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Biomedical subjects

M Lozano

Publications and source records attributed to M Lozano.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

"Abnormal" electrocardiograms in patients with cocaine-associated chest pain are due to "normal" variants.

"Abnormal" electrocardiograms are found in 56% to 84% of patients with cocaine-associated chest pain. This study was designed to assess whether these findings can be explained by "normal" variations in young patients' electrocardiograms. This cross-sectional study was conducted in a municipal hospital emergency department and walk-in clinic. History and results of an electrocardiogram for consecutive patients with cocaine-associated chest pain, aged 18 to 35 years, were compared to normal controls matched for age, race, and gender. Electrocardiograms underwent detailed analysis by two physicians blinded to both the study protocol and the hypothesis. Interphysician concordance for electrocardiographic diagnosis was substantial. There were 112 patients enrolled, 56 in each group. There was no significant difference found in the mean frequency of electrocardiographic diagnoses between the cocaine-associated chest pain patients and controls. The early repolarization variant was common. In conclusion, "normal" variations (J point and ST segment elevations) account for many of the "abnormal" electrocardiograms observed in young patients with cocaine-associated chest pain. Further study is needed to define the prevalence of these "normal" variations, and to determine if standard electrocardiographic criteria for thrombolysis apply to young patients.

Adolescent↗
PubMedDate not supplied

Urban search and rescue medical teams: FEMA Task Force System.

Recent national and international disasters involving collapsed structures and trapped casualties (Mexico City; Armenia; Iran; Philippines; Charleston, South Carolina; Loma Prieta, California; and others) have provoked a heightened national concern for the development of an adequate capability to respond quickly and effectively to this type of calamity. The Federal Emergency Management Agency (FEMA) has responded to this need by developing an Urban Search and Rescue (US&R) Response System, a national system of multi-disciplinary task forces for rapid deployment to the site of a collapsed structure incident. Each 56-person task force includes a medical team capable of providing advanced emergency medical care both for task force members and for victims located and reached by the sophisticated search, rescue, and technical components of the task force. This paper reviews the background and development of urban search and rescue, and describes the make-up and function of the Federal Emergency Management Agency (FEMA) Task Force medical teams.

Emergency Medical Services↗
PubMedDate not supplied

Determinants of wound infections after surgery for breast cancer.

BACKGROUND: There are evident risks factors stemming from any the local post-surgical infection, which merits analysis of morbidity derived from conservative and radical surgery after treatment of the operable breast cancer. STUDY DESIGN: 107 patients with breast cancer recruited between November 1995 and October 1997 were evaluated. From that total, 36 patients were subjected to quadrantectomy, axillary lymphadenectomy and postoperative radiation while 71 patients were subjected to modified radical mastectomy. RESULTS: 7 % percent of patients who underwent modified radical surgery succumbed to postoperative local infection vs. 17 % of patients subjected to breast conserving therapies. Local infections were associated with the older patients (63 vs. 54 years old, p=0.03) and greater obesity (p=0.04). Upon logistic regression analysis conservative surgery exhibited adjusted Odds Ratio of 6.42 (1.27-32.28), p =0.02. In postoperative infection group average hospital stay increased by 6 days (p= 0.0001). CONCLUSION: In the present study main risk factors associated with postsurgical wound infection after breast cancer treatment proved to be advanced age, greater obesity and conservative surgery. Nonetheless, more studies are necessary to confirm current findings.

Breast Neoplasms↗
PubMedDate not supplied

Cutaneous leiomyosarcoma in a child.

Superficial leiomyosarcomas are infrequent tumors that are very rare in childhood. We report on a 12-year-old white boy with a cutaneous leiomyosarcoma of his left groin. Immunohistochemical study revealed positive immunostaining with antibodies to vimentin, desmin, and smooth muscle actin. The tumor was removed with wide surgical margins.

Child↗
PubMedDate not supplied

Variations in the electrocardiograms of young adults: are revised criteria for thrombolysis needed?

OBJECTIVE: The evaluation of chest pain in young adults has changed with the recognition of cocaine-induced myocardial ischemia. The high frequency of abnormal electrocardiograms (56-84%) in the cocaine-user population is largely due to "normal" electrocardiographic variants (early repolarization). The authors sought to determine the frequency of these "normal" variants in a young population, and whether these findings can be confused with acute ischemia. METHODS: A prospective convenience sample of subjects aged 18 to 35 without known heart disease was interviewed and had 12-lead electrocardiographic tracings performed. An emergency physician (physician 1) and a cardiologist (physician 2) read the tracings while blinded to patient history, age, and race. When the physicians disagreed, another physician adjudicated the diagnosis. RESULTS: Four hundred fourteen subjects (127 black, 175 Hispanic, and 112 Caucasian) were enrolled. Overall, 154 tracings (37%) were normal, 245 (59%) were abnormal but nondiagnostic for ischemia, and 15 (4%) were consistent with ischemia. Frequencies of repolarization "abnormalities" as determined by physicians 1 and 2, respectively, were: blacks, 32%, 51%; Hispanics, 26%, 35%; Caucasians, 17%, 27%; chi-squared, p = 0.02 and 0.0004. Patients with ischemic electrocardiograms according to physician 1 had a high frequency of repolarization "abnormalities" according to physician 2, and vice versa (100%, 61%). Electrocardiographic criteria for thrombolytic use per physician 2 were present in 31 patients (7%): blacks, 9%; Hispanics, 10%; and Caucasians, 2%; chi-squared, p = 0.03.

Adolescent↗
PubMedDate not supplied

Spanish perspective on enlarging a small specialty: the national research network for liaison psychiatry and psychosomatics.

The Spanish Research Network in Liaison Psychiatry and Psychosomatics (REPEP) comprises 11 centers (nodes), and was one of the successful applicants in a very competitive call for a networking program for the National Institute of Health "Carlos III" project. This article describes its general objectives and strategic plans. Both qualitative and quantitative results support our statement that this "perspective" should help to enlarge what is presently a small specialty. Synergies in the network have been potentiated; an ambitious national study on depressive comorbidity in complex medical patients has been executed; and new research and training programs have been initiated.

Forecasting↗
PubMedDate not supplied

[The psychiatric emergency in the general hospital: an analysis of the indications for hospitalization].

The following is a study of psychiatric emergencies in a General Hospital in Madrid (Spain). The Psychiatric Emergency Service of the Ramón y Cajal Hospital in Madrid received a total of 3,693 patients in 1988. This was 3.4% of patients seen in the General Emergency Service. The study is based on an analysis of the variables that influence a recommendation of hospitalization and their statistical significance. Hospitalization was recommended more frequently in males and those with diagnoses of depression, alcoholism and schizophrenic or paranoid disorders.

Adolescent↗
PubMedDate not supplied

[Histamine liberation and specific IgE against Dermatophagoides pteronyssinus in parasitized patients].

We studied 98 patients with different parasitosis, without clinical symptoms of mite sensitization, most of them coming from Guinea. Histamine release to Dermatophagoides pteronyssinus was performed using whole blood. Specific IgE to the same antigen was measured by EAST, as well as by an immunodot with the same antigen extract employed for the histamine release test. Finally, the EAST positive sera were studied by immunoblotting. The presence of specific IgE by EAST could be proved in 31 patients, but these antibodies were nor detected by dot, blot and histamine release. On the other hand, only two patients showed a positive histamine release test to D. pteronyssinus and in these two cases the EAST to mites was negative. There was no relation between total IgE levels and specific IgE to mites. The presence of mite-specific IgE showed a significative association to the parasite Trichuris trichiura (odds ratio 3.09). This fact suggest that the specific IgE values found in this population can reflect some cross-reaction between parasites and allergens. It is the author's opinion that the same study should be performed in european patients in order to test the relationship between mite-specific antibodies and the presence of parasites, specially of Trichuris trichiura.

Adolescent↗