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Biomedical subjects

L Aliaga

Publications and source records attributed to L Aliaga.

52 records · Page 3Linked to original sources
PubMedDate not supplied

Mycotic aneurysm of the aortic arch.

A 61-year-old diabetic woman presented with a mycotic aneurysm of the aortic arch, also involving the left subclavian and vertebral arteries, caused by Staphylococcus aureus. Two months before, she had suffered from staphylococcal septic arthritis in her left knee. The patient was treated with antibiotics and an emergency operation was performed involving aneurysm excision and in situ synthetic graft replacement. She died on the fourth postoperative day from hemorrhagic shock.

Aneurysm, Infected↗
PubMedDate not supplied

[Utility of bronchoalveolar lavage in the diagnosis of respiratory infection in HIV patients].

From January 1, 1992, to December 31, 1995, we studied 52 bronchoalveolar lavages in 45 HIV-infected patients. All patients with pulmonary symptoms and/or new pulmonary infiltrates underwent bronchoalveolar lavage (BAL) when the results of blood cultures and mycobacterial smears of sputum and urine were negative. Lavage fluid was investigated for the presence of P. carinii, bacteria, mycobacteria, fungi and virus. BAL was diagnostic in 39 (75%) cases. The organisms more frequently isolated were P. carinii and M. tuberculosis. Only one pathogen was identified in 28 cases (54%); two in ten (19%); and three in one patient (2%). BAL was, generally, well tolerated by the patient and had a high diagnostic yield in the evaluation of patients with HIV infection and respiratory symptoms.

Adolescent↗
PubMedDate not supplied

[Allergic reactions to local anesthetics].

We studied 35 patients which had been sent by various specialists to the Allergy department of a general hospital because they had an adverse reaction to some type of local anesthetic. The subjects underwent three types of tests: a prick test, an intradermoreaction test and a provocation test using three local anesthetics: procaine 2%, lidocaine 2%, mepivacaine 1% with no vasoconstrictors or parabens in order to rule out the possibility that the reaction was due to these substances rather than the local anaesthetic being tested. The results indicated that both the prick test and the provocation test of the local anesthetics included in the study were negative for all of the patients. One patient who had an adverse reaction to Hostacain was tested with that same anesthetic. The patient tested positive in the intradermoreaction test with a 1/10 solution but was not able to be tested with a solution free of parabens due to lack of availability. The results of our study coincide with the bibliographic research done in that real allergic reactions to local anesthetics are infrequent. The methodology used effectively distinguishes those patients with a risk of real allergic reactions there by indicating to the physician the safest local anesthetic for the patient.

Adolescent↗
PubMedDate not supplied

[Idiopathic hemochromatosis. Review of the literature and study of 17 patients].

Idiopathic hemochromatosis is an inherited and primary disease. Its definition requires: a) a family history of abnormalities of iron storage; b) an association with HLA; c) inadequate iron absorption in relation to iron stores in liver and other territories; d) the absence of any other known causes of iron overload. The recent evidence of its high family related frequency and the existence of an effective treatment, demand the understanding of this entity and the strongest medical effort towards the diagnosis in the pre-cirrhotic stages. We present here the results from the study of 17 patients diagnosed of idiopathic hemochromatosis over a seven year period in the University Clinic of Navarra. Our aim is to review this subject and to compare our findings with those described in the current literature.

Adult↗
PubMedDate not supplied

Interrelationships between systemic hemodynamics, urinary sodium excretion, and renin-angiotensin system in cirrhosis.

We studied the interrelationships between systemic hemodynamics, sodium excretion and the renin-angiotensin system in 28 nonazotemic cirrhotic patients on a sodium restricted diet. Renal hemodynamics were also assessed. The patients were divided into three groups. Group A comprised 9 patients without ascites or edema; group B comprised 8 patients with ascites and relatively high sodium excretion (41.9 +/- 12.9 mmol/day); and group C comprised 11 patients with ascites and very low sodium excretion (4.8 +/- 12.9 mmol/day). There were no significant differences in urine flow, glomerular filtration rate or effective renal plasma flow between the three groups of patients, although renin and aldosterone levels were significantly increased in group C. Groups A and B did not differ in hemodynamic parameters and no differences were found between the three groups in heart rate or in plasma volume. Group C, however, showed significantly higher cardiac index and lower arterial pressure and systemic vascular resistance. Plasma volume was inversely related to systemic vascular resistance, and natriuresis correlated significantly with both cardiac index (inversely) and systemic vascular resistance (directly). In addition, renin and aldosterone levels were inversely correlated with both mean arterial pressure and systemic vascular resistance. The systemic hemodynamic disturbances in nonazotemic cirrhotics is paralleled by the impairment in sodium homeostasis, suggesting that the decrease in systemic vascular resistance is the primary event leading to hypotension, high cardiac output and the activation of the renin-angiotensin system in these patients.

Adult↗
PubMedDate not supplied

[EMLA. A new topical anesthetic].

The method most widely used at present for cutaneous analgesia is local anesthetic infiltration. Pain occurs when the needle penetrates and when the anesthetic is deposited and diffuses. The procedure is not risk-free. It is therefore not surprising that many attempts have been made to develop an anesthetic formula that is effective when applied topically to intact skin. Early efforts were unsuccessful due to either low analgesic efficacy or side effects. The problem was solved several years ago in the European market by the EMLA (Eutetic Mixture of Local Anesthetics) cream. The EMLA cream has been shown to be useful as a topical anesthetic on either intact or damaged skin. Its clinical profile is safe, with a low incidence of side effects. We feel it is a useful tool for preventing pain in a variety of procedures that call for cutaneous analgesia. It may also be used as premedication for perineural injection of anesthetics, providing greater comfort for the patient. This article describes the main pharmacological principles that make EMLA an effective topical analgesic, as well as indications for its use in the clinical practice of anesthesiology.

Anesthetics, Local↗
PubMedDate not supplied

[Anesthetic considerations in patients with human immunodeficiency virus infection].

In the last few years many articles have been published on AIDS, the mechanism of transmission, prophylaxis and therapeutic possibilities; however, very few publications are available related with anesthesia of patients infected with HIV or AIDS. The authors have therefore undertaken this review in which following a brief description of the etiology, pathogenesis, physiopathology and treatment of the disease, the problems of anesthesia are specifically dealt with. The need for knowing the different active or latent clinical alterations, such as neurologic (encephalitis, meningitis, peripheral neuropathies, myelopathies, etc.), respiratory (pneumonias by Pneumocystis carinii), cardiovascular (myocardiopathies), digestives (oropharingeal candidiasis, hepatopathies), psychologic (drug addiction), hematic (anemias, leucopenias) coagulopathies, nephropathies, etc. must be emphasized. Before the possibility of such a broad pathology good evaluation and preoperatory preparation is essential. With regard to anaesthetic technique, regional anesthesia is of choice except in certain cases of neuropathies. Although patients with a high degree of immunosuppression present a high risk of infections of the nervous system, the global risk is lower than if general anesthesia with prolonged artificial respiration were received.

Anesthesia, Conduction↗