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Biomedical subjects

L Fernandez

Publications and source records attributed to L Fernandez.

At least 55 records · Page 3Linked to original sources
PubMed1997

[Treatment of the sequelae of enucleation by septal chondro-mucosal composite graft. Report of 21 cases].

Enucleation frequently and progressively causes an enophtalmus and atrophia of the inferior eyelid, thereby leading to a height deficiency. Buccal mucous grafts give rise to phenomena such as secondary retraction. This may have complex and painful post-operative outcomes. However, when a septal chondromucous graft is performed, the height in the inferior palpebral part becomes more aesthetic, more retentive and quickly allows the wearing of a more voluminous prosthesis. Thus, the notinable enophtalmus can be corrected and the aesthetic quality of the looking is substantially restored. The authors report this surgical procedure and the results obtained with 21 patients which appear to be particularly promising.

Adolescent↗
PubMed1996

Validation of a differential PCR and an ELISA procedure in studying HER-2/neu status in breast cancer.

HER-2/neu oncogene status and total cellular p185HER-2 content were simultaneously analyzed in 415 invasive breast-cancer specimens by differential PCR and ELISA respectively. Mathematical analysis of the data led us to establish a cut-off value of 1.7 for the ratio between the intensity of the HER-2/neu gene band and the reference gene band, to consider the HER-2/neu gene amplified, and of 260 fmol/mg protein, to consider p185HER-2 over-expressed. Of the 415 tumors studied, 15% showed a diverse degree of HER-2/neu gene amplification. Of these tumors, 87% showed over-expression of the p185HER-2. Of the remaining 352 specimens that did not display HER-2/neu gene amplification, 97% showed no p185HER-2 over-expression (p < 0.0001). In 40 selected samples with a p185HER-2 level lower than 260 fmol/mg protein, the degree of p185HER-2 phosphorylation was very low or undetectable. Conversely, 38 of 46 selected tumors with a p185HER-2 level higher than 260 fmol/mg protein exhibited a considerable degree of p185HER-2 phosphorylation (p < 0.0001). Our data suggest that: (i) differential PCR and ELISA, which are relatively simple procedures, give similar information on HER-2/neu status in breast cancer; and (ii) given the large series analyzed, the cutoff values established can be considered as safe values for determining whether, in a given tumor, the HER-2/neu oncogene is amplified or p185HER-2 is over-expressed.

Base Sequence↗
PubMed1996

Bedside percutaneous tracheostomy with bronchoscopic guidance in critically ill patients.

BACKGROUND: Bedside percutaneous dilational tracheostomy, a relatively new method of tracheal cannulation, provides safe and ready access to the trachea to relieve airway obstruction and tracheopulmonary secretions. The dilational technique has undergone various modifications during the past decade. Complications of this procedure are primarily related to the lack of direct visualization during tracheostomy tube placement and to poor patient selection. OBJECTIVE: To report the utility of percutaneous dilational tracheostomy with bronchoscopic guidance in 162 critically ill patients. MAIN OUTCOME MEASURES: Mortality rates and complications associated with this technique. RESULTS: Twenty-five patients (15.4%) died while hospitalized. No deaths were related to tracheostomy. There were four (2.5%) major complications: one pneumothorax and three posterior tracheal tears, which healed spontaneously. There were five (3.1%) minor complications: one posterior mucosal disruption, one minor bleeding episode, and three minor episodes of cellulitis. One hundred thirty-seven patients (84.6%) were discharged. Twenty-nine patients (21.2%) were available for follow-up and were experiencing no significant problems or complications following the procedure. Compared with standard open tracheostomy, charges were reduced by $1628.20 per patient ($263,768.40 total savings). CONCLUSIONS: Bedside percutaneous tracheostomy with bronchoscopic guidance is safe and cost-effective. Complications compare favorably with that of open tracheostomy. Major complications should be avoided with continuous bronchoscopic observation during the procedure.

Adult↗
PubMed1996

Protective effect of a platelet-activating factor antagonist (WEB-2086) in postischemic renal failure.

The purpose of this study was to evaluate the renoprotective effect of a specific platelet-activating factor antagonist (WEB-2086) in an experimental model of normothermic renal ischemia. Twenty New Zealand white rabbits were studied for 2 days before and 24 hours after a 60-minute period of renal ischemia induced by bilateral clamping of the renal arteries. The animals were divided into two groups: a control group (group A; n = 10) and a treated group (group B; n = 10). In group A the urinary flow rate decreased significantly (from 0.098 +/- 0.008 ml/min to 0.029 +/- 0.005 ml/min) (p < 0.001) and there was a significant reduction in creatinine clearance (from 11.4 +/- 1.2 ml/min to 3.4 +/- 1.1 ml/min) (p < 0.001). In group B no significant changes were observed, although the urinary flow rate increased even in the postischemic period (from 0.09 +/- 0.008 ml/min to 0.11 +/- 0.02 ml/min). Microcirculatory cortical flow showed a postischemic reduction in both groups, although it was most significant in the control group (group A = 43.7%, group B = 71.5%; p < 0.001). Histologic study showed mild damage with patchy tubular necrosis in both groups, although this injury was less severe in the treated group. The results suggest that the preoperative administration of WEB-2086 produces a potent diuretic effect with significant attenuation of postischemic acute renal failure.

Acute Kidney Injury↗
PubMed1996

Air rifles--lethal weapons.

Modern air rifles are very powerful and potentially dangerous, yet they are sold without a license because they are considered toys. We report on 16 patients who were shot with air rifles. Nine of these patients were treated in the last 3 years. Seven patients sustained injuries to the chest and upper back. The BB (ball bearing) penetrated the aorta of two patients, one of whom died. One of two patients shot in the abdomen had injuries to the iliac artery and the colon. Three patients were shot in the head and neck, three in the extremities, and one through the penis. Particularly alarming to us is the fact that nine patients had been shot intentionally after minor arguments with other children. The assailants were neighborhood children in seven cases, a friend in five, and a sibling in two.

Adolescent↗
PubMed1996

A spectroscopic NMR investigation of the calcium silicate hydrates present in cement and concrete.

NMR spectroscopy is applied to study microstructure of calcium silicate hydrates present in cement and concrete. It is shown that 29Si NMR gives information on the siliceous skeleton of the hydrates. 1H NMR, using CRAMPS techniques, allows to discriminate between protons linked to silicon atoms or to calcium atoms. A first investigation of reference compounds indicates that 43Ca NMR will be powerful to determine calcium atom sites in the structure.

Calcium Compounds↗
PubMed1996

Epidural regional hypothermia for prevention of paraplegia after aortic occlusion: experimental evaluation in a rabbit model.

PURPOSE: The efficacy of epidural regional hypothermia in the prevention of acute and delayed-onset paraplegia, as well as possible complications and limitations of this technique to a clinically acceptable form, were evaluated in 49 New Zealand white rabbits. METHODS: A modified rabbit spinal cord ischemia model of infrarenal aortic occlusion for 30 minutes was employed. The study was performed in two phases. In phase I (n=20), regional hypothermia induced by epidural perfusion of iced normal saline solution (4 degrees C) was tested versus control in 10 rabbits each (groups A and B). In phase II (n=29) the animals were subdivided into three groups to study the kinetics of absorbtion and distribution of methylene blue (group C; n=10), radiographic contrast material (group D; n=9), and measurement of cerebrospinal pressure while an epidural iced solution was or was not infused (group E; n=10). RESULTS: At 24 and 48 hours, all of the normothermic animals showed irreversible paraplegia (Tarlov score 0). In contrast, at 24 hours none of the rabbits undergoing epidural cold infusion were paraplegic, although at 48 hours one animal had weakness of a hindlimb (Tarlov score 3). Plasma concentration-time profiles of a continuous epidural perfusion with methylene blue showed that the spinal canal is a highly compliant space. Epidurographs showed that epidural perfusion tends to spread more in a cephalic than caudal direction and the main uptake is by the vascular compartment. Despite the large volumes infused (78.75 ml/hr; range, 50 to 100 ml), we observed only a modest transient increase in cerebrospinal fluid pressure (from 2.5 +/- 0.3 mm Hg to 5.4 +/- 0.1 mm Hg), although some animals had intracranial hypertension. CONCLUSIONS: Regional hypothermia induced by epidural cold perfusion has a highly protective effect against the ischemic spinal cord damage. However, this method probably does not avoid the risk of delayed-onset paraplegia. An important limitation of this technique is the difficulty of controlling the intrathecal pressures.

Animals↗
PubMed1996

Temporary intravenous bag silo closure in severe abdominal trauma.

Several temporary abdominal wall closure techniques have been described in the literature. We present our experience with an inexpensive and efficient method of temporary abdominal closure when bowel edema and distension preclude safe primary closure. Our technique is a variation of the silon (silo) closure used in the repair of gastroschisis and omphalocele, using a pre-gas-sterilized, soft 3-L plastic cystoscopy fluid irrigation bag cut to an oval shape and stapled or sutured to the skin edges of the wound.

Abdominal Injuries↗
PubMed1996

Effect of policosanol on platelet aggregation in healthy volunteers.

Policosanol is a new drug whose cholesterol-lowering effects have been demonstrated in experimental models, healthy volunteers, and patients with type II hypercholesterolaemia. The effect of policosanol on platelet aggregation was investigated in a randomized, placebo-controlled, double-blind study conducted on healthy volunteers. This included a trial of the effects of single doses (5 to 50 mg) and a study of the effects of repeated doses administered for 7 days. In the single-dose study, the percentage of platelet aggregation in response to the threshold concentration of ADP and epinephrine measured from 8:00 to 10:00 increased significantly in the placebo group, while policosanol (5, 10, 25 and 50 mg), administered orally, inhibited the increase of platelet aggregation induced by ADP and epinephrine determined at the same time. Policosanol administered at 20 mg/day for 7 days significantly inhibited platelet aggregation induced by ADP and epinephrine, although the inhibition reached by the 10 mg/day dose tended to be less significant (p = 0.06). A modest effect (p = 0.068) on collagen-induced platelet aggregation was only observed at the highest dose (50 mg/day). The low dose (5 mg/day) was ineffective. Policosanol did not affect the coagulation time when administered at single or repeated doses. No side-effects were reported in treated or placebo groups.

Adult↗