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Biomedical subjects

M Román

Publications and source records attributed to M Román.

At least 19 recordsLinked to original sources
PubMed2003

Stress fractures of the femoral neck and coxa vara.

BACKGROUND: Theoretically, coxa vara substantially modifies the biomechanical conditions of the femoral neck, increasing the effect of direct muscle pull and leading to fatigue of opposing muscle groups; such modifications would appear to favour the appearance of stress fractures. METHODS: We studied 22 stress fractures of the femoral neck, 12 in patients with coxa vara (group A) and 10 in patients with a normal neck-shaft angle (group B), to assess the possible influence of the femoral angle in the production of stress fractures. RESULTS: Intergroup differences were found for age at the appearance of the fracture (younger patients in the coxa vara group) and symptom duration (longer in group A). CONCLUSIONS: It is suggested that coxa vara predisposes to femoral neck stress-fracture.

Aged↗
PubMed2001

Stress fracture of the femoral neck in a child. Case report and review of the literature.

Fatigue fractures generally appear in normal bone following increased repetitive activity or strenuous exercise, when imbalance occurs between applied force and elastic resistance. Femoral neck fatigue fractures are most common in athletes and young military recruits; such fractures in children with open physes are very rare. This paper reports a fatigue fracture of the femoral neck in an 8-year-old girl presenting with pain in the anterior aspect of the right thigh, of one month duration and without evidence of previous injury. Bed rest and relief of weight bearing are indicated for nondisplaced compression fractures. Surgical treatment is indicated for tension fractures. In most cases, the outcome is favorable, and complications are rarely reported.

Bed Rest↗
PubMed1999

[Aortic valve replacement with a pulmonary autograft (the Ross operation) in adult and pediatric patients. A preliminary study].

INTRODUCTION AND OBJECTIVES: Aortic valve replacement with the patients own pulmonary autograft (the Ross procedure) is by now, the best surgical method for the replacement of the diseased aortic valve in certain groups of patients, this is particularly true for young adults and children or neonates with complex left ventricular outflow tract obstructions. The procedure was described by Donald Ross in 1967, and many years have passed. So in view of the accumulated experience the indications have extended to a wide group of patients which include children, neonates and young adults with formal contraindications for anticoagulation. In this publication we present our experience and our preliminary results in a group of fifteen patients which include adult and pediatric. MATERIAL AND METHODS: In six patients the etiology of lesion was congenital and in the remainder nine the valve had an acquired lesion. Two patients had an open heart procedure before this operation both of them to relieve an obstruction to the left ventricular outflow tract. In this group of patients the Ross procedure was carried out inserting the pulmonary autograft in the aortic position as a total root which was always reconstructed with cryopreserved pulmonary homograft, the mean homograft diameter was 26.1 +/- 4 mm (19-35). RESULTS: In all patients a transesophageal echocardiogram was performed in the operating room and postoperative, 1 or 2 months later. Only in one patient a mild aortic regurgitation was detected, no significant transaortic or transpulmonary gradients were detected postoperative. One patient was reoperated for bleeding in the postoperative course, there was no hospital mortality in our group and all the patients had an uneventful postoperative period. In the short term follow-up (41-155 days). All the patients are free of anticoagulant therapy, all them are in New York Heart Association Functional Class I. CONCLUSIONS: The patients presented in this publication which include adult and pediatric, are the first group of patients operated in our country with some excellent preliminary results. We hope that this procedure will become popular and that other surgical groups will adopt it as another surgical tool to replace a diseased aortic valve.

Adolescent↗
PubMed1997

Respiratory syncytial virus infection in infants is associated with predominant Th-2-like response.

Viral infections have been associated with cellular immune responses and production of Th-1 cytokines. Respiratory syncytial virus (RSV), however, induces virus-specific IgE, which might be a consequence of a Th-2-like activation. To test this hypothesis we quantified interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) in the supernatant of peripheral blood mononuclear cells cultured for 24 and 48 h in the presence or absence of phytohemaglutinin and pokeweed mitogen and the lymphocyte phenotypes to analyze subsets and their activation markers, from 15 hospitalized infants during an acute lower respiratory infection caused by RSV and 17 healthy control infants from 1 to 15 mo of age. Compared with the control infants, those infected with RSV had an increase in the number of B-cells (p < 0.02) and decreases in both CD8+ T-cells (p < 0.01) and activated CD8+/CD25+ suppressor/ cytotoxic T-cells (p < 0.007). In RSV-infected infants, IFN-gamma production was subtotally suppressed, whereas IL-4 production was decreased to a lesser degree, giving significantly (p < 0.001) increased IL-4/IFN-gamma ratio compared with that in the control infants. These findings suggest a predominant Th-z-like response in RSV-infected infants, which could explain some aspects of the immunopathogenesis of RSV infection and the RSV-specific and nonspecific IgE antibody responses observed.

Antigens, Viral↗
PubMed1993

Relaxation by calcium antagonists of potassium-contracted trachea from normal and sensitized guinea-pigs: influence of epithelium and the surface of drug entry.

A technique by which drug access was restricted to either the mucosal or the adventitial surface of tracheal rings, isolated from normal (unsensitized) or sensitized guinea-pigs, was used to study the role of the epithelium in the relaxation produced by calcium antagonists (verapamil, nifedipine, cinnarizine and flunarizine) of K(+)-induced contraction. In trachea from normal guinea-pigs, the relaxation to verapamil for unrestricted or mucosal drug entry was reduced in the absence of epithelium, whereas the relaxation produced by nifedipine, cinnarizine or flunarizine was unchanged. In sensitized trachea, the relaxation elicited by the calcium antagonists tested was similar in intact and epithelium-denuded tracheal rings irrespective of the surface of drug entry. These results confirm that the epithelium influences the relaxation to verapamil. This modulatory effect is absent in sensitized trachea and is not shared by other calcium antagonists.

Animals↗
PubMed1993

[Orthotopic heart transplant. Study of early morbimortality (< or = 30 days). Experience at the Reina Sofía Hospital (Córdoba)].

From may 1986 to december 1991, we have performed 90 heart transplantation in the Hospital "Reina Sofía" from Córdoba. In the present study we analyze the early morbidity and mortality in a retrospective study on complications and factors determining its incidence. Seventy patients were male (86%) and 13 female (14%). Age ranged from 12 and 65 years. The 31% of patients needed in pharmacological support before transplantation, 15 of them were operated in a emergency situation because of cardiogenic shock. The pulmonary resistances oscillated between 0.5 and 8.7 units/m2 (Wood) (mean 2.5 +/- 1.4 units/m2). The mean time of ischaemia was 136 +/- 38 minutes (range 5-255 min). Hospital mortality (< or = 30 days) was 8.8% (8/90). No predictive factors from donor and recipient were found. Three main influences on complications were analyzed: a) influence of myocardial temperature, b) role of hematic cardioplegia, and c) usefulness of Aprotinin. Eighteen patients (20%) developed severe bradyarrhythmia needing a pacemaker in the post-operative period. We found a significant relationship with myocardial temperature (4.3 +/- 2.1 vs 6.2 +/- 2.6; p < 0.05) and transport solution temperature (5.8 +/- 2.3 vs 7.3 +/- 1.9; p < 0.05). No significant influence was found on the time of ischaemia, previous heart disease, previous treatment with Amiodarona, clinical condition, etc.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Epithelium modulates the reactivity of sensitized guinea-pig trachea: influence of the surface of drug entry.

A technique by which drug access was restricted to either the mucosal or the adventitial surface of tracheal rings isolated from sensitized guinea-pigs was applied to study the role of the epithelium in modulating responses to KCl, acetylcholine, histamine and antigen (bovine serum albumin, BSA). Epithelium removal did not alter the responsiveness or sensitivity of tracheal rings to KCl. In contrast, a leftward shift occurred for concentration-response curves to acetylcholine (concentration ratio (CR) = 4.1), histamine (CR = 2.9) and BSA (CR = 33.9) entering from the mucosal surface of de-epithelialized trachea. This shift was not associated with changes in the maximal effect of the spasmogens. Response to the adventitial entry of these spasmogens was not altered by epithelial stripping. These results confirm that the epithelium modulates tracheal responses to certain spasmogens including antigen challenge. This role was exclusively exerted for mucosal drug entry. The mechanism underlying this protective effect of epithelium remains to be determined.

Acetylcholine↗
PubMed1991

[Myocardial revascularization and complete correction of tetralogy of Fallot in an adult. A case report].

The case is reported of a 62 year-old male having a clinical history of grade II dyspnoea from 9 year ago and recently showing grade II angina. He had presented mild cyanosis. Suspecting the existence of coronary arteriosclerosis, and with the clinical diagnosis of tetralogy of Fallot based particularly on two-dimensional and M-mode echocardiography, and angio-hemodynamic study was made which confirmed the presence of congenital heart disease and also revealed significant coronary lesions of the circumflex and right coronary arteries. The patient underwent surgery which involved complete correction of the tetralogy of Fallot and the placing of two aortocoronary grafts onto the circumflex and right coronary arteries. Favorable progress was noted both immediately after operation and 6 months later. Although cases have been described of Fallot disease associated with acute myocardial infarction, we believe that this is the first time a patient has undergone myocardial revascularization at the same time as undergoing complete correction of the congenital heart disease.

Coronary Artery Bypass↗
PubMed1990

Role of epithelium in agonist-induced contractile responses of guinea-pig trachealis: influence of the surface through which drug enters the tissue.

1. A method has been used in guinea-pig isolated tracheal rings to achieve selective drug entry from the adventitial or mucosal surface. A study has been made of the effects of epithelium removal on responses to spasmogens entering the tissue solely from the adventitial or the mucosal surface. 2. Cumulative concentration-response curves for KCl (1 to 100 mM), acetylcholine (0.1 microM to 10 mM) and histamine (1 microM to 1 mM) were constructed in intact and epithelium-denuded tracheal rings in circumstances where drug entry was unrestricted or restricted to the adventitial or mucosal surface. 3. Epithelium removal did not alter the responsiveness or sensitivity of tracheal rings to KCl either when drug entry was unrestricted or when drug entry was restricted to the adventitial or mucosal surface. 4. When acetylcholine entered from the mucosal or adventitial surfaces of intact tracheal rings its concentration-response curve was displaced to the right with respect to that obtained for unrestricted drug entry. A greater rightward shift was observed for mucosal drug entry than for adventitial drug entry. Epithelium removal potentiated acetylcholine entering from the mucosal surface to a greater extent (27.5 fold) than it potentiated acetylcholine entering from both surfaces (4 fold). Epithelium removal did not potentiate effects of acetylcholine entering from the adventitial surface alone. 5. In intact tracheal segments, concentration-response curves for histamine entering from the mucosal surface were displaced to the right compared with those for histamine entering in an unrestricted fashion or from the adventitial surface alone. This displacement was absent in epithelium-denuded preparations. Epithelium removal potentiated (2-3 fold) histamine entering from the mucosal surface or entering in an unrestricted way. It did not potentiate histamine entering from the adventitial surface alone. 6. Our findings suggest that the epithelium does not modulate tracheal responses to KC1. Its ability to modulate responses to acetylcholine and histamine is observed when these spasmogens enter the tissue from the mucosal surface but not when they enter from the adventitial surface. The mechanism by which epithelium removal preferentially potentiates acetylcholine and histamine entering from the mucosal rather than the adventitial surface remains to be determined.

Acetylcholine↗
PubMed1990

Immunoreactivities for Entamoeba histolytica in patients with amebic liver abscesses.

We defined the major specificities of antibodies present in sera from patients with amebic liver abscesses, diagnosed by gamagrafia. These immune reactivities were analyzed against plasma membrane and extract antigens of Entamoeba histolytica, resolved by electrophoresis and blotted to nitrocellulose scheets. We observed that each of the 26 patients revealed a distinct pattern in the plasma membrane and in the total extract preparations. Most of these sera detected a prominent plasma membrane polypeptide of 166 kDa. We also observed that the same pattern of specificities persisted in the patients sera for six months after treatment.

Animals↗
PubMed1990

A comparison of repair and replacement for mitral stenosis with partially calcified valve.

From January 1978 to December 1987 we operated on 135 patients with calcified mitral stenosis. In 60 patients a conservative operation was performed (group I). Nine patients required mitral annuloplasty associated with the commissurotomy. The other 75 patients underwent mitral valve replacement (group II). In 37 patients a mechanical prosthesis was used and in 38 a biologic one. The patients given mitral valve replacement had a more heavily calcified valve than those undergoing a conservative procedure. Twenty-one patients (12 from group I and 13 from group II) required associated tricuspid annuloplasty. The mean follow-up time was 69.1 months (1 months to 10 years). There were no significant differences between the two groups in terms of operative death (0% and 4%, respectively), postoperative functional class, actuarial survival rate at 10 years (84% and 96%, respectively), and probability of freedom from thromboemboli at 10 years (98% and 96%, respectively). However, the probability of freedom from reoperation at 10 years significantly favored the conservative surgery group (84% and 69%, respectively, p less than 0.01). Finally, the probability of freedom from complications at 10 years was also significantly higher in the conservative surgery group (82% and 64%, respectively, p less than 0.005). Because of these results we believe that conservative surgery is, at present, a better alternative than mitral valve replacement for patients with partially calcified mitral stenosis.

Actuarial Analysis↗
PubMed1989

Neurocysticercosis. Short course of treatment with albendazole.

Eighteen patients with nonenhancing parenchymal brain cysts were treated with albendazole; 9 patients were treated for 3 days and 9 patients for 1 month at daily doses of 15 mg/kg of body weight. Three months after starting therapy, results showed that in both groups the treatment was highly effective. Control studies carried out in the same group before the trial did not show any significant improvement. Five patients were controls and were treated only with symptomatic drugs. The total diameter of the lesions was reduced from 220.1 mm to 52.1 mm, which signifies a reduction of 76.3% in patients treated for a period of 3 days, and from 278.5 mm to 82.1 mm, which is 70.5%, in patients treated for 30 days. We conclude that albendazole administered according to the 3-day therapeutic scheme proposed above is as highly effective for the treatment of parenchymal brain cysticercosis as the 30-day scheme.

Adolescent↗
PubMed1989

[Piroxicam and fentiazac do not change the arterial pressure in hypertensives patients undergoing treatment].

We evaluated the effects of piroxicam (n = 20) or fentiazac (n = 11) in 31 hypertensive patients whose blood pressure had been controlled by treatment with propranolol, celiprolol or nifedipine, with or without associated diuretic therapy. No significant change in blood pressure was observed from pretreatment levels during or after a 4 week therapy with these drugs. We conclude that fentiazac and piroxicam do not interfere with an adequate control of high blood pressure in hypertensive patients responding to conventional therapy.

Acetates↗
PubMed1988

Optic glioma with progressive occlusion of the aqueduct of Sylvius in monozygotic twins with neurofibromatosis.

Monozygotic twins sisters with optic glioma "in mirror image" (one with involvement of the left optic nerve and the other with the right optic nerve) and hydrocephalus secondary to progressive stenosis of the aqueduct have been found in a series of 128 cases below 14 years of age with neurofibromatosis. The optic glioma was diagnosed in each of the twins at 2 years of age. In one twin the tumor involved only the optic nerve but in the other the glioma affected the optic nerve and spread to the homolateral zone of the optic chiasm. First symptoms of hydrocephalus appeared at 8 years and 11 years of age respectively but ventriculo-peritoneal shunting procedures were performed to relieve intracranial hypertension at 11 years and 15 years of age respectively. At 2 years of age both twins had pneumoencephalography which demonstrated normal air passage through the aqueduct and cerebral ventricles of normal size and morphology. Posterior studies with CT-scan demonstrated progressive obstruction of the aqueduct with very slow progression of the hydrocephalus in each twin, although it was not observed simultaneously. The increased intracranial pressure was tolerated for many years in each twin without obvious symptoms which could be attributed to the slow progression of the aqueduct obstruction.

Adolescent↗
PubMed1986

[Cerebellar tuberculoma. Clinical and radiological course].

A six-year-old child with intracranial hypertension is described. Cranial computed tomography showed an expansive mass surrounded by a contrast enhancement ring in the right cerebellar hemisphere. Chest roentgenograms showed signs of pulmonary tuberculosis. Intracranial lesion was diagnosed as a tuberculoma and treated with tuberculostatic agents. Serial computed tomography scans showed a reduction of size of tuberculoma and appearance of a residual calcified image.

Antitubercular Agents↗
PubMed1978

Concealed atrial electrical activity.

In the following paragraphs we describe a case diagnosed clinically and haemodynamically as a cardiomyopathy. Atrial flutter which was not in evidence in the standard ECG was diagnosed by the use of a new technique of amplification and filtering of special surface leads (T.A.F.). The diagnosis was later confirmed by means of special internal techniques (intra-atrial ECG and His bundle recording). The existence of a subpraventricular rhythm, probably sinusal, and also unapparent in the standard ECG, was observed by using the same method after electrical defibrillation. We comment on the extreme rareness of discovering concealed atrial rhythms and their possible explanation, and we emphasize the usefulness of the T.A.F. technique in their diagnosis.

Adult↗