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Biomedical subjects

M Moya

Publications and source records attributed to M Moya.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Abscess of the psoas muscle: analysis of 11 cases and review of the literature].

BACKGROUND: Abscess of the psoas muscle (AP) is an infrequent disease of difficult diagnosis, developing spontaneously (primary AP) or by extension of a subjacent infection (secondary AP). In recent years changes have been observed in its etiology, advances in its diagnosis and modifications in the treatment schedules. METHODS: The cases of AP diagnosed from 1983-1996 were retrospectively studied. RESULTS: The cases included 11 AP, 5 (45%) primary and 6 (55%) secondary, of which the source of origin were: spondylitis in four, sacroiliac arthritis in one and intestinal in another. The clinical presentation was characterized by its prolonged course (evolution of symptoms greater than 30 days in 64% of the cases), with the most frequent symptoms being flank/abdominal pain (82%) and hip/inguinal pain (45%), with fever being presented in only 36%. The diagnostic profitability of echography and computerized tomography (CT) were 57% (4/7) and 91% (10/11), respectively. One case was diagnosed with magnetic resonance. The causal microorganisms were: Mycobacterium tuberculosis (36% of the cases), Staphylococcus aureus (18%), polymicrobian flora (18%) and Salmonella enteritidis, Streptococcus intermedius and Escherichia coli in 9% each. Eight cases (73%) underwent percutaneous (5 cases) and surgical (3 cases) drainage, with the evolution being favorable in 10 (91%) and death in one despite adequate medicosurgical treatment. CONCLUSIONS: The clinical presentation of AP is often unspecific, thereby delaying its diagnosis, and thus, CT is the procedure of choice. The tuberculous etiology continues to be frequent in our environment. Ultrasonographic or CT guided percutaneous drainage is a valid therapeutic alternative versus surgery.

Adolescent↗
PubMed1998

[Absorptive pattern of individual fatty acids and total fat in full term babies. Its stability in the absence of lactose].

OBJECTIVE: Lactose absence implies a decrease in calcium absorption. If not absorbed, calcium soaps can be produced with the intestinal fatty acids. Absorption and retention of total fat, individual fatty acids, calcium, magnesium and phosphate have been compared between two groups of children, one fed with lactose free formula and higher levels of calcium (FSL) and the other with standard starting formula (FI). None of them had additional arachidonic or docosahexaenoic acids. PATIENTS AND METHODS: A randomized prospective study was made on 19 term newborn babies by means of metabolic balance measurement during an 8 day period (four days of a stabilization period on the formula, 3 days of the balance period and the final day for feces collection). Both groups were selected following the same criteria for gestational age, balance age, and weight and length at both time periods. Aliquos from the formula were collected daily, as well as all feces and urine during the balance period. Calcium and magnesium quantification of the corresponding ashed products was performed by means of atomic absorption, while Pi was with a colorimetric assay. Total fat was extracted by organic solvents and quantified by gravimetry. Lipid phase fatty acids were methylated, extracted and quantified by means of gas chromatography with a detector of flame ionization. RESULTS: Total fat content and the percentages of each fatty acid did not differ, only calcium concentration in FSL was slightly higher (64.9 +/- 6.9 vs 58.9 +/- 7.0 mg/100 g). No differences were found between groups in relation to ingestion, excretion and retention. The percentages of calcium and total fat retention, however, were slightly superior in the FI in relation to the FSL group. Ca: 68 +/- 22 mg/kg/d, 49 +/- 14% vs 56 +/- 23 mg/kg/d, 48 +/- 17% and total fat: 6.6 +/- 1.2 g/kg/d, 92 +/- 8% vs 6.8 +/- 1.5 g/kg/d, 90 +/- 9%. Absorption of MC fatty acids was 99% for C8. Linoleic and alfalinolenic acid showed an absorption of around 90% despite the big differences in their intake (10/1). Net retention of linoleic acid was 933 +/- 168 mg/kg/d (FI) and 963 +/- 190 mg/kg/d (FSL) and the amount of alpha-linolenic acid was 95 +/- 16 (FI) and 100 +/- 22 mg/kg/d (FSL). No correlation could be found between the amount of excreted calcium and the total amount of fat in feces or with any of the fatty acids studied. This was true for each group studied separately or when considered as a single group. CONCLUSIONS: The absorptive pattern of fatty acids in full term babies, when quantified did not show any conspicous alterations in relation to the accepted values of other ages. The absence of lactose (FSL) in a formula does not make any change in the absorption of total fat and the individual fatty acids when compared to lactose containing formula (FI), when these are present in the same proportions. Supplemented calcium in the formula without lactose could compensate for its lower absorbtion. The absorptive pattern of fatty acid in full term babies did not show any conspicuos alterations in relationship to the accepted values of other ages.

Absorption↗
PubMed1998

[Increase in the incidence of occipital plagiocephaly].

INTRODUCTION: The diagnosis and treatment of posterior plagiocephaly is one of the most controversial aspects of craniofacial surgery. PATIENTS AND METHODS: The purpose of this study is to describe a recent increase in the incidence of occipital plagiocephaly without synostosis in our hospital during the last 6 months. The shift in the referral patterns is roughly contemporaneous with the American Academy of Pediatrics recommendations regarding infant sleep position. The temporal coincidence of this increase with the recommendation to avoid the prone sleeping position, to reduce the risk of sudden infant death syndrome, suggests a possible causal relationship. If the association is causal, education regarding the need of head position rotation coupled with that for sudden infant death syndrome should obviate positional occipital plagiocephaly. CONCLUSIONS: The feature of true lambdoid synostosis versus those of deformational plagiocephaly secondary to positional molding are inadequately described in the literature and poorly understood; the differential diagnosis is important in relation to a conservative diagnostical and therapeutical intervention in patients with positional molding.

Craniosynostoses↗
PubMed1997

Influence of different levels of neonatal mild/moderate hypoxia-ischemia in learning abilities of rats at the age of one month.

We studied the effects of mild/moderate hypoxia-ischemia in 90 newborn Wistar rats divided into 3 groups. Two of the three groups were submitted to two different levels of hypoxia (FiO2 = 0.05, group F5 and FiO2 = 0.1, group F10) and the third to normoxia (FiO2 = 0.21, group F21) in a thermoneutral and controlled environment. We examined their influence in a maze test 1 month later after two training trials, a 48-hour fasting period and handling stress just before starting the trial. The learning ability in animals exposed to FiO2 = 0.1 was lower (significantly higher number of squares crossed F10 = 37.57 +/- 20.8) than the others (F21 = 26.22 +/- 19.25; F5 = 26.56 +/- 14.97; p = 0.0481), while group F5 had the best learning improvement measured by the reduction in wrongly crossed squares (F5 day 25 = 25.08 +/- 19.9; day 26 = 13.04 +/- 13.91; day 30 = 10.08 +/- 9.66; p = 0.0427). These differences in group F5 as well as the maze solution profile (defined by analysis of 15 variables considered) was significantly closer to the control group F21 than the less hypoxied group F10. We discuss whether these paradoxical results in learning abilities reflect the influence of the hypoxic levels to which the newborn animals were submitted, or to the effects of uncontrolled variables in this study.

Animals↗
PubMed1997

[Detection of cognitive deterioration in elderly patients attending an emergency hospital service].

BACKGROUND: An increasing proportion of patients attended at hospital emergence departments (HED) are elderly people. OBJECTIVES: a) To check the reliability of the usual medical assessment to detect the cognitive deterioration in elderly people attended at HED, compared with that performed systematically by means of an evaluation test of cognitive functions; b) to study the applicability of such a test in HED, on the basis of the time necessary for its administration, and c) to describe the deterioration prevalence in that group of patients and identify the possible associated risks for its detection in patients. PATIENTS AND METHODS: Prospective study including patients aged > or = 60 years attended at a HED, using the orientation, memory and concentration test (OMC) to perform the cognitive assessment. RESULTS: A total of 352 patients who had no exclusion criteria out of the 536 attended during the study period were included. Cognitive deterioration was not detected in 111 patients (31.5%); it was mild in 147 (41.8%), moderate in 71 (20.2%) and severe in 23 (6.5%). In patients with moderate-severe deterioration according to the OMC test, such a deterioration was detected by the usual medical evaluation in 7% of cases. The mean time in completing the test was 2.6 +/- 0.9 minutes. An age > or = 80 years was associated with an increased relative risk for detecting moderate-severe cognitive deterioration (1.98; 95% CI, 1.42-2.78; p < 0.001), whereas the discharge diagnosis of respiratory disease was associated with a decrease of the relative risk (0.41; 95% CI, 0.19-0.89; p < 0.05). No association was observed with other factors, such as gender, home residence or final destination from the emergency department. CONCLUSIONS: The prevalence of cognitive deterioration in elderly people attended at HED is high and increases with age. The OMC test can be administered at HED to detect cognitive deterioration, which is not frequently detected by the usual medical assessment.

Age Factors↗
PubMed1997

[Perinatal differences in asphyxic full-term newborns in relation to the presence of hypoxic-ischemic encephalopathy].

OBJECTIVE: To study the perinatal differences of full-term newborn infants with perinatal asphyxia in relation to their neurologic manifestations (postasphyctic encephalopathy). MATERIAL AND METHODS: Prospective epidemiologic study over perinatal asphyxia in full-term infants born in our hospital between november 1991-february 1995. Perinatal asphyxia was graded as non-severe (first minute Apgar score < or = 6 and/or umbilical artery pH < 7.20, with abnormal fetal heart rate patterns and/or meconium stained amniotic fluid, and the need for immediate neonatal resuscitation) and severe (first minute Apgar score < or = 3 and umbilical artery pH < 7.10). Hypoxic-ischemic encephalopathy was graded as mild, moderate and severe based on classification of Levene and Sarnat & Sarnat. The perinatal variables were graded as prenatal (gestationals and obstetrics), neonatal (resuscitation, general data of the newborn, and organic manifestations of asphyxia) and postneonatal (neurologic sequelae at follow-up). RESULTS: During the study period there were 3,342 full-term, live births. Perinatal asphyxia developed in 156 (31 severe and 125 non-severe). Neurologic manifestations were present in 25.6% of asphyxiated newborns: 40 cases of hypoxic-ischemic encephalopathy (mild in 30, moderate in 5 and severe in 5). The main differences between asphyxiated newborns with and without hypoxic-ischemic encephalopathy were: chronic maternal diseases, pathologic obstetric antecedents, distocic deliveries, neonatal resuscitation, severity of perinatal asphyxia, sex and weight of newborns, days and origin of admission, birth injury, extraneurologic manifestations (mainly pulmonary, digestive, haemodynamic and cardiologic) during neonatal period, and neurologic sequelae at follow-up. CONCLUSIONS: The main perinatal differences in relation to postasphyctic encephalopathy are important in the knowledgement of their pathogenic mechanism (interrelation between neurologic and extraneurologic manifestations) and their follow-up (hypoxic-ischemic encephalopathy is the most important prognostic factor of neurologic sequelae in the full-term asphyctic newborn).

Apgar Score↗
PubMed1997

[Early infantile epileptic encephalopathy and glycine encephalopathy].

INTRODUCTION: Early infantile epileptic encephalopathy (EIEE) with suppression burst activity in EEG (Ohtahara syndrome) is a rare type of epileptic encephalopathy in infancy and represents the earliest type of age-related symptomatic generalized epilepsy. The main etiologic factors associated to EIEE are cerebral dysgenesia and metabolopathies, principally nonketotic hyperglycinemia. CLINICAL CASE: We report a neonate with EIEE secondary to glycine encephalopathy, diagnosed by increased of LCR/plasma glycine index.

Brain Diseases↗
PubMed1996

[Perinatal asphyxia, hypoxic-ischemic encephalopathy and neurological sequelae in full-term newborns: an epidemiological study (1)].

INTRODUCTION: Perinatal asphyxia, and its neurologic manifestations (hypoxic-ischemic encephalopathy) is the most important cause of brain injury and neurologic sequelae in full-term infants. OBJECTIVE: The aim of this study was to know the incidence of perinatal asphyxia, hypoxic-ischemic encephalopathy and neurologic sequelae in our full-term infants. MATERIAL AND METHOD: Prospective epidemiologic study of perinatal asphyxia in full-term infants born in Universitary Hospital San Juan (Alicante, Spain) between November 1991-February 1995. Perinatal asphxyia was graded as non severe (1-minute Apgar score < or = 6 and/or umbilical artery pH < 7.20, with abnormal fetal heart rate patterns and/or meconiumstained amniotic fluid, and the need for immediate neonatal resuscitation) and severe (1-minute Apgar score < or = 3 and umbilical artery pH < 7.10). Hypoxic-ischemic encephalopathy was graded as mild, moderate and severe based on classification of Levene and Sarnat & Sarnat. Neurologic sequelae in 12-24 months follow-up was graded as mild, moderate and severe based on classification of Finer and Amiel-Tison. RESULTS: During the study period there were 3.342 full-term, live births. Perinatal asphyxia developed in 156 (31 severe and 125 non-severe), with an incidence of 4.66 cases per 100 full-term newborns. Neurologic manifestations was present in 25.6% of 156 term infants with perinatal asphyxia: 40 cases of hypoxic-ischemic encephalopathy (mild in 30, moderate in 5 and severe in 5). The incidence of hypoxic-ischemic encephalopathy was 1.19 cases per 100 full-term infants. The asphyctic newborns were regularly assessed. Ten infants was lost to follow-up. The incidence of neurologic sequelae, in 115 asphyxiated full-term infants follow-up at least 12-24 months, was 16.5%. CONCLUSIONS: Despite the widespread use of the term perinatal asphyxia, there is little uniformity on the clinical definition of asphyxia, which makes comparison of incidence, treatment and outcome very difficult. The main epidemiologic differences in the studies of perinatal asphyxia and hypoxic-ischemic encephalopathy are due to little agreement on their definition. A consensus is necessary.

Apgar Score↗
PubMed1996

[Perinatal asphyxia, hypoxic-ischemic encephalopathy and neurological sequelae in full-term newborns. II. Description and interrelation].

INTRODUCTION: There have been several attempts to relate either perinatal asphyxia at birth or abnormal neurological findings after asphyxia in neonatal period (hypoxic-ischemic encephalopathy), to outcome. OBJECTIVE: To investigate, in full-term infants, the relation between perinatal asphyxia, hypoxic-ischemic encephalopathy and neurologic sequelae at follow-up, and to define the main neurologic sequelae (cerebral palsy, mental retardation, neonatal death). Material and method. Prospective epidemiologic study over perinatal asphyxia in term neonates born in Universitary Hospital San Juan (Alicante, Spain) between November 1991-February 1995. Perinatal asphyxia was graded as non severe (1-minute Apgar score < or = 6 and/or umbilical artery pH < 7.20, with abnormal fetal heart rate patterns and/or meconium-stained amniotic fluid, and the need for immediate neonatal resuscitation) and severe (1-minute Apgar score < or = 3 and umbilical artery pH < 7.10). Hypoxic-ischemic encephalopathy was graded as mild, moderate and severe based on classification of Levene and Sarnat & Sarnat. The abnormalities on psicomotor development are based in the neurologic 'alert signs' and in the neurologic sequelae; this sequelae was graded as mild, moderate and severe based on classification of Finer and Amiel-Tison. The relationships between these variables are studied by univariant and multivariant analysis (Cox's regression). RESULTS: The incidence of neurologic sequelae, in 115 asphyxiated full-term infants follow-up at least 12-24 months, was 16.5%; 4 cases of severe sequelae, 4 moderate and 11 mild. The overall asphyxia-related infant mortality rate was 0.87/1.000 live births. The main sequelae detected at follow-up was motor disability, and other disabilities like mental retardation, epilepsy, sensorial defects, were infrequents. The incidence of cerebral palsy was 0.87/1.000 live births, and 2.6% asphyctic term neonates. We found a statistically significant (p < 0.001) association between severity of perinatal asphyxia and/or evidence of hypoxic-ischemic-encephalopathy and the neurological development at follow-up. Of the several factors associated to risk of neurologic sequelae on univariant analysis, only two were independently associated on multivariant analysis: severe perinatal asphyxia (RR = 2.82; IC = 1.07-7.39) and postasphyctic encephalopathy (RR = 4.17; IC = 1.48-11.75). CONCLUSIONS: Most survivors of perinatal asphyxia do not have adverse sequelae. The best predictive tool for the neurological prognosis at follow-up was severe perinatal asphyxia at birth and evidence of encephalopathy in neonatal period. Our study confirm that perinatal asphyxia is infrequently the cause of cerebral palsy and mental retardation.

Asphyxia Neonatorum↗
PubMed1995

Nonimmediate reactions to betalactams: prevalence and role of the different penicillins.

In patients treated with penicillins, adverse cutaneous reactions can occur within minutes or may take several days to develop. IgE antibody-mediated reactions are well documented, but other mechanisms may also be involved. In particular, nonimmediate reactions have not been studied extensively, and the purpose of the present work was to establish the incidence of such reactions among a large group of patients and to study the penicillins involved. A total of 380 subjects with a history of a cutaneous reaction following administration of a penicillin antibiotic was included in the study. Skin tests and specific IgE measurements (RAST) were carried out using various penicillins and penicillin-related reagents, and patients were also challenged with various penicillins. In some patients with delayed skin test responses, skin biopsies were carried out. The tests confirmed that 74 subjects (19.4% of total investigated) had suffered a cutaneous reaction to a penicillin derivative, and 29 of these subjects (7.6% of total or 39% of confirmed) showed evidence of having suffered a nonimmediate reaction. The latter group were identified by giving a positive delayed direct challenge, and in 65% of the cases a delayed skin test response was detected. In most cases, these responses were to amino penicillins. Skin biopsies showed a lymphomonocytic cell infiltrate. Nonimmediate reactions to penicillins are a reproducible phenomenon, suggesting that a specific mechanism is responsible. By direct challenge, 93% of responders were positive to amino penicillins (10.3% ampicillin, 82.7% amoxicillin), indicating a major role for these penicillins in nonimmediate reactions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗