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Biomedical subjects

J Santamaria

Publications and source records attributed to J Santamaria.

At least 73 records · Page 4Linked to original sources

Diaphragmatic elevation in stroke.

We compared the relative elevations of the two diaphragms in the supine chest films of 62 patients with recent hemiparesis due to a supratentorial stroke with that of 92 acute coronary patients without neurologic disease. Patients with severe hemiparesis or lesions larger than 40 ml exhibited an excessive elevation of the diaphragm on the paretic side compared with controls. This finding was more common with lesions involving the genu of the internal capsule and/or the near anterolateral area. Measurement of the interdiaphragmatic elevation difference may give information on the location and/or size of the stroke.

Cerebral Hemorrhage↗

Recidivism in a cohort of young Australian drinking-drivers.

Four hundred and sixty-three men aged 18-25 years were referred to a counselling programme in 1975-1977, after their first conviction for an alcohol-related traffic offence. Records of the Victoria Police, and those of the Motor Registration Board, were searched for subsequent alcohol-related traffic offences up to February 1984. Those subjects who had left the State of Victoria or had died were identified, and a "survival" curve was constructed where survival implied freedom from reconviction for an alcohol-related traffic offence. By means of Cox's proportional hazards model, the rate ratios of a number of predictor variables of recidivism were calculated; those of significance were the number of drinks per week, social class, and a history of "family troubles with drinking". Reduction of alcohol consumption may be a more appropriate goal in programmes that are concerned with the counselling of young drinking-drivers than is attempted modification of the drinking-driving nexus.

Accidents, Traffic↗

Hemodynamic changes from spinal cord stimulation for vascular pain.

The hemodynamic changes induced by spinal cord stimulation (SCS) have been studied in a group of 20 patients with peripheral vascular pain. The surgical technique consisted of the introduction of 1 or 2 electrodes in the subarachnoid space up to the level of the painful area, for mono or bipolar SCS. Several techniques have been used for evaluation of hemodynamic changes induced by SCS. Peripheral blood flow speed was measured by means of ultrasound Doppler, showing a raised maximum speed during stimulation, and a tendency of the pulse wave to return to normal. Thermography showed a marked increase of temperature in the painful area. Preoperatively, plethysmography showed an absence of the typical flow waveform, whilst postoperative recordings showed a small wave of progressively increasing amplitude. Scintigraphy with 201TI showed an increase in muscular blood flow in previously hypovascularized areas. The mechanism of action of SCS on peripheral blood flow and vascular pain is discussed.

Blood Flow Velocity↗

Chronic alcoholic proximal wasting: physiological, morphological and biochemical studies in skeletal muscle.

Electromyography, muscle histochemistry and assay of all glycolytic enzymes, phosphorylase, glycogen, carnitine and several mitochondrial marker enzymes in skeletal muscle (vastus lateralis) were carried out in two groups. One group comprised chronic alcoholic patients with prominent proximal wasting, the other was an alcoholic group with normal neuromuscular examination. Biochemical results were compared with data from control groups with normal muscle histology and with non-alcohol related type 2b fibre atrophy. Either 2b atrophy factor or 2b variability coefficient were increased in all wasted alcoholic patients, with normal values in alcoholics without wasting. Electromyography studies were usually normal in proximal muscles, although several patients had mild distal neuropathies. A significant fall in activity of phosphorylase and all glycolytic enzymes was found in wasted alcoholics with reference to normal controls. In the non-ethanolic 2b atrophy group the activity of several glycolytic enzymes was also significantly lower, but for each enzyme the mean activity was not depressed to the same extent as in the wasted alcoholic group. Muscle glycogen, carnitine, and mitochondrial marker enzyme activities (isocitrate dehydrogenase, monoamine oxidase, cytochrome oxidase) were normal in alcoholics with proximal wasting. It is concluded that there is no deficiency of mitochondrial marker enzymes in wasted alcoholics and that a significant depression in glycogenolytic and glycolytic enzyme activity is seen which is explained in part, but probably not fully, by 2b fibre atrophy.

Adult↗

Site of bronchodilatation with inhaled ipratropium bromide and fenoterol in normal subjects.

To assess the effectiveness and site of action of bronchodilatation with an inhaled anticholinergic bronchodilator, ipratropium bromide, and a beta adrenergic agonist, fenoterol, we measured the density dependence of maximal flow and the density dependence of pulmonary resistance using a digital computerized averaging circuit. Eight normal subjects were studied on two separate days, before and after the bronchodilators were administered in a double blind manner. Both drugs resulted in significant and equivalent bronchodilatation. However, there were no significant changes in the density dependence of maximal flow or pulmonary resistance with either agent. These results in normal subjects, therefore, do not support the hypothesis of a preferential site of action of inhaled anticholinergic agents and beta-adrenergic agents.

Administration, Inhalation↗

Peripheral neuropathy in meningococcal septicemia.

We report a case of a mixed sensorimotor, predominantly axonal mononeuritis multiplex that developed after a severe meningococcal septicemia and disseminated intravascular coagulation (DIC) with associated distal limb necrosis. Ischemia resulting from the DIC-induced multiple vascular occlusions is suggested as the leading cause of this neuropathy.

Child↗

Polymicrobial anaerobic septicemia due to lateral sinus thrombophlebitis.

Continuous polymicrobial anaerobic septicemia was the main manifestation of a lateral sinus thrombophlebitis (LST) in a patient who had a history of chronic otitis media. Five different anaerobic microorganisms were isolated in blood cultures. Three of them were also present in ear cultures. The diagnosis was confirmed at surgery and the patient was successfully treated with moxalactam disodium therapy. This case emphasizes that LST should be considered before polymicrobial anaerobic septicemia, especially if there is a history of chronic otitis media.

Adult↗

Osmolarity of tear microvolumes in keratoconjunctivitis sicca.

Determinations of tear film osmolarity were performed to evaluate their usefulness in diagnosing keratoconjunctivitis sicca (KCS) and to evaluate the possible role of elevated tear osmolarity in this disorder's pathogenesis. Tear samples were obtained using a new technique that virtually eliminates the problems of reflex tearing and sample evaporation. The tear osmolarity of 36 samples obtained from 31 normals eyes averaged 302 +/- 6.3 (SD) mOsm/liter; 38 samples obtained from 30 KCS eyes averaged 343 +/- 32.3 (SD) mOsm/liter. The sensitivity of a single measurement was 94.7% and the specificity was 93.7%. Tear samples taken on separate occasions from one normal subject ranged between 295 and 309 mOsm/liter; those obtained from a KCS patient ranged between 312 and 424 mOsm/liter. Hypersmolarity of the tear film in KCS may play an important role in inducing the disease seen in the cornea and conjunctiva.

Adolescent↗

Cerebral infarction of the basal ganglia due to embolism from the heart.

We studied 8 patients with cerebral infarction in the deep territory of the middle cerebral artery (MCA). All patients had a definite cardiac source of emboli and no known factors for thrombosis. Mixed sensory and motor deficit was found in all but one patient and CT scan showed larger lesions than usually reported in lacunar infarcts. Contrast enhancement was seen in all cases in which CT scan was performed in the second or third week. It is concluded that embolic infarcts in deep cerebral territory of MCA from a cardiac source are more frequent than previously reported. This diagnosis has to be considered when CT scan demonstrates a deep cerebral infarct.

Adult↗