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Biomedical subjects

M Gil

Publications and source records attributed to M Gil.

At least 73 records · Page 4Linked to original sources
PubMed1996

Vocational outcome of aphasic patients following severe traumatic brain injury.

The incidence and course of aphasia, and its impact on vocational outcome, were determined in a group of 351 patients with severe traumatic brain injury (TBI). Aphasia was found in 11.1%, the common forms being amnestic (56%, 22/39), expressive (10.3%, 4/39) and receptive (10.5%, 8/39), as found on the first language assessment. No age difference was found between the aphasic and non-aphasic patients. Coma was more common in the aphasics than the non-aphasics (95% and 82%, respectively), although its mean duration was shorter. Aphasics had more severe locomotor deficits (p < 0.01, Fisher test) and tended towards more severe cognitive disorders (p = 0.07, Fisher test). There was no difference between the groups in incidence of behavioural disturbances or occupational outcome. Most of the aphasic patients improved after therapy, and two recovered completely. The presence of aphasia did not have negative prognostic implications for occupational outcome.

Activities of Daily Living↗
PubMed1996

[Periodical EEG pattern modifications in herpetic encephalitis treated with acyclovir].

The presence of PLED or localized or lateralized periodic activity in encephalitis strongly suggests that the encephalitis is due to the herpes simplex virus. Nevertheless, there has been controversy over its clinical significance. In addition, since the introduction of antiviral drugs in the treatment of herpes encephalitis in its initial stages, the prognosis of the disease has improved. We studied nine patients all diagnosed as having herpes encephalitis and treated with acyclovir. The presence or absence of periodic activity and its characteristics were analyzed. It was seen that either there was no such activity, or if there was, it was not exactly as classically described.

Acyclovir↗
PubMed1996

[Prognostic factors of early mortality in the 1st episode of hemorrhage caused by esophageal varices].

AIM: To assess the prognostic factors of early mortality in cirrhotic patients with the first variceal bleeding episode. PATIENTS AND METHODS: Fifty-five cirrhotic patients with endoscopic evidence of variceal bleeding treated with sclerotherapy during emergent endoscopy were included. RESULTS: Permanent hemostasis was obtained in 36 patients (65.5%). Fourteen (25.4%) patients died within six weeks of the bleeding episode. Twenty-four variables obtained at admission and in the following days were compared between patients who survived (n = 41), and died (n = 14). In the univariate analysis the following variables were related to early mortality: prothrombin ratio (p = 0.04), the presence of ascites (p = 0.004) and encephalopathy (p = 0.06), albumin (p = 0.01), Child-Pugh score (p = 0.0003), hemostasis during endoscopy (p = 0.002), absence of rebleeding at 24 hours (p = 0.01) and early rebleeding (within five days after the bleeding episode) (p = 0.006). Multiple logistic regression identified the Child-Pugh score (OR 11.86, CI 95% 2.54-55.48; p = 0.001) and early rebleeding (OR 6.27, CI 95% 1.29-30.44; p = 0.02) as prognostic independent factors of early mortality. CONCLUSIONS: The degree of hepatic failure and early rebleeding are prognostic independent factors of early mortality in cirrhotic patients after the first variceal bleeding episode.

Analysis of Variance↗
PubMed1996

[Kaposi's sarcoma of the bile ducts with cutaneous involvement in a patient with AIDS].

A 30 year-old man with acquired immunodeficiency syndrome was admitted because of abdominal pain, jaundice and fever. A severe pancreatitis without gallstones was detected. Later, dilation of biliary tract and clinical worsening appeared. Cholangiography revealed sclerosing cholangitis and papillary stenosis. Kaposi's sarcoma of the gallbladder invading the biliary tract was found. Only two reports of Kaposi's sarcoma of the biliary tract without cutaneous lesions have been published in a living patient. Pancreatitis has not been previously described as a clinical presentation of this malignancy.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Electrical status epilepticus during sleep].

INTRODUCTION: Sleep electrical status epilepticus (SESE) is a rare entity whose diagnosis depends or showing spike and wave complexes on the EEG during more than 85% of the duration of NoREM sleep. Typically it presents in children, most of whom have subjacent epilepsy. It is currently accepted that SESE is asymptomatic, although its persistence may give rise to severe neuropsychological sequelae. There are no references to sleep disorders in these patients. We present the case of a seven year old girl with SESE, hypersomnia and secondary nocturnal enuresis. CLINICAL CASE: The seven year old patient had a past history of simple partial crises with motor symptoms. There was progressive hypersomnia and nocturnal enuresis. The polysomnogram showed SESE. The Test for Multiple Latencies in Sleep (TMLS) showed pathological diurnal somnolence. HLA DR2 typing was negative. Neuropsychological study showed severe alterations in the language area, with a normal intelligence quotient. CONCLUSIONS: The new findings presented suggested that SESE is an intrinsic sleep disorder and not merely an EEG pattern. Since it occurs in children, sometimes with neuropsychological deficits, systematic TMLS should be done. The association of hypersomnia, changes in immediate visual memory and autistic regression suggest involvement of the limbic system.

Brain↗
PubMed1995

[Left ventricular hypertrophy in a general hypertensive population in Barcelona].

BACKGROUND: Left ventricular hypertrophy (LVH) is a well known cardiac risk factor. There are no data available as to the epidemiology of this disease in the general hypertensive population in Spain. METHODS: A randomized sample (n = 267) of a general hypertensive population under the age of 80 years was followed in a Basic Health Care Area located in the center of Barcelona, Spain. A Doppler-echocardiographic study of the patients was carried out. The patients were considered to have LVH when they demonstrated an index > 134 g/m2 of left ventricular mass in males and > 110 g/m2 in females. The odds ratio (OR) was estimated on presentation of LVH associated with exposure to different factors. RESULTS: A prevalence of LVH diagnosed by echocardiogram was observed in 64% (confidence interval 95% from 58.3 to 69.8%). The independent risk factors associated with the presence of LVH were female sex, age and systolic blood pressure. CONCLUSIONS: Left ventricular hypertrophy is a frequent cardiovascular risk factor in the general hypertensive population in Spain. A systematic search by echocardiography cannot be recommended in primary health care until cost-effectiveness studies have been performed.

Aged↗
PubMed1995

Plasma leukocyte elastase concentration in angiographically diagnosed coronary artery disease.

OBJECTIVE: To evaluate the clinical usefulness of leukocyte elastase determination in the diagnosis of coronary artery disease (CAD). BACKGROUND: Recent research has shown the important role of elastase, a proteolytic enzyme released by neutrophils, in the pathogenesis of CAD. METHODS: 141 patients underwent coronary angiography during investigation of chest pain and/or heart valve disease. Ninety-six had coronary lesions and 45 non-stenotic coronaries. The patients were characterized as regards presence or absence of angina (stable or unstable), family history of CAD, smoking, diabetes mellitus, hypertension, leukocyte counts, and plasma lipid and elastase concentrations. Among CAD-group patients, those with simple atheromatous plaques were distinguished from those with complex plaques. RESULTS: Elastase concentrations were greater in the CAD group than in the non-CAD group (49.7 +/- 2.8 micrograms.l-1; as against 29.5 +/- 2.2 micrograms.l-1; P < 0.001), and greater among complex-plaque CAD patients than among simple-plaque CAD patients (65.2 +/- 5.3 micrograms.l-1 as against 38.6 +/- 1.9 micrograms.l-1; P < 0.001). Logistic regression analysis showed (a) that the risk of CAD varied with elastase concentration, angina status, age and sex, increasing by 11% for every 1 microgram.l-1 increase in elastase concentration; and (b) that among CAD patients the risk of complex plaques was greatest for those with unstable angina and high elastase concentration, increasing by 6% for every 1 microgram.l-1 increase in elastase concentration. CONCLUSIONS: Peripheral blood leukocyte elastase concentration is a sensitive diagnostic marker of CAD. High values suggest the presence of complex atheromatous plaques.

Clinical Enzyme Tests↗
PubMed1995

Doppler echocardiographic comparison of small (19 mm) bileaflet and pericardial heart valve prostheses in aortic position.

The resting haemodynamics of five types of small (19 mm) aortic valve prosthesis (2 bileaflet, 3 pericardial) were evaluated with Doppler echocardiography in 43 patients. Two received St Jude Medical and six CarboMedics bileaflet valves and 35 were given bioprostheses--16 Ionescu-Shiley, four Mitroflow and 15 Labcor-Santiago. No significant differences in peak or mean transvalvular pressure drop or in effective valve area were found between the bileaflet and the pericardial valves or among the three types of bioprosthesis. All but one of the bileaflet prostheses showed a characteristic regurgitation pattern, with two lateral and one central jet, and 16 (46%) of the bioprostheses showed central regurgitation, but in no case were these jets haemodynamically significant. Thus the 19 mm bileaflet and the studied pericardial prostheses all have satisfactory resting haemodynamics, and all are suitable for implanting in small aortic roots.

Adult↗
PubMed1995

Activity of leucocyte elastase in women with coronary artery disease documented using angiography.

BACKGROUND: Recent studies suggest that leucocyte elastase is involved in the pathogenesis of atherosclerosis. The objective of this study was to characterize the role of leucocyte elastase in arterial disease in women. METHODS: Forty-two women underwent coronary angiography because of chest pain or valvulopathy. Twenty-three showed no signs of lesions (group 1) and 19 had coronary stenosis (group 2). Their age, weight and height were recorded, together with the presence of angina, arterial hypertension, diabetes mellitus, any family history of coronary disease and levels of tobacco consumption. Leucocyte counts, lipid levels and neutrophil elastase concentrations were determined from peripheral blood samples. RESULTS: Levels of elastase were found to be significantly higher in group 2 than in group 1 (mean +/- SD 53.3 +/- 15.9 compared with 28.6 +/- 16.8 micrograms/l, P < 0.01). Patients from group 2, who had a greater mean age (69 +/- 7 compared with 58 +/- 9 years for group 1, p < 0.001), were more often diabetic (26% compared with 0%, p < 0.05) and were more likely to have family histories of ischaemic cardiomyopathy (59% compared with 18%, P < 0.05). However, multivariate analysis indicated that age and elastase levels were of independent value as predictors of coronary artery disease. CONCLUSION: The concentration of elastase in peripheral blood is higher in women who have stenosis on coronary angiography.

Aged↗
PubMed1994

Hexose transport across the apical and basolateral membrane of enterocytes from different regions of the chicken intestine.

The properties of hexose transport across the apical and basolateral membranes of chicken enterocytes have been studied in the small and large intestine. Results show that (a) isolated epithelial cells from all segments except the coprodeum can accumulate 3-O-methylglucose (Glc3Me) against a concentration gradient, by a Na(+)-dependent and phloridizin-sensitive mechanism. (b) The cell cumulative capacity for Glc3Me (control/phloridizin-incubated cells) is lower in the small intestine than in the large intestine (rectum = proximal caecum = ileum > jejunum > duodenum). (c) Theophylline enhances the cell Glc3Me cumulative capacity 2.9-fold in the duodenum and 2.4-fold in the jejunum but has no effect in the other segments studied. (d) Analysis of sugar uptake indicates that net hexose influx rates decrease from proximal to distal regions: jejunum > duodenum > ileum = proximal caecum = rectum for the apical transport system (alpha-methyl glucoside as substrate and phloridizin as inhibitor) and duodenum > jejunum > ileum = proximal caecum = rectum for the basolateral system (2-deoxyglucose; theophylline). (e) The duodenum and the jejunum show high apical and basolateral hexose transport rates, which confer a significant capacity for sugar absorption on the proximal intestine. More distal regions, including the ileum, the proximal caecum and the rectum, have transport systems analogous to those of the proximal intestine that keep a considerable potential capability to recover hexoses from the lumen.

3-O-Methylglucose↗
PubMed1994

Immunological status of patients with denture stomatitis and yeast infection after treatment of maxillofacial tumors.

Therapeutic modalities employed in the treatment of maxillofacial malignancy, tumor resection, radiation and chemotherapy, can result in local and systemic changes in healthy oral tissues many years after anticancer therapy has been stopped. The immunologic status of a select group of nine individuals who underwent surgery of the maxillofacial region and after head and neck irradiation, with severe and persistent denture stomatitis was studied. A significant impairment of granulocyte and lymphocyte functions and increased concentrations of serum IgG, as compared to healthy controls, were found in the patients of the study group. It is concluded, that this group of patients show immunological abnormalities many years post therapy, which must be recognized by the clinician in order to effect a cure.

Adult↗
PubMed1994

[Aortic pseudoaneurysm and acute myocardial infarct secondary to thoracic trauma].

Three cases of traumatic cardiovascular disease following chest trauma in males with no previous ischemic heart episodes are presented. One of them coursed with a combination of myocardial infarction and aortic pseudoaneurysm in an unusual location. The others coursed with and acute myocardial infarction and an aortic pseudoaneurysm, respectively. It is also underlined the utility of transthoracic and transesophageal echocardiography as well as a routine hemodynamic evaluation in this kind of patients.

Accidents, Traffic↗
PubMed1994

Echocardiographic features of the normofunctional Labcor-Santiago pericardial bioprosthesis.

Echocardiography was performed in 94 patients with a total of 99 normally functioning Labcor-Santiago bioprostheses, 62 in the aortic and 37 in the mitral position. The following variables were measured: peak and mean transvalvular velocities, peak and mean instantaneous pressure gradients as calculated from the modified Bernoulli equation, pressure half-time, cardiac index, stroke volume and effective orifice area (using continuity and Hatle equations). Regurgitation patterns were sought by transthoracic echocardiography (all valves) and, for selected mitral bioprostheses, by transesophageal echocardiography. Calculated mean aortic pressure gradient ranged from six to 10 mmHg and calculated effective aortic orifice area increased with ring diameter, with means of 1.27 cm2 for the 19 mm valve and 2.58 cm2 for the 27 mm valve. For mitral bioprostheses, mean pressure gradient ranged from 3.0 to 4.5 mmHg and calculated effective orifice area from 2.27 to 2.73 cm2. Only central regurgitation was observed. The Labcor-Santiago pericardial bioprostheses created little resistance to forward flow. In the small aortic root their hemodynamic performance was as good or better than that of other currently available devices. It is hoped that this new design will contribute increased in vivo mechanical durability.

Adult↗
PubMed1994

Endocarditis with pericardial bioprostheses: clinico-pathologic characteristics, immediate and long term prognosis.

Between 1977 and 1992, 30 consecutive episodes of infective endocarditis in 28 patients involving pericardial bioprostheses were diagnosed and treated in our hospital. Eleven (37%) were early pericardial valve endocarditis occurring in the first 60 days following valve surgery, and 19 (63%) were late endocarditis. In both the early and late groups, more aortic that mitral valves were affected (19/30). The most frequent pathogen in the early cases was staphylococcus, (S. epidermidis in five cases, S. aureus in one). The most frequent pathogen among late cases was streptococcus: (St. viridans in four, St. faecalis in two, St. bovis in one). In four cases (13%) no pathogen was isolated. Twelve patients received antibiotic treatment alone, six specific for the pathogen and other six only arbitrarily chosen regimen. All patients were cured in the former and all patients died in the latter group (four with negative blood cultures and two in whom identification of the pathogen was delayed-Proteus mirabillis in one case and Brucella mellitensis in the other). Valve replacement during the infective endocarditis episode was necessary in 18 cases, either because of failure of the antibiotic treatment or because of heart failure secondary to prosthetic malfunction. Peri-annular abscess was present in five cases. Surgical mortality was 22.2% (4/18). In all, 11 patients (39%) died during the active stage of infective endocarditis. The most frequent cause of death was heart failure (45.5%). All four patients with negative blood cultures died. The most advisable strategy for treating bacterial endocarditis of pericardial bioprostheses is a combination of antibiotic therapy and early surgery, especially in cases of staphylococcus endocarditis.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1994

[Myocardial ischemia secondary to a bilateral coronary fistula with drainage into the pulmonary artery trunk].

A case of bilateral coronary artery fistula into main pulmonary artery which courses with crisis of angina and subepicardial ischaemic changes in anterolateral leads is presented. The interest of the case reported is based on the peculiar anatomy of the fistula; there is only an unique collector to the pulmonary artery for both fistula and they present a completely different way of emerging: an unique vessel from the right coronary artery and several vessels from the anterior descending coronary artery. Ligation of the fistula was performed successfully and postoperative course was uneventful.

Angina Pectoris↗
PubMed1993

Chronic stress induced changes in LH secretion: the contribution of anorexia associated to stress.

The effects of chronic intermittent immobilization (IMO) on serum LH levels of adult male rats were studied. Chronic IMO (2 h daily for 13 days) did not alter basal LH levels, but abolished the LH response to acute stressors (IMO and tailshock). The inhibition of LH caused by acute exposure to IMO for 4 or 18 h was similar in control and chronic IMO rats. Also the LH response to exogenous LHRH administration was normal in chronically stressed rats. When a group of rats eating the same amount of food as that eaten by immobilized rats was introduced (pair-fed), an inhibition of LH response to acute stressors quite similar to that found in chronic IMO rats was observed. These data indicate that chronic stress-induced inhibition of LH release caused by short-term exposure to acute stressors was located above the pituitary and was mainly due to anorexia accompanying daily exposure to the stressor.

Analysis of Variance↗
PubMed1993

Sarcomatoid renal cell carcinoma: a case of spontaneous regression of metastases.

The spontaneous regression of metastases in renal cell carcinoma is usually associated with the clear cell carcinoma histologic type. We report a case of spontaneous regression in a man with lung metastases from a sarcomatoid renal cell carcinoma variant. At present, 1 year after regression was first evident, the patient remains in remission.

Adult↗