Kondo insulators modeled by the one-dimensional Anderson lattice: A numerical-renormalization-group study.
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Biomedical subjects
Publications and source records attributed to M Guerrero.
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The prevalence of anti-Borrelia burgdorferi antibodies was studied in Granada, Spain, between January 1991 and November 1993 in 354 patients with suspected Lyme disease (group 1); in 50 patients either with syphilis (n = 32) or without syphilis but with a positive Rapid Plasma Reagin test (n = 18) (group 2); and in 150 healthy subjects (group 3). In addition, intrathecal antibody production was evaluated by EIA in CSF samples obtained from 117 patients in group 1. Anti-Borrelia burgdorferi antibodies were detected by EIA in 58 patients (16.4%) in group 1, 29 (8.2%) of whom were positive by Western blot. Intrathecal antibody production was detected in one patient. In group 2, 8 (16%) patients had a positive EIA result, but none of these was confirmed by Western blot. western blot was negative for all subjects in group 3. The results of this study indicate that anti-Borrelia burgdorferi antibodies are not uncommon in our area, although Lyme disease is rare.
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The authors present a booklet for the patients with acute myocardial infarction. The main purpose of the booklet is to be a complement in the treatment for myocardial infarction patients, the leading cause of death in Brazil. It contains information about the disease, risk factors, return to work and treatment.
A multidisciplinary group of experts involved in the treatment of critically ill patients participated in a workshop conference designed to develop practice recommendations for the recognition, assessment, and treatment of anxiety in the critical care environment. Anxiety was identified as a ubiquitous problem in critical care that may interfere with healing and recovery. The faculty agreed that clinicians should be familiar with the signs and symptoms of anxiety and should be able to determine when interventions are necessary. Whenever possible, nonpharmacologic methods for anxiolysis should be incorporated into intensive care protocols. Intensive care personnel should be trained in those interventions that require specialized expertise, and they should become familiar with the drugs available for the treatment of anxiety. Protocols for determining the best agents to be used in a given setting and their most appropriate method of administration should be established. Pharmacologic and nonpharmacologic treatments are not mutually exclusive but should be complementary. Finally, procedures for obtaining psychiatric consultation, when necessary, should be in place.
OBJECTIVE: Evaluation of efficacy of intravenous flecainide to revert supraventricular arrhythmias to sinus rhythm in patients with respiratory insufficiency. DESIGN: Comparative randomized prospective trial. SETTING: ICU in a University Hospital. PATIENTS: 30 patients with acute respiratory insufficiency or acute exacerbation of chronic respiratory insufficiency and supraventricular arrhythmias. Intravenous flecainide was administered to 15 patients (Group A) (2 mg/kg for 10 min and continuous perfusion of 1.5 mg/kg for 1 h). Intravenous verapamil was administered to 15 patients (Group B) (0.15 mg/kg for 5 min and continuous perfusion of 0.005 mg/kg/min for 1 h). MEASUREMENTS AND RESULTS: The categories of patients' arrhythmias were: Group A-atrial fibrillation (AF) in 5 cases, atrial flutter (AFl) in 2, multifocal atrial tachycardia (MAT) in 4 and other supraventricular tachycardia (SVT) in 4. Group B-AF in 6 cases, AFL in 2, MAT in 2 and SVT in 5 cases. Flecainide reverted arrhythmias to sinus rhythm in 12 out of 15 cases (80%); of these 12, 11 reverted with the initial bolus. Verapamil reverted 5 out of 12 cases (33.3%, p < 0.01). No significant secondary adverse effects were detected. CONCLUSION: Intravenous flecainide is an effective antiarrhythmic drug to treat acute supraventricular arrhythmias in patients with respiratory insufficiency.
A prospective, randomized, controlled study was performed to determine the haematological and biochemical changes and clinical safety of postoperative autotransfusion (Solcotrans Orthopedic Plus system) in patients undergoing spinal surgery. Fifty patients were studied and were randomly allocated to Control (n = 25) and Solcotrans (n = 25) groups. Both groups had their postoperatively drained blood collected into the Solcotrans reservoir but only the Solcotrans group had this salvaged blood considered for reinfusion. After a 5-h postoperative collection period, analysis of the shed blood showed a haematocrit of 0.26 +/- 0.11, few platelets (80 +/- 63 10g.l-1), a fibrinogen level of less than 0.1 g.l-1 and a high level of D-dimers. The salvaged blood did not clot and aerobic and anaerobic culture produced no growth. The volume of blood collected was greater than 200 ml in 21 patients in the Solcotrans group who were autotransfused (384 +/- 101 ml, range 200-600 ml), and in 16 patients in the Control group. Within 15 min following completion of reinfusion of the salvaged blood there was a significant, but moderate decrease in platelet count (181 +/- 74 vs 223 +/- 90 10g.l-1, P < 0.001) and fibrinogen concentrations (2.1 +/- 0.8 vs 2.3 +/- 0.9 g.l-1, P < 0.02), and an increase in circulating D-dimers (P < 0.001) and plasma free haemoglobin concentrations (236 +/- 155 vs 82 +/- 79 mg.l-1, P < 0.001). Prothrombin time (PT) and activated partial thromboplastin time (APTT) did not increase, and potassium concentrations were not significantly affected.(ABSTRACT TRUNCATED AT 250 WORDS)
The case of a 25-year old man who presented with meningoencephalitis as the sole clinical manifestation of Q fever is described. Serological studies revealed the presence of IgM and IgG antibodies to Coxiella burnetii. The patient responded favourably to a ten-day course of i.v. ceftriaxone and was discharged without any neurological sequelae.
This prospective study was designed to compare the haemodynamic response to insertion of either a laryngeal mask or an orotracheal tube. Twenty patients scheduled for orthopaedic surgery were randomly assigned to two groups : laryngeal mask group (n = 10) and orotracheal tube group (n = 10). Patients were premedicated with flunitrazepam (1 mg i.m.) and anaesthesia was induced with propofol (bolus of 2.5 mg.kg-1, followed by a continuous infusion of 10 mg.kg-1.h-1) and vecuronium (0.1 mg.kg-1). Heart rate and mean arterial pressure were assessed non-invasively before and after induction of anaesthesia and immediately after tube or laryngeal mask insertion. Orotracheal intubation elicited a significant increase in heart rate (92 +/- 16 vs 77 +/- 19 b.min-1, p < 0.05) and in mean arterial pressure (117 +/- 21 vs 85 +/- 16 mmHg, p < 0.05), whereas there was significant increase in heart rate (74 +/- 11 vs 72 +/- 12 b.min-1) and mean arterial pressure (86 +/- 8 vs 81 +/- 10 mmHg) after insertion of the laryngeal mask. In both groups, plasma catecholamine concentrations were not significantly modified after tube or laryngeal mask insertion. It is concluded that, under propofol anaesthesia, laryngeal mask insertion does not induce any significant haemodynamic response in ASA 1 patients. In the opposite, orotracheal intubation increases both heart rate and mean arterial pressure.
A new device for postoperative autotransfusion (ConstaVac, Stryker) was assessed after total hip replacement in 43 patients, mean age 63 +/- 13 years. Intraoperative blood was administered to 27 patients (63%), autologous blood only in 19, homologous blood only in 6 and both autologous and homologous blood in 2. The blood shed during an average 5-hour postoperative period had an haematocrit of 23 +/- 7% and included only few platelets (72 +/- 83 G.l-1). It did not clot as it contained there was less than 0.1 g.l-1 of fibrinogen and a high concentration of D-dimers. In 30 patients (70%), the amount of blood thus collected exceeded 200 ml. An average of 327 +/- 131 ml were subsequently retransfused to these patients. Postoperative autotransfusion induced a moderate but significant decrease in platelet counts (205 +/- 66 vs. 224 +/- 67 G.l-1, p < 0.02) and fibrinogen concentrations (2.3 +/- 0.7 vs. 2.4 +/- 0.6 g.l-1, p < 0.03), and an increase in circulating D-dimers (p < 0.001). Coagulation tests, free plasma haemoglobin and potassium concentrations were not significantly altered. Since the haematocrit of the blood lost was lower than that of the patients', the haematocrit did not increase significantly. Posttransfusion shivering occurred in two patients (7%). Bacteriological cultures of the lost blood and of venous samples obtained after postoperative autotransfusion remained sterile. Postoperative autotransfusion is a simple technique with few side-effects, which might be safely associated with other methods used to decrease the rate of homologous blood transfusion.
Continent urinary reservoirs (CUR) have replaced ileum and colonic conducts as the best method for urinary diversion. The author present their experience with two patients in whom they fashioned a CUR in the Dr. Arnulfo Arias M. Metropolitan Complex using the ileocecal segment and part of the transverse colon (The Miami or Florida porch technique). They describe the clinical histories, surgical technique and the results obtained. They feel that the CUR has a large capacity, works at low pressure and is technically accessible. They consider it a good choice when urinary diversion is needed.
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We have explored the role of mitochondrial 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) synthase in regulating ketogenesis. We had previously cloned the cDNA for mitochondrial HMG-CoA synthase and have now studied the regulation in vivo of the expression of this gene in rat liver. The amount of processed mitochondrial HMG-CoA synthase mRNA is rapidly changed in response to cyclic AMP, insulin, dexamethasone and refeeding, and is greatly increased by starvation, fat feeding and diabetes. We conclude that one point of ketogenic control is exercised at the level of genetic expression of mitochondrial HMG-CoA synthase.
The effect of intrathecal administration of antiepileptic drugs on electroshock-induced convulsions (maximal electroshock seizure, MES test) was investigated in an experimental study in rats. Drugs tested were phenobarbital sodium (50-800 micrograms), sodium valproate (50-6,400 micrograms) and midazolam (50-250 micrograms), delivered into the cerebrospinal fluid via a catheter placed in the upper cervical intrathecal space. Control animals were tested with saline. The animals were tested in the MES test 30 min after drug administration. Phenobarbital sodium showed a dose-related protective effect on the tonic phase of the convulsion, with a 50% effect at a dose of 200 micrograms. Sodium valproate showed a less protective effect, even when reaching doses that produced neurological symptoms. Midazolam protected at a high dose but produced a severe decrease in motor activity. The results indicate the feasibility to treat experimental convulsions by means of intrathecal injection of antiepileptic drugs.
We used a retrospective search and confirmation method to establish the number of new cases of insulin dependent diabetes mellitus diagnosed between Jan 1, 1986 and Dec 31, 1989 in subjects under 15 years of age in the Metropolitan region of Chile. All hospitals and outpatient facilities of the National Health Service, other hospitals and private offices of endocrinologists and specialists in diabetes were surveyed, as well as the registry from the Juvenile Diabetes Foundation. A total of 115 cases, 52 in males and 63 in females were found, for an annual incidence of 1.69 and 2.15 per 100,000, respectively. Overall, the annual incidence rates were 2.22 in 1986, 1.22 in 1987 (p < 0.001), 2.13 in 1988 and 2.09 in 1989. A greater number of cases was diagnosed at age 4 in males and at age 12 in females (p < 0.001). The greater number of cases were diagnosed from June to August (winter) and the lowest in October (p < 0.001).
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There is no mention in the literature of any analytical method to quantify toxins present in fruits of Karwinskia humboldtiana. It is recommended that thin layer chromatography and densitometry in situ be used, since it is rapid, sensitive and specific. Great variations in the toxin content of fruits collected in different regions of the state of Nuevo Leon (Mexico) were found, showing the importance of applying an analytical method before beginning toxicological experiments.