the optimal dose of acetylsalicylic acid (ASA) to achieve the best antithrombotic effect is unknown; some papers show that high doses augment experimental thrombosis. By means of autologous platelets labelled with 111In-oxine, we have quantified the accumulation on different materials used in cardiovascular surgery (woven, knitted and double velour Dacron, Avcothane 51 elastomere and smooth surface and rough surface pericardium). Samples of these fabrics were placed in a laminar flow chamber connected between the right atrium and femoral artery of the experimental animals (dogs). The animals were divided into four groups of eight dogs: Group I: no treatment Group II: animals treated one week earlier with ASA (1 mg/kg/day) Group III: as in Group II, but at a dose of 5 mg/kg/day Group IV: as in Group II, but at a dose of 20 mg/kg/day. The materials upon which the least amount of platelets were accumulated were the smooth, epicardial surface of pericardium (SP) and Avcothane (AV). The least deposition was produced in Group III, with the exception of SP. In the case of this material, there was no difference between Groups I and III. In Group IV, the deposit was greater with respect to the untreated group (Group I), except in the case of AV, in which there was no difference between Groups I and IV.

Animals↗