Biomedical subjects

M Morales

Publications and source records attributed to M Morales.

At least 253 records · Page 14Linked to original sources

PubMedDate not supplied

Time course of the effects of cervical epidural anesthesia on pulmonary function.

BACKGROUND AND OBJECTIVES: During cervical epidural anesthesia the C4, C5, and sometimes C3 nerve roots are anesthetized. One might therefore expect pulmonary compromise due to the block of the phrenic nerve if anesthesia extends to C3. This study was conducted to measure the effects of cervical epidural anesthesia using 2% lidocaine on pulmonary function, with specific attention given to the time course of pulmonary changes in relation to spread of analgesia. METHODS: Fifteen adult patients without preexisting lung disease undergoing carotid endarterectomy, breast surgery, or cervical epidural steroid injection were enrolled. Cervical epidural anesthesia was performed at the C7-T1 interspace using 300 mg lidocaine with epinephrine. Pulmonary function, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), maximum inspiratory pressure (MIP), and SpO2 while breathing room air were measured prior to and 5, 10, 20, and 40 minutes after lidocaine injection. RESULTS: Analgesia to pinprick reached median dermatomes of C3 to T8 (range: C2-T12) by 20 minutes after lidocaine injection. FEV1 and FVC decreased approximately 12-16% between 20 and 40 minutes after injection. Maximum inspiratory pressure and SpO2 did not significantly change. CONCLUSIONS: Cervical epidural anesthesia using 300 mg lidocaine results in measurable reduction in bedside pulmonary functions concomitant with the spread of analgesia to the C3 dermatome. These changes were complete 20 minutes after lidocaine injection. In patients without preexisting lung disease, these changes were not clinically significant, except in one patient. We conclude that motor block of the phrenic nerve is incomplete under the conditions of this study.

Adult↗

PubMedDate not supplied

Use of heparin for cytapheresis and plasmapheresis in a continuous flow centrifuge.

We evaluated the use of heparin in continuous flow centrifugation by continuous infusion. Doses were modified by assessment of the anticoagulant effect by the thrombin time dilution test (TTDT). Heparin is an efficient anticoagulant in continuous flow centrifugation and the TTDT is an effective and reliable method for control. The initial dose in leukapheresis is one unit per milliliter of blood during the first hour, then one-half the dose during the next hour, and then a one-quarter of the dose until the procedure is completed. A TTDT performed every 30 to 60 minutes will indicate whether the heparin dose should be modified. For plasmapheresis, it is necessary to determine the specific dose for each patient. There was no case of bleeding or extracorporeal coagulation of the blood.

Adult↗

PubMedDate not supplied

Assessment of blood glutathione peroxidase activity in the dromedary camel.

Blood glutathione peroxidase (GSH-Px) levels in 709 normal dromedary camels (442 females and 267 males) were assessed in the Canary Islands. All animals were intensively reared, and three different nutritional systems were evaluated, depending on selenium content of the diet. Mean GSH-Px level in the total population was 288.5+/-157.2 IU x g(-1) Hb. Reference ranges were estimated and enzymatic activities below 51 IU x g(-1) Hb were considered inadequate. GSH-Px activities obtained in females (298.1+/-155.7 IU x g(-1) Hb) were significantly (P = 0.037) higher than in males (272.6+/-157.2 IU x g(-1) Hb). When age groups were compared, only males between 6 and 12 months old exhibited significantly lower mean GSH-Px (P = 0.006) than females. A high correlation (r = 0.88) between serum selenium concentration and blood GSH-Px activity was estimated, and the regression equation was y = 2.5101x + 42.423. Selenium content of the diet above 0.1 mg x kg(-1) DM seems to supply adequate selenium requirements for dromedaries under intensive husbandry.

Age Factors↗

PubMedDate not supplied

Hypouricemia and cancer. A study of the mechanisms of renal urate wasting in two cases.

Two cases of hypouricemia in association with malignant diseases are presented. One patient had metastatic breast cancer and the other an undifferentiated retroperitoneal sarcoma of the childhood. Uric acid renal handling was studied with the pyrazinamide and benzbromarone tests. Both patients had reduced postsecretory reabsorption of uric acid. The increase of serum uric acid levels in both patients, after a partial response to chemotherapy, indicates the possible paraneoplastic origin of hypouricemia. Our results are discussed and compared with other reports in the literature.

Adolescent↗

PubMedDate not supplied

Lactose digestion and clinical tolerance to milk, lactose-prehydrolyzed milk and enzyme-added milk: a study in undernourished continuously enteral-fed patients.

We investigated: (1) the capacity to digest and tolerate the lactose administered by continuous infusion of intact milk to undernourished tube-fed patients, and (2) the effectiveness of lactose-prehydrolyzed milk, and of the addition of exogenous lactase to milk at infusion time, to reduce lactose maldigestion and increase clinical tolerance. Carbohydrate digestion was evaluated in 10 subjects with the hydrogen breath analysis test during 8 hr of observation. Lactose intolerance was determined by evaluation of subject's symptoms. With the infusion of intact milk (IM), none of the subjects were able to efficiently digest the lactose infused (5.6 +/- 0.35 g/hr, mean +/- SEM) and 86% of them experienced major symptoms of intolerance. With the infusion of lactose-prehydrolyzed milk (HM) and enzyme-added milk (EM) there was a highly significant reduction in lactose maldigestion. More importantly, major symptoms were present in only 10% of subjects with EM, and were completely eliminated with HM. Lactose maldigestion and intolerance represent a major limitation for the application of milk-based polymeric formula for liquid diets in undernourished subjects. The use of exogenous beta-galactosidases represents an alternative to avoid such reactions.

Adult↗

PubMedDate not supplied

[Reference values for the central motor conduction time and silent period obtained by the transcranial magnetic stimulation].

INTRODUCTION: Normal values of reference to transcranial magnetic stimulation for the motor central conduction time (CCT) and silent period (SP) is recorded in 30 healthy control subjects over abductor pollicis brevis. MATERIAL AND METHODS: We get for the CCT four measurements: two with low intensity of stimulus, 5% plus the motor threshold, with and without facilitation (CCT1 and CCT1 fac.); and two with high intensities of stimulus, elevating the magnetic stimulation intensity to 1.5 times the threshold (CCT2 and CCT2 fac.). RESULTS AND CONCLUSIONS: The mean and standard deviation of each measurement are: CCT1: 9.34 +/- 1.19, CCT1 fac.: 7.12 +/- 1.1. CCT2: 8.84 +/- 1.05 and CCT2 fac.: 6.57 +/- 1.05. Given that the CCT and SP doesn't follow a normal distribution, the medium and the 5-95% percentiles for the normal values of reference are calculated; there are: CCT1: 7.15-11.32, CCT1 fac: 5.27-9.42. CCT2: 7.05-10.73 and CCT2 fac: 4.91-9.14. For the silent period gets only one measurement employing high intensities. These last measurement were recorded in two localizations: on vertex and on motor area, selecting the greater duration. Given the great individual variability of this period in normal population absolute and ratio for the difference duration of SP between both sides are calculated. The latency of the SP is 50.2 +/- 5.99, 95 percentiles 39.1-64.63, the duration 151 +/- 32.51, 95 percentiles 102.63-239.55. The total SP measured from the discharge of the stimulus to the end of the silent period is 201.71 +/- 33.27; 95 percentiles: 151.39-296.4. The comparison of both hemispheres would give us pathological security for the 99.99% of the population for more than 14.94 ms of absolute difference, and for less of the 79.81% of ratio difference. A summary of the discoveries of the silent period in different pathologies is contributed in the discussion.

Adult↗

PubMedDate not supplied

Crohn's disease as a risk factor for the outcome of pregnancy.

BACKGROUND/AIMS: To study the effects of Crohn's disease on the course of pregnancy and the influence of pregnancy on the activity of Crohn's disease. METHODOLOGY: The course of 35 pregnancies in 23 women with Crohn's disease were reviewed over a 12 years period. RESULTS: Nine pregnancies (25%) started when Crohn's disease was active. We observed 2 exacerbations among the 9 pregnancies with active disease and 7 exacerbations among the 26 pregnancies with quiescent disease: this represents a total exacerbation rate of 26% similar to non-pregnant women with Crohn's disease. The course of pregnancy was normal with a full-term delivery in 22 cases (63%). We observed 5 premature deliveries (14%), 5 spontaneous abortions (14%), 1 induced abortion (3%) and 2 liveborns with severe malformations (6%). Preterm delivery was significantly associated with reactivation of Crohn's disease during pregnancy (P = 0.009), whereas fetal loss was significantly associated with activity of Crohn's disease at the time of conception (P = 0.015). CONCLUSIONS: Pregnancy does not appear to influence the course of Crohn's disease. The relapse rate of Crohn's disease during pregnancy is similar to that of the general Crohn's disease population. Active Crohn's disease at the time of conception or reactivation during pregnancy are risk factors for abnormal pregnancy outcome.

Adult↗

PubMedDate not supplied

Influence of extracellular calcium on the actions of guanidine at the rat neuromuscular junction.

Guanidine has been shown to potentiate neurotransmission at the skeletal neuromuscular junction. The present study was undertaken to evaluate whether reductions in extracellular calcium affect the action of guanidine on the reversal of neuromuscular blockade induced by dibekacin and d-tubocurarine in the rat phrenic-hemidiaphragm preparation. Guanidine reversed the blocking effect of d-tubocurarine, the maximal effect occurring with 3 mM at 15 min. This reversal effect of guanidine was potentiated when the extracellular calcium concentration was reduced from 2.5 mM to 1 mM and 0.3 mM. Guanidine was also effective in reversing the neuromuscular depression caused by dibekacin. In this case, it was more potent than in the d-tubocurarine-treated preparations. The maximal effect was observed with 3 mM after 15 min of exposure. When the extracellular calcium concentration was reduced from 2.5 mM to 1 mM, a potentiation of guanidine effects was observed. In this situation, the maximal effect of guanidine was observed with only 0.7 mM. However, further reductions of extracellular calcium (0.3 mM) did not show further increases. The present results show that guanidine reverses the blockade induced by dibekacin and d-tubocurarine, being more potent against the former drug. This suggests that guanidine may be useful in relieving the blockade due to a restriction of calcium entry. Its effects were potentiated when the extracellular calcium concentration was lowered to 1 mM and, in d-tubocurarine-treated muscles, to 0.3 mM. Thus, the effects of guanidine are calcium-dependent but only in a certain concentration range.

Animals↗

PubMedDate not supplied

[Distribution of capsular types and antimicrobial susceptibility of Streptococcus agalactiae causing infections in Argentina].

Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients. The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes. This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium. The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina. In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes. All the isolates were found to be sensitive to penicillin. A 6% of resistance to erythromycin and a 4.5% to clindamycin were detected. In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected. These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine. The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment.

Argentina↗

PubMedDate not supplied

Iron metabolism, inflammation and anemia in critically ill patients. A cross-sectional study.

INTRODUCTION: For critically patients, enteral immunonutrition results in notable reductions in infections and in length of stay in hospital, but not on mortality, raising the question as to whether this relate to the heterogeneous nature of critically ill patients or to the absence of the altered absorption of specific nutrients within the immunonutrient mix (e.g. iron). Immune-associated functional iron deficiency (FID) is not only one of the many causes or anaemia in the critically ill, but also a cause of inappropriate immune response, leading to a longer duration of episodes of systemic inflammatory response syndrome and poor outcome. OBJECTIVE: This prospective cross-sectional study was undertaken to assess the prevalence of FID in critically ill patients during their stay in intensive care (ICU) in order to find the more appropriate population of patients that can benefit from iron therapy. METHOD: Full blood cell counts, including reticulocytes (RETIC), serum iron (SI), transferring levels (TRF) and saturation (satTRF), serum TFR receptor (sTfR), ferritin (FRT) and C-reactive protein (CRP) were measured in venous blood samples from 131 random patients admitted to the ICU for at least 24 h (Length of ICU stay, LIS; min: 1 day; max: 38 days). RESULTS: Anaemia (Hb < 12 g/dL) was present in 76% of the patients (Hb < 10 g/dL in 33%), hypoferremia (SI < 45 microg/dl) in 69%; satTRF < 20% in 53%; FRT < 100 ng/mL in 23%; sTfR > 2.3 mg/dL in 13%; and CRP > 0.5 mg/dL in 88%. Statistically significant correlations (r of Pearson; *p < 0.05, **p < 0.01) were obtained for serum CRP levels and WBC**, Hb*, TRF**, satTRF*, and FRT**. There was also a strong correlation between TRF and FRT (-0.650**), but not between FRT and satTRF or SI. LIS correlated with Hb*, CRP**, TRF*, satTRF* and FRT**. CONCLUSIONS: A large proportion of critically ill patients admitted to the ICU presented the typical functional iron deficiency (FID) of acute inflammation-related anaemia (AIRA). This FID correlates with the inflammatory status and the length of stay at the ICU. However, 21% of the ICU patients with AIRA had an associated real iron deficiency (satTRF < 20; FRT < 100 and sTfR > 2.3). Since oral supplementation of iron seems to be ineffective, all these patients might benefit of iv iron therapy for correction of real or functional iron deficiency, which in turn might help to ameliorate their inflammatory status.

Anemia↗

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Pseudomyxoma peritonei: a clinicopathologic analysis and follow-up of 21 patients.

BACKGROUND/AIMS: Pseudomyxoma peritonei is an uncommon disease characterized by the presence of mucinous peritoneal implants associated with an abdominal neoplasm. Our objective is to consider the characteristics of this entity in our western Mediterranean urban population. METHODOLOGY: All cases diagnosed with pseudomyxoma peritonei by our hospital during a period of 16 years were reviewed. Data from their clinical records and the biopsy samples were analyzed. RESULTS: We found 21 cases of pseudomyxoma peritonei with a male/female ratio of 10/11 and a mean age of 59 years. The predominant presentation symptom was abdominal pain (17 cases, 6 of them with acute abdomen). The most frequent primary site of origin of the pseudomyxoma was the appendix (10 cases). The histologic diagnosis was malignant (associated with carcinoma) in 17 cases and indeterminate behavior in 4. The follow-up was available for 15 patients (mean follow-up of 41 months), while six patients have been lost. Nine patients have died during the follow-up and the other 6 patients are still alive after follow-up. CONCLUSIONS: Laparotomy is the main tool for diagnosing pseudomyxoma peritonei. The appendix is the most frequent primary site of origin of pseudomyxoma peritonei, followed by bowel; the latter being more important than previously described. In most cases the histology is malignant. The prognosis is bad with a mortality greater than 60% at 5 years.

Adult↗

PubMedDate not supplied

Breast cancer and diet in Spain.

Breast cancer is the foremost cause of cancer death in women. A possible relationship has been suggested between breast cancer and cholesterol-rich diets, although no clear link has been established till now. This is an epidemiological study of the evolution of breast cancer mortality in Spain during the period 1977 to 1985, and it was made in relation to the principal dietary components of this country. The study period involved has made it necessary to take into account the corresponding changes in demographic structure; thus, standardization or specific fitting permitted comparisons. Global energy consumption in Spain is under 150 kcal per person per day for 50% of the population, and less than 180 kcal per person per day for 98% (range: 140 to 162) during the study period involved. Low correlation values were observed in relating mean breast cancer mortality rates for the 50 Spanish provinces to the dietary components studied. However, the most significant correlations relate mean mortality rate to total lipids, fiber, cereals, and Vitamin C intake.

Breast Neoplasms↗

PubMedDate not supplied

Digestive cancer in relation to diet in Spain.

Dietary factors are widely considered to be largely responsible for the different cancer incidences observed in different populations. In the present study we investigated the possible influence of dietary habits on the incidence of digestive cancer in the provinces of Spain. Data on specific mortality due to digestive cancer corresponding to the period 1975 to 1985 were obtained from the Instituto Nacional de Estadística. Nutritional data on the different provinces were in turn gathered from the Instituto de Nutrición del Consejo Superior de Investigaciones Científicas. The information was processed by the SPSS statistical software package. Lifestyle and socio-cultural factors are found to influence dietary risk factors in digestive cancer, particularly among women. The most significant correlations with the different cancers studied corresponded to total energy intake (responsible for 27.4% of variance), animal fats, and smoked fish and coffee. The latter is related to oral and esophageal cancer in particular (responsible for 15.4% of variance). Consumption of carrots and frozen vegetables is responsible for 6.5% of variance, vs. 4.4% of variance for alcoholic beverages, sugar, and Vitamin D. Differences are noted between both the sexes and their relationship to the different cancers studied.

Adult↗

PubMedDate not supplied