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Biomedical subjects

L M Torres

Publications and source records attributed to L M Torres.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

Prenatal and perinatal lead exposures alter acoustic cry parameters of neonate.

We performed acoustic analyses on cries elicited from a subset of healthy babies born to the Mexico City Prospective Lead Study at 2 days (n = 75), 15 days (n = 176), and 30 days (n = 166). Lead was measured in maternal blood every 8 weeks during pregnancy from week 12 to delivery and in umbilical cord (1-38 micrograms/dL, 0.05-1.84 mumol/L). Percent nasalization and number of cries decreased in babies born to mothers with higher lead levels in the last two trimesters while median fundamental frequency increased in babies born to mothers with higher lead at 12 weeks of pregnancy, and with higher cord lead in multiple regression analysis. Decreased percent nasalization was related to increased brainstem auditory evoked response latencies and interpeak intervals in a subset of the sample. The results suggest an effect of gestational exposure to lead on apparatus innervated by cranial nerves and/or lead effect on cry mediated by lead-altered auditory function. Altered baby cry and auditory function associated with lead might contribute to developmental delays by affecting early communication between caretaker and baby.

Acoustics↗
PubMedDate not supplied

Efficacy and safety of dipyrone versus tramadol in the management of pain after hysterectomy: a randomized, double-blind, multicenter study.

BACKGROUND AND OBJECTIVES: We assessed the efficacy and safety of dipyrone in comparison with tramadol in the relief of early postoperative pain following abdominal hysterectomy. METHODS: A total of 151 women between 18 and 60 years of age undergoing abdominal hysterectomy during general anesthesia participated in a randomized, double-blind, controlled, multicenter study. Seventy-three patients received dipyrone and 78 received tramadol. Patients received an intravenous loading dose of the study drug immediately after operation followed by intravenous (IV) maintenance infusion and IV on-demand boluses up to a maximum number of predetermined doses/day of 8 g dipyrone and 500 mg tramadol. The duration of the study was 24 hours. RESULTS: The mean (SD) number of boluses in the dipyrone group was 3.8 (2.4) and 3.5 (2.5) in the tramadol group (95% confidence interval, -0.455 to 1.175), and the percentage of patients requiring rescue IV morphine (dipyrone 26.9%, tramadol 26.8%) was not statistically significant. Other analgesic efficacy parameters, such as pain intensity differences, sum of pain intensity differences, pain relief assessed by the patient, or patients who required the maximum number of demand doses, were not different between treatment groups. A significantly higher percentage of adverse gastrointestinal effects was found in patients given tramadol (42.1%) than in patients given dipyrone (20.2%) (P <.05). Also, a significantly higher number of tramadol-treated patients required ondansetron to control nausea and vomiting at 1 hour (19% v 7%), 2 hours (26% v 11%), and 24 hours (46% v 29%) (P <.05) after surgery. Patients and the investigators reported similar tolerability for both study arms. CONCLUSIONS: Dipyrone and tramadol showed similar efficacy for early pain relief after abdominal hysterectomy. Nausea and vomiting, possibly caused by the tramadol, occurred more frequently in those patients. In this group, the need of the antiemetic drug ondansetron was also higher.

Adolescent↗
PubMedDate not supplied

[Comparative study of inhalation induction by vital capacity breath in adults using 6% sevoflurane with oxygen or 4.5%sevoflurane in 50% nitrous oxide].

OBJECTIVE: To evaluate the efficacy, side effects and hemodynamic characteristics of induction by vital capacity breath in adults using 6% sevoflurane and oxygen versus 4.5% sevoflurane and 50% nitrous oxide. PATIENTS AND METHODS: We assigned 50 ASA I-II patients aged 20 to 70 years old randomly to two groups of 25 to receive either 6% sevoflurane in oxygen or 4.5% sevoflurane in nitrous oxide. All patients were premedicated with oral bromazepam (1.5 to 3 mg). Induction was by vital capacity breath using a Mapleson A circuit (8 l. min-1) for 5 min. We recorded induction time, side effects, hemodynamic variables and patient opinion after surgery. RESULTS: Induction time was significantly faster for the sevoflurane-oxygen group (60 +/- 10 s) than for the sevoflurane-nitrous oxide group (71 +/- 8 s) (p < 0.001). Complications were minor and hemodynamic variables stable in both groups, with no statistically significant differences. The patients expressed satisfaction with both induction techniques. CONCLUSIONS: A vital capacity breath of 6% sevoflurane provided rapid induction. Induction was no more rapid when 50% nitrous oxide was added and the incidence of side effects did not decrease. Hemodynamic variables are stable during induction with sevoflurane with or without nitrous oxide, making this a well-tolerated alternative technique that is positively evaluated by patients.

Adult↗
PubMedDate not supplied

[Drugs that alter hemostasis and regional anesthetic techniques: safety guidelines. Consensus conference].

Patients about to undergo surgery are often taking drugs that alter hemostasis and affect anesthesia, particularly when neuroaxial techniques are used for subarachnoid or epidural anesthesia. The aim of this paper is to provide safety guidelines for regional anesthesia in patients receiving hemostasis-altering drugs, in order to reduce the risk of bleeding. We offer a detailed discussion of patients treated with inhibitors of platelet aggregation (emphasizing that such treatment alone is not a contraindication for neuroaxial blockade although certainly guidelines must be followed), unfractionated heparin (anesthesia should be started at least 4 hours after administration of this drug or 30 minutes before, provided pulmonary arterial pressure is normal), low molecular weight heparin (which should be administered 12 hours before or 12 hours after the anesthetic technique), and oral anticoagulants (provision of regional anesthesia depends mainly on International Normalized Ratio monitoring). We also stress that removal of catheters should follow criteria similar to those listed above, that the risk of complications due to bleeding increases considerably in association with these drugs, and that adequate neurological monitoring is essential during postoperative recovery. Overall, the final decision to use regional anesthesia in patients receiving drugs that alter hemostasis must be made on an individual basis after assessment of benefit and risk.

Administration, Oral↗
PubMedDate not supplied

[Diazepam reversion with flumazenil. Gasometric and sympathetic-adrenal study].

We report the effects of flumazenil as reversion agent of the effects of diazepam at high doses as a part of short-duration general anesthesia. We have studied ten women in ASA I general condition who received anesthesia with fentanyl, 2.5 micrograms/kg-1, diazepam, 0.4 mg/kg-1 and O2/N2 at 60%. At the end of the operation, flumazenil, 0.2 mg, was administered. Hemodynamic, respiratory and adrenergic effects were evaluated. The degree of awareness and subjective feeling of the patient at awakening were also evaluated. After administration of flumazenil, awareness state was significantly higher (p less than 0.001) and it persisted during the duration of the study (120 minutes). Respiratory rate and pO2 increased significantly with administration of flumazenil (p less than 0.25 and p less than 0.01, respectively) and pCO2 decreased from 42.2 mmHg to 37.9 mmHg (p less than 0.05). Neither hemodynamic parameters nor plasma concentration of catecholamines changed significantly. As secondary effects attributable to flumazenil, four patients complained of nausea and one patient referred anxiety. We conclude that flumazenil allows to carry out anesthetic techniques with high doses of benzodiazepines even in short duration interventions with safety and without cardiocirculatory nor sympathetic-adrenal alterations.

Adrenal Glands↗
PubMedDate not supplied

Detection and analysis of paraquat in confiscated marijuana samples.

A spectrophotometric method used to test for paraquat in 160 confiscated marijuana samples is described. Twenty of these samples (12.5 per cent) tested positive for paraquat. Nine confiscated hash oil samples tested negative. The identification of paraquat was proven by isolation, chromatography, and spectral methods. The cannabinoids in paraquat positive Cannabis samples were analysed.

Cannabis↗