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Biomedical subjects

J Vidal

Publications and source records attributed to J Vidal.

At least 361 records · Page 20Linked to original sources
PubMedDate not supplied

Embolization of bronchial arteries of anomalous origin.

PURPOSE: To highlight the importance of detecting bronchial arteries of anomalous origin in patients with massive or recurrent hemoptysis. METHODS: In a series of 300 patients submitted to bronchial embolization in our hospital since 1986, we found 25 (8.3%) with 27 anomalous bronchial arteries. Eighteen patients presented with recurrent hemoptysis (10 massive) and seven with their first episode of massive hemoptysis. RESULTS: Of the 27 anomalous bronchial arteries demonstrated, 24 originated from the aortic arch, one from the left thyrocervical trunk, one from the right subclavian artery, and one from the lower descending thoracic aorta; two of the arteries demonstrated showed no pathological findings. Hemoptysis resolved following the first embolization in 14 patients (56%). In nine patients (36%) more than one procedure was necessary to arrest hemorrhage. In two patients surgical intervention was required. One patient died from bleeding. CONCLUSIONS: In cases of hemorrhage when the cause is not easily identified, or in cases of recurrence in spite of accurate embolization of pathological arteries, the presence of bronchial arteries of anomalous origin should be considered. Embolization is more difficult in these cases and there is an increased risk of complications.

Adolescent↗
PubMedDate not supplied

Knitted dacron grafts used for abdominal aortic reconstruction: sizing references.

This study was undertaken to analyze immediate and mid-term knitted Dacron graft dilation and to establish which parameters should be taken as a reference when aortic graft dilation is evaluated. A Dacron knitted microvel double velour vascular graft (Hemashield Gold) was implanted in 30 patients with aneurysmal (19 cases, 63%) or occlusive (11 cases, 37%) aortic disease. The stems of bifurcated prostheses (27 patients, 90%) and tube grafts (3 patients, 10%) were measured. The package sizing (labelled size) was compared with the external diameter measured intraoperatively with a slide caliper, prior to implantation and after complete clamp release. Additional measurements were obtained by ultrasound 1 and 6 months after implantation, and in 16 cases (53% of the patients) ultrasound and computed tomography (CT) were performed at the end of the first year. The means of the measurements were compared using Student's t test for matched pairs. The statistical significance level was set at p values < 0.05. There was a statistically significant difference between the package sizing (15.3 +/- 1.1 mm) and the external diameter measured prior to implantation (18.7 +/- 1.3 mm); and with the external diameter following implantation (19.6 +/- 1.4 mm), (p < 0.01). External diameters measured prior to grafting and following implantation (after complete clamp release), when compared with the manufacturer's size, showed a mean increase in graft diameter of 3.4 mm (22%) and 4.3 mm (28%), respectively. There were no statistical differences between the external diameter measured after clamp release (19.6 +/- 1.4 mm) and the size determined by ultrasound 4 weeks (19.3 +/- 1.2 mm) and 6 months (19.8 +/- 1.5 mm) following surgery (p values 0.11 and 0.56, respectively). Considering size after clamp release as a reference (19.6 +/- 1.4 mm), an almost significant (p = 0.08) increase in the diameter (0.7 +/- 1.5 mm) was obtained at the end of the first year when the measurement was performed with ultrasound. However, when the measurement was performed by CT at the end of the first year, the differences (0.9 +/- 1.6 mm) revealed statistical relevance (p = 0.04). There was no statistically significant difference between the sizes obtained by ultrasound (20.3 +/- 2.1 mm) and by CT (20.5 +/- 2.2 mm) at the end of the first year (p values 0.07). The package sizing is not a reliable parameter for choosing the size of knitted Dacron grafts. Immediate increase in diameter noted in Dacron grafts is caused by discrepancies between the package sizing and the measured diameter after clamp release during implantation, and by an initial adaptation of the textile structure. This must be taken into account for an accurate investigation of the immediate graft dilation rate, and if further follow-up is contemplated, a measurement to be taken as a reference should be performed by ultrasound or CT in the immediate postoperative period.

Aorta, Abdominal↗
PubMedDate not supplied

[Surgical treatment of recent severe sprains of the knee. Does the anterior cruciate ligament of the knee merit suturing?].

The authors have reviewed 62 cases of acute ligamentous injury of the knee, all surgically treated. They emphasize the importance of good co-ordination of muscles and ligaments in the function of the knee. The menisci should be preserved wherever possible. Direct suture of the anterior cruciate ligament gives poor results (20 per cent successful). They recommend immediate transplantation of a hamstring (semi-tendinosus) tendon by the Lindeman's technique. They conclude that the anterior cruciate ligament should not be sutured. In three cases it was resected with good results.

Humans↗
PubMedDate not supplied

[Short and long term hemodynamic effects of amiodarone in patients with hypertrophic obstructive myocardiopathy. Combined evaluation using invasive and noninvasive methods].

Amiodarone is an antiarrhythmic drug with negative inotropic effect; therefore an study of hemodynamic effects of this drug in obstructive hypertrophic cardiomyopathy was performed. Seven consecutive patients with hypertrophic cardiomyopathy were studied prospectively. Intraventricular pressure gradient was determined at rest and during the Valsalva manoeuver during left heart catheterization; traces were obtained before (control) and at 10, 20 and 40 minutes after amiodarone, 10 mg/kg of body weight, was given IV. Simultaneously a mode M echocardiogram and carotid pulse were registered, Internal diameters, ejection time, percentual shortening, systolic anterior motion of the mitral valve, and mesosystolic aortic closure were measured. Afterwards oral amiodarone was administered to the same patients for 3 months. In this chronic phase the same phono-echocardiographic parameters and isovolumetric relaxation time were measured at 6 and 12 weeks. Parenteral administration of amiodarone reduced intraventricular gradient from 48.3 to 6.2, 8.7, and 1.3 mmHg. at 10, 20 and 40 minutes (p less than 0.001); mean pressure with Valsalva decreased from 78 to 19.6, 20.4, and 22.5 mmHg. (p less than 0.001). In four patients there was a reduction of left ventricular end diastolic pressure, Ejection time percent shortening and aortic closure intensity were reduced, systolic diameter and the distance septum, forward movement increased. The maximal effect was found 40 minutes after the injection of amiodarone. In the chronic phase the negative inotropic effect returns to near control values, but there is an increase in ventricular volumes with a significant shortening of the isovolumetric relaxation time. Amiodarone IV, decreases the intraventricular gradient in obstructive hypertrophic cardiomyopathy probably by a negative inotropic influence. This action almost disappears with oral amiodarone but there is a notorious improvement of left ventricular compliance.

Adult↗
PubMedDate not supplied

[Postoperative spinal cord ischemia in thoracoabdominal aneurysms].

At the present article, 12 cases of paraplegia secondary to the surgical treatment of thoracoabdominal aneurysms are presented. Study includes patients admitted between 1973-1987 for treatment and rehabilitation of its medular injury. Factors of risk, surgical technics practiced, peroperative complications and type of medular injury are analyzed. The most common medular injury was an anterior medular syndrome (rather than 60%). In the same way, preventive methods are analyzed and somatosensory evoked potentials (SEP) and motor evoked potentials (MEP), both in developing phase at the present moment, are recommended as the most viable method for detecting changes during the surgical procedure.

Aortic Dissection↗
PubMedDate not supplied

[Diagnosis and treatment of coital penile injury].

Two cases are presented of non-penetrating coital trauma of erect penis. This is a rare pathology. No prospective studies are therefore available, but instead there is much controversy. We review the existing literature as well as the various diagnostic and therapeutic attitudes and we propose an algorithm to systematize its management.

Algorithms↗
PubMedDate not supplied

Long-term results obtained with the Bankart method for the treatment of recurring anterior instability of the shoulder.

This review of cases was the product of a multicentric study the results of which were discussed during the Round Table discussion on the treatment of recurring anterior instability of the shoulder for the Spring Session of the S.OF.C.O.T 90. It is the purpose of this study to evaluate the long-term results obtained with Bankart capsuloplasty. Fifty-three patients were reviewed with a long-term follow-up of more than 10 years. Their performance in sports and during everyday life was evaluated. The procedure may be the cause of mild joint stiffness in external and internal rotation, but it is distinguished for its scarce tendency to provoke arthrosis and for its excellent results in relieving pain, as compared to other procedures such as the Latarjet method. Thus, its results in terms of stability are comparable to those obtained with other methods. In this series the results seem to be correlated with sports activity, age and the side operated on. The worst results were obtained in very young amateur athletes and in non-dominant shoulders. Long-term follow-up showed that results were stable in time, with no functional progression or decline in sports activity.

Adolescent↗
PubMedDate not supplied

[Arterial blood pressure in various groups in the urban population of Morelia City].

Four groups from a urban population of Morelia were inquired, to determine frequency of high blood pressure and provide basic information of arterial hypertension in relation with other variables; 2638 persons were checked. Age ranged from 10 to 90 years, (771 men, 1867 women). Age, sex, weight and height were also measured. Evaluations were performed in the morning with mercury sphygmomanometer registering first and fifth korotkoff's sounds in orthostatic position with a second selective evaluation in sitting position. Availability of medical services and knowledge about presence of arterial hypertension were also evaluated. Blood pressure and prevalence of hypertension had similar behavior with regard to age: pressure recordings were higher in men before 40 years. After this age were higher in women. In general, 14% had high blood pressure, in the second evaluation this value dropped to 7%. For 11% of the studied population, high blood pressure had been previously recorded 7 out of 10 cases of hypertension did not have any control. Three of them had not information about this illness. We found a positive correlation between weight and blood pressure (p less than 0.001) specially among women.

Adolescent↗
PubMedDate not supplied

Influence of central and peripheral norepinephrine on the antibody response.

This paper intends to study the effect on the antibody response of profound, or mild variations of (central and peripheral) noradrenergic activity. An intraperitoneal injection of 6-hydroxydopamine (100 mg/kg) at the time of immunization impaired the anti-sheep-erythrocyte antibody response in both normal mice and in mice previously denervated with 6-hydroxydopamine; treatment with 6-hydroxydopamine, 7 days before immunization, did not affect the response. This suggests either a direct effect of the neurotoxin on the antibody response or an indirect effect via denervation and supersensitivity. Therapeutic doses of guanethidine (0.5-2.5 mg/kg) which do not damage the adrenergic axons, affected marginally and transiently the antibody response to sheep erythrocytes. Intracisternal injection of 6-hydroxydopamine (a 75-ug pulse, or three 25-ug pulses), DSP4 (a 75-ug pulse), or guanethidine (three 100-ug pulses) did not alter either the anti-trinitrophenyl natural-antibody response or the anti-sheep-erythrocyte antibody response. Swimming (at 32 degrees C) transiently and slightly enhanced the anti-sheep-erythrocyte (IgM) antibody response. It is proposed that the physiological fluctuations in the level of (central or peripheral) noradrenergic activity transiently and minimally influence the antibody response.

Animals↗
PubMedDate not supplied

[Directed chemotherapy in superficial carcinoma of the bladder conditioned by the knowledge of recurrence factors].

A retrospective study of 56 patients (23 primary and 36 relapsing) with superficial vesical carcinoma and treated with transurethral resection and directed chemoprophylaxis was done. Directed chemoprophylaxis is define as a specific type of adjuvant therapy where the drug is determined by a previous study with multivariant analysis of the relapse risk factors of a group of 385 cases, where the chemotherapeutic agent was also a variable. The drug is specified by the data introduced in a microprocessor program. Such chemoprophylactic approach has achieved a marked reduction in the relapse rate and increased the disease-free interval from 8 to 3 and from 70 to 83.5 respectively, with regard to the free drug choice approach.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Modulation by neurotransmitters (norepinephrine, serotonin) of the murine antibody response to autologous and heterologous erythrocytes.

The modulation by norepinephrine and serotonin of the persistent antibody response to autologous and heterologous erythrocytes has been studied in [(C27Bl6xCBA/Ca) F1] mice. Serotonin (subcutaneously administered) transiently decreased the response to both autologous erythrocytes and rat erythrocytes; nevertheless, inhibition of serotonin synthesis (with p-chloro-phenylalanine) barely affected the responses. The influence of norepinephrine has been investigated by (subcutaneous) administration of ephedrine (a sympathomimetic) or by neonatal sympathectomy with 6-hydroxydopamine. Neither the sympathomimetic nor the sympathectomy substantially altered the response (of adult mice) to autologous or heterologous erythrocytes. Treatment with p-chloro-phenylalanine of adult mice (which had been neonatally treated with 6-hydroxydopamine) resulted in impaired responses to both autologous and heterologous erythrocytes. On the whole, a fall in the level of norepinephrine or serotonin exerted, at most, a minor influence on the persistent antibody response to self and foreign erythrocytes, but a decrease of both amines exerted a greater influence.

Animals↗
PubMedDate not supplied

[Demonstration of the role of stimulation of purinergic receptors in the electrophysiologic effect of adenylic compounds in man].

In order to study the mechanism of action of AMP on the AV node conduction, 10 patients with re-entrant tachycardia including the AV node in the circuit (SVT) were studied. The mean age was 32.8 +/- 11.1. Tachycardia was induced by programmed atrial stimulation. Electrophysiological studies were made in all the cases. Intravenous injection of AMP suppressed SVT in all the patients in the first part of the study. The mean doses was 0.095 +/- 0.037 mg/Kg., and the mean time was 15.2 +/- 2.6 sec. In the second part (after 0.04 mg/Kg. IV atropine) the induced SVT was suppressed with a mean doses of 0.122 +/- 0.45 mg/Kg of AMP (P = NSD) in a mean time of 16.2 +/- 2.2 sec. (p = NSD). In the last part of this study the intravenous injection of aminophylline (4 mg/Kg) avoided the suppression of induced SV T in 8/10 patients. In to patients the AMP doses was 0.250 mg/Kg., and in the other 0.075 mg/Kg. Our studies demonstrated that the mechanism of action of AMP is by means of agonistic stimulation of purinergic receptors in the AV node.

Adenosine Monophosphate↗