Biomedical subjects
L Aguilera
Publications and source records attributed to L Aguilera.
[Preoperative thrombocytopenia with a postoperative diagnosis of thrombotic thrombocytopenic purpura].
A 64-year-old woman came to the emergency room complaining of vomiting and abdominal pain; appendicitis was suspected and surgery ordered. A blood work up showed a significantly low platelet count (39,000/microliter) and 6 units were transfused before surgery. The only observations during surgery were ileitis and Meckel's diverticulum. Thrombocytopenia persisted over the first 48 hours after surgery in spite of another transfusion of platelets, with worsening awareness and acute renal failure. After diagnosis of thrombotic thrombocytopenic purpura (TTP), the patient was admitted to the intensive care unit and treatment with fresh plasma and corticoids was started. Two weeks later, after complex evolution and ten sessions of plasmapheresis, the patient was transferred to the hematology ward. TTP must be considered a medical emergency. Platelet transfusions are contraindicated, as they can cause serious clinical deterioration. A low platelet count before surgery should lead to differential diagnosis to determine the cause, with the aim of judging whether platelet transfusion is warranted or not. In some etiological processes, such as in the case we report, platelet transfusion may be life-threatening; corrective measures must be taken early in the process and such transfusion avoided.
[Adult onset subacute sclerosing panencephalitis. Report of two cases with atypical presentation].
Subacute sclerosing panencephalitis is an infrequent central nervous system viral disease and is a late manifestation of persistent infection by a mutant form of measles virus. Since it affects mainly children and teenagers, the diagnosis in older ages is difficult. Its main clinical symptoms are cognitive impairment, behavioral disturbances and myoclonia. We report two males, aged 21 and 22 years old, presenting with the disease with atypical manifestations. One had a catatonic syndrome and the other, amaurosis. The recognition of the different presentation forms of the disease, endemic in developing countries, allows an earlier diagnosis and a more efficient treatment, when available.
Incidence of transient neurologic symptoms after hyperbaric subarachnoid anesthesia with 5% lidocaine and 5% prilocaine.
BACKGROUND: Hyperbaric 5% lidocaine has been associated with transient neurologic symptoms (TNSs) after spinal anesthesia. A prospective, masked, randomized study was conducted to compare the incidence of TNSs after spinal anesthesia with hyperbaric 5% lidocaine or 5% prilocaine to assess the utility of prilocaine as an alternative to lidocaine in patients having short surgical procedures. METHODS: The number of patients to be enrolled (100 per group) was determined by power analysis (80%, P = 0.05) considering an incidence of TNSs after spinal anesthesia with lidocaine of at least 11% according to data reported in other studies. Two hundred patients scheduled for elective surgery expected to last <60 min were allocated at random to receive spinal anesthesia with hyperbaric 5% lidocaine or hyperbaric 5% prilocaine. Three to 5 days after spinal anesthesia, all patients were interviewed by an anesthesiologist who was blinded to the group assignment and details of the anesthetic and surgical technique using a standardized symptom checklist. Patients with symptoms underwent neurologic examination. RESULTS: Both groups were comparable with regard to demographic data and details of the surgical and anesthetic procedures. The incidence of TNSs in both groups was low and differences were not found (4% in the lidocaine group and 1% in the prilocaine group). The mean age of patients with TNSs (58 yr) was higher than that of patients without TNSs (48 yr; P < 0.05). No relation with any of the other variables was found. CONCLUSIONS: The low incidence of TNSs among lidocaine-anesthetized patients (4%) may account for the lack of significant differences between hyperbaric 5% lidocaine and 5% prilocaine and to the insufficient power of the study to exclude the possibility of a type II error.
[The incidence of Culicidae in an urban area of Ciudad de La Habana during 1995].
In the present paper it is made an analysis of the incidence of culicides in the municipality of Marianao, Havana City, during 1995, after following the requirements of the National Program for the Eradication of Aedes aegypti. 6 species of mosquitoes were found in the municipality, with a predominance of the Culex quinquefasciatus and Aedes mediovittatus species. 4 focuses of Aedes aegypti were detected during this period. It was found that the groups of deposits preferred by the culicides for their breeding in this municipality were other deposits, low tanks, artificial deposits and larva traps. The People's Councils 4 and 5 (Libertad and Pogolotti) had the highest number of focuses (967 and 1,240, respectively, and therefore, they need more attention. It is analyzed the influence of the deficiencies of the public services, such as the collection of solid, wastes (garbage) and the existence of leakages and sewing overflows, on the proliferation of mosquitoes in the municipality.
[The effect of 2 diets on the biological aspects of Blattella germanica (Dictyoptera: Blattellidae) under laboratory conditions].
It was conducted a study of 2 colonies of Blattella germanica (Dictyoptera: Blattellidae) kept since 1994 in the laboratory at 29 +/- 1 degrees C, 70-75% of relative humidity and with different foods: one on a diet without proteins, consisting in portions of potatoes (Solanum tuberosum, L.), ripe banana (Musa paradisiaca, L.) and a sugary solution 10%, and the other with a protein content of 20.45% composed of pulverized and dry laboratory food for rats and a source of water. 6 nymphal stages were found with both types of food. There were determined the times of interchanges and the time of nymphal development, which were much shorter among the nymphs fed with proteins. The longevity of each sex showed no significant differences in connection with the type of food used. The times of appearance and eclosion of the oothecae of each oothecal cycle were determined with both foods. It was found that the females deposited up to 5 oothecae during their lives with the 2 types of diet. The average of nymphs per ootheca among the females fed with proteins was much greater (t = 5.33; p < 0.001). The results of this study show that when the food for B. germanica contains proteins, its nymphal development is faster and its reproductive capacity increases, which means that protein is a necessary nutrient for the diet of this species.
Fracture of the neck of a femoral component in a total hip arthroplasty: a case report.
Fracture of components of a total hip arthroplasty occur is a recognised complication. We report an unusual case in which the fracture occurred through the neck of a femoral component on a Lord type of total hip arthroplasty.
Serum protein binding of propofol in critically ill patients.
BACKGROUND: Disease-induced modifications in the level of serum proteins may change the degree of binding of drugs highly bound to serum proteins. METHODS: The serum protein binding of propofol, an intravenous anaesthetic agent was studied in vitro in samples of serum from healthy volunteers (n=28) and from critically ill patients (n=17). The free fraction was obtained by the ultrafiltration technique and was measured by high-performance liquid chromatography. Concentrations of serum albumin, alpha1-acid-glycoprotein and free fatty acids were also measured in all samples. RESULTS: The percentage of free propofol was significantly increased (P<0.001) in critically ill patients (1.31 (1.06-2.25)%) vs control subjects (1.07 (0.49-1.47)%). Albumin levels were significantly decreased (P<0.001) in patients (16.3 (8.8-24.6) g x l(-1) vs 45.8 (31.4-55.5) g x l[-1]), while levels of alpha1-acid-glycoprotein were increased (P<0.001) (1.9 (0.9-2.8) g x l(-1) vs 0.9 (0.5-1.4) g x l[-1]), as were levels of free fatty acids (0.68 (0.50-1.14) mmol x l(-1) vs 0.37 (0.11-1.05) mmol x l(-1); P<0.05 ). No correlation was found between levels of alpha1-acid-glycoprotein or free fatty acids and the bound/free ratio of propofol. However, a linear relationship was found between levels of albumin and the bound/free ratio (r2=0.25; P<0.001). CONCLUSION: In conclusion, in these critically ill patients, an increase in the percentage of free propofol occurs. The significance of this observation remains uncertain, but may be validated in future studies. However, the observation supports the common idea that potent drugs should be given with great care in critically ill patients.
[Venous occlusion after catheterization of both subclavian veins for hemodialysis].
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[Life tables of Blattella germanica (Dictyoptera: Blattellidae) under laboratory conditions and their importance for its control].
A study of the life tables of Blatella germanica (L.) 1767 was conducted under laboratory conditions. 3 treatments were used a according to the number of individuals in each breeding flask (A = 9 flasks with 20-25 individuals, B = 17 flasks with 30-35 individuals, and C = 30 flasks with a newly hatched nymph each). The main parameters of the population growth were calculated by the TABVID software . The respective values for treatments A and B were the following: net reproduction rate (Ro 2.23 and 2.37), natural increase finite rate (lambda = 1.06), natural increase intrinsic rate (r = 0.06), and mean generational time (T = 13.89 and 15.64). The behaviour of the survival probability by age, the fertility rate, and the mortality rate were graphically registered. Life expectancy for treatment C was 16.47 and the survival rate for this treatment was represented by a graph. Graphics of the growth curve of this species and of the survival rate for treatments A and B were shown. The latter was concave, which means that mortality is higher during the young stages. This study provides esential cuantitative basic date that allow to carry out a more efficient control if fight is directed to the period where the highest natural mortality was found, that is, at the step from nymph 6 to adult in treatments A and B.
Serum tryptase measurement in diagnosis of intraoperative anaphylaxis caused by hydatid cyst.
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[Post-anesthesia recovery. How can it be evaluated?].
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[Effect of acute intestinal obstruction on infrared systems for measuring anesthetic gases].
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[Safety of sevoflurane in humans].
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[Biological aspects of Blatella germanica (Dictyoptera: Blattellidae) in laboratory conditions].
In a study of Blatella germanica (L) 1767 (Dictyoptera: Blattellidae) carried out in laboratory conditions, 6 nymphal stages were found in a period of 114.71 days, at 29 +/- 1 degrees C and 80-90% of relative humidity. Times of appearence and eclosion of every ovipositted ootheca, as well as the offspring average of each one, were determined. Females ovipositted up to 5 oothecas during their life. The maximum average of eggs found per ootheca was 29.22. The average longevity of males was lower that that of females (77.23 and 98.40 days, respectively) (t = 2.21; p < 0.05).
[The performance of the Aedes aegypti eradication program in 2 towns of Ciudad de La Habana province, 1990-1992].
It is made a comparative analysis of the behaviour of the Aedes aegypti eradication program in two municipalities of Havana City with different characteristics during 1990-1992. The results show that in both municipalities the recipients with the highest positivity to mosquitoes were the following categories: other deposits, artificial deposits, and low tanks, followed by a second group that included tubs, tires, and larva tramps. The positivity of the larva tramps was observed in both municipalities and it is stressed their role in the stabilization of mosquitoes invading the urban ecosystem. There were 8 varieties of species at Plaza municipality, and 9 at the 10 de Octubre municipality. There are similar species in both municipalities.
[Refractory epilepsy in adults and the new antiepileptic drugs: the role of gabapentin].
The features of refractory epilepsies and the role of functional surgery and new antiepileptic drugs is reviewed. Among the latter, gabapentin, a drug with peculiar pharmacokinetic properties, is highlighted as a therapeutic alternative in refractory epilepsies and eventually for epileptic patients without previous treatment. A new type of relationship between the pharmaceutical industry and physicians, that privileges clinical research, is discussed.
[The effect of abiotic factors on the incidence of Aedes aegypti in the town of 10 de Octobre, Ciudad de la Habana Province, 1982-1992].
An analysis of the relation among the quantity of focuses of Aedes aegypti, the rains and the temperatures in rainy and dry periods from 1982 to 1992 in 10 de Octubre municipe, at City of Havana, was carried out. No correlation was found between the number of focuses and the rains occurred in both seasons, and it was just the same between the number of focuses and temperatures. Thus, emphasis is made in the need for a strong surveillance along all year.