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Biomedical subjects

M Palma

Publications and source records attributed to M Palma.

53 records · Page 3Linked to original sources
PubMed1993

[Damage from reperfusion: no-reflow phenomenon].

It is well known that rapid myocardial reperfusion, obtained using thrombolysis and/or PTCA, continues to be the best treatment for evolving myocardial infarction. However, a number of experimental studies have drawn attention to the fact that myocardial recovery following reperfusion may be limited by the onset of numerous deleterious biochemical events which occur during reperfusion. Studies carried out after thrombolysis have shown that the perviousness of the vessel and the existence of flow at the level of the epicardial vessels do not necessarily correspond to the recovery of tissue perfusion since a perfusion defect may persist in the presence of angiographically documented anterograde flow. This discrepancy, which occurs during reperfusion, has been attributed to marked cellular enlargement caused by ischaemia both in irreversibly damaged areas and in those which may potentially recover. In basal conditions, endothelial-neutrophil interaction is inhibited by negatively charged molecules present on endothelial cell membranes and by the production of numerous anti-inflammatory substances. During ischemia, on the other hand, anti-inflammatory and endogenous vasodilating substances are depleted in association with the appearance, on the surface of endothelial cells, of molecules favouring leukocyte adhesion. Of these the glycoprotein which has been characterized in greatest detail is the endothelial leukocyte adhesion molecule (ELAM 1) whose production and appearance on the endothelial surface is linked to cytokine-dependent endothelium activation. Ischemia may also stimulate the activation of neutrophils secreting chemiotactical and vasoconstricting factors, and cytotoxic compounds (reactive oxygen metabolites and proteolyte enzymes).(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Adhesion Molecules↗
PubMed1993

[Hemodynamic and functional hepatic effects of isosorbide-5-monitrate in cirrhotic patients with portal hypertension].

Isosorbide 5-mononitrate reduces portal pressure in acute conditions. The aim of this work was to assess its effects and tolerance development after 30 days of use in alcoholic cirrhotic patients without history of variceal bleeding. Nine patients with portal hypertension (7 with esophageal varices) were studied. Hepatic and systemic hemodynamic parameters were measured in basal conditions, after one hour and after 30 days of treatment (40 mg b i d). One patient was lost from control at 2 weeks. In the total group, portal pressure decreased from 15.1 +/- 3.7 mm Hg to 12.1 +/- 5 at one hour and 11.3 +/- 5.5 mm Hg at 30 days (p < 0.002). In two patients, portal pressure was not modified. Portal blood flow increased significantly at one hour in the 7 responder patients. Hepatic blood flow (indocyanine green clearance) was not modified; thus, estimated hepatic resistance decreases in both periods. Intrinsic indocyanine green clearance (a measure of hepatic function) did not change in any period. Systemic blood pressure decreased and cardiac rate increased only after one hour. The fall in portal pressure did not correlate with changes in portal or hepatic blood flow. It is concluded that isosorbide 5-mononitrate decreased portal pressure in 7 out of nine patients, even after 30 days of treatment, without untoward effects over hepatic function or perfusion.

Adult↗
PubMed1993

Effects of short-term oral digoxin on left ventricular diastolic filling in patients with ventricular dysfunction. An echo-Doppler study.

34 patients with ventricular dysfunction (18 in NYHA class II and 16 in NYHA class III heart failure) whose clinical status was stabilized by diuretics and systemic vasodilators, entered a randomized trial to compare the effects of short-term oral digoxin and active placebo on left ventricular diastolic function, non invasively evaluated by echo-Doppler transmitral left ventricular filling flow. At baseline patients were subdivided by reversal--the ratio of peak early (E) and late (A) transmitral filling velocities--E/A < 1 (group I) or normal--E/A > or = 1 (group II) echo-Doppler E/A ratio; group II exhibited a shorter deceleration time (125 +/- 20 ms vs 198 +/- 38 ms, p > 0.05) and isovolumic relaxation time (64 +/- 15 ms vs 93 +/- 10 ms; p < 0.05) as well as a higher peak E velocity (85 +/- 28 cm/s vs 54 +/- 20 cm/s; p < 0.05), ("restrictive" left ventricular filling pattern). After 4 weeks, no changes in all echo-Doppler parameters were noted in group I in response to either oral digoxin or active placebo. Clinical amelioration (defined as reduction by at least one functional class) was observed in 3 patients after digoxin.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1992

Left ventricular diastolic function with epirubicin therapy: an echodoppler study.

Thirty patients undergoing epirubicin therapy for primary lung cancer were studied by echocardiography and Doppler echocardiography. 2 D ejection fraction (EF) and Doppler left ventricular filling parameters (peak E, peak A, E/A ratio) were calculated before and after the completion of therapy. No differences in the mean values of these parameters were observed. However, 6 out of 30 patients (20%) showed left ventricular filling abnormalities; in 2 of them a slight reduction of EF was also noted. These abnormalities seem to be dose related. A longer term prospective study will be required to evaluate whether these findings are irreversible and to establish the clinical implications of our observations.

Adult↗
PubMed1990

[Tachyarrhythmia caused by paroxysmal atrial fibrillation following heat stress].

The Authors describe a case of paroxysmal atrial fibrillation, in young patients with apparently healthy hearts due to heat stress and expound the pathogenetic mechanisms. They point out the importance of a complete cardiologic examination: sometimes paroxysmal atrial fibrillation is an initial symptom of silent cardiovascular disease.

Adult↗
PubMed1990

[Staging of spinal metastasis using special techniques of magnetic resonance imaging].

The diagnosis of spine metastasis is a problem of great interest which leaves many questions unanswered. In this field MR imaging plays a fundamental role, as the only technique able to directly demonstrate the changes in bone marrow tissue, bound to tumoral activity. The introduction of gradient-echo (GE) sequences has helped reduce examination time. Moreover, with the accurate choice of pulse-sequence parameters (TR, TE, flip angle) additional information is acquired which is not yielded by conventional spin-echo (SE) sequences. Our study was aimed at evaluating MR sensitivity in the different stages of bone metastatic evolution. The comparative adequacy was evaluated of combined bone scintigraphy and conventional radiology versus MR imaging in 62 patients with vertebral metastases. Time interval between bone scan and/or radiological study and MR exam ranged from 10 days to 8 months. SE and GE T1-weighted images, and SE and GE T2-weighted images on the sagittal plane were employed, and axial images; coronal images were rarely acquired. Metastases were demonstrated by MR imaging at 122 vertebral levels, versus 88 true positives of combined scintigraphy and conventional radiology. Scintigraphic false-positives were observed at 15 vertebral levels, versus 9 with radiography. GE sequences were superior to SE ones in detecting vertebral morphologic lesions and bone marrow involvement thanks to their improved resolution and sensitivity. Moreover, GE sequences demonstrated tumoral bone marrow spread and persistent tumoral activity in the follow-up of spine metastases. Our results point to GE sequences as those of choice because of their higher resolution and sensitivity, which also allow response to treatment to be evaluated.

Humans↗
PubMed1989

[Trichomonas vaginalis infection in pregnant women and newborn infants].

We studied 149 pregnant women at delivery and 113 newborns in order to determine the frequency of T vaginalis infection. Neutral red stain, dark field microscopy and culture methods were used with comparable yields. The age of women ranged from 12 to 43 years. A 27.5% infection rate was detected in mothers but all newborns were free from infection. Infection rates in relation to age among mothers confirmed previously reports.

Adolescent↗
PubMed1984

[Effects of a municipal immunization program on the vaccination coverage in a school population].

We report the results of a Municipal Immunisation Program in a industrial community. These results were evaluated through the School Health Program. Our immunisation policies resulted in a substantial increase of immunity covering with particular impact on the less wealthy social layers. Immunity rats rose from 32% to 71% of the population. We conclude that our program is an adequate policy for control of infection diseases.

Adolescent↗
PubMedDate not supplied

Imaging studies in partial epilepsy in children and adolescents.

We reviewed the results of imaging studies on 111 children and adolescents with partial epilepsy to determine which imaging procedure had the greatest sensitivity and specificity for partial epilepsy in this age range. All cases were classified as idiopathic, lesional, and cryptogenic epilepsy based on the 1989 International League Against Epilepsy Classification. All patients had magnetic resonance imaging (MRI) and 98 also had computed tomography (CT). Thirty patients with negative CT had MRI lesions that were most likely the cause of the epilepsy, and the initial diagnosis of cryptogenic partial epilepsy was changed to lesional partial epilepsy. We concluded that CT use is unwarrantedly common. MRI should be considered the procedure of first choice. CT has a complementary role, and functional neuroimaging should be encouraged.

Adolescent↗
PubMedDate not supplied

Fulminant hepatic failure caused by diffuse intrasinusoidal metastatic liver disease: a case report.

A 53-year-old woman experienced rapidly progressing liver failure four years after a quadrantectomy for a breast carcinoma. She had received adjuvant chemotherapy and radiotherapy, and second-line chemotherapy for bone metastasis one year earlier. The hepatic failure manifested with ascites, jaundice, elevation of serum bilirubin and hepatic enzyme levels and hypoalbuminemia. Imaging studies showed an enlarged liver without metastatic lesions. The patient died of hepatic decompensation within two weeks. Liver examination at autopsy revealed massive neoplastic infiltration consistent with a primary breast carcinoma. It is important to realize that this unusual pattern of liver metastasis cannot be demonstrated even with the most advanced techniques of instrumental diagnosis (CT scan, ultrasonography and magnetic resonance imaging), and should be taken into account in the differential diagnosis of rapidly progressing liver failure.

Autopsy↗
PubMedDate not supplied

[Chorea in hemodialysis: Is chorea just a neurological syndrome or is it related to uremia or dialysis?].

Chronic renal failure and haemodialysis patients are prone to develop encephalopathy. The causes of encephalopathy are often unclear. Clinical signs of encephalopathy in the uraemic patient often overlap with several other affections causing neurological disorders. Whenever basal ganglia are anatomically involved, movement disorders arise, including chorea. Some acute and chronic neurological syndromes associated with chronic uraemia have consistently been reported (uraemic encephalopathy, dialysis disequilibrium syndrome, dialysis dementia, nephroangiosclerosis neuropathy and ageing neuropathy). Other clinical conditions in which neurological involvement exists are not so frequent in both haemodialysis patients and in the general population (Wernicke's encefalopathy, Creutzfeldt-Jacob disease). Because of the non specific symptoms and the very heterogeneous aetiology, a careful physical examination should be performed in haemodialysis patients with clinical signs of encephalopathy and the main metabolic alterations should be sought; moreover, central nervous system imaging examination is often appropriate. In case of basal ganglia anatomical involvement, supported by findings of imaging techniques, it is necessary to evaluate individual causes of encephalopathy by means of more accurate tests including analysis of cerebro-spinal fluid, measurement of plasma levels of vitamin B components and laboratory tests searching for more uncommon diseases such as Huntington's chorea and Wilson's disease.

Aged↗
PubMedDate not supplied

[Poor digestion and intolerance to lactose in Mexican adults. Importance of evaluating them with regular doses of milk].

Lactose digestion capacity after ingestion of habitual doses of milk and its effect on milk intolerance and consumption were studied in 205 mexican adults. In a double-blind study, subjects received two treatments involving the intake of 360 mL of intact whole milk and the same amount of 90% lactose-hydrolyzed milk. Lactose maldigestion was determined by the hydrogen breath analysis test and was detected in 31.5% of the subjects. Symptoms of milk intolerance were present in only 9.5% of the study population. The prevalence lactose maldigestion and intolerance in mexican adults is lower than previous values reported using pharmacological doses of lactose. No effect of lactose intolerance on habitual consumption of milk was detected.

Adolescent↗